Category Archives: Existential

Why People Often Choose Misery Over Change

Human beings are constantly faced with making the choice between two paths: One path that keeps them in the safe and comfortable straits of what they know, and another that entices with a different way of being, less restricted and more promising.

Which way should I go? Should I stay in my comfort zone or venture down the path of novelty?

This question becomes heightened for every person who chooses to come to therapy.

The Price We Pay for Staying Safe:

The decision to see a therapist is by definition the decision to heed the murmur from deep inside that begs of the person to leave the safety of the familiar and take a turn towards something new.

Why does the person want to do this? 

Because the familiar, for all its safety, is often also a great source of suffering.

A few examples will illustrate this:

  • I live most of the time in my head where I can plan and feel in control of my life, but this is also my curse, for I cannot really surrender to my feelings and cannot really feel much passion or excitement in my life.
  • I live most of my life in the pursuit of achievements so I can finally become popular or accepted by others, but this relentless striving is also the source of my sense of being a failure and not being good enough or lovable just the way I am.
  • I bottle up my emotions and consider sadness and the need for others a sign of weakness, but this also keeps me isolated and alone and causes anxiety whenever my sadness is never far around the corner.

In these examples, the Faustian bargain to preserve my integrity, my self-esteem, my pride, or my security, came at a price and this price is what brings me to therapy:

I am not happy, I am not at peace with myself, I worry about unknown threats from the inside, or look around me and find that my life looks more restricted than that of my friends or my neighbor.

I am growing tired of the price of safety. My desire for growth and for change now has the upper hand.

Why Do We Often Choose Misery over Growth?

However, as I enter the therapy room, my sense of safety comforts me where novelty frightens. I feel new things, but these feelings are strange and alert me of a danger. My therapist gently asks me to get out of my head and into my body where feelings live, and I all of a sudden feel out of control, unsure of my direction, and vulnerable to harm.

I start to think, maybe my Faustian bargain was not so bad after all. The path of novelty is filled with dragons. Better the devil I know!

It is tempting at this moment to retreat and to make peace with a lesser life.

As the Danish existentialist philosopher Soeren Kierkegaard rightly says in one of his essays:

“In addition to my other numerous acquaintances, I have one more intimate confidant. My depression is the most faithful mistress I have known — no wonder, then, that I return the love”

Kierkegaard’s depression, like my anxiety, or your deadness have been the bedfellows of our lives. For all the misery they bring to us, they are after all compromises intended to ward off something worse, and protect us from the dangers of a life without them.

Sound strange?

Well, it is more logical than one would think.

Why Are We Reluctant to Give Up Misery?

Every person who comes to therapy has an innate need for self-preservation and an innate need for growth.

The need for self-preservation got activated early on in life to help us deal with unpleasant experiences and ruptures in our relationships with others.

We went into our head, numbed ourselves to sadness, or befriended our self-critical voice, because we needed to do so to stay safe and minimize the risk of harm.

However, now as adults, what we could not deal with as children or as adolescents, is no longer the same kind of existential threat to us, and yet we continue on with the same old coping that helped us survive when we knew no better.

Now in our therapy when our therapist wants us to venture outside our customary coping to see if the dragons are still there, we instinctively want to coil back and stay inside the cardboard box we have constructed to stay safe, but which has also become our prison.

We all Resist Change at Some Level:

In therapy, we have a word for this desire to sacrifice our growth for a life of a certain kind of misery. We call it resistance.

Resistance is not a conscious decision. It is the decision our organismic need for safety makes for us, even if we consciously complain of the very life patterns we secretly gravitate towards.

Resistance keeps us away from the real pain, the real fears, and the real sacrifices we have made, and thereby prevents us from having new experiences that would help us resolve old wounds and make us leave therapy transformed.

We all Want Change at Some Level:

Luckily, we have another voice inside, another striving or drive that will not be silenced and will continue to remind us that we are limiting ourselves, until we aren’t anymore.

Psychologist Diana Fosha has named it our transformance striving, and it is just as powerful of a contender as our resistance. If we don’t heed it, it will nag us like a kind of existential guilt, the kind that will make us filled with regrets about what we could have done or should have done when we look back at our life in old age.

How Therapists Help People Grow:

The role of the therapist is to appease the resistance while allowing more room for the transformance.

The therapist does so by providing enough safety and comfort for the person to attempt something new, and helps the person reflect on and experience the benefits of their little excursions outside their comfort zone.

They align with the transformance striving which gradually becomes loud enough to defeat the resistance.

When the resistance is no longer keeping the person stuck on the same fearful path that have limited their lives for fear that they could not cope with the alternative, the person realizes that they have more resources and capabilities than they previously thought.

They are now free to choose the path of growth over the path of safety at the cross roads of their lives.

Avoiding a Painful Past: To Leave a Place You Must First Arrive

The title of my blog post this week contains one of the essential insights of my work as a psychologist.

Too many people spend their lives leaving places they have never actually arrived at.

A person who had a traumatic childhood might say they would rather just forget about the past and move on, which is their way of leaving without first arriving.

Another person might spend their entire life in a search for meaning on the mountain tops of Nepal or in the pursuits of promotions or recognition at work, which is their way of not addressing the source of an emptiness, but simply displacing it into an ever elusive ambition of becoming someone better or of transcending themselves. They spend their entire life leaving a place without really fully understanding the place they are trying to leave.

Neurosis and Human GrowthAs the now deceased psychoanalyst Karen Horney has written about in her excellent book “Neurosis and Human Growth”, many people lose themselves in the empty pursuit of a never-ending self-improvement, and end up living an entire life trying to become someone other than themselves. They lose their life on what she calls the altar of glory, that is, in the pursuit of a better version of themselves that is really just another way to abandon a confrontation with the hurts of their own past.

The outcome of such a driven pursuit to simply move on without fully understanding that from which one is trying to move on, is a loss of a kind of happiness that comes from feeling rooted in one’s history and grounded within oneself.

The Price We Pay for Trying to Escape from Our Past:

So many people nowadays come to therapy complaining that they don’t really know what they are passionate about, or saying that their lives feel meaningless. Maybe they report feeling like a machine, and not really having access to the flow of emotions that would make them feel alive. Or maybe they report feeling lost and confused, empty inside, and in search of a purpose.

These are the symptoms of leaving without first arriving.

They announce to us that we are not in touch with ourselves, that we have taken leave of ourselves before first accepting the struggles, traumas, memories, or feelings that would allow us to work through our issues without abandoning ourselves. They are signs that we have attempted to leave ourselves by numbing ourselves, tuning out, avoiding, or prematurely conforming. They are signs that we have paid the price of trying to get somewhere safer and better by leaving our “luggage” behind or by leaving painful pieces of ourselves behind in our unprocessed and unresolved past.

But we can’t leave a place simply by avoiding it. We must first “say our goodbyes”.

Leaving Pain Behind Is an Active Process:

Truly leaving a place that feels unpleasant, overwhelming, shaming, or traumatic is an active process of facing and confronting that which haunts us.

To face and confront a belief about oneself, an emotional reality, or a painful memory we must first accept it.

Only when we accept that which we have tried to leave behind can we begin the active process of mourning our losses, shedding our tears, developing compassion for ourselves, or expressing anger at others for what we needed from them but never got. This kind of emotional repair work is only possible when we truly arrive at those places which we wish to leave behind.

Leaving can now become an active emotional process, rather than an avoidance that simply shuts out by shutting ourselves out.

Experiencing Transformation Through Our Emotions:

In the realm of emotions, getting away from something is paradoxically only possible by going into it.

Only by going into that which is unpleasant or overwhelming or distasteful, do we realize that we can come out on the other side with new realizations about ourselves. If we truly enter into our emotions, like one would ride a wave, we will see that emotions have a way to carry us to new shores. They don’t have to become stuck places in our lives, but can be starting points for truly working through sadness, anger, loneliness, and despair.

Rainer Marie Rilke: Austrian Existentialist Poet
Rainer Marie Rilke: Austrian Existentialist Poet

As the poet Rainer Marie Rilke writes:

“Where something becomes extremely difficult and unbearable, there we also stand already quite near its transformation”

And transformation through going through the motion of our emotion is exactly what is needed in order to leave a place.

Discovering the Joy of Our Aliveness:

By working our emotions through to completion rather than short-circuiting them in an effort to leave them behind, we can let our suffering transform us and in turn transform our suffering.

The Transforming Power of AffectDiana Fosha, for example, has found that clients who truly work through their emotions in therapy, experience a variety of transformational affects, like a sense of mastery, curiosity, confidence, joy, pride, and compassion. People report feeling moved and touched, or experiencing amazement and wonder. They no longer feel weighed down by the pain, or blemished by their past, but instead feel “lighter”, shed tears of joy, and get filled with tenderness toward themselves and others.

These kinds of shifts are signs that we are rediscovering who we really are instead of spending our life running from ourselves. They are signs that we are getting in touch with an aliveness and resilience within, and that growth brings about a joy that avoidance can never obtain.

They are signs that we are finally leaving a place that we have truly arrived at, and that we no longer have to abandon ourselves in order to find peace and comfort with who we are.

image of psychodynamic therapist, Dr. Rune MoelbakAbout Me: I am Rune Moelbak, Ph.D., Psychologist in Houston Texas. I help people arrive at their past so they can truly leave it behind instead of spending their life running from themselves.

 

Ways to Deal with Heartache and Heartbreak

No feeling is so painful as the pain of the human heart…

One client of mine, when asked what it was like to feel shut out and rejected by her partner, used the word “soul-crunching” to describe her pain

In fact heartache and heartbreak are often described by people through metaphors of brokenness.

Heartache and heartbreak literally destroy something inside of us. We feel as if we have fallen to pieces, as if our lives are in ruins, and as if who we are and what we live for is no longer intact.

What Science Says:

Research shows that heart-ache and heart-break are not just painful experiences metaphorically speaking, but that they literally impact the same parts of the brain as physical pain. So when we say our heart is hurting, it literally is.

What You Need to Know about Heartache and Heartbreak:

Heartbreak, which describes the pain of a break-up, and heartache which is a more general description of the pain in the heart we feel when someone we love dies, are similar in many ways to the term “psycheache” which is a term used to describe the pain of being alive often reported by people who are suicidal.

All three terms express a pain of existing which only humans can feel. And there are really only two responses to deal with it. We can shrivel in the face of it and try our best to avoid it, or we can enter into it and become wiser from it.

The Two Ways to Deal with the Pain of a Broken Heart:

Avoiding the Pain:

The pain of heartache and heartbreak is so difficult to tolerate that our natural instinct is to want to run from it.

We run from the pain in different ways:

If we have just broken up with someone who matters a great deal to us, it might be tempting to simply get involved with another person and skip the the painstaking process of grieving the loss. However, a broken heart is not ready to love again before it has healed, and healing takes time. This is why a rebound relationship is never the best way to deal with a broken heart.

Another way we may distract ourselves is to simply keep busy and try to distract ourselves through activities, projects, work, or being social. In this approach, we simply try to never be alone or never fully stay long enough in the moment, to truly feel our pain. Of course, such a flight from ourselves, is bound to fail in the long run. Since we are not really dealing with the pain, the healing process never really begins, and we just end up postponing the inevitable.

A third way to deal with gut-wrenching pain is to shut the grieving process down by numbing ourselves to our emotions and hardening our heart. The pain of living is here dealt with by becoming a little less alive. While this might feel preferable to feeling the pain of existing, the long-term price of this strategy is steep, and we often end up feeling alienated and cut off from everything good life has to offer.

Learning from the Pain:

Because every attempt to simply avoid our pain is destined to fail in the long-run or to come with a heavy price tag, a wiser path to follow is to heed the message of the broken heart itself.

If you do this what you will discover is the following: Your heart is broken because you dared to love and let others matter.

Now in the absence of your loved one, you have lost a piece of yourself and are no longer whole. Your existence, without the other person, no longer feels full or sufficient. Love opened up life’s riches, and now that it has closed these riches down, the pain you feel is the pain of the absence and meaninglessness of a life without such love.

And although your heart is trying to warn you not hurry back into the same kind of vulnerability that left you bereft, it has also just revealed the meaningfulness, joy, and value of a life of mattering to someone and letting someone matter to you.

Its message is therefore not to avoid loving, but to take the time to reflect on the big questions brought about by the encounter with the inevitable pain and joy of an open heart.

  • What has loving and losing revealed to you about what is really important in life?
  • What has it revealed to you about yourself and about others?
  • Did you make mistakes and do you have regrets?
  • What lessons can you carry with you into your next relationship?

Only if you fully go into these often painful and quite dizzying questions about the meaning of your life, do you unlock the wisdom contained within your heartbreak.

Then you will live to love again, and be a little more prepared for the inevitable heartaches and heartbreaks of life.

Empty Hearts and Full Hearts:

 As Jon Fredrickson, a social worker and practicing psychodynamic therapist has said:

The person whose heart has been broken and gives up loving ends up with an empty heart.

The person with a broken heart who continues to love has a full heart, knowing that everyone we love we lose through death or abandonment.

That is why there are only two kinds of hearts: empty hearts and loving hearts.

It takes courage to face the inevitable losses and yet, in spite of it all, to keep on loving and being open to life

(Source: Jon Frederickson: Co-Creating Change)

image of psychodynamic therapist, Dr. Rune MoelbakAbout Me: I am Rune Moelbak, Ph.D., psychologist and psychodynamic therapist in Houston Texas. I help people move through their difficult emotions to find greater peace and comfort with who they are. Visit: www.bettertherapy.com for more information. 

The Allure of The Image

At my last visit to my hair stylist, I happened to pick up a recent copy of a glamour magazine and haphazardly flipped through the pages, mostly out of boredom.

Although I know I did not exactly have a Eureka moment, I was struck by the fact that in image after image, as I perused the pages, I saw only smiling faces. These looked like people who were having the time of their life and who had discovered the closest thing to the bliss the Buddha was talking about.

For some reason my eyes were drawn to an article about Joan Collins, the famous Dynasty actress, who apparently has a quite enthralling estate in France. She showed it all to the reader with her smiling “hubby” by her side.

It struck me how alluring this depiction of life is. These are people who have it all. They have become the image of what so many people strive for: happiness, success, beauty, wealth, everlasting love.

And yet as I began to look closer, I noticed sudden cracks in the image of perfection. Joan Collins is aging and reminding me that the Joan Collins of Dynasty is a mortal. You could notice the faint contours of liver spots on her skin and none of the make-up could conceal her many wrinkles. I was particularly attuned to her signs of aging, because I myself recently had to come to terms with the inevitable loss of youth. Noticing my first gray hairs and the beginning signs of balding have recently forced me reckon with the fact that I am middle-aged, not everlastingly young.

The Illusory Pursuit of the Image:

Why is the idea of the image such an important source of allure and suffering in human existence?

The allure of the image is in some sense the allure of something eternal and unchanging; some kind of end state that we can arrive at or merge with.

An image, like a photograph, is immutable, just like a concept or an idea. It is in the realm of images that we can imagine things like true love, everlasting beauty, success, and so on. In the realm of the image, these are attainable states, or qualities people can possess, and we often aspire to merge with these attributes, to become them, or acquire them.

And yet life as the Buddha reminded us is not static, but always changing. Nothing ever stays the same. We never stay the same. And so the image in human existence is really an illusion. It is an aspiration Sigmund Freud might talk about as a death instinct: the desire to return to a non-human form, which is really antithetical to life.

The Image and Jaques Lacan:

Psychoanalyst Jacques Lacan talked a lot about the problems that come from identifying ourselves with an image. He pointed out that our internal experience is really quite shifting and fragmented, but that we learn to identify ourselves as a thing in the world through having our image reflected back to us in the mirror or by other people.  He identified a specific developmental stage around 6 months of age when the child first begins to think of him or herself as that person in the mirror.

The problem with this identification is that it betrays a truth about us, which is that we are never really a unitary whole, never really fixed in our nature like the image would convey. The pursuit of becoming a static image therefore is at odds with life and a source of great suffering.

Lacan pointed out that what distinguishes us as human beings is that we live in a symbolic reality, or a reality of meaning, and this fact is both what makes images possible, and robs us of ever becoming one with them.

symbolism
The symbol’s frustration of our attainment of our ideals

Words, like mathematical symbols, are never fixed in what they refer to: 1 + 1 can apply to apples as well as people, and the word “successful” can be attached to multiple different images, and can even mean different things at different times for different people. This slippery nature of symbols means that we never quite arrive at the final destination that we can dream about or aspire to: The idea of something, and the experience of that idea never quite merge. Because the symbol offers us a meaning rather than an “edible”, there is never really anything at the end of the rainbow. We can never really sink our teeth into the image.

Learning from Celebrities:

This is probably also why there are no shortage of examples of people who seemed to have it all but who ultimately ended up self-destructing. Elvis Presley, Marilyn Monroe, Michael Jackson, Eazy-E, or even Brittany Spears all ended up discontent and unfulfilled. Perhaps what is different about them and the average Joe is that they were forced to confront the fact that the image always alludes us.

learning from celebrities
What can we learn from the self-destructive habits of celebrities who seem to have it all?

Many people find solace and hope in the dream about the image. How often don’t we hear people say things like: When I win the lottery I will quit my job and move to the Caribbean. They have the comfort of a different life as a possibility: the life they read about or dream about.

But people who have actually lived the dream, and still find the image eluding them are in a different quandary. Either they have to up the ante (such as perhaps run for president once they have already proven that they are successful in business) (wink wink), or confront the truth that images are illusions, and that life will always rob us of the satisfaction that would come from merging with our dream.

Perhaps that is why Elvis Presley, Marilyn Monroe, and Michael Jackson turned to drugs. They had to find a way to escape the realization that they couldn’t run from themselves. That at the end of the day they are mortal, they age, and they don’t get more than simple and temporary enjoyments from the images they so want to be.

A life in pursuit of an image is in this sense a wasted life, because it is the pursuit of something that can never satisfy, or that is always elusive.

The Take Away:

As people we are ever changing, and we are different from the still perfection of the images we see around us on TV, hear about from others on Facebook, or attribute to others based on their appearance or our own projections.

I will not say that I have attained the wisdom to live my life in accordance with this truth, but life teaches us this lesson sooner or later, as my own confrontation with aging has made it apparent.

The only question left for us to wrestle with is whether we can accept this fact, or want to spend our life fighting it.

image of psychodynamic therapist, Dr. Rune MoelbakAbout Me: I am Rune Moelbak, Ph.D., a psychologist in Houston, TX. I help people find ways to be more authentically themselves. Visit my website: www.bettertherapy.com to learn more.

What Is Your Depression Telling You?

In my many years of experience as a psychologist and a psychotherapist, I have seen exceptionally few clients for whom depression was simply a disorder of the brain.

In the vast majority of cases, once a person begins to examine their feelings and their life more closely, they discover that their depression has a meaning and a message.

Depression, in other words, is not just a medical illness, but is what happens when a person is stuck in some aspect of their life without knowing exactly why.

Depression Hides its Own Cause:

Depression often conceals its own reason for being there. It is not unusual for a person to be depressed without being able to pinpoint some definite event that explains why they are depressed.

This absence of a cause often makes it feel like depression has no meaning and is simply the sign of a brain in disarray.

Perhaps this is why the vast majority of people end up treating their depression with anti-depressants, encouraged, no doubt, by commercials on TV.

However, if you go down this route you will largely miss the point of your depression, and will not  grow in the way your depression is challenging you to grow.

Your Depression has a Message:

why am I depressed?The reason why you are depressed is often not apparent. This itself is one of the hallmarks of depression. Depression tells us: you are stuck in some way, unable to deal with some emotion, haunted by the aftereffects of some experience, or dragged down by the reoccurrence of some pattern of behavior.

If you simply knew which emotion, experience, or behavior made you stuck, then perhaps you would not need to become depressed. Then you would have a pathway out: you would know what to do, or what to change.

The fact that you are depressed, however, tells you: it is not that easy.

Perhaps you have a need to be more assertive in life in order to not be walked all over, but this in turn triggers a fear that other people will reject you or that you will be abandoned by others.

Or perhaps, you have a vague hunch that you are not happy in your marriage, but this realization would have such disastrous consequences for life as you know it, and so instead you suppress it with the consequence that you are now depressed.

In both of these examples, depression simply communicates that you have hit some stumbling block to the authentic acceptance and expression of yourself.

It tells you: you need help to find a different path out of your current dilemma, and that your current solution of ignoring or suppressing isn’t working.

How to Get Unstuck from Your Depression:

What we discover when we take the challenge posed to us by our depression, is that we are almost always depressed for good reasons, even if it does not look like it from where we stand.

The trick of getting out of your depression is to get help to expand your awareness of what it is that is keeping you stuck. Once the full picture of what is keeping you depressed is brought to light, you will no longer feel stuck, and therefore no longer be depressed.

This was the case for both the person who could not be assertive, and the woman who could not allow herself to embrace her discontent with her marriage…

The Man Who Could not Be Assertive:

depressed manIf the person who is unable to be assertive begins to examine some of the fears that keep him stuck in unfulfilling relationships, he may begin to gain access to more of his frustrations with other people, which he now no longer needs to block from his awareness.

As he allows himself to more fully embrace his anger, he may realize that he is tired of always trying to please people, and may begin to express more dissatisfaction when people let him down. As his anger becomes accessible again, he may also be able to feel entitled to his sadness that people have not really been there for him, and to challenge his negative view of himself as someone who is not deserving of respect. As he gets to the root of where his negative belief of himself comes from, and begins to access more compassion for himself, he may be able to shift his view of himself and feel more entitled to have his needs met.

His depression, which was simply telling him that he was stuck in the dimness of a narrow awareness, would now give way to insight and new possibilities of being himself. As he would then no longer be stuck, he also would no longer be depressed. His depression would have served its purpose, and he would have heeded its message.

The Woman Who Was Unhappy in Her Marriage:

depressed womanIf the person who is unhappy with her marriage begins to more fully allow herself to feel her discontent, and if she examines what the fears are about that hold her back from accepting her discontent, the dilemma in which she is stuck may begin to shift. She may be able to more fully discover what she needs in order to be happy in her marriage and may begin to realize that she has some options to more actively fulfill these needs that do not involve getting a divorce. The fear of realizing that she and her husband may in reality be incompatible, may then lessen, and may cease to serve as a barrier to more fully embracing her needs and wants.

As the unconscious dilemma in which she was stuck begins to become known, and she begins to become more fully aware of the reason for her fears and her unhappiness, she is then able to unlock the message of her depression and use it to become unstuck.

What is Your Depression Telling You?

In the majority of the cases of depression I have seen in my many years as a psychotherapist, there was a message to be unlocked in the person’s depression. Once the person began to fully access and examine the full extent of their feelings and experiences, they were able to see what their depression was telling them, and were able to feel unstuck again.

The reasons for one’s depression, cannot be found by looking at the bottom of a pill bottle, but must be discovered through a process of self-examination that is best facilitated by the process of psychotherapy. Only then will you address the real issue which your depression is telling you to look at, and only then will you be able to set your life on a different path.

If you want to understand your depression better, watch my video in which I explain some frequent causes of depression:

image of psychodynamic therapist, Dr. Rune MoelbakAbout me: I am Rune Moelbak, Ph.D., a psychologist who specializes in helping people unlock the message of their depression. Please visit my website for more information about the treatment of depression. 

Growing Strong in Your Weak Places

“The world breaks everyone and afterward many are strong at the broken places” (Ernest Hemingway)

Ernest Hemingway spoke of a universal psychological truth, when in A Farewell to Arms, he suggested that you grow stronger in your broken places, much like a wound that heals itself by growing a protective scab.

Those who suffer through difficult experiences and invalidating environments have to find within themselves a strength that others don’t necessarily have to. They grow stronger in their weak places.

Strengths through Suffering:

If my family was abusive, my psychological survival would demand of me that I stretch myself beyond the normal requirements for human development.

I might have to develop special abilities to numb my feelings, get into my head, or depend on myself, in order to survive such an upbringing. As a result, these facets of my human capacities will become more developed in me than they will in others, and might give me special advantages, in spite of their drawbacks.

If I become skilled at numbing, suppressing, or silencing my feelings, I might be particularly skilled at working in professions that are too emotionally intense for others. I might handle the job of a paramedic, that would make others queasy, with an even keel, or I might keep calm in a crisis situation when others lose their ability to think or to act.

The Need to Rise Above our Vulnerabilities

The world is filled with people, who due to their trials and tribulations in life, have developed unique facets of themselves that have propelled them into successful endeavors: Comedians who learned that laughter was the best medicine to cheer up their depressed mothers, business men who vowed to never lack money in order to overcome the suffering endured by their parents, and world travelers who came to embrace freedom and independence to deal with the anxieties of getting too close to others.

Alfred Adler, one of the early psychoanalysts, developed the idea that human beings have an inherent need to rise above their weaknesses and excel at something.

Oftentimes our particular hardships become the driving force that propels us to succeed, or that supplies us with a mission for our life and a reason to get out of bed in the morning.

The Desire to Be Super-Human

A colleague of mine recently finished his dissertation on what he calls the “Superwoman Schema”. This is a mindset originally found in a subset of African-American women. These women develop a belief that they must be strong at all times, never show their vulnerable emotions, never allow themselves to depend on others to have their needs met, and always set their own needs aside to take care of others.

This Superwoman schema, helps such women develop the thick skin that allows them to keep afloat in tough environments, and not let their personal feelings get in the way of what they need to do.

Although disavowing one’s own needs and setting one’s feelings aside comes at a price, it is undoubtedly also what has propelled some women like these to achieve great success.

If you have watched the Real Housewives of Atlanta, you will know what I mean. These ladies do not easily let their vulnerabilities show. Having a thick skin has helped many of them rise above tough upbringings, feelings of abandonment and histories of abuse.

Attending to the Underlying Wound:

Of course, the strengths that are born out of weaknesses, also tend to have their downsides. The more one tends to pursue life goals out of an underlying wound, the more these goals tend to take on a compulsive quality: I MUST be strong at all times, I can NEVER allow myself to depend on others, I NEED to ALWAYS be smarter than the next person, I can NEVER make enough money. These dictates soon become tyrannical and perpetuate a judgment of oneself as never quite good enough.

Being human for such people is a dangerous reminder of the past they are trying to leave behind. They therefore spend their lives aspiring to rid themselves of their human frailties. Of course such endeavors are ultimately futile since one can never become what one is not.

Instead of dealing with their pain, and grieving the nurturing they didn’t receive, such people instead disavow their feelings, hoping that they can out-run them. With each accomplishment, however, they only alienate themselves further from who they truly are, and remove themselves one step more from the self-acceptance they ultimately long for.

As long as we cannot accept all of our human experience, including the full gamut of human emotions, from assertive anger, to the pain of disappointment, from the sadness of loss, to our need for closeness, we will always fall short of realizing our most precious project: to become who we are, not more than who we are.

Dr. Rune Moelbak

 

About Me: I am Rune Moelbak, Ph.D., clinical psychologist in Houston, Texas. I help people attend to their emotional wounds so they don’t have to spend their entire life running away from their pasts.

The Psychological Meaning of Drug and Alcohol Addiction

An addiction to drugs and alcohol is not really an addiction to the drugs or to the alcohol. Rather we become addicted to a way of life. Our drug of choice, for better or for worse, helps us find our bearing in the world, and it is much more difficult to let go of a way of existing than it is to let go of a simple physiological enjoyment… 

My Own Sweet Addiction:

Recently I tried to break my own addiction to coffee. Over a period of time I felt that my daily dose of mocha served more to keep me afloat than to enhance my well-being. Instead of giving me a pleasant kick, coffee had started to become my daily crutch; a simple means to not feel utterly exhausted. After two years of gradually increasing my daily fix to simply stay alert, I finally found the resolve to kick my habit.

The first days after quitting, were horrible, of course. I felt quite down, my body started aching, and I had trouble staying awake during important meetings. Gradually, however, the withdrawal symptoms started wearing away, and life started to get back to a new normal. And just when I was feeling the wonderful clarity that comes with a sober mind, I started realizing that I am not the kind of person who wants to live a life without coffee.

Coffee for me is more than just a kick in the morning or a tool to stay awake. It is the enjoyment of sitting on my sun-bathed patio reading a book while treating myself to an aroma filled cappuccino. It is the satisfaction of sharing laughs with friends after a well-deserved meal that needs just that finishing touch which only coffee can provide. It is a reason to go out on a Sunday afternoon  and spend a couple of hours in a coffee shop for a slight change of ambience… It is not just a cup of coffee, but a lifestyle. Its effects go far beyond the simple physiological kick…

What this tells me is that: The addiction to coffee, just as the addiction to alcohol, cannabis, or any other drug or habit, is mainly a psychological addiction.

Addiction as a Love Affair with Life

It is easy (relatively speaking) to beat the physiological part of an addiction, but it is a monumental task to rid oneself of the addiction to life as we know it and enjoy it WITH our cherished addiction.

In the addiction literature, this psychological component of addiction is often minimized. It is referred to as the secondary gain or the reinforcement enhancing effect of addiction. And yet, it is this psychological, social, and contextual significance of the habits we form that is most likely to make us return time and time again to that cigarette, scotch on the rock, or sweet cup of Joe…

If there is any doubt in your mind about the power of our psychological needs in shaping our behavior, lets turn to an episode of the TV-show Frasier for support. In the episode “Where There’s Smoke There’s Fired”, Frasier agrees to use his psychiatric expertise to help his “manager” Bebe, break her smoking addiction. At one point, as Frasier and Bebe are sitting at the dinner table, Frasier asks her “What do you like so much about smoking?” Bebe’s answer, although fictional, is quite illuminating of the psychological impact a drug can have:

I like the way a fresh firm pack feels in my hand. I like peeling away that little piece of cellophane and seeing it twinkle in the light. I like coaxing that first sweet round cylinder out of its hiding place and bringing it slowly up to my lips, striking a match, watching it burst into a perfect little flame and knowing that soon that flame will be inside me. I love the first puff, bringing it into my lungs. Little fingers of smoke filling me, caressing me, feeling that warmth penetrate me deeper and deeper till I think I’m going to burst. Then whoosh!… watching it flow out of me in a lovely sinuous cloud, no two ever quite the same.

After hearing Bebe’s monologue, we are bound to wonder: Is this an addiction or a love affair with life? Surely giving up smoking will for Bebe not simply be about giving up on cigarettes, but about letting go of a very meaningful engagement with life…

Treatment of Drug Addiction is Treatment of a Lifestyle

The problem with many of our understandings of psychological phenomena, not least in the field of addiction, is that we are mired in a dualistic understanding of the world. What this means is that we separate objects in so-called objective reality, from our subjective experiences and the lives we live. This often creates a barrage of treatment approaches and techniques intended to target the physiological or brain-based components of our psychological experience, or that focus squarely on our behaviors and not the motivations, intentions, and meanings of our behaviors.

And yet, a cup of coffee, a cigarette, or a glass of wine never really exists outside of a life context of real people who fill their lives with experiences of a meaningful nature. An alcoholic beverage is never just that, but is always in some way a meaningful activity. It is a drink I have as a part of feeling included when I am out having a good time with my friends. It is a drink I need in order to deal with emotions or stress, which would otherwise eat me alive. It is a symbol of living the high life, a way to protest against lack of meaning in another area of life, or an enjoyable ritual in its own right. Regardless of whether or not the drink helps fulfill a healthy or unhealthy need, it is never just a drink, but a slice of life.

Coming to terms with addiction is therefore always about coming to terms with the psychological choices and meanings of the particular existence I live. Treatment of drug addiction is not the treatment of a drug, but the treatment of a life. Beating the physiological part of addiction is the easiest part. Creating a new life, and finding new ways to organize what one finds enjoyable and meaningful about life is by far the hardest.

At the end of the day, this is one of the reasons why the desire to change a habit, frequently requires a change in self or a new outlook on life. Therapy, of course, is one way to facilitate this process…

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Want more? To read more about my meaning-based take on the treatment of drug and alcohol addiction, download my article: The Value of Adopting a Human Science Approach in the Management and Treatment of AddictionYou can also read an interview with me on a Humanistic Approach to Addiction published by Sociedad Iberoamericana de Informacion Cientifica (SIIC) in both English and Spanish

About me: I am Rune Moelbak, a psychologist in Houston, TX, providing individual and couples therapy for people who want to get to the root of their problems. To read more, visit my website: www.bettertherapy.com

The Existential Choice: How to Choose Your Therapist Wisely

If you are suffering from depression, anxiety, or some other psychological struggle, there is almost always two directions you can go.  Whichever path you choose will have profound implications for the general direction your life will take…

The Symptom Path:

One direction is to stay at the surface and treat the symptoms as if they were problems in themselves.

If you suffer from insomnia, for example, what are some strategies you can use to trick yourself into falling asleep? This technical and managerial approach to life fits well with a modern zeitgeist of efficiency and productivity.

If you have a problem, all you need to do is to be smarter about it, and manage your life better.  If you are depressed, then go to the gym, change your diet, force yourself to be social, or recite positive messages to yourself before you go to bed. And if that doesn’t work: take a pill. Statistics show that every 10th person in Iceland lives an existence on anti-depressants, and in the United States the numbers are comparable.

The problem with this first direction is that it alienates us from our symptoms. When we take a pill to “rid ourselves” of a bad mood, we simultaneously tell ourselves that our mood has no inherent meaning or function. When we treat our insomnia as a simple problem to be solved, we simultaneously turn it into a purely behavioral symptom devoid of any personal meaning.

As Darian Leader argues, in his book The New Black, symptoms in this approach are seen as mistakes to be avoided rather than the bearers of truth.

Most of us are relieved by this fact, because most of us prefer a quick fix to our problems over the more labor intensive work  of exploring our inner lives. As Darian writes, “We prefer to see symptoms as signs of some local disturbance rather than difficulties which concern our whole existence”.

The Meaning Path:

And yet the other direction we can go as suffering individuals, is precisely back into the meaning and psychic function of our symptoms. Although the labor of finding out why I might be depressed or unable to sleep can be arduous, avoiding it, is to live my existence in some form of denial.

There really is no substitute for getting to know myself well enough to understand what my symptoms mean and why they are there. If I don’t, then the underlying issues remain and the symptoms will simply return in some other form at a later date.

The kind of depth oriented therapy I advocate,  cannot be reduced to simple formulas or strategies, and cannot be delivered as some form of education. It requires entering into therapy as an experience, where questions rather than answers guide the work. It also requires a suspension of that managerial mindset that wants to plan out time and view everything in terms of productivity and output.

Good therapy is not about simply changing your behaviors, your routines, or your way of thinking. It is about exploring the meaning of your symptoms. It is about honoring the underlying reason why you have become depressed, why you have started to feel anxious, or why you have begun to suffer anguish in one or the other way.

As the following video illustrates it in the case of depression, this reason is often not just some external cause, but is often an inner difficulty or struggle that first needs to be brought to light. Therapy is the process that allows this to happen…

About me: I am a psychotherapist offering meaning-based therapy in Houston, Texas. Visit my website for more videos and information…

 

Psychotherapy: Does Insight Cure?

Over the past 100 years, therapists have asked themselves the question: what really produces change in people? In this connection, the role “insight” plays in helping us resolve our issues has often been a point of contention… So does insight really cure?

Insight in Psychoanalysis

In the heyday of psychoanalysis, a prevalent belief was that change resulted from understanding our unconscious conflicts, or making the unconscious conscious. The main tool of the psychoanalyst was believed to be the offering of an interpretation of the unconscious truth of which the client was unaware. Unfortunately to get to this point, people often needed to be in “analysis” for years, and the outcomes weren’t necessarily that consistent nor impressive.

The Cognitive-Behavioral Critique of Insight

This led to a wave of criticism against the psychoanalytic idea that insight is a sufficient condition for change.

Cognitive Therapy:

The dissatisfaction with the slowness of change led a psychoanalyst like Aaron Beck to focus instead on making the client aware of the more immediate automatic thoughts that exist just beneath our conscious awareness. He invented what has now become known as cognitive therapy, an approach where the therapist uses logic to help the client refute their “irrational” emotion-driven beliefs. Instead of spending years probing the unconscious in search for “truth”, Aaron Beck and his followers instead engage directly with the client’s thoughts and help them realize the absurdity or contradictions of some of the things they tell themselves.

Unfortunately this kind of rational approach to change often does not really address the logic contained in a person’s emotional responses and it ends up reinforcing an untenable division between the emotional and logical dimensions of existence. Clients end up at war with themselves, and the unaccepted emotional impulses eventually tend to return with a vengeance.

Behavioral Therapy:

Other therapists have responded to the dissatisfaction with lack of change through insight by emphasizing “practice” over “understanding”. They advocate that you take concrete steps to change something about your life and help nudge you in that direction by addressing all the obstacles that get in your way. Unfortunately this kind of behavior therapy often leaves you feeling that you are acting against your own will or against your own emotions. Although you may succeed in changing your habit for a while, most people end up back in their comfort zone once therapy is over and they have no “coach” yelling in their ear.

Both the cognitive and the behavioral approaches to therapy are essentially ways to speed up the process of change by tackling problems directly, and circumventing the slow process of insight. However, ironically, they often do so by not having sufficient insight into the problems they set out to change. They frequently offer premature solutions to inadequately understood problems and they often don’t really have a complex enough understanding of the forces at work within the person.

Insight as Experiential Truth

In my opinion, a lot of the backlash against insight-oriented approaches to change, has to do with a premature definition of what insight really entails. If we define insight as intellectual understanding, then the critics are probably right: Nobody was ever really changed by simply knowing about their problems or having an explanation for why they do things the way they do them.

However, insight is not the process of passing information from one mind to another. That would be teaching, not therapy. The insight that good therapy produces is both intellectual and emotional, or rather, it is existential. It addresses the person as a whole, at a level where no division exists between mind and emotion. The quality of such an insight is that it is irrefutable.

We have these kinds of insights throughout our lives, and we can recognize them as such, because they do not allow us to go back to the way things were. Once they happen, they transform us. They are the insights that we get from watching a really thought-provoking movie that impacts both emotions and mind and let’s us see the world in new ways. They are the insights about ourselves that we gain from being in a romantic relationship, or breaking up a relationship. In short they are the insights from life’s many little significant moments that make us realize something about who we are or what the world is like.

Existential philosopher Martin Heidegger speaks of this kind of truth as Aletheia or unconcealment. It refers to the moment when something that was always already there, is shown to us. When this happens, I don’t experience it as some intellectual understanding, but as a homecoming or a return to something which had been forgotten or covered over.

Psychotherapy as an Experience of Truth

Psychotherapy is a process of unconcealing these irrefutable truths contained within our own experience. These kinds of insights return me to myself and give me no room for argument.

The best way to reach them is not to provide explanations to people, to engage in logical arguments with them, or to suggest ways for them to act differently. It is to provide an experience.

Insight is therefore not just about what is revealed, as the critics often assume. It is also about how it is revealed. Simply telling someone a truth is not effective and is easily refutable. Letting someone experience truth, on the other hand, is quite a different story. My experience can teach me something about myself that I can just as little refute as I can refute that I have a nose, or that I have two ears. If I had a good time at a party, for example, this truth is irrefutable. It does not matter if someone else tells me it was a bad party. My truth is irrefutable. I cannot undo the fact that the party was enjoyable for me.

Therapy is a process of giving a person an encounter with the truth of their own experience. This is what insight as aletheia is really about.

It can be as simple as giving a person the realization back that a word he seems to be using creates a tie between his history of being sexually abused and his current social anxiety. “I don’t speak much in social situations”, he says. “You don’t speak much, or you keep silent?”, I utter. Without me telling him, the client has now been given back an experience of the connection between his shyness and the fact that he has had to keep a secret about his abuse all his life. I did not provide a laborious explanation, but used my words to “unconceal” something; to show him rather than tell him. The result was a visceral reaction in the client who now experienced himself in accordance with a new truth. He had been given a new foundation for his thoughts and experiences, revealed to him by his own words and his own unmistakable reaction to my words. He had learned a truth which could not be undone.

Therapy proceeds through such little insights, and a person changes without ever really forcing a new behavior or battling a single thought. So to answer our question: Does insight cure? The only way to tell is to experience it for yourself…

Note: If you would like to read more about therapy as an experience of truth, read my article: “On Cultivating the Therapeutic Moment. From Planning to Receptivity in Therapeutic Practice.”

About me: I am Rune Moelbak, an insight-oriented therapist in Houston, Texas. Visit my website for more information. 

The Myth of Major Depression – Why Depression is not an Illness…

depressed person

The Rise of Major Depressive Disorder

It has become common nowadays to think of depression as a medical condition. If you visit your general health practitioner, she might ask a few questions about your energy level, appetite, sleep, and mood and, if you answer these questions in a particular way,  tell you that you have “Major Depressive Disorder”. Major Depressive Disorder, you will be told, is a real illness. And like any real illness, it even comes with its own pill prescription (SSRIs)…

This way of thinking about depression, however, is really the product of a medical discourse that has been spoken so many times that it is has begun to ring true. And yet, as a psychologist with many years of experience helping people who are depressed, I am here to tell you that the emperor has no clothes on…

The Reduction of Subjective Distress to Objective Symptoms

The talk about depression as an illness is really the result of a more overarching trend in the mental health field to reduce life to objective behaviors or symptoms. We take two individuals and observe how they act, talk, or say they feel. We extract the behavior they have in common, and bam! we have arrived at a symptom. One person’s sleepless nights, for example, are equated with another person’s sleepless nights, and what we now have is the symptom of “reduced sleep”. When we observe a collection of such abstract symptoms that appear to frequently occur together, we end up with a “syndrome”, or a certain cluster of symptoms. And when we give a name to such a cluster, by inventing nouns like “Major Depressive Disorder” or “Generalized Anxiety Disorder”, these nouns then take on the status of illnesses that appear to preexist and explain the appearance of the symptoms.

The Loss of the Subjective Meaning of Depression

So what is the problem with this way of thinking? Well, for one, we have abstracted the symptom from the life of the person, and without this person, the symptom has lost its meaning. It is for example quite different to have a sleepless night because one feels empty inside and can’t stand the stillness of the night, and to have a sleepless night because one lies awake beating oneself up about things one should have done differently during the course of the day. In the one case, the sleeplessness announces to the person that they have become too alienated from their own experience (emptiness being the result). In the other case, the sleeplessness may bear witness to a traumatic event that the person has resolved to deal with by feeling eternally guilty…

The idea of the symptom as some abstract behavior erases these differences and treats each individual’s behaviors as if they were the same. Reduced sleep thus becomes a rather hollow concept. In its abstractness, it hides more than it reveals. To say of both instances of sleepless nights that they refer to the same phenomenon is a stretch, for what looks the same on the surface, betrays significant differences when an understanding of the life of the person is taken into account.

When depression becomes a universal construct or set of behaviors, its true meaning is lost. For in reality, there can be no depression outside the concrete life of an individual. And even though we may label two people’s behaviors as depressed, the meaning of their depression can vary widely. One person may be depressed because they are faced with a life situation that demands they assert themselves, but have fears about doing so, and therefore can do nothing but admit defeat. Another may be depressed because they have cut out social contacts to deal with their social anxiety and now find themselves devoid of meaningful relationships. In short, there are as many types of depressions as there are people who are depressed. There is always a unique story to be told…

The problem with a construct like Major Depressive Disorder is that it gives us the illusion that it exists as some “thing” in itself. It conveys that the “wizard behind the curtain” is a disease process and not a person.

A Faceless Healthcare…

In line with this view, “treatment” of depression becomes a rather impersonal endeavor. One treats “symptoms” not “people”. Instead of taking time to listen and understand, to help people figure out what depression means in the context of their other life problems, one now gets prescribed an SSRI or gets education about sleep hygiene…

Constructs like Major Depressive Disorder, and the philosophical assumptions that underlie them, lead to a faceless kind of healthcare that is devoid of the subjectivity of the person. They trade an abstract category, for the real deal…

Depression is, and always will be, shorthand for a multitude of particular ways that people struggle. Only when we understand the life of each struggling person, will we succeed in understanding what depression really is, for it is many different things to different people. Depression is not a “thing”, and is not an “illness”. Instead it is a marker of a particular stuckness in a person’s life. It  acts as an invitation or perhaps a dictate to discover something deeper about ourselves…

About me: I am a clinical psychologist in Houston Texas. Visit my therapy website to read more about my treatment approach to depression.