Existential Aloneness

Joseph Burgoin
Anxiety
·
Destinations
·
The Psychotherapy Relationship
10

During a recent session, my client Ellen was talking about how poorly she had done over our two-week Christmas break, in terms of looking after herself and using what she'd learned in treatment.  It worried her and she didn't  understand why it should be so since she'd recently been taking much better care of herself.  Coming back to her first session after the holidays seemed immediately to make her feel better, less distracted by the fantasies and obsessive thoughts that had troubled her during the break. I had some ideas about why this should be so but didn't at first mention them; I waited to see where this train of thought would take her.

Later in the session, Ellen mentioned that she'd had a "scare" earlier in the week.  She works as personal assistant to the boss of a medium-sized company; her boss had been away during the holidays and in his absence, some of his oversight duties had fallen onto her shoulders.  She took off a few days herself during that period but because her boss was away, she felt it would be irresponsible to take as many days as she would have liked; this made her feel resentful, to have to deprive herself in order to fulfill her duties.

On the first day after her boss returned from his vacation, it occurred to Ellen that she should probably consult the firm's calendar (which she had failed to do for a week or so), to see whether there might be an upcoming due-date for one of the firm's projects.  Sure enough, there was a project due that very day; she alerted the appropriate personnel and in the nick of time, they managed to complete the assignment for delivery.  It troubled her that she had "forgotten" all about the calendar and wondered why she should have remembered on that very day.

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Emotional Dependency and Stealth Control

Joseph Burgoin
Detours
·
Points of Departure
·
Relationship Issues
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The Psychotherapy Relationship
49

In my psychotherapy practice, I've had a number of clients who suffered from emotional dependency issues:  in their personal relationships, they often seemed helpless and extremely needy.  I'm sure you've known such people.  They may appear clingy and possessive; they often get involved with someone very strong and competent, a Rock of Gibralter type.  In extreme cases, the relationship consists almost entirely of one person taking care of the other.  Incapacitating depressions may be frequent or continuous, to such an extent that the emotionally dependent person may be unable to hold down a job or function as an independent adult, so completely reliant on the other person that at times he or she seems infantile.

As clients, such individuals quickly become dependent on treatment for support.  Even if they're coming for more than one session per week, the gap between those sessions will feel too long; they may make frequent "emergency" calls on weekends or in the middle of the night.  If a therapist isn't careful, such clients can become extremely taxing and emotionally draining.  We may feel intense pressure to provide emotional relief; if we're not empathic or supportive enough, these clients may become intensely angry with us.  In some cases, it actually feels like a relief when they quit in a rage and seek treatment elsewhere.

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The Art of the Apology

Joseph Burgoin
Destinations
·
Social Behavior
30

Over the holidays, I said something hurtful to someone I care about.  It got me thinking about how to make a genuine apology, and the emotional obstacles that stand in the way of saying "I'm sorry."

Nobody likes to admit he or she is wrong, for starters.  Most of us want to believe we're sensitive and that it's other people who are the problem.  Also, the guilty feelings that come with recognizing you've hurt someone else, along with the blow to your self-esteem when you see yourself behaving badly, are not easy to tolerate.  Typically we'll try to defend against those painful feelings by justifying ourselves.

In my own case, I noticed I kept telling myself that the hurtful thing I'd said was actually true.  I would focus on the other person's irritating behavior; although I never told myself so in these exact words, the implication was that he deserved to be told.  Repeated self-justification in the form of mental "arguments" in which you keep trying to convince yourself or somebody else that you're in the right usually mean just the opposite.  Eventually I recognized my fault.

So how to apologize?  Here is my cardinal rule for how to frame an apology:  genuine apologies never contain the words "if" or "but".  For example, never say, "I'm sorry if I hurt your feelings," or "I apologize for being insensitive, but such-and-such happened earlier ..."  Those words have the effect of watering down the apology by either calling the injury into doubt or assigning true responsibility elsewhere.  I've often heard people tell me, "I'm sorry if I came across too strong in what I said to you," or something similar; those apologies always felt half-hearted.  I notice that once I decide I've done something wrong and begin to frame an apology, "if" or "but" always appears in the first draft.

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Psychotherapy Issues Arising from Bipolar Disorder Symptoms

Joseph Burgoin
Depression and Bipolar Disorder
25

In this video, I use the film 'Limitless' to illustrate some of the clinical issues addressed in this post:

<a href="http://www.linkedtube.com/CEqrDZLd20U264a6079ac9269aceb65df276b591c78.htm">LinkedTube</a>

[NOTE: IF YOU HAVE BEEN DIAGNOSED WITH BIPOLAR DISORDER, BEFORE YOU CONSIDER TAKING PSYCHIATRIC MEDICATIONS, PLEASE EDUCATE YOURSELF ON THE DANGERS OF SUCH DRUGS AND LOOK INTO ALTERNATIVE FORMS OF TREATMENT. I've written a series of posts concerning (1) the dubious theory that mental illnesses such as bipolar disorder and bipolar ii disorder result from an imbalance in brain chemistry, (2) the fact that widespread use of antidepressants and other psychiatric medications can be linked to an explosive increase in the length and severity of many mental illnesses, and (3) the false claim that psychiatric drugs correct chemical imbalances in a way analogous to taking insulin for diabetes. Another post discusses the role of psychiatric medication in the increase of the symptoms of bipolar disorder in our culture.]

In an earlier post, I discussed the core problem in bipolar disorder or manic-depressive illness:  a feeling that the internal damage is so pervasive that there's no realistic hope for improvement, leading to a search for "magical" solutions instead.  IN this post, I'd like to give a case example, a young man in his 20s who might have been considered "cyclothymic" rather than receiving a full diagnosis of bipolar disorder, though his mood swings demonstrate the same high/low dynamics.  If you haven't read it already, you might want to take a look at my post on hopeless problems and perfect answers before reading on.

Jeffrey was an extremely bright and talented young man, recently graduated from college, who aspired to be a writer.  He came to me because of depressive episodes so severe he felt barely able to function.  He managed to hold down a clerical job to support himself despite his depression, attempting to write in the evening after work and on weekends.  If he were feeling deeply depressed, he couldn't write a word. After work, he'd often collapse into a state of inertia, barely able to feed himself, watching mindless TV.  He suffered from extreme insomnia and often slept but a few hours.

Jeffrey badly wanted to have a relationship but felt completely worthless, as if everything about his adult functioning self was a facade, and that as soon as anyone got close to him, they'd find out he was a fraud.  He would describe himself as a loser, "damaged goods," or "a worthless piece of shit."

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Further Thoughts on the Lost Art of Conversation

Joseph Burgoin
Destinations
·
Social Behavior
3

In my last post, and in my post on narcissistic behavior, I was complaining about conversations that too often involve other people dumping their problems, or new acquaintances who want only to talk about themselves.  I had an experience earlier this week that helped me appreciate a different kind of social interaction.  Nothing compares with a truly intimate and reciprocal exchange between close friends, but here on Christmas Eve, I want to write about some very satisfying interactions I've had with strangers.

For the first time, we're here in Colorado for the holidays; in our local town, there's a big sledding hill, and earlier this week, we took our new sleds for an inaugural run.  There were other families on the hill, people we'd never met before; I was struck with how easily we fell into conversation.  We talked about the merits of the different sleds we all owned and laughed as the children went over bumps and tumbled onto the snow.  One family offered to let us try their Flexible Flyer, an aged piece of equipment the father had owned since he was a little boy.  Other than this last personal bit of information, nobody talked about themselves or trotted out a favorite story; nobody asked us any questions.  It was a completely satisfying social experience and, in its way, intimate.

It made me think about the conversations we often have with other hikers, met by chance on the trails in Rocky Mountain National Park.  The "camaraderie of the trail," I call it.

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