LoveLink Podcast

I was featured on LoveLink's podcast and we talked about how I apply a trauma-informed approach to working with couples. I think it turned out pretty good, but let me know what you think. 

The Truth about Trauma Work

I was working with a couple terrorized by demons of severe trauma experienced as children, re-inflicted on each other. They lashed out at each other trying to cause as much pain on the other as they felt themselves. 

And I dove in head first with barely a safety line in tow. 

Utterly uncertain that I would be effective or helpful. 
In a zone. Half unconscious. 
Trying desperately, 
using everything I've learned, making stuff up along the way. 
Tracking them to see what worked; 
stabbed with pangs of regret and doubt when it didn't. 
Moving in and out of panic and beautiful poignancy. 

The session focused on de-escalating the husband, he with a history of violence, while
monitoring the fear and the fury in her eyes who suffered the violence. 
Trying to stay empathic to his pain, while
not forsaking the pained by pushing him
to acknowledge the pain he has caused. 
He moved between ferocious disappointment that everyone let him down and his unbearable shame that he in turn disappointed others in ways nigh unforgivable. 

My heart ached for him. 
Holding both his suffering and his crime was unbelievably difficult
and only possible for me because of the painful work
of accepting my own crimes and broken parts. 
It triggered in me a deep sense of sadness, shame, acceptance, and  compassion. 
Then tenderness, for both of us. 

I stayed with him, 
brushing aside the hurtful parts, mining for the hurt. 
Digging barehanded for shrapnel lodged in his heart, without anesthesia. 
Phantom pain from my own shrapneled heart burning in resonance. 

When something did work, it didn't feel like I could take credit. I'm so aware of how often the very same acts fail with someone else or in some other moment. The only conclusion I come back to again and again leaves me with a deep gratitude for the angel of therapeutic healing that blessed us that day and for the courage of my patients who grace us to co-create these magical moments greater than anything we could imagine or will alone. 

*shared with permission

two brothers learn to feel and heal

Yesterday i met with two young school-age brothers, whose mom brought them in so they can learn to get along better and stop fighting. I’ve met with them separately and the older one says he likes to hurt and tease his little brother because the little brother is annoying and makes up lies to get the older one in trouble. The younger one wishes that they would get along better but he feels like the older brother doesn’t like him and hurts him so he has to get revenge to make him stop and to hurt him back. 

The boys come in a little silly and aggressive with each other. They are huge, burly young boys dripping with testosterone. Last session, the younger made up this joke: whenever we said something that made him feel proud, he said, “I can feel my chest hairs growing!” I imagine them as bear cubs wrestling in the wild. The mother does a great job of keeping their energy in check and to my surprise these boys have always been able to sit through entire therapy sessions and stay engaged in conversation, a feat that I rarely see from school age children. 

We review that the purpose of today's session is to help them learn to get along better. Mom brings up an example from last weekend: the younger one had a baseball bat. The older one chimes in and says that the younger one was swinging the bat. The younger one denies swinging it; he was just holding it. The older one gets frustrated with the lying and they start going back and forth. 

We try to move past this by continuing with the story. The older one continues, saying that he was holding a large stuffed animal as a shield. The younger one interrupts, “It wasn’t that large." The older one gets agitated again, so we try to hurry on, knowing that this won’t get us anywhere. 

The older one says that the younger one then hit him in the knuckle and showed me the bruise. He’s getting really agitated and accuses the younger one of doing it on purpose. The younger one vehemently denies it and goes back to saying that he didn’t swing the bat. This makes the older one even more livid and the moment is escalating. 

I stop them from going back and forth about what exactly happened and ask the younger one what he is feeling. He takes this seriously and reflects for a while, which is so amazingly adorable because it shows how mature and willing he is to think about his emotions and it shows how much good parenting he must have received to want to access these feelings. The older one is capable of this too, by the way. 

Nevertheless, he can’t come up with anything. I ask if I can offer some ideas. He nods. 

I ask, “Do you feel bad?” 

“Yes”

“Why? Because you hurt your brother?”

“Yes”

“What should you do when you feel bad about hurting your brother?”

“…say I’m sorry?”

“Yeah!”

“But, I already did!”

The older brother cries out, “No, you didn’t! You never said you were sorry and you never feel bad!” 

Mom tries to jump in saying that she thinks she heard the younger one apologize, but she wasn’t in the room to hear it actually. 

I’m trying desperately to figure out how to move away from this back and forth quibbling, which all people get mired in.

I recenter back into what’s happening now and try to figure out why the older is mad right now. I say to him, “You know what I think is going on?” He gives me his attention. Another adorable hallmark of attachment security and willingness to de-escalate. “I think that just thinking about what happened and seeing your bruised knuckle is making you feel hurt again.” 

He tells me that that’s partly true but that more than anything he’s mad because his brother is lying! I love that he rebutted and clarified, because it’s such a sign of autonomy and agency, and engagement with the self-exploration. 

Then, I try to help him see that his younger brother is feeling defensive and bad so he’s trying to minimize what happened. He doesn’t care. I admit to myself that that strategy didn't work. He doesn’t want to acknowledge his brother’s experience when he’s hurt. 

So, I turn to the younger and repeat that his brother is mad and hurt right now, so what can he do to help his brother feel better. He starts by saying that his older brother needs to learn to tell the truth. His older brother gets angry and says, “He asked what YOU should do!” I nod in agreement. 

The younger one says, “Say I’m sorry?” 

The older one, whose head was down, snaps to and glares at his brother. The younger one smiles back nervously, I think. This part happened really fast, and I was in the middle of saying something like, “And that you didn’t mean it?”

The younger one says, “Yeah, that’s what I was trying to say," referring to his “lying” about not swinging the bat. 

The older one is not having it. 

I realize that I missed something and ask what just happened and why the older looked at his brother. 

The older says that the younger is lying. I disagree saying that if the older had looked at his brother while he was apologizing he would have seen that his brother was being sincere. The mother nods in agreement. 

The older continues, “But I’m getting this weird feeling on my side and I only get that feeling when I know that someone is lying to me about feeling sorry.” This is reminiscent of a breakthrough moment earlier in our work when we talked about how missing his mother when he is hurt is just something that his body naturally feels. He really liked that his body had a form of wisdom that made it okay for him to feel certain ways. 

The younger brother goes and sits on his mother’s lap. I can see that he’s upset because he opened up to be vulnerable and he was rejected. 

I realize that I was also quibbling and finally notice that the older boy has his head down. His face is reddened, and he looks sad. I ask him what he’s feeling. He doesn’t know. The younger brother chimes in, “Disappointed.” This is such a lovely acknowledgment that his apology wasn’t enough. But, the older brother lashes out, “No it’s not!"

Realizing that nothing we could say would feel good enough for this little boy, I suggest to him that he’s turning into the Hulk, which I’ve described to him in the past. I say that he’s so hurt that his Hulk is coming out to protect him and it’s making him want to be mad instead of hurt. I say, “It feels so much better to be mad than sad." 

He lightens up and agrees, “Yeah, being mad is fun! I like to hurt my brother!” 

And I think i can sense in the corner of my eye that the younger one is steeling himself for more cycles of useless vendettas, which is a realization that dawned on him last session and inspired him to want to work things out with his brother.

I interrupt the process and say, “Oh now I get it. You’re too upset to accept your brother’s apology!” 

He agrees and mumbles to himself, “I need to get the anger out.” He starts breathing deeply, clenching his fist and trying to figure out what he can punch, which is all quite adorable too because he’s acknowledging that his anger is limiting him right now and he’s taking responsibility for reducing it. 

However, I think he can do better. I tell him, “You know, I don’t think you need to get the anger out. I think you need to learn to stay in the hurt and get the hurt out.” He looks at me with a look of repulsion. 

I press on, "How can you do that?”

He says he has no idea. 

I say, “Well, you see what your brother does when he gets upset?”

“Yeah, he lies about me.”

“No, not that. He goes to sit in your mom’s lap.” She’s still holding the younger one lovingly in her lap. 

He looks up with another look of repulsion, like he’s too grown to run to his “mommy." His mother reacts playfully by extending her arms out to him, suggesting she can hold both of them, but also exaggerating the gesture to acknowledge his repulsion. 

I fold an insight based on this into the next thing I say: “I think it’s tough to be the older brother. Because once your brother came around, he got all the attention and you thought you had to take care of yourself, even though that’s not true.” 

As I’m hoping would happen, his mom jumps, “Yeah that’s right. I want you to know that you can always come to me. Like remember that time you came to me and said, ‘Mom, I need some alone time with you,' and we did. We had some really special time together?” 

The boy lightens up and I can tell that he’s okay and we have run out of time. The younger one holds up his hand and the older one mirrors it. It’s hard to tell whether this is a request for a high five or a threat. They stay like this and are smiling. They resume playing, trying to work out whether they trust each other enough to close the loop of intimacy they just created. 

Running out of time, I turn to the mom to debrief about what happened and she wants to bring the boys back to do this again. As we are looking at our schedules, the older one yelps. They were still playing this strange game of brinksmanship, and the younger one had slapped the older one’s hand. The rough play that got them into this place of hurt over the weekend is happening again, but this time it doesn’t escalate into such personal pain. They move on. The mother very quickly tells them both to stop but we are both rushing to warp up. They barely register her and just move on to enjoying more rough and tumble play, wild cubs again who are not harboring resentment as they balance the limits of playful aggression and connection. 

*shared with permission

How to Perceive Others

SEEING is perceiving with the eyes. True seeing brackets preconceived notions and biases so things are seen as they really are. Like drawing shadows and contours instead of “eyes” “nose” and “mouth.”

HEARING is perceiving with the ears. True hearing listens to both the words and the prosody. It plumbs for quivers of hurt underneath the blaring of anger. 

KNOWING is perceiving with the mind. True knowing engages the heart and the mind. It wraps understanding with compassion and like-minded humanity. 

Once truth is revealed, BEARING is the greatest gift that can be given. It requires sitting in another person’s hurt and agony, feeling without becoming overwhelmed or moving to fix or solve.  

Ode to A Depressed Person

I know someone who always feels like ending her life. I told her that I admired the way she lived, which is a ridiculous thing to say. Why would anyone admire someone who is always at baseline suicidal? I tried to unpack what I meant by it and this is what came out:

You, who bears this unrelenting weight of depression,
wake every morning and ask, "Why not today
finally Rest?" 

I know for you
life drags on
despite your protestations,

but I believe that you
more than anyone else has
this remarkable opportunity
, or maybe undesired obligation,
to choose life
every
moment.

See, for you, life
is not a given, 
like the certainty of sunrise.

Every morning, you must choose,
stay or go? 
Every morning, you ask yourself, why stay?
How do I make
today
at least bearable
and possibly worthwhile? 

Then,
to see you be kind and generous and loving,
I am left concluding,
that love alone fulfills life's purpose. 

And, I am reminded that for me love is the source from
which all worthwhile things must spring
(I worry so much about how much hate drives our politics these days)

Then, I feel
reaffirmed, revitalized,
and grateful, for you, who bears this weight, 
reminding me to love and
act in all ways from love.

Testament to the courage of trauma work

Everyday I'm grateful for the chance to share my patients' journeys to overcoming so much and claiming their lives as their own, free from history and fear. This time the work has been put down on paper in the form of a memoir that documents one person's entire history of abuse and recovery. He was so afraid and ashamed to share it, yet it was one of the most powerful acts of healing he could have ever experienced, and it has touched the life of others in a way that he could never have imagined. Talk about turning tragedy into triumph. 

The last part of the book includes scenes from our sessions together, which is always hard, like listening to and disliking your voice when you hear it played back. But, I take a step back from this self-consciousness and stand in amazement and pride at what we accomplished in the journey of our work together. 

I feel it would be too self-promotional to tell everyone to go out and buy the book (like saying, "Look how great I am," which I'm clearly not), so suffice it to say that I think it could be an inspirational read for anyone who has lost hope or doesn't believe that things can ever get better.

I also have to qualify with a trigger warning: the first few chapters go into detail about childhood abuse and can be hard to get through. It was for me at least. 

Grandson of a Ghost: A Suicide's Secret Aftermath

By Scott Depalma

Buy on Amazon

Today's Touching Family Moment

Today a man,
who just months ago
was unsure
whether he wanted family therapy
(at least with me)
then only wanted to work on problem solving,
then only wanted to intellectualize,

finally cried
about missing his father,
grieved the imminent loss of his favorite uncle,
and shared how he suffers
a desperate longing
to connect
with his teen-age son
(who can't make sessions
because of other commitments).

And his wife and daughter
leaned into his pain
with tears in their eyes,
not talking,
not problem solving,
only conveying
love
and gratitude.

And I too honestly
felt moved
like listening to Adele
or singing Karaoke :-) 

And I reassured the father
that this new man
will draw his son
inexorably
like love
is wont to do.

Being a Good Listener, the Key to Being a Good Therapist

Wow, I just watched a video by The School of Life that captures 80% of what I have taken so long to learn in my journey to become what I feel is a good therapist: a good listener. I've never heard anyone else articulate the essential ingredients of good listening so concisely and so in line with the things I've had to learn on my own through hundreds of hours of practice. I'm embedding the video at the bottom.

Here is a summary of the key points: 

1. Encourage people to elaborate their point, instead of responding with your own story, because most people don't know quite what they are trying to say and need to talk it out to pinpoint it; and keep the speaker's history in mind as you listen to new information and connect it all, so they make new insights and feel deeply heard. 
2. Urge clarification about why someone feels a certain way to help them understand their own life themes and values and definitely don't move to reassurance and advice giving too quickly.
3. Don't moralize and judge; instead, respond with small sounds of sympathy and reassurance. Realize that we are all weak and vulnerable in some way. Warm to vulnerability, instead of rejecting it.
4. Separate disagreement with hostility. Invite or at least allow for disagreement in the relationship to show that people don't always have to agree to remain in relationship with each other. (This one isn't as often used as a therapist but sometimes it does happen). 

In my thinking, I've been summarizing good listening as Compassionate Curiosity, a nonjudgmental empathic desire to keep learning more and more about a person that can only happen through explicit intention, bracketing of judgement and willingness to identify the hidden virtues and values behind embarrassing and shameful emotions that block true exploration. So very similar!