therapy

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October 30, 2010

Whitaker on “Social Therapy”

Posted by Nathen under Carl Whitaker, therapy, words
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I’m reading Whitaker and Malone’s 1951 book The Roots of Psychotherapy, an early attempt at a general theory of therapy. Whitaker was a psychiatrist who started working with families in the very early days of the family therapy field. It’s a good book, though not an easy read.

My favorite of his ideas so far is that of the social therapist. He says that since everyone has troubles, and everyone has some capacity to help others through troubles, everyone is a potential “patient” (therapists still called their clients “patients” back then), everyone is a potential “social therapist,” and every interaction between people has the potential to be therapeutic.

What causes a potential “patient” to become an actual “patient,” and go ask a professional therapist for help is a failure of that person’s social-therapy community to help with their troubles. That, and the “patient’s” overcoming their own fear of change and their fear of the stigma our culture places on getting therapy.

Whitaker also tackles the sticky question, “What is a cured patient?” and concludes, “In short, the patient gets access to other human beings and, incidentally, enters the community as an adequate social therapist, no longer so concerned with himself that he cannot get and give therapy to others in a social setting.” (p. 79)

 

September 29, 2010

Intentions for Year 40

Posted by Nathen under affection, being kind to myself, exercise, food, graduate school, healthcare, lists, meditation, rituals, self-care, therapy
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I turned 39 at 8:50 this morning. I’m on the cusp of middle age! As usual, I used my flights to and from Not Back to School Camp to brainstorm about my 40th year. Camp is a great end-of-year celebration and source of inspiration. I’m going to do a lot this year–finish my Master’s degree and see clients for at least 400 hours, for example–but I’ve decided not to put that stuff on my list. I want to concentrate on how I do it. I just watched the outgoing cohort finish up my program and they seemed really stressed out. I want to do it without overwhelming myself, in good health. I want to enjoy it. So I came up with one intention that sums it all up:

This year, I intend to take exquisitely good care of myself.

To me, that means that I think about myself like I do my best friends, with affection and optimism, with care. I am not a slave to being productive.

When I touch myself, I do so gently, with attention, not mechanically or absent-mindedly. Like I would someone I love.

I don’t eat crap.

I meditate 30 minutes every day.

I exercise 45 minutes every day.

I do my physiotherapy daily and get health care whenever I need it.

I get good attention, from friends, co-counselors, or a therapist, when I need it.

I take a day off every week.

I say yes to social invitations.

I sleep a bare minimum of 8 hours a night. That means giving myself an hour to chill out with nothing electric and no reading before bed, and an hour to lie in bed before I need to be asleep, so I don’t get worried about falling asleep quickly enough.

I keep my living space looking nice.

I have some ritual (yet to be designed) which helps me stop thinking about my clients when I leave the clinic.

I’ve also put a lot of thought into how I will prioritize my commitments. They will probably often conflict with each other and I’d like to be able to make choices about what to do and what to leave out with minimal stress. That part will be a work in progress for a while

 

July 27, 2010

No Guilty Pleasures

Posted by Nathen under 10000 hour rule, CFT cohort, dancing, guilty pleasures, lists, mastery, reading, record production, self-care, therapy, writing
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Our check-out at the end of group supervision last night was naming our “guilty pleasures.” My cohort-mates mostly talked about TV shows they were watching, plus some fiction reading. When it was my turn, they shot down every single extracurricular activity I offered. Not one qualified as a guilty pleasure. Here’s the list:

Reading Ken Wilber’s Integral Psychology

Watching Ken Burns’ documentary Jazz

Listening to Sol Stein’s Stein on Writing on audiobook

Listening to This American Life, Radiolab, and a couple other podcasts

Recording Reanna a cover of “Got To Get You Into My Life”

Dancing every week

I think they might have given me dancing if I hadn’t tried their patience with the other stuff first. I didn’t think to say writing for my blog, which is probably the pleasure I feel the guiltiest about, but they probably wouldn’t have given me that either.

It doesn’t seem like I have time to watch TV. I don’t even have a TV, come to think of it, and I haven’t figured out how to get TV shows on the internet. I’m watching a little of the jazz doc each night as I brush my teeth, but it’s hard to imagine watching multiple seasons of TV shows, like my cohort-mates are. It would take a major shift in lifestyle. I did listen to Murakami’s (excellent) The Wind-Up Bird Chronicle last spring, but only while I was driving, so it took 15 weeks to finish.

I feel conflicted about my lack of guilty pleasures. I’d like to have that kind of laid-back lifestyle. I want to be more relaxed. This summer–this next four weeks of this summer–is my only even partly unstructured time before I graduate next June. And who knows after that? I’ll have loans to pay off.

On the other hand, it doesn’t sound relaxing to add something to my schedule! Plus, I like the stuff that I’m doing, and I’m working on wrapping my head around something with infinite depth. When I finished my two-year record-production program in the 1990s, my teacher Josh Hecht said, “This is a deep subject that you have scratched the surface of, but you now know what you need to be able to do. The next step is figuring out a way to do it for 14 hours a day, every day. In 20 years or so, you’ll be very good at it.” That was his lifestyle, and it made him an excellent record producer. He worked all day, had no time for non-audio entertainment, read only the two very best trade magazines, participated in only the two very best trade organizations. He slept five hours a night.

This is a path of mastery like Erickson’s 10,000 hour rule; to get good at any complex endeavor, you have to put in about 10,000 hours. Being a therapist certainly qualifies as a complex endeavor! The catch is, weeks after Josh told us how to become a good record producer, he got very ill and was forced to take a long vacation–his first vacation in decades, I believe. I think that was the point my supervisor was making about guilty pleasures; this is a demanding career in many ways. How do I master it while maintaining my health, motivation, and clarity?

 

June 14, 2010

Irvin Yalom’s Existential Factors

Posted by Nathen under existential factors, existential therapy, Irvin Yalom, lists, the meaning of life, therapy, therapy models
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Existential psychotherapist (and the author of Lying on the Couch, When Nietzsche Wept, and The Schopenhauer Cure) Irvin Yalom suggests that humans face five existential factors that play a large role in our lives and in the success of psychotherapy. This is how he describes them in The Theory and Practice of Group Psychotherapy, on page 98:

1. Recognizing that life is at times unfair and unjust

2. Recognizing that ultimately there is no escape from some of life’s  pain or from death

3. Recognizing that no matter how close I get to other people, I must still face life alone

4. Facing the basic issues of my life and eath, and thus living my life more honestly and being less caught up in trivialities

5. Learning that I must take ultimate responsibility for the way I live my life no matter how much guidance and support I get from others

 

June 12, 2010

Congruent & Incongruent Communication, Paradox & Double Bind

Posted by Nathen under behavior, children, communication, congruent communication, cybernetics, double bind, experiential family therapy, family therapy, going meta, incongruent communication, lists, love, mental disorders, paradox, parenting, Paul Watzlawick, psychology, relationships, talking, therapy, transparency, Virginia Satir
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Family therapy got started when the grandparents of the field, interested in cybernetics–the science of self-regulating systems–started studying communication in families. Some of the more interesting ideas they came up with were the three progressively more problematic kinds of contradiction. This is a summary of Virginia Satir’s version of those contradictions, from Conjoint Family Therapy:

Simple contradiction: This is when a person says two things that contradict each other straightforwardly, as when someone might say, “I love you but I don’t love you.” This kind of contradiction consists of assertions that are incompatible, but at least out in the open, in an easily decodable way. That means that the receiver of the message can easily comment on the contradiction, saying “I don’t understand what you mean. You didn’t make sense to me just then.”

Paradoxical (or incongruent) communication: A paradox is a special kind of contradiction, where the incompatible statements exist on different “logical levels.” That is, one of the statements is part of the context of the other statement. These are significantly more difficult to decode and comment on. The two logical levels in human communication are usually verbal and non-verbal behavior, where the non-verbal behavior is the context for the verbal. For example (from p.83) “A says, ‘I hate you,’ and smiles.” If A had said “I hate you” with an angry look on their face, that would be congruent, but what does “I hate you” mean in the context of a smile? This is more confusing than the simple contradiction, both because it is more difficult to track the two levels of communication simultaneously, and because we have unspoken social norms against commenting about how someone is speaking. Consequently, it takes more awareness and bravery to question the speaker’s intent when they present you with this kind of contradictory communication. (Satir calls paradoxical communication “incongruent communication.”) Being able to metacommunicate, or comment on the communication going on, is the major tool of the psychotherapist. We don’t usually know it, but this skill is the main thing we go to therapists for.

The double bind: The double bind is a special kind of paradoxical communication that was first laid out in Watzlawick and colleagues’ Pragmatics of Human Communication. A double bind is a paradox with two additional rules, giving four total requirements:

1) A verbal statement

2) A contradictory non-verbal context

3) A rule that you are not allowed to metacommunicate

4) A rule that you are not allowed to leave the field

This happens to people all the time. Children, especially, mercilessly, unconsciously, are put in this position a lot because they are not in a position to leave their parents “field.” They are completely subject to their parents on every level.

Here’s an example: A parent, obviously stressed out, tense, and in pain for whatever reason, says to their child, “I love you.” This puts the child into a double bind, because the statement is contradicted by the “I don’t love you” expressed by the parents’ body language and facial expression. That’s 1) and 2). Third is that the child can’t comment on the contradiction because they don’t have the tools, and even if they did, and said something like, “Mom, I hear you saying that you love me but it doesn’t really seem like you love me right now. It seems like you’re having other feelings,” the child would almost certainly be punished in some way for being insubordinate, for questioning the parent’s love, for questioning the parent’s word, for making the parent feel uncomfortable. Fourth is that the child is not allowed to leave the field. That is, even if they had the communication tools, the awareness, and the bravery, they have no where else to go if they are rejected by the parent. Their lives are dependent on the love and support of the parent. They are stuck in the field. To cope, they “learn” one or both of the following:

I am not lovable. My parent knows this, and I have figured it out, but at least they are pretending that they love me, which keeps me alive, so I’ll go along with the pretense that they love me.

I may be lovable, but love feels awful. Still, it’s the best thing available.

Then the child grows up and, having their own children, perpetuate the process, being a pretending-to-be-lovable parent with awful-feeling love to give to the next generation. Not only that, but they develop adaptations to this way of living that look like DSM-diagnosable Mental Disorder conditions.

Metacommunication and congruent communication: Notice that metacommunication is the key out of all of these situations. In the case of a true double bind, you might need the help of someone else’s (a therapist’s or friend’s) metacommunication, but metacommunication is still the key. Someone needs to stand up and say, “I’m confused! Can we slow down here and talk about what we’re talking about? What can you say to me right now that your body language and facial expression will agree with?”

 

May 31, 2010

Diagnostic Criteria for Schizophrenia

Posted by Nathen under diagnosis, diagnostic criteria, disease, documentaries, drugs, DSM-IV-TR, etiology, family therapy, lists, mental disorders, mental illness, psychology, psychopathology, psychosis, psychotropic medication, schizophrenia, tests, therapy, World Health Organization
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Schizophrenia is a fascinating set of phenomena, the study of which has launched a thousand ships including, arguably, my field, family therapy; many of the original family therapists left psychiatry to study schizophrenia (or, as the DSM would have me write it, Schizophrenia–capitalizing words gives them more authority, don’t you think?) as an interactive process. That is, if all behaviors make sense in their context, what context might make schizophrenic behavior necessary?

There was an almost violent backlash against this line of thinking, as it seemed to (and did, in many cases) blame mothers for their schizophrenic children–as in the unfortunate phrase “schizophrenogenic mother.” The conventional wisdom about schizophrenia these days reads like a pharmaceutical company press release, something like, “Schizophrenia is a biological disease of the brain which is at present incurable, but there are drugs which can help manage the symptoms, and if taken regularly can provide a decent quality of life.”

So schizophrenia is assumed to be a biological disease of the brain though it, like every other Mental Disorder, has no laboratory test that can detect its presence. The best we can do is a set of behavioral diagnostic criteria which, frankly, are a bit of a mess. You may notice as you read that different flavors of schizophrenia may have nothing or little in common with each other. Are they really the same “disease”? We don’t know.

We do have good evidence that you can inherit, in some fashion, a tendency for one of these constellations of behaviors. There is good evidence that environmental factors are also important, though they are not a big part of the mainstream discussion. We also have evidence that therapy helps in a lot of cases. There is some (hotly contested, I’m sure) evidence from the World Health Organization that unmedicated schizophrenics can eventually recover while those on medication do not. Here is a trailer for a moving documentary about two recovered women and the public perception of schizophrenia, called Take These Broken Wings. Also, consider checking out the documentary A Brilliant Madness, about John Nash, in which puts the lie to A Brilliant Mind, which showed Nash recovering with the help of psychopharmaceuticals.

The DSM says that schizophrenia may be overdiagnosed (or at least is diagnosed more often) in African- and Asian-American men, that it affects men differently than women (men tend towards the negative symptoms were women tend towards delusions and hallucinations), and that incidence rates are something like .5-1.5% of adults.

Here are a few terms that you’ll need to know to get through the criteria:

affective flattening: does not show emotion. Also, “affect” means “emotion” to scientists and people who like to talk like scientists.

alogia: lack of speech.

avolition: lack of motivation.

prodromal: symptoms coming early on in the course of a disease.

echolalia: repetition of others’ speech sounds.

echopraxia: repetition of others’ movements

And here are the diagnostic criteria, word-for-word, from the DSM-IV-TR, pp. 312-319:

Diagnostic criteria for Schizophrenia

A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

(1) delusions

(2) hallucinations

(3) disorganized speech (e.g. frequent derailment or incoherence)

(4) grossly disorganized or catatonic behavior

(5) negative symptoms, i.e., affective flattening, alogia, or avolition

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.

B. Social/occupational dysfunction: For a significatn portion of the time since th onset of the distrubance, one or more major areas of functioning such as work, interpersonal relations, or self-care are mardekly below the level achieved prior to the onset (or when the onset is in childhood or adolewscence, faliure to achieve expected level of interpersonal, academic, or occupational achievement).

C. Duration: Continuou signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. Doring these prodromal or residual periods, the signs of the ditrubance may be manifested by only negative symptoms or two or more symptoms listen in Criterion A pressent in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

D. Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.

E. Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition.

F. Relationship to a Pervasive Developmental Disorder: If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

Classification of longitudinal course (can be applied only after at least 1 year has elapsed since the initial onset of active-phase symptoms):

Episodic With Interepisode Residual Symptoms (episodes are difined by the reemergence of prominent psychotic symptoms); also specify if: With Prominent Negative Symptoms

Episodic With No Interepisode Residual Symptoms

Continuous (prominent psychotic symptoms are present throughout the period of observation); also specify if: With Prominent Negative Symptoms

Single Episode In Partial Remission; also specify if: With Prominent Negative Symptoms

Single Episode In Full Remission

Other or Unspecified Pattern

Diagnostic criteria for 295.30 Paranoid Type

A type of Schizophrenia in which the following criteria are met:

A. Preoccupation with one or more delusions or frequent auditory hallucinations.

B. None of the following is prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect.

Diagnostic criteria for 295.10 Disorganized Type

A type of Schizophrenia in which the following criteria are met:

A. All of the following are prominent:

(1) disorganized speech

(2) disorganized behavior

(3) flat or inappropriate affect

B. The criteria are not met for Catatonic Type.

Diagnostic criteria for 295.20 Catatonic Type

A type of Schizophrenia in which the clinical picture is dominated by at least two of the following:

(1) motoric immobility as evidenced by catalepsy (including waxy flexibility) or stupor

(2) excessive motor activity (that is apparently purposeless and not influenced by external stimuli

(3) extreme negativism (an apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved) or mutism

(4) peculiarities of voluntary movement as evidenced by posturing (voluntary assumptions of inappropriate or bizarre postures), stereotyped movements, prominent mannerisms, or prominent grimacing

(5) echolalia or echopraxia

Diagnostic criteria for 295.90 Undifferentiated Type

A type of Schizophrenia in which symptoms that meet Criterion A are present, but the criteria are not met for the Paranoid, Disorganized, or Catatonic Type.

Diagnostic criteria for 295.60 Residual Type

A type of Schizophrenia in which the following criteria are met:

A. Absence of prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior.

B. There is continuing evidence of the disturbance, as indicated by the presence of negative symptoms or two or more symptoms listed in Criterion A for Schizophrenia, present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

 

May 29, 2010

Carl Rogers’ Mechanisms of Action of the Therapeutic Relationship

Posted by Nathen under Carl Rogers, common therapeutic factors, emotions, lists, reality testing, therapeutic relationships, therapy
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What is therapeutic about therapy? It seems to have a lot to do with the kind of relationship that the therapist and client create. This is Carl Rogers’ version of what happens in an ideal therapeutic relationship, quoted from Yalom’s Group Psychotherapy (p. 62). If you want to see footage of Rogers trying to create this relationship, I posted clips here.

1) The client is increasingly free in expressing his feelings.

2) He begins to test reality and to become more discriminatory in his feelings and perceptions of his environment, his self, other persons, and his experiences.

3) He increasingly becomes aware of the incongruity between his experiences and his concept of self.

4) He also becomes aware of feelings that have been previously denied or distorted in awareness.

5) His concept of self, which now includes previously distorted or denied aspects, becomes more congruent with his experience.

6) His becomes increasingly able to experience, without threat, the therapist’s unconditional positive regard and to feel an unconditional positive self-regard.

7) He increasingly experiences himself as the focus of evaluation of the nature and worth of an object or experience.

8) He reacts to experience less in terms of his perception of others’ evaluation of him and more in terms of its effectiveness in enhancing his own development.

 

May 18, 2010

Three Approaches to Psychotherapy: A Film Series

Posted by Nathen under Albert Ellis, Carl Rogers, Fritz Perls, Gestalt Therapy, Person Centered Therapy, Rational Emotive Behavior Therapy, therapy, video
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Posting about Albert Ellis yesterday reminded me of this cool film series made in 1965 called Three Approaches to Psychotherapy. It shows three very famous therapists talking with the same client, named Gloria. First is Carl Rogers doing his non-directive Person Centered Therapy. Next is Fritz Perls doing his demanding-total-authenticity Gestalt therapy. (This was developed with his wife, Laura, making it the only one having significant female authorship.) Last is Albert Ellis doing his the-way-you-are-thinking-about-things-makes-you-unhappy Rational Emotive Behavior Therapy.

I don’t know how much of the following is true, but this is what I’ve heard: Part of the deal in making this film was that Gloria could choose a therapist based on her very short sessions with each of them. She chose Fritz Perls. Later, she struck up a friendship with Carl Rogers that lasted the rest of her short life. She died in her 50s.

Recent research on what makes therapy effective suggests that the style of therapy you use is not a major factor. It seems to do more with the quality of the relationship between the client and the therapist and how much the client believes the therapy will help. In light of that it’s striking how different these approaches are. You will see what I mean.

Each therapist’s section is about 30 minutes. Each therapist presents his basic theory, talks with Gloria for a bit, and then talks about what he thinks he just did. Rogers’ is broken up into several clips–that’s the only way I could find it. Perls’ and Ellis’s videos are each in one piece, and from Google video instead of YouTube, so they take longer to load. You might let each of the longer clips run through before watching it to avoid it breaking up if you have a slow connection like I do.

 

May 17, 2010

Albert Ellis’s 15 Irrational Ideas

Posted by Nathen under Albert Ellis, beliefs, cognitive therapy, emotions, etiology, ideas, lists, prefrontal lobotomy, psychotropic medication, Rational Emotive Behavior Therapy, therapy, thinking
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Albert Ellis was one of the guys who invented cognitive therapy, which began as a kind of wacky-fringe psychotherapy in the 1950s and has grown to be one of the dominant and most-researched forms of therapy today. It’s effective and simple–easy to teach. Ellis’s version of cognitive therapy, Rational Emotive Behavior Therapy, is alive and well too.

Ellis’s basic tenets were that thoughts or beliefs, not events, cause emotions and that irrational thoughts or beliefs cause our emotional problems. Most people think it’s their situations that are causing their problems, but Ellis said that we feel bad when our situation is in conflict with an irrational belief, and that it is the belief that makes us feel bad. So his style of therapy basically consisted of deconstructing people’s irrational thoughts and beliefs.

I think that he was right in a lot, though not all, cases. There are many other effective forms of therapy that, instead of cognitions, target behavior, emotions, social systems, or some combination of the four. There are also, of course, non-therapy interventions that aim to improve people’s psychological experience by targeting biological systems, like drugs or the prefrontal lobotomy, and interventions that target political systems–various kinds of activism.

But irrational beliefs are as good a place to start as any. Here is Ellis’s list of our major irrational ideas, quoted from Jacobs, Masson, & Harvill’s Group Counseling: Strategies and Skills (pp. 285-6). Keep in mind that these don’t usually exist as overt beliefs–you might have to dig to find them in yourself, running you.

Which few are your main irrational ideas?

1) It is a dire necessity for an adult human being to be loved or approved by virtually every other person in one’s life.

2) One should be thoroughly competent, adequate, and achieving in all possible respects if one is to consider oneself worthwhile.

3) Certain people are bad, wicked, and villainous and they should be severely blamed or punished for their villainy.

4) It is awful and catastrophic when things are not the way one would very much like them to be.

5) Human unhappiness is externally caused and people have little or no ability to control their sorrows and disturbances.

6) If something is or may be dangerous or fearsome, one should be terribly concerned about it and should keep dwelling on the possibility of its occurring.

7) It is easier to avoid than face certain life difficulties and self-responsibilities.

8) One should be dependent on others and needs someone stronger than oneself on whom to rely.

9) One’s past history is an all-important determiner of one’s present behavior and because something once strongly affected one’s life, it should indefinitely have an effect.

10) There is invariably a right, precise, and perfect solution to human problems and it is catastrophic if this perfect solution is not found.

11) One should become quite upset over other people’s problems and disturbances.

12) The world should be fair and just and if it is not, it is awful and I can’t stand it.

13) One should be comfortable and without pain at all times.

14) One may be going crazy because one is experiencing some anxious feelings.

15) One can achieve maximum human happiness by inertia and inaction or by passively and uncommittedly enjoying oneself.

 

May 13, 2010

Parataxic Distortion

Posted by Nathen under co-counseling, countertransference, emotions, family therapy, going meta, Harry Stack Sullivan, parataxic distortion, psychology, Sigmund Freud, therapy, transference, words
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My favorite new term from my family therapy program is parataxic distortion, coined by the “American Freud” and one of the grandfathers of family therapy, Harry Stack Sullivan.

A parataxic distortion is when a current situation or person reminds you of something from your past, often without you knowing it, such that you behave to some degree as if you are in your past, dealing with that situation or person. Parataxic distortion is an umbrella term for confusions like Freud’s transference (client gets inappropriately emotional about therapist) and countertransference (therapist gets inappropriately emotional about client). It is also very much like to co-counseling’s “restimulation of distress.” Most likely every psychotherapeutic school has its own name for this phenomenon.

The idea is that there is a way in which your memories are categorical, not specific. That is, if your dad hit you when you were a kid, you not only attach fear and anger to your dad in your memory, you also attach it to a range of things, maybe bald men, short men, men in general, authority figures in general, certain kinds of places or rooms, etc.

Mostly, our memories are useful. This ability to generalize, for example, helps us avoid burning ourselves on hot stoves in general instead of having to painfully learn not to touch each hot stove. Neat trick!

But with a parataxic distortion, our unconscious memory keeps us from being able to understand and deal with situations as they are, in the present. It patterns your behavior. It limits your options. Usually without your knowing it, it makes your life more scary, sad, irritating, and ultimately isolated than it needs to be. Most therapeutic modalities have some version of this three-stage recipe for resolving parataxic distortions: 1) Form a trusting relationship with someone who has less distortion in the area you have trouble with. 2) Have a “corrective emotional experience,” where you basically re-experience your distortion-driven emotional pattern while demonstrably safe in this trusting relationship. 3) Have a “cognitive reappraisal,” meaning come to a new understanding of your behavior in light of current reality as it is. Go meta.

Easier said than done, of course, but well worth it!

 

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