The Task of the Modern Psychotherapist

What would Freud say if he overheard me offering medical advice to a client for a toenail infection? He might be horrified because he’d want to probe for the deeper meaning of the topic. Imagining this

conversation with the great psychoanalyst inspired me to address some changes in the practice of psychotherapy and psychoanalysis since Freud’s time.

Of course like Freud, the psychotherapist aspires to the motto that  “Nothing human is alien to me.” Ideally, we’re not shocked by any confession, and we’re sworn to honor a client’s privacy, except in situations of potential suicide or homicide.

Freud believed that the mind is a blank slate or tabula rasa in Latin. The question then becomes to what extent does heredity, opposed to the environment, impact the tabula rasa of the developing brain. A simple answer today is that our perceptions of the mind change in accordance with discoveries in neuroscience.

For example, disorders like autism and attention deficit disorder, recognized and treated early in a person’s life, portend a more favorable prognosis. This observation connects and supports the hereditary nature of both conditions, and the environmental factors (involved in timing) of treatment. In other words, early intervention has a greater impact on the developing brain, and implies that windows of opportunity close rapidly.

Today psychotherapy is not restricted to an exploration of the unconscious, nor to the wealthy, elite, artistic, or intellectual.  The variety of psychotherapeutic techniques has broadened, and the psychotherapist hopes to meet the client’s challenges rather than adhering to a theory.

Freud’s outlook was decidedly more deterministic than today’s open-ended approach. Diagnosis doesn’t necessarily determine prognosis. We know we don’t have all the answers and expect the unexpected regarding possibilities and potential. Like the stock market, the outcome of psychotherapy is unpredictable: Past performance doesn’t predict or guarantee future results.

For example, a patient of mine, whom I refer to as Mr. Z., began psychotherapy following an affair. He questioned whether he should leave his wife. As therapy progressed, he was surprised to realize that he, himself, was the problem, not his spouse. He could barely tolerate his own company. He simply didn’t like himself. His outlook changed: Instead of focusing on what his life lacked, he began to appreciate his partner and home life.

For Freud, an objective of treatment was to convert neurotic suffering to the universal suffering of humankind. Today, the psychotherapist is more likely to focus on the positive aspects of life, like transformation and appreciation.

We live longer and recognize the capacity and human potential to change: We have the chance to engage in multiple careers, relationships, hobbies, interests, and travel. The psychotherapist supports change and maintains an open mind regarding the ability of a client to transform his life.  Our objective is to help the client become aware of how, when, and why he may get in the way of his goals (for example, fears of change, success, failure).

Regardless of a therapist’s orientation ­­­­––interactive, relational, psychodynamic, behavioral, cognitive––the “good-enough” psychotherapist conveys a belief in his client, and supports his efforts to improve his life and become the best, authentic person possible. (The term “good-enough” originates from the psychoanalyst, D.W. Winnicott, who applied the term to mothering).

Conclusion: The “good-enough” psychotherapist adapts theories to relate and collaborate with clients to support their growth and help examine obstacles that interfere with their constructive goals.

Dear Reader, I welcome your thoughts. jsimon145@gmail.com

Money, Power, and Your Health

A recent AARP conference (ideas@50+ ) featured Arianna Huffington, president and editor-in-chief at The Huffington Post. In her presentation “Thriving After 50,” she spoke about retirement and the fact that people are not saving enough to “thrive” in their future. According to the Employee Benefit Research Institute, about 36 percent of American workers have less tan $1,000 in retirement savings. Sixty percent have under $25,000 and 58 percent have debt problems.

There is little doubt that lack of sufficient money constitutes a major stress and contributes to bodily ills.  Our attitudes toward money undergird much of our lives,  impacting our lifestyle and sense of well-being. Yet many of us ignore the task of managing our finances, often with dire consequences.

Taking stock of your money with an eye on your financial future is a good idea. Here are some examples.

Do I think money:

1. is meant to spend on myself? Some of us feel deprived and believe material possessions will erase the suffering. For example, Mr. G. purchased multiples of shoes, sweaters, etc. filling his apartment with stuff he could never use.  Ultimately he had to declare bankruptcy.

2. can lift me out of the doldrums? Often a depressed person attempts to lift his mood by buying something new. Mr. B. realized the glitter of the new item quickly faded, and he wasn’t dealing with the real problem, but covering it over, like painting a rotting floor board.

3. is meant to spend on my children, because I’m generous,  want the best for them? Mr. V. wanted to save his children from accumulating  college debt and paid all their expenses. However, he neglected to save for himself and had to postpone retirement.

4.  is for others to handle?

Ms. W. knew in her “heart and mind” that she shouldn’t go into business with her husband.  But she did not listen to herself. When the business failed, she had to ask her son to help. He took over her finances, and she found herself in the humiliating situation of having to ask him for money.

5. requires too much discipline?

  At age 70, Ms. Q. still expected someone to bail her out as her mother did when she was a child. “Mom would open the cash register in her beauty salon whenever I asked for money.”

6. doesn’t have to be protected?

Mr. M. gave up his health insurance, betting on the odds that he wouldn’t get sick. When he became ill, his wife divorced him so she didn’t have to cover his medical bills.

7. is too frightening a matter to face?

  Mr. O. was often in a panic about his finances because he was too frightened to figure out how much he really needed to retire.

Once we recognize the psychological snafus, we can appreciate that 

the principles of money management are relatively simple.

1. Purchase what you really need.

2. Spend as little as possible to get the most.

 A woman doesn’t have to go beyond her budget to find attractive clothes. Similar styles are sold in Macy’s and Bergdorf’s.

3.Save as much as possible. No one can predict if or when an emergency will arise, and most of us want to have the option to retire.

4. Pay down debt as soon as possible.

Conclusion: Taking care of our money is an important aspect of taking care of ourselves--our health and sense of well-being. Investing time and effort in managing our money pays off in more ways than dollars.

P. S. Here is a haiku that is relevant to money management:

To finally know

the plum, use the whole heart too,

and your own nose.

  

   Onitsura (1660-1738)

It inspired me to write my own:

To counterbalance

the gross substance of lucre

seek the plump rose

 Dear Reader, I welcome your responses. Jsimon145@gmail.com

Permission & Prohibition

As humans we are dependent on obtaining permission from someone, sometimes for almost anything we do!

Permission applies to behaviors whether they relate to our bodies, our minds, our feelings or our socio-cultural behaviors.

Let’s begin with our bodies. The baby naturally puts his fingers and toes in his mouth. Understandably, he eventually learns not to.  Sucking one’s thumb is certainly not permissible after a certain age. We all learn that many bodily functions belong out of public view.

But lack of permission regarding our body can be detrimental. In his fifth decade, Mr. K. thought he was becoming deaf.  The doctor found mounds of wax were occluding his auditory canal. When his ears were cleaned, he heard very well.  He realized he had never cleaned them because his mother told him not to put anything in his ears.

Most of us learn that our feet are dirty and require no attention beyond washing. But Ms. W. suffered from foot pain and the podiatrist gave her exercises that decreased inflammation and prevented contractures of the toes. We’ve learned to diminish and regard feet as “inferior,” but they are most essential in supporting and balancing our entire skeleton and aligning our bodies.

When we fail to have permission and go against our parents, we may suffer dire consequences. On my recent vacation to Hallstatt, Austria, I learned about Saint Barbara, patron saint to the miners since the seventh century. On the mountainside many visit her prominent shrine. Barbara, a beautiful 29-year-old woman, was beheaded by her father for converting to Christianity! (Fortunately, disobeying a parent doesn’t often lead to this extreme!)

Undoubtedly, we grow up without permission to accept our feelings. We often hear a parent say to a child, “Don’t be sad. Don’t cry.” Rarely does time or opportunity allow an exploration of why the young person should or shouldn’t be sad.

In psychotherapy the client gains permission to experience all feelings and thoughts, to understand them and to figure out what to do with them. Obviously not all thoughts and feelings are appropriate to express or act upon.

A big lesson in life is having permission to make mistakes. Years of schooling teaches us that mistakes lower our grades. But in the real world, we learn a lot from making mistakes. A classic example is the experience of Dr. Alexander Fleming, who discovered the earth-altering antibiotic penicillin, when his Petri dish became accidentally contaminated by a mold.

Regarding permission and socio-cultural practices, examples are almost endless.  Mr. R. grew up in a country where the fish head was considered the most tasty part of the anatomy. In the U.S. he met people who wouldn’t eat this food unless it was thoroughly cleaned.

Conclusion: Re-examining our behaviors regarding permission and prohibitions in the realm of body, mind (belief systems), feelings and socio-cultural practices can be beneficial to our health and well-being.

Dear Reader, I welcome your comments. Jsimon145@gmail.com.