Sunday, November 27, 2011


Being a "thinker" is, for the most part, a positive quality.  Careful consideration about what's going on in the world around you results in improved decision making.  As with most things in life, however, thinking too much can create problems.  Most of us have, at some point, probably commented or heard someone else remark, "I think I'm over-analyzing the situation" or "I'm probably just over-thinking this."

So what is analytical thinking?  Mary Blast, PhD ( describes it as "understanding a situation by breaking it apart into smaller pieces, or tracing the implications of a situation in a step-by-step causal way."  She states that, among other things, analytical thought includes setting priorities, recognizing several likely causes of events, identifying likely consequences of an action, anticipating obstacles, and thinking ahead to one's next steps.

What does it mean to "over-analyze?"  In my opinion, analysis crosses the line to over-analysis when it turns into rumination.  The purpose of analysis is to gain a clear understanding of a problem or issue with the ultimate goal of developing solutions to a problem or identifying effective ways to approach or cope with an issue.  In other words, the process of analysis should eventually lead to 1. Clearer understanding of a problem or situation and 2. Possible answers, solutions, approaches, etc. to the issue under consideration.  If thinking about a problem's possible causes, consequences, etc. makes the problem less clear and makes you feel more confused about it then you can be fairly certain that you are over-analyzing it.  If considering how to approach a given situation causes you to become so overwhelmed that you are unable to act then you can be sure you are over-thinking things.  If contemplating the implications of a particular issue leads you to conclude that you have absolutely no control over the situation or its outcome but you continue to contemplate them again and again anyway, you are no longer engaging in productive thought; you are ruminating.

When dealing with a problem, concern, etc., there comes a point when the best thing to do is to stop thinking about it; you know you have reached that point when thinking about it ceases to be productive and begins to make you feel anxious, upset, or depressed.

I'll give you a personal example of how this can play out.  Lately I've been spending a lot of time thinking about my finances and planning for my long-term financial security.  I finally became eligible for my company's 401k plan about a month ago.  Now that I'm contributing 10% of every paycheck to my retirement account I've had to adjust the amount I'm able to spend and save.  It didn't take long to realize that I don't have a lot of money left over for leisure spending.  I've considered several possible ways to free up some more money.  I've looked into refinancing my mortgage at a lower interest rate; I discovered that I don't qualify for any of the government refinancing programs and don't have enough equity in my home to do it through the bank that owns my mortgage. I am currently exploring other options.  I've thought about increasing the deductibles on my health and auto insurance policies - which would only cost me more if I had a health or automobile emergency - in order to decrease my monthly payments.  I haven't reached a firm decision on whether or not to do it.

All of these ideas and decisions are a result of productive analysis of my financial situation.  Thinking about my finances is not, however, always a productive endeavor.  Here's an example of what goes through my mind when I'm engaging in unproductive thought:

Man, I hardly have any money left from this paycheck.  But at least I'm putting a lot of money away for the future.  Plus, when [my husband] finishes his master's degree he'll get a good job and be able to help out more.  But what if he can't find a job?  I can't pay all the bills by myself AND save for the future.  Plus, I want to eventually have a kid.  What if it takes him so long to find a job that I'm too old to have a kid by the time we can afford it?  Would I still be able to lead a happy life if I never have a child?  Will we end up becoming two lonely old people with no one to visit us?  Wait, will we even be able to afford to retire?  I'M saving money for retirement but he hasn't started yet.  I don't think my money will be enough to take care of both of us.  Man, am I going to have to keep working until I'm 80 years old?  Well, I might as well.  It'll keep me from feeling so lonely when we have no one to come visit us...

By this time I've usually started to feel anxious and depressed.  I also feel helpless because I have absolutely no control over how long it will take my husband to find a decent paying job when he graduates in May.  He may not even have that much control over it.

So I tell myself not to think about it.  I push it from my mind and find something else to occupy my attention. Of course, these thoughts eventually creep back up again, but I do my best not to indulge them.  They are just thoughts.  Like all thoughts, if I don't grab onto them they will come and then go.  If I label them as thoughts and refuse to accept them as truth then they will not have the power to make me anxious and unhappy.

So that's it.  Being a "thinker" is mostly an asset.  The problem with us thinkers is that we sometimes get carried away by our thoughts.  It is important to keep in mind that thoughts are just thoughts.  When they cause us to suffer, we can choose to let them go.

Sunday, November 20, 2011

Why do we keep re-enacting the past?

Human beings have a tendency to re-enact their pasts that seems almost compulsory.  People who are physically abused as children are more likely to abuse their own children or to later marry a physically abusive partner.  Boys who are sexually abused as children are at an elevated risk for sexually abusing others as they get older.  Girls who are sexually abused as children have a greater risk than others of becoming strippers or prostitutes.  A girl with an alcoholic father is more likely as an adult to marry an alcoholic man.  A boy with an alcoholic father has a higher risk of becoming an alcoholic himself.  Women who have been sexually assaulted as teenagers or adults have an elevated risk of future sexual assaults.

This is the stuff of therapy.  Unfortunately, the negative patterns people repeat or re-enact over and over again in their lives can be extremely resistant to change.  This is particularly true for patterns that developed as a result of early childhood life experiences.  The foundations of personality are laid down and solidified during childhood.  Any sort of traumatic experience (even something like being repeatedly criticized by a parent or having a parent who never shows affection) that occurs during this time becomes woven into the very fabric of an individual's personality.  It becomes part of who they are.

This can be exceedingly frustrating for therapists.  It is very difficult to work with a patient who continues to repeat the same problematic behaviors despite recognizing the negative impact they have on their lives (and on the lives of those they love).  It's easy to conclude that the person doesn't want help or doesn't want to change.  I've had a few patients like this over the years.  I eventually concluded that they needed a more experienced or more competent therapist.  I just reached a point where I'd tried everything I could think of and I didn't know what else to do.

I can also recall several instances in my own life when I knew I shouldn't take a particular course of action -- knew I would regret it later -- but did it anyway.  It's almost as if, for those moments, logic and reason simply didn't matter to me.  I can't say that reason abandoned me -- I can clearly recall thinking to myself that whatever I was about to do was a bad idea and that I shouldn't do it.  But there was something else -- some sort of pull -- that was stronger than reason.  It was that pull that led me to decide, "I know it's bad for me but I'm going to do it anyway."

I think that is what is must be like for those of us who repeat the same negative patterns of behavior over and over again.  There is some sort of pull that compels us to do these things, despite knowing that there will be undesirable consequences.

My issue was that in the course of looking for a committed romantic relationship, I repeatedly became involved with men who had "commitment issues."  It was never done intentionally; remember, I was looking for a committed relationship.  When I became interested in someone it was not usually readily apparent that this person had problems with commitment.  It was only after we became involved that the commitment issues became apparent.  Even so, I would remain in the relationship, always against my better judgment and always to my personal detriment.

Despite all the personal growth and self healing I was able to achieve, I never really "resolved" this issue.  When I met my husband he initially indicated that he was looking for a committed relationship.  About a month after we started dating he changed his mind; he needed to focus on getting his life together first.  Despite knowing this, I continued to see him maybe twice a week for several months.  Eventually, he worked through some of the problems he was having and told me he was ready to be serious.  So I never really stopped getting involved with "unavailable" men; I just happened to get lucky.

The point is, if I couldn't stop my own self-destructive behavior patterns, how can I help someone else stop theirs?  Whenever I have a patient who presents with repeated self-destructive behaviors I end up feeling powerless to help them and completely defeated.  I keep working with them and trying to help but I never really feel like I'm accomplishing anything.

In theory, however, just being there to listen without being judgmental, to validate the patient's feelings, and to accept that person exactly as he is -- is, in fact, helpful.  ("It feels like what I do with my friends," I always say to myself.  "How can it be therapy?").

Author David Wallin ( explains why this kind of mindful presence is therapeutic.  "If our early involvements [with our parents or primary childhood caregivers] have been problematic, then subsequent relationships can offer second chances, perhaps affording us the potential to love, feel, and reflect with the freedom that flows from secure attachment.  Psychotherapy, at its best, provides just such a healing relationship."

When I think about it, maybe that's what all of us who repeatedly engage in the same problematic behaviors need - a second chance relationship.  Maybe my husband is that second chance relationship for me.  And maybe for my patients I can provide that second chance...

Sunday, November 13, 2011


We don't often admit it, but all therapists have patients they don't like very much.  It's usually a relatively infrequent occurrence.  Over time, however, a pattern tends to become apparent; for an individual therapist, there is a certain "type" of patient that consistently evokes a negative response.

Personally, I have trouble working with patients who excessively and consistently complain about their problems but show no real interest in making any changes.  They often respond to feedback or suggestions with a litany of reasons why these ideas won't help them.  They frequently fail to attempt any therapeutic strategies in between sessions, despite my encouragement.  Sometimes, they insist that they only way to make things better is to change the circumstances in their external environment.  Inevitably, these are circumstances over which they have absolutely no control.  I fairly consistently point out that they have no control over this particular aspect of their external environment but suggest that they can learn to cope with it more effectively.  Usually, this makes them angry.  I find this exceedingly annoying.  I just don't think there is anything to be gained from repeatedly complaining about circumstances you can't change.

One of my coworkers recently gave a brief presentation on countertransference that made me start to think about how I react to certain patients.  Countertransference refers to any emotional response on behalf of a therapist that stems from his or her therapeutic interactions with the patient.  The idea is that a therapist's emotional reactions to a patient frequently have to do with the therapist's own unresolved issues.  Instead of being annoyed with the patient for causing a negative emotional response, the therapist should look at herself to figure out why she is reacting the way she is.

Honestly, I can't tell you why this one particular type of patient bothers me so much, at least not yet.  I did, however, find a good suggestion for dealing with my countertransference by a psychologist named Dr. John Martin (  When dealing with a patient who triggers strong emotions, Dr. Martin suggests setting aside one full session with that patient to pay attention to myself.  In other words, I should avoid any challenging or deep conversations during that session so that I can pay attention to what I am thinking and how I am feeling.  Specifically, I should notice my feelings about my interactions with the patient (e.g., How do I feel about what I say to the patient?  How do I feel about how he/she responds to what I say?, etc.) and about my relationship with the patient overall.  As my feelings change throughout the session, I should try to notice what is happening to the patient's behavior.  After the session, I should ask myself, "How am I contributing to the dysfunction in my relationship with this patient?"

It's funny how things always seem to point back to mindfulness.  It seems to offer a solution (or at least an approach) to every negative thought, feeling, behavior, or situation that life presents.  Dr. Martin doesn't call his approach to countertransference "mindfulness," but that is exactly what it is.  Giving my nonjudgmental attention to my emotions as they arise will make me less reactive to them.  Dr. Martin offers this as a technique that will prevent me from being drawn into a patient's "emotional drama."

Sunday, November 6, 2011

Self growth

I consider myself to be a relatively self aware person.  Over the years, I have engaged in a lot of self-analysis, soul searching, and self reflection in an effort to understand what my problems are and to figure out how to deal with them.  I spent a lot of time learning to like myself as a person.  I taught myself not to immediately act on feelings of insecurity or jealousy, which ultimately led to me having fewer feelings of insecurity and jealousy.  I learned how to portray self-confidence (even though I didn't feel self confident), which eventually generated feelings of confidence.  I learned to listen when someone gives me negative feedback and to avoid becoming so defensive that I am unable to consider the validity of what I'm being told.  I learned to accept responsibility for my role in a conflict, even if part of me clings to the need to be right.  I learned to say no and set limits as needed.  I started forgiving myself for making mistakes.

When I compare how I used to be to the way I am now I think to myself, "Wow.  I've come a LONG way."  I worked hard to become a better, happier person.  I experienced a lot of emotional pain but I grew from it.  When I consider how far I've come I feel proud.

And then I got married.  A romantic relationship is, without a doubt, the best context for personal growth to occur.  In my opinion, personal growth has to occur for a relationship to be a satisfying one.  Why are romantic relationships so uniquely suited for self growth?  Because while these are the relationships that typically bring out the best in us, they are also the relationships that are guaranteed to bring out the worst in us.

Think about it.  What other relationship makes you feel as vulnerable as a romantic one?  What other relationship so consistently triggers your insecurities?  And who besides your romantic partner is likely to be as forthcoming with you about the not-so-pleasant parts of your personality?  A romantic partner typically spends more time with you than anyone else; he or she will notice things about you that others never have the opportunity to see.

Needless to say, my new marriage has provided innumerable opportunities to re-examine myself.  I firmly believe that people should always seek to know and understand themselves and should always be willing to grow.  These are lifelong endeavors.  Still, it's been really difficulty for me to re-examine the way I do things yet again and make changes.  I suppose that because I'd only just reached a point where I was satisfied with who I am I wanted to sit back and enjoy it for a while.

For years I've devoted so much time and energy into learning to love and accept myself.  Maybe I'm just tired.  Yet I can't stop.  I have to learn to accept things about my husband that sometimes drive me crazy.  That might require me to consider why something that is relatively unimportant bothers me so much.  Then there are the things that bother my husband about me that I never really saw as a problem before.  Some of these my husband will have to learn to accept; others I will have to work on changing.

So now is really not the time to sit back and enjoy my hard-earned self-esteem.  Maybe I was kidding myself anyway, to think you ever reach a point where it's ok to stop growing, even for a little while.

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