Looking past traditional counseling

I have begun my private practice, effectively stepping out on the proverbial ledge and taking the first step off. Now after spending money on office space, advertising (being a former graphic artist did save me a boat-load of cash on design and printing, read: home printer), I am beginning to trickle in clients, one, two, three… I have studied, learned and incorporated therapies that interested and engaged me into my ‘tool box’ such as CBT, Narrrative, and Mindfulness. These have proven effective in my work.

Many years ago, well, actually a couple of decades, I was introduced to a magnificent gentleman, a child psychiatrist working at a psychiatric hospital in Maine. He is fascinating to speak with, a presence of great gentleness and penetrating insight. I remember going to his home for a small party of friends and the conversation moved through many topics such as work, friends lives’ and onto Tarot. One person asked if the host can do a reading for her. “of course,” he said.

Now, I once had a Tarot reading done as a gift for my birthday one year previous from a friend. It intrigued me, and afterward I mussed around with the content of the reading for weeks. Some of the reading would not be revealed to me for years later. So, here was I at this great man’s home and he was about to do a Tarot reading. I looked at him as he said yes to the reading and he asked me if I wanted to have a reading next. Was it the look of eagerness in my eyes? Maybe.

What I learned from this man was amazing, and the friendship and mentorship was even more amazing. A little history on him without revealing his name or anything truly personal: He reads Tarot as I have said. This man also was an ordained Wiccan, attends a Catholic church every Sunday, and conducts past-life regressions (some of which was done this very evening, and no, I wasn’t brave this particular night.)

I introduce this man because he began a change in my thinking about psychology and how Tarot can play a significant role in counseling others. As I had in previous posts stated; I had kept Tarot and counseling separate from each other. But I had always found it interesting that when I had conducted a Tarot reading it seemed to morph into a counseling session. When a person is receptive to the method of using Tarot and they are open to understanding the issues they are repressing, the cards always represent these issues rather well. The person receiving the reading is receptive to conversation and counseling on what the cards represent, what is troubling her or him at the time.

So, incorporating Tarot into a counseling session may seem out of the ordinary, to say the least, but ordinary does not seem to be a proper word when talking of counseling. Again, and I will repeat this several times (a day…), Tarot is not mystical, magical device to call upon spirits for divining the future. Tarot is a method of engaging with our subconscious to delve into the issues we often hide in pain from our conscious minds. There is a connection between the reader and the person receiving the reading that become deep and at times moving, much like a counseling session.

Tarot and inter-being

Inter-being,
I came upon that word in a book. It reminds me of Jung and his collective unconscious. thinking of this word reminds me that we are all connected in ways we seldom are aware.
I wrote in my last post about incorporating Tarot into counseling. If anyone has ever had a tarot reading done by someone that knew what they were doing, would know that there is a deep interconnectedness that happens during a reading. Often, a person (the reader) who you don't know is able to delve into your life and the issues that you face and offer help, insight and new possibilities. Inter-being.

As I had offered in the last post I want to speak about tarot in a counseling session and knowing when to use it and when not.
I begin with an age limit on tarot. I do not do readings for anyone below the age of 21 years. (many adolescents get upset about this!) The reason for this is that their life is in development as is their brains. Their lives are in constant change with growing physically, mentally and spiritually. I believe that they need to learn and understand the world without the possible intensity of a tarot reading.

I also believe that tarot should not be read to persons experiencing psychosis or any other major psychiatric symptom, they are too fragile to accept the possible outcome of the reading or fully understand the cards. Imagine a person experiencing psychosis getting the death card or the devil card, neither card is a 'bad' card. So who can have a tarot reading in a counseling session? The man or woman experiencing an addiction and cannot find themselves inside the addiction, willing to delve into a spiritual place to find answers and be able to talk about what is presented in the reading in a safe environment with an understanding professional.

A couple having difficulties with finding a common voice between them. Having them experience separate readings and finding a common theme in both readings is helpful in creating a place for them to begin to find that common voice they had lost. In many ways tarot is useful in bringing out what may lay hidden through several counseling sessions. all it takes is a willingness and an open mind.

Tarot & Psychology

I have been reading the book Tarot and Psychology by Arthur Rosengarten. Ph.D. It is an interesting book about the use of Tarot in counseling sessions. Up until now I had not incorporated Tarot into counseling. I have been reading Tarot cards for many years now and have always found many of the readings became counseling sessions with the querants (or clients).
Many people think Tarot readings are the work of the devil, or are calling on mystical spirits to inhabit the room or the air about the reading. I think this is sad in its ignorance of how Tarot really works. We all carry the answers to our problems inside of us, most often hidden from our conscious mind. Tarot simply is a vehicle to tap into your (and the reader's) subconscious in a gentle and visual way. There is no 'hocus-pocus' about it.
In some of the readings I have done that had been powerful in their ability to bring the most important problems and choices to the querant, I have had what might be called insights into the reading that the querant may not be cognizant of at the time. Sometimes the insights are good to discuss during the reading, and sometimes the insights are best kept from the querrant in the reading. An example may be a reading that illustrates a relationship difficulty that shows a possible breakup of the couple. Giving this information to the querant may cause the future of the couple to change, putting into his/her mind an inevitability to the reading, which may not be true.
Tarot does not predict the future.
What the readings do is to give possibilities, to define the issues most important to the person receiving the reading (querant). In the last part of the sentence, I give an example: I had done readings for a single mom of two adolescent boys. She wanted a weekly reading. her intention (more in that soon), was to find what next man would enter her life. Every time her reading showed issues between her sons and her. On the one final reading, I stated (again) that she need work on her relationship with her sons before she could engage in a successful adult relationship. I say final reading because she chose to not have readings after a difficult conversation about her relationship with her boys.
as illustrated, most Tarot readings show what is most important in your life, usually not what you want to hear in a reading, much like counseling? I think so.

Next post: How Tarot is effective in a counseling session, and issues in using Tarot with some clients.

“When we are mindful, deeply in touch with the present moment, our understanding of what is going on deepens, and we begin to be filled with acceptance, joy, peace and love.”
― Thich Nhat Hanh

Connecting

I have been working with a Clinical Trials company assesing subjects (people) over the phone for depression to qualify them for a Major Depression Med. Most sound depressed, some more than others. Some answer the Hamilton Depression scale with a bright affect (happiness in their voice), but answer the questions with a score that define they have depression, I atribute that to a possible good day when I called them.
One woman I called was on the verge of tears throughout the call. She was going through significant traumas in her life and as she described so well, was having trouble feeling like life was worth living. When I do the depression section of the scale I ask the person if they had thought of suicide, and if so, when was the last time. Most say they have not considered it, others state the last time was several years ago. This woman stated she thought of dying last week.
I asked her to elaborate on this and describe the intensity of the feeling and how far did the thoughts go, i,e., was it a passive thought such as "I don't care if I live or die," or did she think of ways to end her life? This woman at the moment choked up with tears said she thought of taking some pills and 'falling asleep.' Throughout her conversation she mentioned Alcoholics Anonymous and how the groups had given her a sense of family and belonging, but she had stopped going years ago.
I asked her why she had stopped. She stated that she tends to ramble on when she talks and feels embarassed by this. Slowly she pulled away from the groups, from her friends and from everyone in general. Entering into this study was a courageous thing for her. She was crying out for help and reached out in a unique way, causing her to be on the phone with me.
I suggested that when she finds herself talking too much and feeling uncomfortable, to apologize for talking too much to the person(s) and let them talk. I said that if she continues to do this, she will begin to learn where that comfort place is in her converaation and begin to learn how to converse in more of a two-way style.
She said she liked this idea and thanked me for the suggestion. I also stated that I heard her talk about AA several times, that maybe she needs to reenter AA and find a group she is comfortable in and begin to open up in meetings and hopefully find friends and possibly a sponsor.
Her verbal affect seemed to brighten a little when she said she enjoyed talking with me and bid me to have a good day. She did qualify for the study and hopefully she finds a meeting she can find her voice in again

John, a sad story...

Many years ago while living in Maine I was standing outside watching people arrive for an AA meeting. A young guy I had seen a couple of times walked up to me and sat down on on a stone wall beside me. I also sat. His head was hanging low off his shoulders. It seemed as if all the weight of the world was crushing him. He looked up at me, his blue eyes shot with red from lack of sleep and worry.
He looked like this from the first day I had seen him. We never spoke until this moment and he never shared in any of the meetings. His name was John. "I need someone to talk with and I like how you speak in the meetings, can we talk?"
He disclosed to me that he was having repeated intense nightmares, waking him in clod sweats and crying out into the night. John said he lived alone in a small cabin in the woods. He said he liked the solitude. John began to talk with me about his nightmares. He said in his dream he is standing outside his car yelling at a woman. he then gets into his car and backs out of the driveway in rage. He then says the woman comes running toward his car screaming at the top of her lungs and waving furiously at him. At this point John said he awakens with terror in his heart, crying out, his pillow wet with tears.
John said these dreams come to him every night.
The meeting was beginning and we walked in and took our seats. John kept his head down and did not say a word. Afterward he quietly thanked me and left the meeting just as it was ending. I found it interesting that no one ever said a word to him. John just seemed to blend into the background. It wasn't until a week later at the next meeting. John appeared from around the corner and walked up to me. Head down and lightly sobbing John told me he wanted the dreams to stop. John said the dreams had become more intense, he awoke one morning with the realization that he had been married, but had no memory to whom or where he lived, only the house seemed familiar.
Again, John stayed until just before the meeting ended. All I knew was his first name at this time. It was a couple of weeks before I saw John again. He appeared to be a shadow. John had lost weight and looked very disheveled. He sat next to me and didn't say a word for a few minutes. I asked John how he was doing. "I don't know what to say, it, it is so horrible, so very horrible.
John sat next to me on that same stone wall and told me a story that would stay with me for the rest on my life. "I remembered everything this morning." John said with a stutter in his voice. Tears welled in his eyes and rolled down his cheeks without protest. "I had the dream again last night but it went further. As I backed out of the driveway in my dream and my wife was running after me screaming and crying. I stopped the car to put it into drive when she began hitting my window screaming 'you killed her, you killed her!' It was then I woke up." John began sobbing uncontrollably. I put my arm around his shoulder and didn't say a word. There was no words, I was empty and full at the same time. empty of words and full of sadness and concern for John.
He continued after the sobs subsided. "I had a daughter. I had a daughter and she was playing in the driveway." John didn't need to finish the story. My heart sank, tears were falling down my face now. John sat there of a few minutes a shudder fell over him. he then got up, I did too. John looked at me and thanked me for listening and talking with him. I asked John where he was going. "Home, I feel really tired and worn out. I think I'll sleep for a while." I was worried for him. I knew this was big, but I didn't know what to do. I gave him my number and told him to call me. John said he didn't have a phone at his place, but would call from the local store later. I still didn't know his last name. In AA we used initials for our last name for anonymity. John drove away as I watched wiping the tears from my eyes.
I never saw or heard from John again. No one at the meeting knew much about him or how to contact him.
Today I still remember John and the tragedy of his life. He had a drinking problem and in one moment of drunken rage at his wife, John changed everything in his life forever.
I wasn't in the field of psychiatry at the time, but after this it was inevitable that I would find my profession.

Still today I pray for John, and myself.

Doing the Dishes

Hello everyone,

At times I find myself feeling a bit overwhelmed, okay more than a bit at times…

The intensity of today brought a lot of emotions, projections and anxiety. As always everything turned out better than the motion picture being played in my head.

Upon my return home from visiting with my mom and siblings I still felt a little tense.

Walking into the kitchen I saw a small pile of dishes in the sink. Seeing this I felt as everyone initially feel. “Oh damn, DISHES!”

This is an interesting situation. I initially dislike doing the dishes, but the second I begin I find my mind and body relaxing. I take doing dishes as a methodical process, spiritual and methodical at the same time actually.

I put away any dishes, silverware, cups and such then turn on the water to a comfortably warm temperature. I wet the sponge and add Dawn. Then the cleaning begins. What I find in this process is that I completely go into a zone. My entire focus becomes the dishes and my cleaning them.

For that time, 15 minutes, half an hour and longer I lose what was happening during the day and afterward find that I have a new focus on my day and my breathing becomes steady and calm.

I know that when moments become intense and overwhelming I bring myself into a calming place during the event and an able to focus and become effective in the moment. But those moments that are merely annoying, well I find that I carry them sometimes throughout the day. As long as I do the dishes all becomes well.

Mindfulness in Psychology

Mindfulness in clinical practice builds on the principles of cognitive therapy.
Mindfulness is a form of conscious awareness in which we are fully aware of experience as it is unfolding. This may not seem different to our usual understanding of awareness, so in order to better understand mindful-awareness we need to first examine common awareness. When we encounter an experience, which could be external, such as a sight, sound, or touch, or internal, such a thought, memory or emotion, the mind tends to react to the experience according to past conditioning. When we look at a tree, we don’t just see the tree as it is, but see a composite of the objective reality of the tree combined with our subjective reality, our internal representation of the tree. We see the products of our subjective reactions to the tree, and often this dominates our perception and awareness so much that we see very little of the truth of what is in front of us.
We can describe consciousness as a continuum between the totally objective truth at one end and the completely subjective reactivity at the other. Many of us reside more on the subjective side than the objective side and our experience is dominated by subjective habitual reactivity that has the effect of blinding us to reality.
Mindfulness is the conscious attempt to correct this imbalance, minimize subjective habitual reactivity and shift consciousness towards objective perception. Hence mindfulness is often described as the direct awareness or bare attention to present experience. It is non-reactive awareness that allows us to completely experience any object of consciousness. One of my favorite terms, which I use to describe mindfulness to clients, is presence. Mindfulness teaches us to be fully present for our experience as it is, rather than thinking about what we are experiencing, analyzing our experience, or reacting with attraction or aversion to what we are experiencing.
In relation to the mind, the Buddha made it very clear that if you want to transform inner emotional suffering, you must open your mind’s eye and look inside to see what’s there. Reactivity and thinking take you away from this primary and direct perception, because when you react, you experience the reaction, not the original object. When you think about your anxiety or trauma, you are experiencing thinking about the object, which is not the same as the original emotion. Reactivity takes you away from being present and this is actually a subtle form of suppression, and when the mind remains ignorant through suppression of any kind, it is prevented from changing.
The first requirement for transforming anxiety is to allow yourself to observe it fully. Without this effort to overcome unawareness, nothing can change. In fact, the unawareness is an essential factor that creates the anxiety in the first place. This is particularly the case for depression, where there is a complex superstructure of negative reactive thinking around the core emotion or trauma. Therefore, the first characteristic or dimension of the mental factor called mindfulness is the active watchful component, called recognition, or vigilance. We train ourselves to recognize each and every movement of reactivity in the mind so that we can stop its proliferation and return to being mindfully aware of the core emotions.
Mindfulness is multi-dimensional; it is not simply learning to be more aware, but continuing from basic awareness to a state of complete presence, in which you look and listen with a clear, still mind. The second dimension of mindfulness is about how you relate to the core emotion, or any other experience that you are observing. Mindfulness is like a spotlight that illuminates the emotion so we can direct our attention to it, and it keeps our attention from being distracted away. Now, we need to continue to shine the light on the emotion and begin the process of mindful-investigation. Mindfulness allows us to build a relationship with our inner emotional complexes that is spacious, non-threatening and safe. We are so used to reacting, that we never actually spend any quality time with our emotions. It is like the busy friend who never seems to have time to have coffee with you. “Sorry, can't stop now. Catch you later.” This is what we do with our emotional suffering all the time; we don’t take the time to simply be present with our inner pain, and it is hardly surprising that the pain persists. Mindfulness is all about making time to be with your emotion, literally sitting with it as you would with a friend, and listening. Hence the second dimension of mindfulness is relationship and presence. We all know how important it is to be fully present with your spouse or friend when they are suffering. They need your presence more than advice or words.
The third dimension of mindfulness emerges quite naturally after you have established mindful-presence and this is investigation. When we investigate an emotion like anxiety or depression with mindfulness, it responds by differentiating into more subtle feelings, memories and inner imagery. We simply see more, and this is very important, because it is in the details of what we see that transformation becomes a possibility. Just like a car that won't start, the best response is to open the hood and look inside the engine. Solutions present themselves. If you see a loose wire, the solution is simple; but you had to look inside first or you would never have discovered the solution. We tend to stay stuck at the superficial outward appearance of our emotions; we take our anxiety or depression to be solid entities, when in fact they are never solid and never what they first appear to be. An emotion is a construct, like a fortress, and mindfulness is the process of taking apart the bricks and mortar. When you begin to disassemble the emotion, then the solutions begin to present themselves quite spontaneously.
Hence, there is a fourth dimension to mindfulness, a transformational domain. First we learn not to react; then we learn to be present. When we are present, we begin to discover the inner structure of the emotion, and this paves the way for transformation. Actually, each of these preliminary dimensions of mindfulness is transformational; overcoming reactivity and learning to relate to inner pain is the hallmark of successful psychotherapy. However, making the inner structure of our depression conscious will directly lead to the transformation at the core level. The psyche has a remarkable ability to heal itself if given the freedom to change and this freedom is provided by mindfulness. It is assumed that we all have an innate inner wisdom-intelligence, called satipanna in Buddhist psychology, which directs change from instability to stability; from discord to harmony; from suffering to well-being. This natural intelligence is just like the wisdom of the body, called homeostasis, which continually makes adjustments to maintain health. It is thought that the psyche is also guided by psychological homeostasis towards well-being and happiness. When mindfulness is established, we create the ideal conditions of inner freedom in which this natural intelligence will direct the process of inner transformation.
From:
http://psychology.wikia.com/wiki/Memory

Mindfulness in everyday

sometimes the moments in life appear like we are looking through a tinted window. we often neglect to see the related patterns in our life, the seemingly small and inconsequential moments that are interlinked and that send us a constant message about our future and the path we are on.
small events like repetition of a number throughout the day or a song being heard more than once (well, on the radio that is a regular occurence if you listen to the same station long enough), speak to something we should be more aware of.
in my previous life i worked in the filed of advertising and graphic arts. a rewarding career for some time in my life, but disillusionment, a need to change my life and not seeing it caused pain and sorrow in my life.
a small voice spoke, actually it was a recommendation that a residential treatment program for adolescents were looking for employees. i could have ignored the small voice, but the catalyst for change had me by the throat.
walking into the building brought the change that lasted for twenty years... it brought me through college and grad school, a new and sometimes frightening insight into human behaviors... mine included... looking back it has been a strange and fantastic trip, and still amazing me each day.

keep your eyes open, there is more to witness and experience than you have ever imagined.

Hiding my Heart

I am sitting here listening to my stereo system, these speakers makes Adele sound like she is really in the room singing in front of me!
The song Hiding My Heart comes on and I begin to think.
There are those moments in life when someone comes quietly knocking on our hearts,
ever so gently the presence of them moves the earth beneath our feet.
But what happens when that gentle, earth moving knocking comes when we dare not respond?
Being in a relationship, married or otherwise holds a deep and very heavy moral dilemma...

The earth moves each time we are in that person's presence, much, much more intensely if there is physical contact, such as a hug. I feel heavy just writing this.
A friendship appears to develop, we see each other daily at a store, a coffee shop, or as chance sometimes plays its game, meeting when least expecting it...
The words are always friendly, safe and friendly.
But what lies behind our eyes is anything but safe. too much of this "safety" and a distance ends up being created. we stop going to that store or find another coffee shop or prays both seeing the person and equally not.

Hiding My Heart, there is danger in holding it in, there is danger in releasing it.
thoughts of what could be, changes to what may have been when looked at in the light of day. Relationships are anything but simple, but again, it is too evasively simple.
It comes down to one second, to a decision in that moment.
The moment that will change everything forever.

The knocking on our hearts remains a quiet stirring within that cannot be answered.
More hearts would be broken than what our hearts can withstand...
In the end the knocking on our hearts just show us that we are still indeed alive and capable of love and in the final decision we find that passion does indeed live, hopefully making us take a much needed look at the relationships we are in and find that it had started back then with a gentle knocking at our hearts

Subtle intentions

in a recent meeting with a couple I found my initial observations to be curiously about their choice of seating. he chose to sit next to me as she chose to sit on a love seat as we talked about his issue and its impact on his life. There were moments during the conversations that opened my eyes a bit to the dynamics of their relationship. often it is not what we say but how we say it. sometimes it is not how we say it but how our bodies say it. posture, facial expressions and even something as subtle as where we look gives me subtle interpretations into what is really meant behind the conversation.
As the man spoke he made many comments about what he has done to try to help himself with this problem he is battling, I looked over at his fiance and saw the quiet words she was speaking with her eyes and body. A small shift in her posture, a look out the window or down at the floor began to speak about her feelings for him at different points of the conversation.
What I find in most relationships that are experiencing trouble is that each person in the relationship are focusing on their internal struggle with the problems and have difficulty seeing the other person and the difficulties between them. to bring them to a new insight requires more than just conversation about their feelings and thoughts. before that can occur a simple exercise could be effective in creating a more powerful environment for that conversation.
the man and the woman are asked to walk into the bathroom, or their bedroom and look in the mirror at each other. the image of them together creates just that, them together. at this point the conversation takes on a more intense focus. the conversation becomes more intimate.

Happy Valentine's Day everyone reading!

Don

Beginning a business

It has been three months since I began setting up my counseling practice. I have a lot done, NPI, Tax ID, malpractice insurance, even got onto Aetna's boards. I need now to find an office to either rent of share, or find a group practice that is looking for a member, I am working with SCORE on setting up my LLC also...
It is a fine beginning, taking a bit longer than I want...

Mindful Interventions soon!