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Archive for January, 2010

Dear and Brad and Angie and Madge:

I think it’s great you have chosen to adopt children who needed homes.

But I want to make sure you know what you are getting into, so you can do it right.

Here are some pointers on adoption.

First of all – please do not fall for the myths.  An adopted child doesn’t come from “heaven” or a baby store – he is someone else’s child.  That birth parent – usually due to terrible circumstances – has done the unthinkable, and abandoned his child to someone else’s care.

That is a tragedy.  In an ideal world, no child would ever have to be taken from his parents.

Your adopted child will feel this separation at a cellular level – even if he was removed from his parents at birth.  He will live with the pain of that trauma his entire life.  He will want to understand what happened, and he will have fantasies about his birth parents, and feelings about them, including anger at them for what they’ve done, and fear about what it might say about him, and his ability to find the love he needs.  This is normal and natural and unavoidable.  It is your child’s right to have these thoughts and feelings.

Your job isn’t to erase your child’s trauma.  It is to help him process it, and to support him through a recovery into a new life with you.

Please don’t ever utter that old line about adopted children being special because they are chosen.  That’s nonsense – and it minimizes the reality of an adopted child’s pain.  Adopted children are special because their parents gave them up.  They are wounded, traumatized children who need extra care because of what they’ve been through.

As you process your child’s trauma with him, please do your best to be honest and open.  Never, ever lie to him.  If you can include his birth parents in his life, please do.  He has a right to know the truth, and to try to maintain whatever relationship he can with the parents who brought him into this world and share his genetic material.  If you feel threatened by the presence of his birth parents, please recognize that this is your problem, not your child’s.  Deal with it on your own.

Be aware that adopted children often display two responses to their situation:  hyper-compliance and testing behavior.

The hyper-compliant child realizes he’s not with his “real” family, so he plays along, but he doesn’t trust it.  He’s on his best behavior because he doesn’t want to receive another shock, and another dislocation.  He tries to be everything you want him to be – no trouble at all.  Along the way, he may neglect his own needs in his attempts to please you.

The testing child is also distrustful.  If his own birth parents disowned him, why should he trust you?  So he tests you. If you claim to love him just as much as your birth children, then how will you react when he smashes a toy, or refuses to obey you?  He wants to know if your love is real – if it is the truly unconditional love he needs so badly. He may attempt to drive you away in the process of testing your love.  There could be some tough times ahead as you struggle to enforce boundaries in a way that communicates love and safety.

Raising a child is never easy.  With an adopted child, you’ll have a slightly different task – one laden with unique challenges.

If you do it right, you’ll bring joy to the life of a child who needs you.  And a special joy to your own life as well.

Namaste.

The People’s Therapist.

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Rage is helpless anger.

If anger finds a productive outlet, it can achieve great things (See Martin Luther King, Mahatma Gandhi, et al.)  King and Gandhi believed their words could be effective agents for change.  There was a receptive audience somewhere – white Northerners, the British public – who would listen, and perhaps embrace a new direction.

But when you feel no one is listening, you lose a sense of efficacy, of control over your environment.  So you go into a rage.  Instead of turning your anger into words, you go into action on unexamined feelings.

Rage is essentially a temper tantrum.  Just like a frustrated toddler who throws a fit because he can’t have his way.

There is nothing more destructive.  Especially when the phenomenon takes place on a large scale – affecting an entire culture.

Mass rage occurred in China from 1966 to 1976, during the so-called Cultural Revolution.

China was humiliated during the 19th and 20th centuries by the fact that it had somehow slipped a couple hundred years behind the Europeans in terms of technological advancement.  This was a temporary situation – China led the world in technology for eons, and they caught up quickly.  But the humiliation and helplessness of those years led to a feeling of rage that exploded in such bloody events as the Taiping Rebellion of 1850-1864 (a civil war triggered by religious fanaticism) and the Boxer Rebellion of 1898-1901 (an outburst of violence by ultraconservative forces against foreigners.)  The ultimate scream of rage was the Cultural Revolution, in which the Chinese, lost in a cult-like worship of Chairman Mao, turned their fury upon themselves, destroying their educational system, smashing their monuments and treasures – and losing an entire generation of human achievement.

It hasn’t only happened in China.  Hitler somehow convinced the German people that they were “humiliated” during WWI, and used it as the trigger for a convulsion of violence against innocents that resulted in the virtual destruction of Germany as a nation.  American Southerners convinced themselves that they’d been “humiliated” during the American Civil War, and used that as the pretext for a bloody outbreak of violence and oppression against innocent African-American citizens during the late 19th century – around the time Mark Twain termed the USA “The United States of Lyncherdom.”

Exactly the same thing is happening today in the Muslim world, and we can only hope they get over it soon.

The pattern is familiar – the “humiliation” of the Muslim nations by foreign occupiers, a deep sense of helplessness and the fall-back into conservatism and reaction, clinging to backward traditions and rejecting anything new that might smack of acculturation.  Then comes the violence – always the violence, officially focused outward on the forces of change, then turned inward, producing cruel persecutions of helpless minorities, and – ultimately – an orgy of self-destruction.

In the end, rage always results in harm to yourself.

The Chinese Red Guards during the Cultural Revolution destroyed their own institutions, persecuted their own intellectuals, dismantled their own universities.

It was a source of amazement, during the 1992 Los Angeles riots, that the rioters were burning their own neighborhoods.  They weren’t burning down Hollywood, they were burning down South Central.

Muslim reactionary fanatics – so-called “terrorists” – destroyed the World Trade Center.  But most of their continuing violence seems aimed at other Muslims, mostly within Muslim countries.  If some young man wrapped himself in explosives and blew himself up in a crowd in the USA, it would be a national trauma.  But this awful event appears to occur on a weekly basis in the Muslim world.

The answer?  A familiar one in the world of psychotherapy:  put your feelings into words.  Don’t go into action on unexplored emotion. Contain the feeling, and investigate it.

Humiliation is when someone tells you something true about yourself that you’ve avoided seeing.  It was hard for the Chinese to own up to falling behind in technology, especially when they’d always led the way.  And it was hard for white Southerners to own up to human slavery being a heinous crime, or for Germans to accept that an imperial age had passed Germany by, and that their boundaries would be limited to those of a mid-sized European country – not a world empire.

It must be tough for the Muslim world to realize that it is due for some self-examination and fresh thinking around issues like democracy, freedom of speech, the treatment of women and separation of church and state, where they are clearly falling behind the rest of the world.

These are truths that need to be heard, and processed.  Instead of lashing out in violence, they could put their upset into words, and achieve personal growth.

If only someone in the Muslim world believed we were listening, and would open up – take that risk – and tell us what’s upsetting him. Perhaps he could write an article, or give a speech, or start a movement – a peaceful movement – that would bring attention and understanding to what Muslims are experiencing around the world.  He could answer the question on everyone’s lips after 9/11 – “why do they hate us?”

Then perhaps we could understand what their upset is really about, and bring this horror to an end.

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A patient told me she couldn’t get over a guy she’d been seeing.

He was no good for her.  He didn’t even seem to want to go out with her.  But she couldn’t let go.

“But I love him,” she explained.

Well, in a manner of speaking.

She was in love with him like a child – the way a child loves a parent.

A child’s love is based upon dependency.  A child loves whoever takes care of him, because he cannot take care of himself.

When a young child says “I love you,” he means “I worship you and you are all-powerful and I depend upon you utterly and you are everything and I couldn’t survive without you.”

It’s the same way religious people relate to their chosen god-objects.  It’s no coincidence they often kneel before statues or altars and refer to “Lord” and “Almighty” and “Heavenly Father,” and so on.

If you live in an island with a volcano and it erupts and burns down your village, you can respond as an adult, and take up volcanology research.  Or you can regress under the stress into a child, and talk to the volcano as a parent-object, asking what you did wrong to make it angry, and trying to please it.

A child is so utterly dependent upon a parent that, if he displeases the parent, he will always locate the fault within.  He will not think – oh, it’s just a volcano, they erupt sometimes.  It must be about the child, something he did – his fault.

My client was relating to the guy she was dating the same way.  And she was beating herself up pretty bad.

Adult love is very different from child love.  It begins with loving yourself.

Then you add three ingredients:

Attraction, Trust, and Respect.

That’s what it means to love someone else, romantically, as an adult.

1.  You are attracted to him.  This is simple enough.  The common mistake here is trying to ignore sexual attraction and turn a friendship into a romantic relationship.  You cannot go out with the guy you SHOULD go out with.  You have to go out with the guy you WANT to go out with.  “But he’s so nice” is not a reason to date someone.  You have to be into him, too.

2.  You trust him.  If someone values you, his attention is focused on you.  Monogamy is the clearest manifestation of a mutual fascination.  But even in the early months of dating, before monogamy enters the picture, trust is already an issue.

Are you worried he might not call?

You shouldn’t be.  You should trust his interest in you.  If you don’t, there’s probably something wrong.  If you value yourself, you will find someone who values you as well.  And if he values you, he won’t leave you wondering if he’s going to call.

3.  You respect him.  The best relationships contain a note of mutual awe.  You think your partner is pretty darned terrific – and he returns the compliment.

Happy partnerships are a bit mysterious – they are secret clubs, with only two members.  We don’t know what Napoleon saw in Josephine, or Gertrude saw in Alice B, or John saw in Yoko – but these famous partners were clearly fascinated with their spouses, and their fascination was returned.

A mature, respectful relationship between equals might seem pretty dull stuff compared to the headlong thrill of worshipping a parent-object like a child.

Yes, it is a bit calmer.  Far less drama.

But believe me, it has its pleasures.

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How can you choose a therapist who’s right for you?

Here’s what to look for:

1. Your therapist should be actively engaged. I was surprised,  years ago, when I read an account by Theodor Reik, an early psychoanalyst, of his analysis with Freud.  The founder of psychoanalysis didn’t just sit there, stroking his beard like a sphinx.  That’s a myth.  Reik described their work together as a 50/50 give and take, a conversation about what Reik was thinking and feeling.

Another myth is the “strict Freudian.”

There’s no such thing as a “strict Freudian.”

Freud wasn’t strict – or grim and serious all the time, either.  He was adventurous, exploratory, flexible, and constantly questioning what he was hearing and seeing, and what he believed was going on.  No one wants a therapist who acts like a punishing father-figure, or just sits there and nods.

That doesn’t mean your therapist should be talking about himself all the time and distracting from your joint task of exploring your thoughts and feelings.  Every good therapist knows that sometimes his job is to shut up and listen – especially when a patient is full of feeling and needs to get something out.  But you should be working together.  Actively.  If you ask him “what do you think?” he shouldn’t just say “what do YOU think?” back at you.  That’s a cop-out.

2. He should enjoy what he does. Every therapist has to look at the clock sometimes.  But if he seems to prefer looking at the clock to looking at you, it’s a problem.  This isn’t a job you do for money – trust me on that.  You do it because you were born with a strange gift – like mathematics or playing the violin – and you feel drawn to it.  And because you love it.  I hope to die sitting in that chair, listening to a patient telling me his thoughts and feelings (or maybe right after he’s left – I wouldn’t want to traumatize him.)

3.  He should welcome all your feelings – including your anger at him. A good therapist needs you to trust him enough to tell him the truth, even if the truth is that you’re unhappy with the work he’s doing.  He doesn’t need you to love him.

It is his honor and privilege to have your trust, and share your secrets.  You pay him.  That’s enough.  He’s not your guru.  He’s your therapist.

4. He should admit his mistakes. We all make them.  Nothing shows you can trust a therapist like his admitting he isn’t perfect.  If he gets something wrong, or chases an idea that’s off the mark, or just has a bad day – you should be able to say so, and he should be able to own it.  No one’s perfect – not even The People’s Therapist.  But any therapist becomes a better therapist if he’s willing to admit he’s human.

5.  He shouldn’t just be the President of Hair Club for Men – he should also be a client.

A good therapist has put in his own time in that other chair, and shed a few tears and had some anger too.  That’s how you get to be a good therapist.  You don’t learn most of it in classes, or from a book.  You learn it by doing it.  A good therapist has had his life profoundly changed in positive ways by psychotherapy.  He wants to share that opportunity with you.

5. He should be a bit of a kook. The best therapists are a little nuts – but good nuts.  Part of the joy of living is reveling in your own uniqueness – enjoying being you.  Lena Furgeri – my first therapist -dresses in flowing purple dresses and lots of big jewelry.  I love it.  She loves it.  She loves opera, too.  She’s a lot of fun.

Freud was a bit of a kook, too.  His office was filled with weird little statues and doo-dads from various primitive cultures.  He loved that stuff.

He was also hopelessly addicted to cigars.  And he was willing to chase any crazy idea if he thought it might lead him to somewhere useful.  He knew you have to get lost sometimes if you’re going to find your way to someplace new.  He came up with a lot of theories, and some were doozies.  Others changed the path of human thought.  But he had to be a little nuts just to take the risk of “thinking different.”

6. He should be a non-conformist.

Psychotherapy is improvisational.  Every patient needs a different therapist, which means every therapist has to be a different person for each patient.  A good therapist loves that challenge.  But you can’t improvise if you’re just reading the notes on the page.  You have to break free, and be yourself.  The best improvisation – think of jazz – balances an established structure with freedom and personal expression.

That’s why your therapist should be a gangsta.  He shouldn’t be afraid to drive close to the edge, take risks, stretch a bit.

The so-called “gangsta rappers” – folks like N.W.A., Eminem, Lil’ Kim, Snoop Dogg, Dr. Dre, 2Pac, the Wu-Tang Clan, Slick Rick and The Notorious B.I.G. – are a loosely-aligned group of musicians and poets whose work has combined a mastery of rhythm and verbal fluency with a desire to surprise their audience and challenge its assumptions – often by taking on sacred cows in ways designed to stir controversy.

In this sense, they’re not so terribly different from other musicians and artists, poets and comedians over the years who have intentionally challenged the “acceptable” in order to show us truths about ourselves – people like Jeff Koons, John Cage, Sam Kinison or Allen Ginsberg.

Your therapist should be like that – willing to take the critical and philosophical tools of psychotherapy and apply them to your life, and your world – the world you live in right now – in a way that makes them fresh, relevant and powerful.

Freud was bucking societal norms just by admitting he was thinking about the stuff that fascinated him – sex, the unconscious, primal drives.  It’s amazing he was able to get away with it, let alone found a new profession.  He was clearly a gangsta.

Just for the heck of it, I’ll close with a musical selection by one of my favorite non-conformists:  Frank Zappa.

Zappa broke plenty of rules.  A brilliant musician – a child prodigy – he took doo-wop music as seriously as symphonic music, and wrote both, as well as pop songs, art songs, chamber music, jazz and outrageous parodies, like his classic, “Valley Girl.”  Zappa did his own thing.  There’s no doubt he was a gangsta.

Here, then, for no apparent reason other than the sheer fun of it, is a Frank Zappa composition titled “Sofa” as played by – you guessed it! …a Bavarian brass band:

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The other day a patient posed a simple, but troubling question:  “What am I supposed to do with all this anger?”

This guy had plenty of good reasons to be angry.  His childhood was an experience I wouldn’t wish on anyone.

But that all happened decades ago.  Both his parents were long dead.  He wondered if he was wrong to still feel this way – if it was time to move on – forgive and forget.

I didn’t think so.  I told him what my first therapist, Lena Furgeri, told me years ago when I asked for advice on how to handle my roiling emotions:

“Keep coming,” Lena said,  “and keep talking.”

You can’t just forget your feelings.  And I’m not a great fan of the term “forgiveness” either.  I’m not even sure what it means.

There’s an interesting documentary, from 2006, called “Forgiving Dr. Mengele.”   It’s about Eva Mozes Kor, a woman who, as a child, was tortured by Josef Mengele, a Nazi doctor at Auschwitz, during hideous experiments he performed on prisoners.

Eva Mozes Kor says she “forgives” Mengele for what he did to her.

This statement has triggered controversy and outrage.  You don’t forgive a Nazi.  Mengele was a monster.

Or do you?  This leads us into a metaphysical morass, attempting to chart the contours of sin and forgiveness.  Perhaps the Catholic Church can attempt such a mission, but that’s not my job as a therapist.

My work is comprehending human emotion.  And I know you can’t just forget anger because you decide to “forgive.”

Anger must be metabolized.

The focus is not on the person who caused your anger, or his actions.

It’s about you – and your emotions.

To metabolize anger you must not fear it.  You must contain it – feel it, study it, learn from it – but not succumb to the temptation to go unconscious and act on it.

When you act unconsciously on anger you “act out” – discharge aggression.  Or you act in – shutting down and refusing to act.

It is tempting to act out (or in) because discharging aggression feels good.

We don’t often own this truth.  But pay attention when you hear that something bad happened to someone you don’t like.  You’ll catch the corners of your mouth pulling up.  You are smiling – a primitive simian indicator of pleasure.  Unconscious sadism is a powerful force. Smashing things is fun.  Violent movies are fun, too.  Most of us are angry most of the time, about something.  Anger co-exists with other emotions, and it doesn’t have to have a logical explanation – it just is, and it gratifies you.

There is a good evolutionary reason why discharging anger feels good .  It’s the same reason sex feels good:  because the animals who were aggressive (and enjoyed sex) lived to reproduce and pass on their genes.

But in the modern world, discharging anger can get you into trouble.  “Losing your temper” – a euphemism for acting out unconsciously by discharging aggression – is like getting drunk.  It might feel good at first, but there’s always a hang-over.  We all know how easy it is to vent anger at the person who happens to be nearest to you, usually the one who cares the most and least deserves this treatment.

The mass unconscious discharge of aggression is commonly known as war.  At some level, it feels good too.  And leads to untold horrors.

That’s why metabolizing anger is a better strategy.  You put the anger into words, and start to understand it.  This process converts raw emotion into communication.

The poet, Rainer Maria Rilke, wrote,  “Let life happen to you.  Believe me: life is in the right, always.”

Feelings are like that – even anger.  You  have to trust them.  Let them in.  Let them happen.

No one can say when you will be ready to move past these feelings – that is up to you.  But the organic process – the metabolizing of feeling – is necessary and unavoidable.

Eva Mozes Kor may or may not have forgiven the horrid Dr. Mengele, but she has metabolized her anger, turning it into words that achieve good for mankind.  She has devoted her life to speaking publicly on the events of the Holocaust, teaching the importance of tolerance and understanding.

In this regard, she resembles another angry person who metabolized his anger to make the world a better place:  Martin Luther King.

Dr. King felt a passionate anger at the injustice of racial segregation.  Like Eva Mozes Kor, he chose not to act unconsciously and discharge his anger in violence.  But he didn’t forgive and forget either.

He metabolized his anger into words.

Inspiring words.

Don’t fear anger.

 

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Groucho Marx once said he would never join a club that would have him as a member.

That’s how one of my patients seems to run her romantic life.

Somehow she always seems to chase the guys who don’t want her – but has no time for the guys who do.

This is a common syndrome, which therapists term “the seductive-withholding love object.”

Here’s how it works:

My patient, like plenty of people, had parents who were impossible to please.  Hers were especially so.  Her father was a cold, distant math professor; her mother a schizophrenic, lost in a maze of paranoid delusions.  They were less interested in their daughter than they were in themselves.

But children are parent-pleasing machines.  They are the product of evolutionary forces that ensure that the child who best pleases his parents is the most likely to survive – and so pass on his genes for parent-pleasing.

If a child cannot please a parent, he has failed in his evolutionary mission.  He places the fault within, and blames himself.

Later in life, he unconsciously continues his hopeless childhood mission – trying to win over people who withhold love.

That’s why my patient chases seductive-withholding love objects.

This syndrome leads to a lot of pursuing people who aren’t interested in you.

Even worse – you end up ignoring attempts at closeness from people who ARE into you.

If you are used to chasing seductive-withholding love objects, you will probably respond to an accepting, interested love object with anxiety or disgust.  You will wonder why someone would want you, when you are clearly not lovable – and it will make you nervous, to try to live up to their positive image of you.  You might also feel a twinge of disgust for a person who would openly pursue someone like you, whom no one should truly want, since even your parents turned you away when you came asking for care.

That’s a bad situation.

What to do about it?

As always, the answer in psychotherapy is AWARENESS.

If I said you were standing in a pot of water over a fire – you’d probably jump out.

Being made aware of your situation might convince you to change your behavior.

One final thought.  The seductive-withholding love object is a powerful force in human societies – in fact, it’s how the military turns young people into fighting machines.

That tough-as-nails drill sergeant who treats the new recruits like dirt?  Yup – a seductive-withholding love object.  They’ll do anything to please him.

By the time he grudgingly acknowledges that they might be okay after all…he’s got them hooked.  And so does the military.

They’ll obediently follow orders, even if it puts their life in danger.

Anything to locate approval and love.

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This week a patient complained he wasn’t sleeping well.  He said he was feeling like a hypochondriac – obsessively worrying about his health.  He’s young, and perfectly well, but suddenly every little ache and pain was bubonic plague.

Cognitive-Behavioral Therapy (CBT) is usually effective for anxiety, so we did a little CBT exercise together, in which you:

1. identify the cognition;

2. reality-test the cognition; and

3. formulate a soothing counter-message.

This sounds simple enough, and it makes good sense.  Anxiety is caused by cognition – predictive thoughts.  You predict that something terrible is going to happen, and that triggers a freak out:  your pulse races, you start to sweat, you can’t sleep – all the standard symptoms of anxiety.

So…first step:  identify the cognition.  The prediction that was causing his anxiety was the thought that his sore throat was caused by herpes.

Second step:  reality-test that thought.  He’d already checked with his doctor and online.  This was not herpes.  Herpes in the throat is a rare condition and would produce different, and far more severe symptoms.

So far so good.

Step three:  formulate a soothing counter-thought.  I asked my patient to tell himself what we both knew – this is just a sore throat, it isn’t herpes.  Relax!

That’s where we ran into trouble.

My patient insisted it wouldn’t work.  He couldn’t help it, he said.  He just kept worrying about his health.

I said he could help it – we can all control our thoughts, if we set out to.  He just didn’t want to.  Some part of him was enjoying scaring himself.

Huh?

Scaring yourself, oddly enough, can be soothing.  By telling yourself you are expecting the very worst, you assure yourself you are prepared for it.  That is intended to calm you down.

Consider what truly scares you.  It isn’t just scary monsters.  It’s scary monsters jumping out of nowhere and saying “boo!”  What scares you most isn’t what you’re expecting – it’s what you aren’t expecting.

So you try to expect everything.

That’s why you have nightmares.  Your unconscious mind brings you the very worst, in an attempt to calm you down by assuring you that you’re ready for it.

Fear is an ancient emotion, located in the amygdala, a primitive part of the brain, near the center.  Fear evolved early, as part of the fight or flight instinct.  Little animals needed fear to tell them to run from danger, just as they needed anger to tell them to fight for their life when a predator had them cornered.

When you are under extraordinary stress, like a mouse being hunted by a cat, you become hyper-alert, in an attempt to assure yourself you aren’t going to be taken by surprise.

But you can’t stay hyper-alert forever.  Soldiers who are in combat for long stretches can develop PTSD – post-traumatic stress disorder – a condition in which the brain is harmfully affected by trying to stay hyper-alert for too long a stretch.

My patient grew up in a world where nasty surprises happened all the time.  His father died when he was young.  His mother, an immigrant, raised him alone, amid poverty and discrimination.  As a boy, he was picked on constantly and never felt safe in his neighborhood or at school.  Now, as an adult, he was attempting to stay hyperalert so he wouldn’t be taken by surprise again.

I urged my patient to switch from dwelling solely on fear to giving his other most primitive emotion a try – anger.  Instead of constantly staying afraid, he could stand up to what scared him and fight back.  His new attitude could be – there’s nothing out there I can’t handle.

Like in Aliens, when Sigourney Weaver grabs the really big flame-thrower and says to the monster “You want to take me on?  Bring it, bitch!”  Every horror movie ends like that.  Someone – a long survivor, maybe – has finally had enough of being picked off one by one by the ax-murderer, and decides to fight back, even against the odds.

My patient liked that approach.  He’d survived plenty already in his life.  He could handle whatever came his way.

Heck, even if it were herpes (which is wasn’t) – he’d deal with it.  Whatever happened, he’d be okay.

Better to fight back than to live your life afraid.

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