psychology notes.

This site was originally created in 2009 as a virtual repository for all of the various psychology and therapy-related things (quotes, articles, videos, music, pictures) I came across both online and in my work as a psychotherapist. It has morphed into something slightly different in the past four years, and is now perhaps slightly more outward facing, but is still at heart a place for me to collect and share things related to the life of the mind.


Disclaimer: Posting something to this site does not mean that I necessarily agree with or endorse the opinions being expressed therein. All text on this site is informational and for educational purposes only. This site is not meant to be a substitute for professional mental health or medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified mental health provider with any questions regarding a medical condition or mental health issue. Do not disregard professional medical advice or delay in seeking it because of something you have read on this site.


And please, be kind to one another.


There is more to life than increasing its speed.
Gandhi

“For me, language is a freedom. As soon as you have found the words with which to express something, you are no longer incoherent, you are no longer trapped by your own emotions, by your own experiences; you can describe them, you can tell them, you can bring them out of yourself and give them to somebody else. That is an enormously liberating experience, and it worries me that more and more people are learning not to use language; they’re giving in to the banalities of the television media and shrinking their vocabulary, shrinking their own way of using this fabulous tool that human beings have refined over so many centuries into this extremely sensitive instrument. I don’t want to make it crude, I don’t want to make it into shopping-list language, I don’t want to make it into simply an exchange of information: I want to make it into the subtle, emotional, intellectual, freeing thing that it is and that it can be.”

Jeanette Winterson

by Ryan Howes

Most people enter therapy wanting something. They seek relief from debilitating symptoms. They want help making a life-changing decision. They long to heal past hurts. Couples need tools for communication. Some want better self-control. Others search for the ability to reach their potential. The list goes on.

If their therapy has the right formula of therapeutic competence, perseverance, compatibility, and good fortune, those individuals will likely reach those goals. They’ll learn what they need to learn, internalize the therapist’s message or voice, and charge into the next challenges of their life.

But many people find that therapy also provides some unexpected benefits. When they leave, they realize they’ve gotten more than they bargained for—sort of a bonus for engaging in the experience. Here are four unexpected benefits of therapy I’ve seen in my own practice:

Depth: In polite society, we’re accustomed to having mundane conversations revolving around the weather, bullet points from work, some celebrity/sports highlights, and the story we just heard on NPR or Fox News. We skip along the surface because doing so is safe and universally accepted. Therapy pushes beyond the superficial to deeper introspective questions of personal experience, historical precedents, deep feelings, and drives—a variety of topics that would never end up on a Facebook status update. When people realize talking on this level is not just interesting, but also productive and healing, they want to recreate this depth in other relationships.

Empathy: It’s kind of ironic: The majority of people come to therapy wanting to understand their own problems and why other people impact them the way they do. But once they delve into their own issues, they discover insights that help them understand their lovers, their friends, their co-workers, and their bosses on a whole new level. A light bulb goes off and they may think, “Oh, that person’s worst experience was when he was abandoned by his dad. I understand why he reacted so strongly when I bailed on our plans.” People often learn to understand the people who inhabit their lives nearly as much as they understand themselves. Or maybe they become curious and ask a few more questions, which leads to this deeper understanding.

Contagion: I can’t count the number of individuals who came to therapy to learn more about themselves and before long, their friends were interested in finding their own therapist. It happens all the time. People feel empowered and excited about growing. Their mood, attitude, and/or behavior changes, and their friends are intrigued. Occasionally, individuals in an entire friend circle will seek their own help and everyone relates on a deeper, more functional level. Fixing your friends is not a reason to seek therapy, but it sure can be rewarding when this is the outcome.

Listening: When a person spends significant time with a professional listener, that person often develops the ability to listen. They sit for many hours with someone who keeps eye contact, pays attention, and indicates reflecting or recalling past information. People in therapy know how good it feels to be on the receiving end of that kind of attention and are more likely to replicate that for their loved ones. They’ve reaped the benefits of close focused attention, had it modeled for them, and can now show it to others.

At the risk of sounding too pro-therapist, the common thread here is that therapy helps people learn to adopt some basic therapeutic characteristics. They learn to talk on a deep level, to empathize with others, to discover the thrill of self-knowledge, and to listen well. This is to be expected, as we humans often take on the characteristics of the people we spend time with, from attitudes to behaviors to communication styles.

Like I said, these are the bonuses of therapy. The main objective is helping people relieve their symptoms and underlying issues. But if they can resolve their problem while becoming better listeners and empathizers with an ability to discuss deep issues in a way that positively impacts their inner circle, what’s the problem?

Sounds like a bonus to me.

Ryan Howes, PhD, ABPP, is a clinical psychologist in Pasadena, California, the founder of National Psychotherapy Day sponsored by GoodTherapy.org, and a writer for the Psychotherapy Networker Magazine.

by Julie Beck

Laughter is the best medicine, or so the cliché goes. Actually, given the choice between laughter and, say, penicillin or chemotherapy, you’re probably better off choosing one of the latter. Still, a great deal of research shows that humor is extraordinarily therapeutic, mentally and physically.

Laughing in the face of tragedy seems to shield a person from its effects. A 2013 review of studies found that among elderly patients, laughter significantly alleviated the symptoms of depression [1]. Another study, published early this year, found that firefighters who used humor as a coping strategy were somewhat protected from PTSD [2]. Laughing also seems to ease more-quotidian anxieties. One group of researchers found that watching an episode of Friends (specifically, Season Five’s “The One Where Everybody Finds Out”) was as effective at improving a person’s mood as listening to music or exercising, and more effective than resting [3].

Laughter even seems to have a buffering effect against physical pain. A 2012 study found that subjects who were shown a funny video displayed higher pain thresholds than those who saw a serious documentary [4]. In another study, postsurgical patients requested less pain medication after watching a funny movie of their choosing [5].

Other literature identifies even more specific health benefits: laughing reduced arterial-wall stiffness (which is associated with cardiovascular disease) [6]. Women undergoing in vitro fertilization were 16 percent more likely to get pregnant when entertained by a clown dressed as a chef [7]. And a regular old clown improved lung function in patients with chronic obstructive pulmonary disease [8]. More generally, a mirthful life is likely to be a long one. A study of Norwegians found that having a sense of humor correlated with a high probability of surviving into retirement [9].

Unfortunately, there’s a not-so-funny footnote to all this: the people who are best at telling jokes tend to have more health problems than the people laughing at them. A study of Finnish police officers found that those who were seen as funniest smoked more, weighed more, and were at greater risk of cardiovascular disease than their peers [10]. Entertainers typically die earlier than other famous people [11], and comedians exhibit more “psychotic traits” than others [12]. So just as there’s research to back up the conventional wisdom on laughter’s curative powers, there also seems to be truth to the stereotype that funny people aren’t always having much fun. It might feel good to crack others up now and then, but apparently the audience gets the last laugh.

What psychoanalysis, at its best, does is cure you of your wish to know yourself in that coherent, narrative way. The trouble is that we use knowing in bits of our lives where it doesn’t work, or where it’s actually not the point.
Adam Phillips
Are we measuring basic facts about children? Or basic facts about rich kids?

by Jane Hu

Living in the San Francisco Bay Area for the past few years, I’ve gotten used to lots of things that would probably seem strange in other cities. Commuting on a unicycle? Sure. Rampant midday nudity? Everywhere. Vegan dinner fundraiser for your Burning Man art car? Of course. So I hardly bat an eye when a 4-year-old says, “My favorite food is edamame.”

As a developmental psychologist, I test children to learn basic facts about kids, such as how they learn language, navigate social interactions, and gain knowledge. These things seem like they should work about the same way for any young human. But there is growing evidence that the timing and efficiency with which children learn these general skills vary a lot based on experience. A huge amount of a child’s early life experience is determined by the family’s socioeconomic status—how wealthy and educated the child’s parents are. The edamame-loving professors’ kids I’ve been testing are unlikely to be representative of an average child, or even an average American child.

There’s a term to describe the types of people who participate in most social science studies: WEIRD. They are weird in the sense that they are unusual compared with most of the world’s population, but WEIRD is also an acronym describing the white, educated, industrialized, rich, and democratic culture they come from. A trio of psychology professors coined this term in a 2010 paper, pointing out that fields studying human behavior often use participants who are “Western, and more specifically American, undergraduates.”

(full story here)

US goalkeeper Tim Howard, who had a record-setting World Cup game today (despite the unfortunate 2-1 loss to Belgium), has been dealing with Tourette’s syndrome and OCD issues since childhood. This article and accompanying video details Howard’s struggles and his continuing efforts to inspire others and dispel the myths and ignorance around TS and associated disorders:

"The United States goalkeeper in his third World Cup doesn’t mind being asked about Tourette’s syndrome, a neurological disorder he has suffered from since childhood.

In fact, despite it being cruelly used to single him out early in his career he welcomes the inquiry and embraces the condition, proud of having controlled it and determined to raise awareness for the benefit of others afflicted.

He might be the most ideal ambassador for a cause that you can imagine, living proof that those with Tourette’s are normal people with the potential to be exceptional. And, with a brush of humor, he dispels the myth that it is simply a condition that makes you swear a lot.

"You know, we don’t all curse," smiled Howard, in an exclusive interview with Yahoo Sports. "I do on the field, unfortunately, to get my point across, but it’s not because of my condition.

"It’s defined as involuntary motor tics, twitches if you like. Some of it is blinking, clearing my throat, different muscle tensing of different body parts. Unfortunately it’s misconstrued and portrayed in a comical way, particularly in Hollywood and movies and stuff." "

Knowledge is important, but only if we’re being kind and gentle with ourselves as we work to discover who we are.
Brene Brown, The Gifts of Imperfection

by Mark Epstein

Talking with my 88-year-old mother, four and a half years after my father died from a brain tumor, I was surprised to hear her questioning herself. “You’d think I would be over it by now,” she said, speaking of the pain of losing my father, her husband of almost 60 years. “It’s been more than four years, and I’m still upset.”

I’m not sure if I became a psychiatrist because my mother liked to talk to me in this way when I was young or if she talks to me this way now because I became a psychiatrist, but I was pleased to have this conversation with her. Grief needs to be talked about. When it is held too privately it tends to eat away at its own support.

“Trauma never goes away completely,” I responded. “It changes perhaps, softens some with time, but never completely goes away. What makes you think you should be completely over it? I don’t think it works that way.” There was a palpable sense of relief as my mother considered my opinion.

“I don’t have to feel guilty that I’m not over it?” she asked. “It took 10 years after my first husband died,” she remembered suddenly, thinking back to her college sweetheart, to his sudden death from a heart condition when she was in her mid-20s, a few years before she met my father. “I guess I could give myself a break.”

I never knew about my mother’s first husband until I was playing Scrabble one day when I was 10 or 11 and opened her weather-beaten copy of Webster’s Dictionary to look up a word. There, on the inside of the front cover, in her handwriting, was her name inscribed in black ink. Only it wasn’t her current name (and it wasn’t her maiden name). It was another, unfamiliar name, not Sherrie Epstein but Sherrie Steinbach: an alternative version of my mother at once entirely familiar (in her distinctive hand) and utterly alien.

“What’s this?” I remember asking her, holding up the faded blue dictionary, and the story came tumbling out. It was rarely spoken of thereafter, at least until my father died half a century later, at which point my mother began to bring it up, this time of her own volition. I’m not sure that the trauma of her first husband’s death had ever completely disappeared; it seemed to be surfacing again in the context of my father’s death.

Trauma is not just the result of major disasters. It does not happen to only some people. An undercurrent of trauma runs through ordinary life, shot through as it is with the poignancy of impermanence. I like to say that if we are not suffering from post-traumatic stress disorder, we are suffering from pre-traumatic stress disorder. There is no way to be alive without being conscious of the potential for disaster. One way or another, death (and its cousins: old age, illness, accidents, separation and loss) hangs over all of us. Nobody is immune. Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific advancement, outside our ability to control it.

My response to my mother — that trauma never goes away completely — points to something I have learned through my years as a psychiatrist. In resisting trauma and in defending ourselves from feeling its full impact, we deprive ourselves of its truth. As a therapist, I can testify to how difficult it can be to acknowledge one’s distress and to admit one’s vulnerability. My mother’s knee-jerk reaction, “Shouldn’t I be over this by now?” is very common. There is a rush to normal in many of us that closes us off, not only to the depth of our own suffering but also, as a consequence, to the suffering of others.

When disasters strike we may have an immediate empathic response, but underneath we are often conditioned to believe that “normal” is where we all should be. The victims of the Boston Marathon bombings will take years to recover. Soldiers returning from war carry their battlefield experiences within. Can we, as a community, keep these people in our hearts for years? Or will we move on, expecting them to move on, the way the father of one of my friends expected his 4-year-old son — my friend — to move on after his mother killed herself, telling him one morning that she was gone and never mentioning her again?

IN 1969, after working with terminally ill patients, the Swiss psychiatrist Elisabeth Kübler-Ross brought the trauma of death out of the closet with the publication of her groundbreaking work, “On Death and Dying.” She outlined a five-stage model of grief: denial, anger, bargaining, depression, acceptance. Her work was radical at the time. It made death a normal topic of conversation, but had the inadvertent effect of making people feel, as my mother did, that grief was something to do right.

Mourning, however, has no timetable. Grief is not the same for everyone. And it does not always go away. The closest one can find to a consensus about it among today’s therapists is the conviction that the healthiest way to deal with trauma is to lean into it, rather than try to keep it at bay. The reflexive rush to normal is counterproductive. In the attempt to fit in, to be normal, the traumatized person (and this is most of us) feels estranged.

While we are accustomed to thinking of trauma as the inevitable result of a major cataclysm, daily life is filled with endless little traumas. Things break. People hurt our feelings. Ticks carry Lyme disease. Pets die. Friends get sick and even die.

“They’re shooting at our regiment now,” a 60-year-old friend said the other day as he recounted the various illnesses of his closest acquaintances. “We’re the ones coming over the hill.” He was right, but the traumatic underpinnings of life are not specific to any generation. The first day of school and the first day in an assisted-living facility are remarkably similar. Separation and loss touch everyone.

I was surprised when my mother mentioned that it had taken her 10 years to recover from her first husband’s death. That would have made me 6 or 7, I thought to myself, by the time she began to feel better. My father, while a compassionate physician, had not wanted to deal with that aspect of my mother’s history. When she married him, she gave her previous wedding’s photographs to her sister to hold for her. I never knew about them or thought to ask about them, but after my father died, my mother was suddenly very open about this hidden period in her life. It had been lying in wait, rarely spoken of, for 60 years.

My mother was putting herself under the same pressure in dealing with my father’s death as she had when her first husband died. The earlier trauma was conditioning the later one, and the difficulties were only getting compounded. I was glad to be a psychiatrist and grateful for my Buddhist inclinations when speaking with her. I could offer her something beyond the blandishments of the rush to normal.

The willingness to face traumas — be they large, small, primitive or fresh — is the key to healing from them. They may never disappear in the way we think they should, but maybe they don’t need to. Trauma is an ineradicable aspect of life. We are human as a result of it, not in spite of it.

Mark Epstein is a psychiatrist and the author, most recently, of the forthcoming book “The Trauma of Everyday Life.”

"Our wisdom is all mixed up with what we call our neurosis. Our brilliance, our juiciness, our spiciness, is all mixed up with our craziness and our confusion, and therefore it doesn’t do any any good to try to get rid of our so-called negative aspects, because in that process we also get rid of our basic wonderfulness."

—Pema Chodron