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Talk Therapy: Sane or Satanic?

I touched a nerve with my post about the pros and cons of the therapist taking the patient through the same things over and over again. They didn’t slam my perspective outright, nor would they. But they flagged some dangers in this technique that are important to share.

Mood music:

[youtube=http://www.youtube.com/watch?v=EZzus86pdls&fs=1&hl=en_US]

What makes their feedback so valuable is that they are therapists themselves. The following responses came my way by way of the LinkedIn NAMI group’s discussion board.

Thanks for sharing, my friends. Readers: See what they have to say and do what you will with the knowledge. There’s more than one way to skin this cat, as the comments show.

First, you should watch this video, which I put in that last post, because that’s what really hit a nerve.

In one of my favorite TV series, The West Wing, Deputy Chief of Staff Josh Lyman undergoes a long, brutal therapy session:

[youtube=http://www.youtube.com/watch?v=23dBqzo2aYY&version=3&rel=1&fs=1&showsearch=0&showinfo=1&iv_load_policy=1]

Kathleen Hockey, Author, Speaker, Mental Health Professional: It seemed to me Josh already knew what happened and the therapist was forcing him to be honest about it, to the therapist and thus to himself. This is good. However, I question the therapist who forces a client to hash over and over in his/her mind things in order to get at what is not remembered. That kind of digging is questionable practice. Also, not found in the West Wing piece (for drama’s sake obviously) is that the therapist’s next step would be to help Josh change his beliefs about the traumatic event and emotionally disconnect from the experience. Talking about the painful experience incessantly without this piece does make a client relive the experience, which is not good.

Me: All valuable points, Kathleen. I agree it’s questionable to rehash things just to get at what’s not remembered. From my experience as a patient, the rehashing was (or certainly seemed to be) designed to make me be honest about things I was dismissing on first and second brush. My experience is that a good therapist always seems to tell when I’m not being honest with myself. That’s when the rehashing happens. It was helpful to me, though I didn’t like it much at the time.That said, everyone is a little different in how they’ll respond to certain tactics. Thanks for your input.

Elena Yobaccio, Private Practice as Elena Yobaccio, MA – Psychotherapist: This therapist is fairly aggressive, which makes for good drama but effective trauma therapy does not (imo should not) progress like this and can be damaging. one of the theories behind “retelling” the traumatic event is that the therapist can help ground and moderate the client’s overwhelming emotions, help them take the story in digestable chunks of whatever size, and reintegrate the impossible-to-accept story into “normal” narrative memory so that it can finally be put to rest and associated memories and emotions, while painful, are no longer interrupting and disrupting life on an involuntary basis. i personally believe this is true and that our minds and hearts will only safely “remember” when we are strong enough, and with a safe enough person–not because we are pushed into it. with that said, encouragement, support and validation are all crucial to the process.

I have worked with many, many severely traumatized patients. I have rarely actually done actual trauma therapy because i have rarely been in a position to perform it safely. i have been through poorly done trauma therapy myself, and I have seen it done well and and done poorly with peers. I do know many people who have told me they avoid seeking therapy precisely because they are afraid they are going to be rushed into a feeling state they already know they can’t tolerate. or, they think that they are going to have some kind of massive cathartic remembering that is going to “cure” them so they try to hasten the process and succeed only in retraumatizing themselves. I think these kind of dramatic reenactments make for entertaining footage but don’t really help people understand what therapy actually is and does.

In terms of relational talk therapy, the key to successful trauma processing is not just remembering, it’s repairing the flow of memory so that the “trauma” is not sitting around un-inegrated in our minds. i think of traumatic memory as kind of an iceberg with big jagged edges free-floating and tearing through the fabric of the soul and the present moment. IMO talk-therapy dealing with trauma should and can only be done by a trained professional after a very strong alliance has been built with the client to provide them with the emotional bond necessary to endure and successfully experience and transform traumatic affect.

With that said, there are also alternatives to “talk therapy” for trauma, such as CBT and EMDR, which at least some people are reporting extremely helpful for PTSD treatment. CBT has never worked well for me, but I know it works well for some and has nothing to do with “telling and retelling” – it’s all about managing symptoms such as phobias and flashbacks; not my speciality either. And I have not personally tried EMDR.

I don’t know that any of this addresses your original point about repeatedly going over old ground, I just wanted to address the TV clip which is pretty representative of how media commonly portrays therapy and trauma therapy in particular.

Me: All great points. Thanks.

Gerry Hughes, Owner, Neuro-Linguistic Learning Center: When working with trauma or PSTD, our first rule is to NOT allow the client to associate in the memories and never allow the client to re-experience the emotions of the event. That type of ‘talk therapy is hack therapy, It is outdated and I think you could make the case that it is abusive. It is the very reason most sane people avoid therapy. 

There are solid techniques to release the emotional charge on traumatic events without re-traumatizing the client. EMDR can be extremely useful especially when the past events are mixed and confused.

NLP and TIME Techniques are awesome at releasing traumatic events. I average about 12 hours (4 sessions) to completely remove the fears, flashbacks, etc. associated with a traumatic experience.

Me: Thanks so much for the insight on NLP and TIME techniques. Fascinating and very helpful information.

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WTF Is That Shrink Doing?

A friend of mine recently started going to a therapist, and he’s puzzled as to why the therapist keeps making him rehash the week. Here’s my theory.

Mood music:

[youtube=http://www.youtube.com/watch?v=34wASuHRuRo&fs=1&hl=en_US]

He’s asking a lot of redundant questions to dig up patterns. They seem like stupid, recycled questions. But when you have to answer the same, stupid questions over and over again, no matter how infuriating that is, something important happens. The stuff that’s really haunting you comes out.

You don’t even realize it’s happening. But it does.

One of my favorite TV series, The West Wing, captured this quite nicely in the episode where Deputy Chief of Staff Josh Lyman undergoes a long, brutal therapy session:

[youtube=http://www.youtube.com/watch?v=23dBqzo2aYY&fs=1&hl=en_US]

Josh didn’t want to answer Dr. Keyworth’s  question about how he cut his hand, but the doctor kept dragging him through it until the truth came out.

That’s a dramatic example. But it makes an important point:

When we’re troubled, we keep things buried deep within ourselves.

And it takes what seem like the dumbest, most repetitive questions over and over again to get the real pain to the surface.

Those stupid questions will last for years. Get used to it.

And be patient, my friend.

You can’t see it now, but it gets better.

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Editing the Legs Off Your High Horse

Erin and I were talking last night about the often shaky relationship between copy editors and writers. We writers tend to see copy editors as nitpickers who just want to make our lives harder. Copy editors tend to see writers as spoiled brats. But what happens when the writer is in the grip of OCD?

Mood music:

[youtube=http://www.youtube.com/watch?v=uR6HPzhlvoc&fs=1&hl=en_US]

I usually shy away from posts about the mechanics of writing and editing because it’s all so — mechanical. And it’s not really relevant to the topics of this blog.

Or is it?

The writers Erin has worked with for more than a decade are professionals covering a particular topic. They get paid to offer their expertise. But there are also the writers who do it for therapy. It’s a critical tool in any 12-Step program and if you’ve been treated for OCD like I have, writing is considered an important method for removing obsessive thoughts from your head. Sometimes it doesn’t work. Most of the time it does.

Here’s where the writers in Erin’s world intersect with people like me:

Sometimes you get someone who writes as part of their recovery program AND as a professional journalist. Most writers have a certain amount of prima donna in them (that goes for the guys). You turn in an article and feel insulted as all hell when the editor has the stones to change something or tell you it needs work.

Now, if you’re like me — a recovering OCD head case with an arsenal of addictive demons pointed at my head at all times — that tendency toward the prima donna becomes monstrous. That’s why I picked the song clip above for my mood music today. Because I’ve had many, many days where I got on my high horse over my writing performance and really did feel like the “Motherfucker of the Year.” That’s really what the song is about: Rock stars whose talents attain them a certain level of recognition getting fat in the head, thinking it’s their way or the highway forevermore.

People like us think we’re better than others. Even though we’re so messed up we can’t see straight.

It’s that type of person — someone like me — who NEEDS an editor.

A good editor can be a  lot like a 12-Step counselor. They’re ready and willing to take a buzz saw to the legs of your high horse. They tell you how to do better. That’s something every writer should be grateful for. 

There are bad editors who can make an article worse and leave a writer feeling dejected for no good reason. But then there are good cops and bad cops, good priests and bad priests. That’s life.

The point is that when you have a good editor, you should expect to be knocked several pegs down the ladder of reality.

I’ve been blessed to work with some great editors in my day: Gretchen Putnam and Al White from The Eagle-Tribune; Anne Saita and Eric Parizo from TechTarget, and now Derek Slater. Eric and I used to have some pretty prickly backs and forth and I after awhile I enjoyed and even looked forward to these moments. We made a lot of decent stories into good stories.

The latter three were well aware of my OCD when we worked together. They could have thrown up their arms, but they chose to work with me instead. I’d like to think I’m a better writer for it. And a lot LESS of a head case.

I still write from a high horse. I still need to have the legs sawed off from time to time.

I’m Narcissism Inc.

I don’t know if I’d want to work with someone like me.

But I’m aware of the problem and I work on it every day.

And I happen to be married to the toughest, most loving editors around.

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The Diagnosis

A lot of readers have been asking me about when exactly I was diagnosed with OCD and how I reacted to it. Did it drive me into a deeper depression? Did I worry about being misdiagnosed? Let’s see if I can retrace those moments…

Mood music:

[spotify:track:4bKGlkCUp5hBEVT14oifgI]

The diagnosis was slow in coming, though I always assumed I had what I had. When I first started getting help in 2004, that first therapist resisted giving me a diagnosis. For one thing, it was still way to early to pin an acronym on my demons. The therapist also hated diagnosing people because she felt a diagnosis was just a label that never tells the entire story.

My third therapist finally gave me a diagnosis in the spring of 2006.

I sat there in her office, staring at the floor as I told her about the old therapist’s dislike of labels.

“Well, do you have obsessive thoughts all the time?” she asked.

“Yup,” I said.

“Does it make you do compulsive things?” she asked.

“Yup,” I said. “I binge eat all the time even though I know it’ll eventually kill me. I just can’t stop.”

“Does it cause disorder in your life?” she asked.

“Absolutely,” I said. “Every day is an exhausting hell.”

“Well, then we may as well call it what it is,” she said.

Obsessive Compulsive Disorder.

Was I misdiagnosed?

It really doesn’t matter. I had a problem that was destroying me from the inside out. Putting a label on it helped me because instead of smoke and shadows, I finally had a way to see my struggle in a more concrete fashion. It had finally taken a form. I could see it, therefore I could punch it. Punch it I did, repeatedly.

It always gets back up and I have to keep throwing punches. But it’s better than trying to swing at shadows.

It’s a tricky thing, because in plenty of cases people do get misdiagnosed and the results are damaging. It can lead to prescriptions that don’t get at the root problem, making you worse.

In my case, the diagnosis was accurate. The treatment turned out to be right on, at least.

I think it was more of a relief than cause for a deeper spiral into depression. Because I had something to call it, I could move on to the next phase of recovery.

I still had many bad days after that. Some of my worst days, in fact. It would still be another two years before I could bring my addictions to heel.

The anxiety attacks didn’t cease until I started taking Prozac in early 2007.

But slowly, I got better.

It would be stupid for me to tell you not to freak and backslide after getting a diagnosis. It can be a frightening thing.

The biggest fear is that everyone will define you if you go public. That didn’t happen to me. At work, I’m judged on how I do my job, not on my disease. Of course, the OCD sometimes fuels some of my best work, which makes that less of a problem.

To me, the lesson is to not let a diagnosis be the excuse to live a less than worthwhile life and give in to your darker impulses.

Like anything else in life, you gotta make the best of it.

Obviously, that’s easier said than done.

Diagnosis-Easier

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Help Her Out

A few days ago I wrote a post about a movie called Machine Man, which deals with a man struggling with OCD. I received a note this evening from the film maker, Kellie Madison. Allow me to share:

“I am the filmmaker working on Machine Man and I wanted to thank you so much for taking the initiative to write this post. It really means a lot to me to be appreciated for the work that I am trying to do. I want to make a film that will impact everyone struggling with OCD and I can’t do it without everyone who cares about this disorder’s help. So, please continue to spread the word and encourage people to go on the site to donate so we can get this movie made!! Thanks again so much!”

No, Kellie: Thank you. As someone who has waged the OCD battle, I’m grateful to people like you for doing something to break the stigma.

Folks: Kellie is funding this film in a grassroots manner to keep the content free of the typical Hollywood bullshit treatment. The more she can raise from people like us, the sooner the film will come out.

So if you can, help her out. We’re all financially strapped, including me. It’s a bad time to ask people to give to a cause. But I ask anyway, because I want to do my part.

Here’s a press release describing the film and Kellie’s approach:

Veteran Female filmmaker Kellie Madison tackles obsessive compulsive disorder (OCD) with narrative feature film; Kicks off never-been-done-before grassroots campaign to raise awareness and funding

For Immediate Release

FEMALE FILMMAKER TACKLES OBSESSIVE COMPULSIVE DISORDER (OCD) WITH NARRATIVE FEATURE FILM

Writer / Producer / Director Kellie Madison Kicks Off Never-Been-Done-Before Grassroots Campaign to Raise Awareness and Funding

(HOLLYWOOD, CA)- Donald Trump. Howie Mandel. Howard Stern. Each of these men is among the most influential public figures of the world. Yet, most wouldn’t imagine that these powerful people all share a common mental disorder. They, along with millions of others around the globe, suffer from Obsessive Compulsive Disorder (OCD), a neurobiological anxiety disorder characterized by intrusive thoughts (obsessions) and a need to perform repetitive and ritualistic behaviors (compulsions). One in 50 adults currently battle with obsessive and compulsive behavior. One in 25 has dealt with the disorder at some point in their lives.

Just as “Rain Main” brought worldwide awareness to autism and “Children of a Lesser God” eloquently dramatized the trials and tribulations of the hearing impaired, Kellie Madison brings us a narrative film that illuminates the debilitating struggle that millions of people who suffer from OCD go through on a daily basis. “Machine Man,” chronicles the spirited tale of an average man, who struggles with an extraordinary problem, facing his most debilitating fear in order to save the woman he loves.

Far too often, people with OCD suffer in silence because of the shame and stigma associated with this disorder.  Some don’t even recognize what they’re suffering from and are terrified to leave their homes.

To date, a film that addresses the daily debilitating fears associated with OCD has yet to be produced. Film is one of themost powerful mediums for conveying messages to audiences around the world. A feature like “Machine Man” can and will create empathy and awareness for those suffering with OCD. This will ultimately affect change by helping people recognize their disorder and subsequently seek proper treatment.

It takes more than a great script and great talent to get a film off the ground.  It takes funding.  Madison is using her passion for the project to attempt a filming feat no Producer has yet to achieve: raising the entire $2,000,000 budget of the film through philanthropic support from the local community. We need YOUR help in spreading the word.  This grassroots campaign is a unique, ambitious and worthwhile endeavor.  Depending on the level of support, all participants will be rewarded, including the opportunity for a role in the film.  Additionally, partial proceeds will go to the International OCD Foundation.

Kellie Madison, as well as experts from around the country are on board and available for interviews. We would appreciate your help and the opportunity to spread the word about this amazing project.

A four minute video introduction about the project is here: http://www.youtube.com/watch?v=rtPgZOpw14E.
You can find “Machine Man” art here: http://mjkpr.com/Machine_Man/.
For more information about the film, please visit HYPERLINK “http://www.machinemanthemovie.com“ www.machinemanthemovie.com.

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Christmas Doesn’t Suck Like It Used To

The Christmas season remains an uncomfortable time of year for me. I’m used to going into a deep depression the second December starts. But something’s different this year. For the first time in a long time, I’m not dreading it.

Mood music:

[youtube=http://www.youtube.com/watch?v=-GNtipSggWY&fs=1&hl=en_US]

Life isn’t perfect. It never will be. Not supposed to be. But I’m finally starting to move past the idea that Christmas is supposed to always be perfect, sparkling and free of pain and strife. Given my tendency to think in absolutes, it used to be that if I had an argument with someone or work was stressful that it was all the fault of the season.

Not helping was the chemical imbalance that set in when the days got shorter. A dark sky for me is usually a dark mood.

What’s different is that I’m looking at a lot of painful, hard work in the rear-view mirror. Years of intense therapy, the decision to bring my addictions to heel, letting God in and going on medication. In the last couple of years, all that toil has been starting to pay off and I’ve felt joys I could never feel before.

In the last year, I’ve also fought back hard against the daylight problem. I went up 20 MG on the Prozac last winter, dropped back to the old dosage for summer and moved back up Aug. 1, when the days become noticeably shorter. I also started using a special lamp — sunshine in a box, as I call it — and that has diminished the extreme moods.

They still come and go, but they’re not nearly as intense as they used to be.

I think the biggest reason I’m not dreading Christmas this time is that my perspective has changed. I’m not craving a “Pleasantville” atmosphere where everyone kicks back and smiles all jolly. I’m not expecting things to be idyllic. I guess you can say I’ve lowered my expectations.

People are still going to fight. Cars will still break down. Loved ones will still die. That no longer means Christmas is destroyed.

A lot of this is based on my deepening Faith.  

This time of year is about celebrating the birth of Christ. I love the glow of a lit Christmas tree as much as the next person. But I don’t care so much about all the gifting back and forth. It feels good to give, but I’ve realized the best thing I can give is my time for a friend in need or a family that’s always there for me.

If not for the sacrifice Jesus made for us sinners, I’d be in a world of shit. For all I know I still am. Purging evil behavior is a complicated task and I very much doubt I’ve mastered it.

Celebrating His birthday is wholly appropriate, regardless of the twists and turns life will inevitably take. Because that birth was our second chance — my second chance.

If you’re a skeptic and think I’m getting into crazy talk, I don’t care. I know I’m no better or worse than you, though in my delusional moments I like to think I am.

This is where my road has taken me, and I’m grateful for it.

And so, I think I can get up the courage to say these two words:

Merry Christmas.

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Thinking in Absolutes: A Bad Idea

One of the problems with a mind laden with OCD is that you think a lot in absolutes. It’s one of the first things you need to stop doing when you finally decide to get help. But six years in, I still haven’t conquered that beast.

Mood music:

[youtube=http://www.youtube.com/watch?v=1CpRCc4Jre8&fs=1&hl=en_US]

Thinking in absolutes when your in a good mood is dangerous because you tend to think you’re so much better than you really are. Example:

Someone tells me I’m a good writer.

Translation in absolute: I’m the best writer in the business.

That’s rubbish, of course. But it’s the way someone like me thinks when I’m wearing my stupid hat. Another example:

Someone tells me they really admire how I am with my children.

Translation in absolute: I’m such an awesome dad.

I try to be. But trust me: I’m not.

Someone tells me I’m a great husband.

Translation in absolute: I’m the PERFECT husband.

Sadly, I am far from it.

Most of the time, when I’m thinking in absolutes, it’s on the negative side. Examples:

You missed the mark a bit with that headline you wrote.

Translation in absolute: 16 years into this career, I still suck at writing.

You shouldn’t have let the kids watch so much TV.

Translation in absolute: I’m a horrible father.

That’s what thinking in absolutes is to me. I either think about something in the best possible terms or the worst. The truth is always somewhere in the middle.

When I think in absolutes, I’m thinking outside the box of reality. It makes for some manic mood swings. Lately, I’m realizing that I’m as far away from getting a handle on this as I was the day I realized something was seriously wrong inside my head and that I needed to get help. 

With that in mind, I go thinking in absolutes again: I’m no better a person than I was all those years ago.

That’s not true, of course. I’ve made tons and tons of progress.

But I have a long way to go.

That’s not something that’s absolutely terrible or absolutely wonderful.

It’s just the way it is.

Fortunately for me, my wife, kids and friends are able to see me as I am, and that — for better or worse — they accept me anyway.

I’m thankful for that.

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Machine Man: The Movie

The disorder I was diagnosed with five years ago is going to be the focus of a movie. I guess that means it’s cool to have OCD now.

A reader pointed me toward the website for “Machine Man: The Movie” yesterday, and I’ve been digging around the site, totally captivated. There’s a “why we’re doing this” clip on the site that sounds a lot like the reasons I started this blog. Machine Man - The Movie

The website is chock full of useful information on the illness and I think the project is going to help a lot of people understand what this is all about.

That makes me happy.

Film maker Kellie Madison deserves a lot of praise for taking on this complicated beast.

She could also use everyone’s help to fund this project.

From the Facebook page:

“We are raising all of the money for this movie through donations and fundraising! Our hope is to demystify some of the stigma attached to OCD and encourage people to seek proper treatment and get their lives back! Be a part of making this project happen!”

At the very least, you should “like” the Facebook page for the film and share it with friends and family. They will learn a lot.

In fact, I’m dedicating this week’s Facebook Follow Friday post to that page.

Please check it out.

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Feeling anxious

No, it’s not an anxiety attack. It’s not fear. But it’s a feeling of anxiousness I haven’t felt in a long while. The trigger is an old friend.

Mood music:

[youtube=http://www.youtube.com/watch?v=ZvxHFmKl_Qo&fs=1&hl=en_US]

I used to live in a constant state of panic over work. The constant fear of not measuring up or being liked. A couple years ago I largely lost those fears. I just decided to do the best I could for me and let the chips fall where they may. That’s worked beautifully so far. I actually enjoy the work instead of wanting to puke over the tasks on my list.

As to how I’m feeling right now, it’s not the fear and anxiety of old. But it could be called a work-related stress. And not something the powers that be are making me feel. This is all me — all about the things in my head. 

I’m excited because we’re starting up a new news-driven blog on CSOonline that I’ve been itching to do for over a year. Some other tweaks are going on to the homepage as part of this. Meanwhile, we’re amping up a new CSO page on Facebook. I’m banging my head against the desk because I can’t seem to get all the news and Twitter feeds posting directly to the wall of the new Facebook page. So the blinders go on and I let the world around me melt as I stare intensely at my screens, groping for the solution. Being a control freak doesn’t help.

I just want to do this stuff and do it well. Better than well.

It’ll happen, but I gotta work on my patience and try to push back on the urge to have it all.

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Sleep

Thanks to a strict food plan I follow to keep the binge-eating disorder in its box, I’m not walking around a bloated mess like I used to. Instead, I gorged on something else yesterday.

Mood music:

[youtube=http://www.youtube.com/watch?v=axzRdFOYpqg&fs=1&hl=en_US]

I napped in the morning, I napped in the afternoon and I have no regrets.

I’ve always had an interesting relationship with sleep.

Back when I was slowly destroying myself, I would fall asleep at all the wrong times: In a restaurant while someone was talking to me, during moments of what was supposed to be catch-up time with Erin, and behind the wheel.

I still nod off early. But I’m up at 4 a.m. almost every morning. I don’t have to be. I just happen to open my eyes at that point. I can’t seem to help it. So by 7 or 8 p.m., it catches up to me.

For the most part, though, I only average about six hours of sleep a night. Sometimes, I get less than that.

When you don’t get at least eight hours of sleep a night for an extended period of time, it catches up with you. In my case, I go into cycles of depression. I feel doom and gloom for no good reason.

Erin knows this, and has been diligent in making me go to bed earlier, even when I’d rather be awake doing other things. 

I usually don’t give the sleep issue much thought, because my demons are rooted in many other, more insidious habits. But a friend of mine was just diagnosed with severe depression, and this dude has had a batshit-crazy sleep schedule for many years now. He gets into his office by 4 a.m. so he can leave early, but doesn’t really go to sleep until around 10 or later. Now it’s caught up with him.

Apparently it caught up to me yesterday. But it wasn’t the anxiety-driven kill switch that kicks in from time to time. This was a no-regrets trip to la-la land. Well, I regret it a little. I wanted to be up later to spend quality time with Erin, because she’s been working crazy hours lately and quality time is hard to come by. Last night I blew it on that score.

But looking at Thanksgiving day as a whole, it was much, much better than stuffing myself until I wanted to be dead.

The perfect balance still escapes me, but who really has the perfect balance anyway?