WHERE IS OUR EMPOWERMENT?

This is one of those periods in human history where we are being hit with one crisis after another raising big questions about what is happening, where are we going and what can we do. The list of crises include: terrorist bombings and mass shootings, increased racial tensions, income inequality, climate change, dysfunctional political processes... a powerful mixture of feelings are being evoked: fear, rage, sadness despair, injustice, powerlessness, distrust... They affect our communities, our families, our patients, us. The cumulative effect of so many feelings over a period of time can be overwhelming producing powerlessness, paralysis, apathy. So much needs to be done to make the necessary changes. As psychotherapists and counselors what is our part?

WHERE IS OUR EMPOWERMENT?

From my perspective as an elder in the field of psychotherapy one primary way we can have a lot of impact is through our work. What is common to all of you readers is that we are working with clients who are suffering and struggling in their personal lives. They are being greatly affected by all this societal instability. We can help them feel empowered amidst this turmoil and to each make their unique contributions to the changes that need to happen. Imagine the ripple effects.
The first step of this process is to help our clients to feel fully all the myriad feelings that are being evoked. This will help to reduce denial and minimalization. Our clients are often afraid of the power of their feelings and what they may trigger from their own personal journey. Through our compassionate hearts we can invite these big feelings into the safety of the therapeutic space. This will provide a container to hold the feelings so that our clients will feel less overwhelmed. This will also increase their compassion for others all over the world who are suffering too. And diminish their feelings of separateness and aloneness.
It is then important to explore more deeply what aspects of their personal story are being tapped into. How do the feelings evoked by the societal crises connect with the feelings of deep sadness,rage,fear,injustice,hopelessness,powerlessness that they have felt in their childhood,adolescence, and adulthood? Exploring this connection can provide an opportunity to deepen their personal work. This will also separate out the past feelings when they usually felt powerless from the ones now being evoked by current events. The awareness of this connection is empowering.
The next step is to encourage our clients to hold these feelings in their consciousness AND to ask themselves the question,"Where is my empowerment now? What can I do?" The cumulative impact of all these issues fell so overwhelming, the amount of work to be done seems so daunting that it produces a sense of powerlessness. However, if we ask ourselves "What connects with who I am and what my interests are? What about my life experience gives me something to offer?" then something will come into our consciousness that can be our unique contribution. We can tell our clients that we are not all called to act on the big stage, but we all can contribute our part to the larger movement for systemic change.
Ralph is a sensitive artist and naturalist; he is a Vietnam Vet in his 60's. All the terrorist attacks and the shootings of black men and policemen were triggering his PTSD. All the impacts of climate change upon "our home - Earth" combined with the political dysfunction were triggering memories of the devastation wrought upon his childhood home by his mother's bipolar disorder and alcoholism. He was feeling enraged, fearful and powerless. After several years of sobriety he had started to drink again. He was ashamed of that and was embarrassed to tell me because he thought that I would be disappointed in him. Of course I was not - it was a projection of his disappointment in himself. I told him many people are coping with the big feelings evoked by these social crises by the addictive use of substances and addictive behavior.
After we worked through more deeply the feelings of his earlier traumas that were being triggered by the current events I told Ralph"It is now important to discern where is your empowerment in these recent world issues." He felt most strongly about the climate change issue. He has a deep heartfelt connection to the Earth as "our home" and feels that we are despoiling our home. He started to think that if he could help people develop a deep personal connection to the place where they lived, the natural setting near their home, they too would develop a deep heartfelt connection. Extending this heart attachment to the natural world they would want to take better care of their home Earth and become more involved in climate change issues. Ralph started by taking his teenage son's friends on nature walks. They loved it. This evolved into him leading guided nature walks for parents and kids in the local high school. The response was very positive and Ralph began to feel that he was making a contribution.
A few other examples: Tom who had been homeless for several years in his late teens and early twenties spoke at his synagogue about "giving voice to the voiceless" including non-human creatures and about the interconnectiveness of all beings; Carla, who had always felt like a "timid mouse", joined the Citizen's Climate Lobby and traveled to Washington to speak directly to Congressman; David decided to make monthly visits to some isolated members of his community; Walter led several workshops at his conservative Christian church about the congregation becoming more inclusive. The connecting thread in all these stories is that each of them moved beyond powerlessness and a sense of hopelessness into taking some action that fit with who they were. They felt also that they were contributing to something greater than themselves.
Of course we can contribute concurrently to working on these societal issues in ways that resonate for us personally. It is important, however, to realize that we can use our unique positions as psychotherapists and counselors to encourage and empower our clients to find their individual pathway - even though it may seem small - of making a contribution.

DEVELOPING POSITIVE INNER STATES

How can we help our clients develop some of the personal character patterns and inner feeling states that will improve their lives? How can we help them: have more perseverance, feel more inner peace, become more assertive, feel more inner strength...? How can we help them cultivate these qualities and emotional states?
Because these are primarily emotional states and because emotional states are controlled by lower level brain functioning(which overrides neocortical processes) rational/cognitive techniques are less effective in producing change. What I have found quite effective is to help clients invoke symbolic images because of their capacity to evoke powerful emotional states.
I'll start the discussion with a personal example. My lifework as a psychotherapist requires me to have a sense of grounded inner strength when presented with the myriad strong emotions of my patients. The work also requires me to have a reliable degree of stamina, especially on those days when I feel personally tired, and yet have to be with patients for hours. For me the image of an old tree with its roots above ground reaching deep into the earth symbolizes inner strength and endurance. On my weekly woodland walks I have sat and meditated many times with my back against a particular old deeply rooted tree. On several occasions I have imagined what that old tree has "witnessed" and "endured." By my frequent visits coupled with breathing meditations I am symbolically imbuing the image of that tree with those qualities and also creating brain patterns. In my office I have a poster of a giant redwood - I have meditated inside redwoods several times - and a stained glass image of the "Tree of Life." Before starting my day's work and also during those sessions when I feel tired, I look at those images and take a few deep breaths. Through this practice I can feel myself tapping into those deep inner states. This usually overrides the tiredness of my ordinary self and enables me to be fully present to my patients.
When we are helping clients develop their own images it is important to emphasize that the symbol needs to come from them - something resonant with their life narrative. Walt was anxious most of the time even when his life was going well. From prior experiences with other psychotherapists Walt knew the reasons for his "inner river of anxiety." He was quite close to his mother whose pervasive fearfulness permeated the atmosphere of his childhood home. As a sensitive child he absorbed her fearful energy into his own consciousness and it became strengthened through brain patterning. In an attempt to counteract this engrained pattern I asked Walt "Is there some place either now or earlier in your life where you have felt more peaceful?" Within a few minutes he began to talk about a local pond that reminded him of a lake near his childhood home. He used to go there to escape the tremendous tension at home. I recommended to Walt that he begin to go to this local place regularly by himself, sit near the pond, say out loud the word "peace" and do fifteen minutes of relaxational breathing. He was so determined to change this lifelong pattern that he started to visit the pond several days a week and quickly lengthened the time of his visits. One day Walt reported that he had taken a picture of the pond. Now that is the image he first sees when turns on his computer. He also hung a framed copy of the picture on his living room wall. Each time he opens his computer or stands in front of the picture he pauses, recalls time at the pond and takes a few breaths. Walt was amazed at how he started to feel internally more peaceful. "My wife has commented how more relaxed I am." Pleased by these results he became even more diligent about incorporating "pond time" into his daily life.
Carla had a lot of difficulty standing up for herself, protecting herself from personal verbal attacks or asserting her own ideas and feelings. She grew up with loving parents who had a pollyannish worldview and refused to acknowledge the dark side of people. She never witnessed them get angry, nor did they allow her to express anger. She felt loved, but totally unprepared deal with a lot of life situations. I asked Carla, "What animal comes to your mind when you think of an animal protecting her young?" Within moments she said "A tigress. I remember as a girl loving pictures of them in National Geographic magazine." Carla talked about the confident way the tigress moved, the sounds she made, her overall attitude of "don't mess with me." I encouraged her to watch tigress videos and to read more about them. I recommended to Carla that when she was alone in the house to imagine herself as a tigress walking around. We also did some deep breathing imagining the tiger inside of her. I asked her to imagine the tigress walking alongside her available whenever she needed her. She continued this work at home for several months. One day she demonstrated for me her tigress growl. She particularly loved the image of her tigress walking alongside her always available. Carla started to stand up for herself more and also to advocate more strongly for her children in their school.
I could offer more examples - the Vietnam vet who developed the image of a Native American shaman as a "Warrior" who helped him with his PTSD symptoms or the psychotherapist who grew up in Cape Cod using a lighthouse as a beacon of hope in her own despair. What is common in all these stories is that each of the symbols taps into some personal experience that resonates with the needed personality trait or desired inner emotional state. Imbuing them with symbolic power so that they can be reliably sustained and strengthening them so that new brain patterns can form and become engrained requires conscious effort and a lot of diligent hard work. Once patients begin to feel the difference and envision a better future they are usually able to do the hard work.

BEING BOTH PROFESSIONAL AND A LOVING HUMAN BEING

I have a dear friend who has been hosting for over forty years a late night radio show about psychological and social issues wherein listeners call in to speak about their struggles. He frequently encourages them to seek professional help for their psychological problems. He has shared with me on multiple occasions that the #1 complaint from these listeners who have had unhelpful experiences with psychotherapists and counselors that they have consulted is "I didn't have any sense that they cared about me as a person." Moreover, the literature on effective psychotherapy has consistently reported that when clients are asked what was most helpful to them they say,"my therapist cared about me as a person." As a reader I ask you,"How often in your professional training and supervision was it emphasized to you the importance of treating your clients with compassion,loving kindness and other forms of heartfelt caring?" From my personal experience in my own training,with the therapists that I've supervised and from the responses I get when I tweet about this topic it is an area that is underemphasized and undervalued in most people's training.
I think that there is an overemphasis on the importance of maintaining professional distance. YES, it is important to have appropriate boundaries, especially with clients whose body and psychic boundaries have been violated. YES, our hard-earned knowledge about what produces psychological problems and our techniques for reducing them are important. AND, it is essential that we move away from the hierarchical, superior-inferior aspects that are culturally built into the roles of therapist-client to move to a more deeply human-human interaction. Through our compassion, simple acts of loving kindness, warmth, sharing of relevant personal stories, encouragement, welcoming attitude, celebrations of moments of growth, emotional nurturance.... and other expressions of heartfelt caring we shift the relationship. It becomes more between two human beings, one of whom is suffering, and the other who has expertise that will alleviate that suffering.
YES, it is very possible and liberating to be both a professional and a loving human being.

BROTHERHOOD/SISTERHOOD

Ii my daily period of meditational preparation before I open the door to see my clients I pray,"Help me to be a vehicle of peace, brotherhood and love with my clients today." [In prior blogs I have talked about being a vehicle of love and peace] With this prayer my intention to place my lifework as a psychotherapist into a larger context - an acknowledgement of our connection of human to human, of the interconnectedness of all beings. The word brotherhood is the term I am using for this connection. Perhaps, if I were a woman I would use the word sisterhood.
Underneath our roles of client-therapist is this human to human connection. When we share relevant aspects of our personal stories that reveal our empathic connection to what our client is discussing we are breaking down barriers to heart to heart connection and underscoring, without minimizing their suffering, that their struggle is part of our common human journey. When we show our caring in whatever way fits for this particular client and our unique personality we are honoring our heart to heart connection. Our clients experience this genuine caring at multiple levels of consciousness. AND, it makes them more receptive to our techniques, insights and suggestions.
It is a massive understatement to say that we live in an area of great divisiveness wherein the experience of "other" as different, inferior/superior, frightening is pervasive throughout most cultures.It is well beyond the limits of a brief blog to even attempt to discuss the why's of this increasing sense of separateness. However, rather than be overwhelmed and paralyzed by the bigness of the problem we can help our clients develop a greater sense of brotherhood/sisterhood and thereby contribute to some of the change that needs to happen.
First,by being both a professional therapist/counselor and a loving human being we are modeling for our clients a way of being in all the varied roles of their lives.
Second, by exploring with them what aspects of their personal histories have contributed to their inner self-criticalness ands judgmentalness of themselves. Then discuss with them how that is directed toward others. It is these aspects of each client's inner landscape coupled with the fear of being vulnerable to psychological attacks by others that contribute to their defensive barriers to a deeper human to human interaction.
Third, in addition to their personal history it is important to discuss the impact of living in the competitive atmosphere of Western culture. This underlying competitiveness - which is so insidiously pervasive that we are usually unaware of its psychological impact - places us in an adversarial position with others. I have found it quite helpful to explore this often unexamined territory with my clients to help them move from an adversarial relationship to a greater sense of feeling their common humanness.
Imagine the ripple effects if thousands of therapists and counselors were helping their clients feel a greater sense of brotherhood, a deeper valuing of our human to human connection.

BEING A VEHICLE OF DIVINE LOVE

In my few moments of meditational preparation before I see my first person of the day one of the prayers I say is "Help me to be a vehicle of Divine Love with my patients today." This prayer reflects an evolution of my thinking regarding my role as a psychotherapist. Increasingly some of the notions of the mystical traditions have become central to my evolving worldview, my view of myself in the world, and my lifework as a psychotherapist. My twice weekly contemplative walks in the woods and my meditations sitting with my back against a tree have contributed to what is unfolding. I playfully think of myself as an "aspiring nature mystic."
Most of the mystics(including Meister Eckhart in the Christian tradition, Abraham Heschel in the Judaic tradition, Rumi in the Sufi tradition) teach about the interconnectedness of all beings. They also say that there exists a metaconsciousness(which has different names in each of their traditions) the essence of which is love. They talk about the Divine and Divine Love.
One of my intentions in my woodland walks is to connect more to the Divine. In my efforts to make the relationship more personal I use the sun as an image of the Divine and refer to it as "the Old One." I find it helpful, and yet I acknowledge that it is a limited attempt to grasp the unknowable. Moreover, I imagine the rays of the sun shining through the trees as emanations of Divine Love - a love that shines on everyone and everything. It is this Divine Love that I'm trying to access in my prayers before seeing my patients.
Periodically people ask me how I have been able to be in the presence of so much pain, doubt, sadness, fear, depression for so many years without getting burnt out. I reply that if I were reliant only upon the small heart of my ordinary ego the accumulated weight of carrying all that would become overwhelming long ago. However, many years ago I began to find it very helpful to access my personal Higher Self as a source of a much greater capacity for compassion and other forms of love. Since then whenever I am able to transcend my ordinary ego and access my Higher Self - whom I have named Wiseheart - during sessions I am able to be a compassionate presence for hours. Moreover, for many years I have thought of Wiseheart as being connected to an infinitely larger consciousness capable of an amount of love that is beyond our ability to understand. Gradually my thinking about that larger consciousness has evolved into the notion that my old friend Wiseheart is an aspect of the Divine and a conduit of Divine Love. Recently I've thought that when I'm connecting to Wiseheart I am being a vehicle or conduit of that source of love. So in my prayer before beginning work I am asking Wiseheart,"Help me to be a vehicle of Divine Love with my patients today."

SACRED ENTRUSTING

It is essential that our patients feel that they "are in good hands" when they come to us with their problems. As their psychotherapy sessions continue they become more vulnerable and reveal to us their innermost thoughts and feelings. Periodically they say,"I've never told this before to anyone." This is a "sacred entrusting." Although they have been wounded by others they are expecting and hoping that we will be different and that we will them with respect, compassion and loving kindness. From my perspective we make with them a sacred agreement, often unspoken, to be that entrusted person.
As part of the evolution of my work, increasingly I feel that there is another sacred entrusting - between me and Life. Between me and the Divine. In whatever way the referral originally occurred Life has presented me with these patients. The Divine asks me, in addition to using my skills and experience, to treat each of them with respect, importance and love. Although I don't usually consciously acknowledge it, I feel that at some higher level of consciousness I am saying "Yes" to that sacred pact.

SELF-COMPASSION

Larry is estranged from his 46 year old daughter and angry with her for the "mess she's made of her life." He feels guilty about the estrangement, yet he is stuck and unable to reach out to her. Doug at 68 years old is preoccupied with thoughts about aging and says,"The thing I want most is to have peace of mind." Yet he looks back upon his life with a lot of regret and shame. Frank is 75. Almost every morning he wakes up depressed with a vague sense of dread about the day. "When I look at my male friends and how much they have accomplished I feel diminished."
What each of these men need is more compassion towards themselves. Although the importance of self-compassion is not often emphasized in our training as psychotherapists and counselors, most of our clients need to learn to be more gentle and kinder toward themselves. For Larry, Doug and Frank the additional need at this latter stage of their lives is to be able to look back at themselves at earlier stages of their development with compassion and loving kindness.
At this stage of my lifework,probably because at 73 I am viewed as an empathic guide, I am seeing a number of patients in their 60's and 70's. From my experience it is quite common for most of us to look back at ourselves at earlier times of our lives and be judgmental and critical. At some level of consciousness we are doing a life review, seeing many mistakes and moments when we hurt others or ourselves. We forget that we were much less psychospiritually evolved then. As we review our lives it is important to find a way to be kind and compassionate towards those earlier versions of our selves.
As we talked more deeply Larry became aware that his daughter was triggering memories of what he was like in his 40's. He was addicted to marijuana and careening from one job to another. He was a "mess." At a subconscious level Larry was angry at her for reminding him of those painful times - filled with self-hatred. If he didn't have to be in her presence then he could suppress those memories. The pathway of his therapy was to revisit his 40's and become more compassionate towards his 40 year old self.
For Doug too the pathway to finding some inner peace and ending his daily self-recriminations about his multiple affairs many years ago was to revisit those times with more compassionate understanding. He came from a background of profound emotional neglect. Doug's mother was very fearful - her fearful energy permeated the atmosphere in their home - and very self-absorbed. That left him with a deep emptiness that he had tried to fill with serial extra-marital affairs,
In the 1960's Frank was actively involved in the peace protests and the counter-cultural "back to the land" movement. He chose the pathway of a simpler life, became a potter and grew most of his own food. Years of hunching over a potter's wheel had taken a toll on his body. He could no longer do the work. Over his lifetime he had earned much less money and accumulated less material goods than the rest of his male friends. Internally he felt inferior to them. As we talked more deeply Frank became aware that he was using the "measuring stick" of his banker father and the culture that he had rebelled against. Of course he felt inferior, but I continually pointed out that was the wrong "measuring stick" for his life.
For each of these men it was helpful, but insufficient, to develop an intellectual understanding of the roots of these feelings. In order for them to feel genuine compassion for themselves however, it was essential to find a way to engage their own personal higher consciousness. For all of us our Higher Self has the capacity for greater love than our ordinary ego self.
Our task as psychotherapists and counselors is to find a pathway for each of our patients to connect to their individual Higher Self as a source of deep compassion. Twenty years earlier Larry had been actively involved in a recovery program to deal with his marijuana addiction and drug usage. It was very helpful to him then. I encouraged him to go to Al-Anon meetings - his daughter was an alcoholic. In our individual meetings we talked about renewing his connection to his personal Higher Power. Slowly in small steps he developed a loving acceptance of his younger self and softened his heart toward his daughter.
Doug is a scientist who did biological research and his primary approach to the world was through objective reasoning. The notion of higher consciousness was totally alien to him. In my effort to form a bridge between the rational realm and higher consciousness I asked Doug whether he had any experiences of deep awe or deep love. He reported several experiences of extraordinary awe during nature walks and many moments of deep love for his sons and his current wife. I said to him,"As a scientist I ask you to look at these experiences as evidence of something beyond the ordinary and ask you to think of what is the source of these feelings." As an earnest person and as a reflective scientist he started to contemplate these transcendent experiences. Gradually I introduced the notion that if he was capable of very deep love towards others he could consider the possibility of directing that love from his personal higher consciousness towards himself.
As part of his involvement with the 60's and 70's counter-cultural movement Frank had explored Buddhism and had been actively engaged for many years in a daily Buddhist meditational practice. In that tradition there is a focus upon compassion and loving kindness towards all sentient beings. As a way of working with Frank's feelings of very low self-esteem I asked Frank whether he had ever directed the compassion and loving kindness toward himself. Reflecting on this question and bringing it to his daily meditation produced an awakening. Frank began as an extension of his daily practice to ask his own "Buddha nature" for more compassion towards himself.
For each of these men the epiphany of a personal pathway towards self-compassion was the initial impetus - the first step in a long journey. Each of them became actively engaged in doing this "homework" between our sessions. The psychotherapeutic work we did can be applied to clients at any stage of life.

BEING A SOURCE OF PEACEFULNESS

One of our roles as psychotherapists and counselors is to be a source of peacefulness in the lives of our clients. I don't know about you as my reader, But I know that this aspect of our work was never mentioned to me in my training or any supervision I received. And yet, my clients who come to me with their anxieties and fears need to feel that my office and my presence are a reliable compassionate source of peacefulness. They periodically comment,"It's so peaceful here."
It is important for each of us to find our own pathway of becoming more peaceful within ourselves and then bring that peaceful presence into our sessions with our patients. For me,that pathway has been a combination of many years of psychotherapy exploring the "river of anxiety" that used to flow through me, thirty five years of meditational practice and many years of contemplative walks in nature. As I reflect back upon myself at earlier stages of my development it feels to me that this combination has gradually produced a palpable psychophysical "rewiring" - a significant change in my inner life and my presence with my patients. I also speculate that it has created new neurological patterns.
One nature setting in particular, a beaver pond two miles from my home, has become especially symbolic of the sense of serenity I now feel most of the time. I have a watercolor painting of a pond in the woods hanging on the wall of my office diagonally across from where I sit. In preparing for my morning's work I take a few moments to look at the painting, recall the sense of peace that I feel at my local pond and ask my Higher Self,"Help me to be a source of peacefulness for my patients." During session I will periodically look at that painting and imagine myself with my in-breath tapping into the serenity that I feel at the pond and with my out breath letting go of any anxiety that my patient may have triggered within me or transmitted to me.
I would encourage each of you to discover your own pathway to inner peacefulness that uniquely fits you. You then can bring that presence into the therapy work and become a source of peacefulness for your clients and find a way to tap into it during sessions.
We also need to help our patients find a way to develop a sense of peacefulness for themselves. This usually necessitates that they do some work between sessions. I usually ask my clients "Can you remember some physical place where at some time in your life you have felt a sense of peace?" It is striking to me how often they recall places in nature. And how frequently these natural settings also tap into memories of natural places of refuge during difficult episodes of their childhood and adolescence.
Bart remembered a lake in a park near his childhood home where he used to go as a refuge from his mother's alcoholism. Richard described climbing out of his bedroom window to escape his father's abuse and the sense of safety he felt sitting under a huge oak tree in nearby woods. This is a brief blog entry,otherwise I would cite many more examples. I suggested to both Bart and Richard,as I have done with many patients, that they explore some local nature setting that reminded them of those childhood sanctuaries. Bart found a bench alongside a pond in his local suburban park; Richard felt drawn to a grove of trees in a nearby state forest. I encouraged each of them to develop a regular practice of going to these places between sessions and while sitting down to "Imagine that with your in-breath you are taking in the peacefulness of this place and with your out-breath are letting go of your anxieties and fears." Yearning for more inner peace in their lives they eagerly embraced this suggestion and visited their places a couple of times each week. Gradually they began to report that they brought the peaceful feeling into their everyday lives. When things became difficult Bart would imagine sitting at the bench and Richard under the big tree, focus on their breathing and say to themselves,"Let go of the fear." They were increasingly amazed and grateful how quickly they felt more peaceful.

I DON'T DESERVE LOVE

This is the most insidious love block. This underlying pattern - often unconscious - contaminates all the possibilities of feeling loved. Whenever someone offers love in any one of its myriad forms - praise, affection, help, commitment … - our client is unable to receive it. On the surface they may appear to be receptive, but they are psychologically unable to take the love in at a deep level. Because at some level of consciousness they feel unworthy of what is being offered to them.
The deeply engrained belief that they don't deserve to be loved, that they are unworthy of a good rich life undermines and sabotages all relationships, any positive feelings about work success and all the gifts of love.
The initial task of psychotherapy with my clients is to help them become more consciously aware of this pervasive pattern of being unable to simply take in love in all its myriad forms. I say to them,"Of course it doesn't make any rational sense that you would block love, but at some level of consciousness it makes emotional sense. There must be some reasons why that happens. From my experience these patterns start in childhood. What about growing up in your family may have contributed to this inner belief that you are unloveable?" This begins the process of exploring the historical roots of the love block.
Jim, a dynamic 48 year old successful businessman had been experiencing episodes of sadness about what's missing in his life - primarily a loving relationship with a woman. Whenever a potentially good relationship starts to become more intimate Jim either ends it or sabotages it so that the woman decides to break it off. Through our exploratory work it became clear to Jim that the physically and psychologically abusive relationship with his mother, who was depressed and addicted to pain killers, had made him feel unlovable. In her addicted state she would scream at him that he was "evil, a devil child". These frequent tirades occurred for years and had a devastating effect on Jim's feelings about himself. Because these feelings of unlovability are usually so deeply engrained for everyone with this love block a lot of work between sessions was essential.
I gave Jim two index cards. On one was written "YOU ARE LOVABLE" and the other,"YOU DESERVE A GOOD LIFE". I suggested to Jim that between sessions he periodically look at these cards, say the words and then notice what happened. Of course this was hard and painful. He would complain to me "those damn cards" reporting the painful memories they evoked and his ever deepening awareness of how hard it was for him to believe those simple phrases. Gradually, as Jim understood the roots of this inner belief - including the epiphany that he was the target for his mother's own self-hatred because of her history of abuse and shame about her addiction - he was able to be more receptive to love. It was particularly meaningful - since Jim was in recovery for his own alcoholism - for him to think that the source of the voice that was saying "You" in the phrase "YOU ARE LOVABLE" was his own personal Higher Power. He liked thinking that his own Higher Power was doing the work of helping him to feel lovable that his parents were unable to do.
One of the benefits of a heart-centered approach to psychotherapy, wherein our genuine caring is more overtly expressed, is that their love blocks get more quickly exposed. Clients with the "I don't deserve love" block have a lot of trouble simply receiving our praise and other acts of caring for them. They react with disbelief,"You're just doing your job which is to make me feel better." Or like Sara said,"When you get to know what I'M really like you won't think that I'm such a good person. Whereas my parents really knew me." Her parents were members of a very conservative Christian sect. They responded to her free-spirited nature and acts of disobedience as her being a "black sheep" a "sinner" and "damned to hell."
My approach to Sara was three-pronged. The first prong was to discredit the sources of her deeply rooted belief that she was unlovable by repeatedly raising the question whether her parents really knew her. It became increasingly clear to Sara that they were absorbed in their own lives. Sara was a target for their anger about their own unhappiness and their projections of very low self-worth.
The second and most important prong was to deliberately not be in the role of the neutral professional , but to make it clear that I really valued and appreciated her as a person. Over a period of time my genuine praise, warmth, consistent encouragement, welcoming attitude, celebrations of her moments of growth and laughter at her jokes made Sara feel that she was a lovable human being.
The third prong was self-forgiveness. Because of the parental implant of this inner belief that she was a "sinner"Sara made a number of bad choices and done things for which she was ashamed. She was relieved to hear that the techniques that I was using to help her forgive herself grew out of my own experience of needing to forgive myself. I will not describe the process in this blog entry because I've written about it extensively In my book "Working From the Heart" and described it in a youtube video.
With Sara and Jim, as with most clients with this love block, the work was intensive and only gradually impactful. And very meaningful for myself as well as my clients.


This blog is based on the LOVE BLOCKS chapter of WORKING FROM THE HEART: A THERAPIST'S GUIDE TO HEART-CENTERED PSYCHOTHERAPY

AN EXTRAORDINARY STORY

I have just finished reading an excellent book,"Speak But the Word…From Multiple Personalities to Wholeness" by Leilani Claire. It is the extraordinary story of the healing journey of how the author - who had 25 personalities - through years of intensive psychotherapy came to a place of wholeness, a final integration. She also describes - which is extremely rare in the literature - what it was like to live in the world for seven years after the ceremony of final integration without being able to use her dissociative adaptations and defenses. Leilani Clare's intention in writing this book was to be helpful to psychotherapists who are treating multiple personalities and to be a source of hope for other multiples who are still struggling wondering what is possible. From my perspective the book can be beneficial beneficial also for other therapists ,like myself, who don't work with multiple personalities or dissociative identity disorder, but who do work with clients dealing with severe childhood physical abuse and/or sexual violation. And for those of us who will be intrigued by the reflections it evokes about the big question,"What is consciousness?"
This blog entry is not intended as a review, but rather as a description of what the book entails and an encouragement to read it.
The initial sections of the book are presented in the format of letters written by two "host" personalities to the original personality to prepare her for integration. These letters describe the history of early sexual abuses starting at the age of three and the roles that each of the 25 personalities have played in the fifty years of life since the initial abuse. It describes then the final integration ceremony, which Leilani Claire calls "the Sacred Marriage", a "wedding of the soul." The last section is a series of yearly reports discussing what life was like for Leilani Claire for each of the seven years after the final integration.
What deeply enriches the book are the inclusion of many paintings - done by Leilani Claire who is an accomplished artist - of the different personalities at various moments throughout the six years of her psychotherapy. In addition. there are also a number of photographs of her from the age of three up to several years after the Sacred Marriage ceremony.
While she was in the process of finding a publisher for her manuscript Leilani Claire was diagnosed with a very aggressive cancer. It progressed rapidly. Near the end she contacted her psychotherapist Stephen Merriman PhD, who is the publisher of Four Rivers Press, and asked if he would take on the publication of her book. Knowing how important it was to her, he agreed. He also wrote the Foreword.
Stephen is a dear friend of mine and that is how I became aware of this important work. While reading it I decided that I wanted to help Leilani Claire tell her story to the many people who could benefit from it. That is why I've written this blog entry.


For more about "Speak But the Word…From Multiple Personalities To Wholeness" go to www.fourriverspress.com

THE SABOTEUR

"I did it again. I know what's good for me to do and I don't do it or I do it for a little while,but can't sustain it. It doesn't make any sense to me why this always happens." This is usually said by my patients with a mixture of frustration, confusion and self-anger. Of course it doesn't make any rational sense to them. Why, even with the best intentions and firm resolve, they are unable to stay with their exercise program, eat the right foods, choose the right partners, not return to their addictions etc. It is so frustrating. And insidious.
My patients want to know why. I usually ask "What comes into your mind about why this might happen?" After he/she gives several possible reasons, most of which are usually accurate, I add "Those reasons are probably correct. And, for most of the people that I've worked with there is usually something else, something unconscious, a part of their personality that I'll call The Saboteur. This is a part of your personality that lurks in the shadows out of your awareness. His/her main function is to undermine your happiness. He loves to be in the dark - that increases his power. So the first step is to bring him out into the light and get to know him, how he works, where did he come from." Of course, it doesn't make any rational sense that we would undermine our own happiness. "Yet", I continue," at some level of your consciousness it makes emotional sense. We need to find out what are the reasons for his/her existence. How did he become so secretly powerful in your personality?" Most of my patients feel a mixture of perplexed and intrigued. It does make sense to them however, that they may be sabotaging themselves because they have witnessed the consistent pattern.
I suggest to them that usually the personal historical roots of The Saboteur are in their childhood years wherein, at some deep level they were made to feel unloveable, unworthy of having a good life. It is not feasible within the limitations of a brief blog entry to discuss all the possible derivations. A few examples may be helpful: one patient was told on multiple occasions by her mother,"I wish that I never gave birth to you"; another patient, in a family of high achievers, was told that he was a "fuck-up" and a source of family shame; another always had a sense that no matter what he dud was "not good enough". One aspect of the therapy is to uncover the roots of this pattern, to look at it with compassion, and to begin to question the validity of this inner narrative.
Another aspect of the work is to use imagery. I tell my patients,"The Saboteur loves to be in the dark out of your conscious awareness, to work in the shadows. That increases his power, his effectiveness. What we want to do is to bring him out into the light, to name him, to develop an image of him." Once they understand how insidious and effective The Saboteur is in consistently undermining their happiness most patients like this part of the work. It makes the perplexing pattern less mysterious, reduces the sense of helplessness and introduces an element of playful creativity. One patient calls this sabotaging part of himself "the little fucker" and imagines him as a gremlin-like creature who stands in the corner of the room and who sometimes has a demonic expression and at other times an impish gleam. Another patient has named him simply "The Voice" and imagines him as a heavy-metal rock star who in a gravelly voice sings a particular song whenever he is trying to get my patient to do something that is not in his best interests. Another person uses her artistic ability to draw pictures of her saboteur and brings them into the office. It is interesting to witness the evolution of these drawings as her saboteur diminishes in power. During sessions with each of these patients whenever I notice an example of the undermining pattern I will say,"It looks like 'the little fucker' or 'The Voice' showed up and ask my patient to imagine what they may want to say or do to their saboteur at that moment. Gradually my patients are able to do that increasingly outside of the sessions and reduce the impact of that part of their personalities.

A WALK IN THE WOODS

At least once a week - often twice - I take a solitary walk in some local woods. Many years ago I recognized my need to be away from everyone to restore myself, to recharge my psychological and spiritual batteries. Our work is depleting. Trying to be a compassionate caring person in the presence of so much suffering and struggle for so many hours each week is draining. As I became increasingly aware of this issue I decided to return to my old sanctuary - the woods. As an adolescent,trying to cope with the inner conflicts created by my father's alcoholism, and needing to find some refuge from the psychological battlefield of the blacktop playground of a working class housing project, I fled to a nearby woods. During that difficult period of my life I spent many hours alone there feeling safe.
It has always been fascinating to me that when I recommend to my patients that they too seek out some local nature setting during periods of profound struggle, they also go to some local nature place - woods, lake, hills, ocean, city park - that was a refuge for them during difficult childhoods.
Whenever I return from my woodland mini-retreats I almost always feel replenished and reenter my ordinary life with a sense of renewed energy for my work and family.
I do not consider these walks as "hikes". They are contemplative sojourns. By walking mindfully I am trying to connect with other levels of consciousness within and outside of me. By physically going away from the pulls and distractions of life I am going toward a deeper connection with my own Higher Self, other aspects of non-personal higher consciousness and the consciousness of the natural world. In this way I am following an ancient pathway. For millennia throughout a wide spectrum of spiritual traditions other seekers, during episodes of personal struggle, have separated themselves from ordinary life and gone out into the natural world in order to connect to higher consciousness. Even though I do not feel affiliated with or attached to any particular spiritual tradition I do not feel alone. I am walking a path that many others have travelled. Many years ago in a moment of playfulness I named this aspect of my personality "the old monk." I have grown very fond of that label.
On the walls of my office I have placed images - a tranquil small pond, an old deeply rooted tree, a woodland path - that remind me of the nature places where I sit in meditation and say my prayers. These images are there to help me to connect with and draw upon those other levels of consciousness as I do my work.


The ideas described in this entry are discussed more fully in the Recharging chapter of my book "Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy" and depicted in the Recharging video on www.youtube/WilliamPRyanPhd

….AND….

This blog entry is intentionally brief. It contains a simple concrete suggestion that is very symbolic in its purpose and potentially multi-layered in its impact. Hopefully, as a reader, you do not find it simplistic.
Whenever my patients use the word "but" in the narrative that describes their thoughts and feelings I encourage them to substitute the word "and". "But" is a word that tens to negate or diminish what preceded it, whereas "and" connotes inclusiveness and coexistence. My intention is to help my clients develop an inner landscape wherein conflictual, sometimes polar opposite, thoughts and feelings can be contained with less tension and more respectful coexistence.
Some examples. Often my patients say,"I feel like I did a good job, but …." and then give a list of reasons why it was not perfect. The positive feeling gets negated or diminished by whatever follows after "but". Other clients describing a spouse/lover/friend say "I love/like ___ but …." and then tell about some annoying or hated characteristics or opposite feelings. Again the love/like gets lost or weakened by the litany of complaints.
Usually I will encourage my patients to substitute "and" for "but" by saying to themselves "I did a good job and I could also have …." as away of counteracting the inner notion That I can't feel good about what I've done unless it lives up to perfectionistic standards. I recommend to other patients to say to themselves "I love my lover/spouse/friend and I hate when he …." as a way of acknowledging and honoring the coexistence of opposite feelings about the same person.
Gradually the use of this simple substitution - in conjunction with our deeper work -becomes a useful tool to expand their capacity to have many complex feelings coexisting within their consciousness.

BE GENTLE WITH YOURSELF

"Be gentle with yourself" is the phrase that I most frequently say to my patients. It is my intention to counteract what, decades ago, Karen Horney called the "tyranny of the shoulds." They are those inner self-critical and judgmental voices that are so deeply engrained in so many of us that we think that they are simply aspects of human nature.
One of the initial steps of the psychotherapy process is to help our clients become more consciously aware how pervasive and insidious these inner critical voices are. And then begin to explore what are their roots. If you observe young children - in recent years I've had more opportunity to this by interacting with my grandchildren - you will witness that this criticalness is not present. How, then, did our clients inner critical "measuring stick" get internalized?
What life experiences with parents, teachers, coaches, and other significant adults in his/her early life contributed to the formation of this "measuring stick"? Answering this questions common background material that most psychotherapists and counsellors explore. It is also important to consider what are the cultural and sub-cultural influences that have contributed to the inner criticalness? The American culture is a very judgmental one and our clients, often without awareness, have internalized its standards. For example, one of the axioms of American culture is that,"You can do anything that you want to do as long as you put your mind to it and work hard." That notion is absurd nonsense, and is a source of feelings of failure and inferiority for many people. The truth is that we all are profoundly limited by our genetics. One small personal example - it exploring its sources how can we as psychotherapists and counselorswould have been impossible for me with very minimal musical ability to have become a cellist in a classical orchestra. No matter how much I practiced. It is then important for all of us to be gentle with ourselves and to come to a place of loving acceptance of our limitations. This will also help us to be more accepting of the limitations of others.
Some of our clients have inner standards that are idiosyncratic. One of my patients has an internalized image of being a generous person. Whenever he fails to live up to that image he chastises himself as "selfish." I often say to him,"Be gentle with yourself" as I gradually get him to look at the impossibility of living up to that standard. No human being could do it - not even the saints.
Within the limitations of a brief blog it is not possible to discuss in depth all the contributors to this "tyranny of the shoulds."
In addition to exploring its sources how can we as psychotherapists and counselors help our clients to counteract this self-criticalness? One pathway is for us to say,"Be gentle with yourself" whenever this voice shows up in sessions. Initially our clients will struggle with being able to take that in. Gradually what happens ,though, is a kind of 'transmission" wherein they internalize that phrase accompanied by the energy of our compassionate presence.
I also write on an index card,"Be gentle with yourself" and encourage my patients to put that in some place where they will see it often. I recommend that they periodically look at it saying the phrase either out loud or to themselves coupled with some relaxational breathing, imagining with the out breath that they are releasing some of the inner judgment or criticalness.
In addition, I suggest that they consider that the source of their own inner voice saying,Be gentle with yourself" is their own Higher Self or personal Higher Power. For some patients that notion does not fit with their worldview. for them I say,"Imagine that the source is some benevolent relative, or teacher. It may either be someone you personally know or some historical figure. Trust whoever comes into your consciousness at this time. Also the image may change over time." Gradually the potency of the inner critical,judgmental voices diminishes and my patients become more compassionate and loving towards themselves.

I DON'T NEED ANYONE, I'M STRONG

So many of our clients have difficulty asking others for help and/or are unable to receive help, even when someone who genuinely cares about them offers it. Why is this? In this brief blog entry I will discuss just two underlying dynamics that I have witnessed in my 40 years of private practice as a psychotherapist. One is a survivor mentality developed because of childhood experiences; the other is the underlying "measuring stick" of masculinity that is prevalent in american culture.

SURVIVORS

By not being able to ask for help or not receiving help when it is offered we block ourselves from a powerful source of love -even when we most need it. To understand how this pattern gets established it is essential to look at the childhood experiences of our clients. What children need the most - a sense of safety, affection, warmth, kindness, valuing of their uniqueness - was is short supply for many of our clients. For some, in addition to neglect, they experienced physical/psychological/sexual abuse wherein their bodies and souls were under attack. They were living in a psychological war zone and often feeling emotionally alone.When they recall these childhood experiences our clients remember thinking,"How do I get out of here? How do I get through this?" at some point they realize that their main task is to survive,to somehow keep their bodies and souls alive until they can leave. So, because they feel that others cannot be trusted to take care of their needs, they become emotionally reliant only on themselves. They develop a strong self-protective inner wall. They don't ask for help feeling,"I'm strong. I can handle it myself, I don't need anyone's help." They are unable to receive help when it is offered feeling,"If I open myself to help from someone I'm putting myself in their hands and they are either unreliable or they will hurt me."
Working with this block is a profound therapeutic challenge. With these clients it is especially important to provide a warm and welcoming environment wherein they can begin to feel safe and know that they can rely on our compassionate caring presence.Simple acts of loving kindness are important. For example, having a welcoming attitude,personally offering them a tissue when they are tearful, offering water/tea/coffee as a symbol of nurturance, praising them for some small act of growth etc. Of course ,these clients often have trouble receiving these acts of kindness. These are very important moments in the therapeutic relationship. It provides us with an opportunity to explore more deeply why they have so much difficulty in receiving these simple acts. More of the childhood history will be uncovered. These moments also lead to another aspect of their relationships that these clients don't usually consider - how their rejection of human kindness affects the person who offers the help. These exchanges within the therapeutic relationship often are the turning points. As they gradually learn to accept help from us, our clients become more open to receiving help from others who genuinely care for them.

INNER MEASURING STICK

Most of the men that I've worked with struggle with this difficulty in being able to ask for help and/or receive it when it's offered. At some level of consciousness they have internalized as a "measuring stick" of their feelings about themselves as a man the archetypal American image of a "real man". A "real man" is someone who can do everything, who accomplishes everything on his own and needs no one. Even though in recent decades this definition of what a man should be is changing, at an unconscious level this old ideal still holds psychological power. What happens for most of my male patients is that whenever they are unable to live up to this totally unrealistic "measuring stick" they feel inferior, smaller than other men. That internal "measuring stick" makes it very difficult to ask for help and/or receive it when offered.
I spend a lot of time in sessions continually bringing this cultural implant into conscious awareness. In addition, I help my patients to look at what aspects of their personal story have contributed to this internal image of what a man should be. I suggest to them is not that they are inferior, but rather that they are using the wrong "measuring stick." the one that has been implanted does not fit who they are. They need to develop a different "measuring stick."
I have written extensively(the "Men" chapter in "Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy") about how,within the therapeutic relationship, we can further help our male clients with this issue.

WISEHEART; A PERSONAL RELATIONSHIP WITH MY HIGHER SELF

Many years ago - as a way of developing a more intimate relationship with that aspect of my consciousness - I named my Higher Self. I call him Wiseheart. By giving him a name that transcendent aspect of my consciousness moved from being an abstract notion (which might have many possible labels: Higher Self, personal Higher Power, Buddha Nature, Christ Consciousness …) to something more concrete and deeply personal. The visual image I have of him is that of a bearded old man who emanates deep loving compassion and wisdom. In a corner of my office, behind the chairs where patients sit, I have placed a totem of Wiseheart - the face of a bearded old man carved from second growth redwood. On a tree across the brook that runs behind my home I have hung a similar concrete image of my old friend. Both of these iconic images are daily reminders of the ongoing presence in my life of Wiseheart.
My life and work have been deeply enriched by this relationship with Wiseheart. The purpose of this brief essay is to encourage other psychotherapists and counsellors, in whatever way works for you, to develop a more intimate relationship with your Higher Self. Hour after hour, day after day we are in the psychological field of the suffering and struggles of our clients. We are exposed to so much sadness, fear, confusion, doubt. To be a compassionate open-hearted presence wherein our minds and our hearts are fully engaged with the struggles of our clients is -if we really allow ourselves to think about it - too daunting a task for our small selves, our small hearts. By connecting to something larger within ourselves, something that has a much larger Heart capable of great compassion and love, and something that is capable of more transcendent perspectives on the issues of our patients, it is very possible to be compassionately present with them for hours without becoming overwhelmed, numb or depleted. Our Higher Self is that source within our own consciousness. The good news is that He/She is always with us. Our task is to become more aware that this aspect of our consciousness exists, to engage more fully in an ongoing intimate relationship with it and to develop ways of connecting with our Higher Self during sessions.
Five minutes before starting my early morning or late afternoon sessions I look at my carving of Wiseheart, take some meditational breaths, and ask Him for assistance. "Help me to be a vehicle of compassion, of loving kindness and the wisdom of the heart with my patients today. Help me to tap into the healing knowledge within me and from other sources of wisdom outside of myself." Then I open the door and welcome my first person.
Invariably as the daily work unfolds I am in the psychological energy field of some big sadness/fearfulness/confusion/anger that my patients are experiencing. I think that the ordinary human reaction at these moments would be to pull back or shut down -probably without conscious awareness -our hearts as a way of protecting ourselves from being overwhelmed by the bigness of the feelings. What I have learned to do as soon as I become aware that my patient is experiencing one of these big emotional states is to look over at Wiseheart and start doing some meditational breathing. With the in-breath I imagine that I am connecting to this Big Heart, that aspect of my Higher Self that is easily able to be present in a deeply compassionate way. I also imagine that I am accessing wisdom perspectives that transcend ordinary consciousness. With the out-breath I imagine that I am letting go of any anxiety about being overwhelmed, that I am releasing any of my patient's big feelings that may have entered the psychological; energy field of my personal consciousness.
I continue to be grateful for and awed by how doing this enables me to be present in an open-hearted loving way in the face of huge patient feelings. For hours. And not feel emotionally drained, numb or detached. Having done this way of connecting to Wiseheart for many years I never cease to be amazed by His capacity to be deeply compassionate in the presence of some horrific stories and to be a source of what some ancient sages referred to as "the peace that underlies all things."
As I end this essay I again want to encourage psychotherapists and counsellors to develop some daily practice of connecting to your personal Higher Self.Before I begin my contemplative walks in local nature settings I say to myself that one of my intentions is to use this time to deepen my connection to Wiseheart. After my meditations I pray that I become more open and receptive to Wiseheart,s love and guidance. I am profoundly grateful that He provides me with loving companionship and wise guidance both in my everyday life and in my work as a psychotherapist. I hope that your Higher Self does the same for you.


This blog entry is based on work in the Small Heart,Big Heart chapter of "Working From the Heart: A Psychotherapist's Guide to Heart-Centered Psychotherapy"

MOVING FROM SURVIVING TO THRIVING

It's so hard to change the patterns of a lifetime. It requires hard, conscious work. And compassion towards ourselves. Our patterns of behaving are deeply rooted. Because these behaviors have been repeated and reinforced so many times during our lives they are so well engrained neurochemically that we are brain-wired to repeat them.
We are also afraid to change our ways of acting and thinking because they serve a self-protective function. They helped us to survive when we were younger. Some of us come from backgrounds of significant physical, sexual or psychological abuse or profound emotional neglect. For many of us the impact of our earlier environment was more subtle. Without an awareness of the impact upon us our parents,teachers et al were critical or judgmental of our sensitive Selves. Or there was a familiar atmosphere of fearfulness, tension, anger or sadness. This felt, at some level of consciousness, unsafe. So our Selves went into a self-protective hiding place and developed outward ways of behaving in order to survive. Although the use of the word survive may,in some instances, seem exaggerated or unnecessarily melodramatic, for the sensitive Self the stakes feel very high and the notion of surviving in a hostile or neglectful environment is very fitting.
For most of our patients - although this is not true for those who are currently in abusive situations - the need to be in a survival mode no longer exists. However,before they are able to put in the very hard work of changing, our patients need to understand how their patterns initially developed. Also, they need to perceive that unwittingly they are continuing now to act as if the same degree of physical or psychological threat still exists. After that initial therapeutic work is done I tell my patients,"It is time to move from surviving to thriving." In order for their Self to develop more fully - to thrive - they will have to do some hard work. While this is happening I encourage them to say to themselves the phrase/mantra, "I'm moving from surviving to thriving." Simple aphorisms - because in a few words they embody a simple and profound truth - like that can be very helpful and potent in this deep inner work.
As therapists it is very important for us to embody and express compassion for how difficult it is to change these patterns. Patients usually become judgmental and angry toward themselves because they are having such a difficult time changing. It seems to them that it should be simple. I often say,"Be gentle with yourself. Be compassionate towards yourself. It is very hard to change the patterns of a lifetime." I remind them that our brains are wired to respond in these ways, that the patterns are deeply engrained neurochemically and that, at some level of consciousness, they serve a self-protective function. Gradually, through my repeating."Be gentle with yourself" my patients internalize this phrase and become more compassionate toward themselves during the difficult process of changing.

HELP ME TO FORGIVE MYSELF

At some point in their therapy every client tells us something for which they need to forgive themselves. Yet for most of us our training did not teach us how to help our clients to forgive themselves. I learned how about twenty years ago from a very painful personal experience.
From that experience I was able to discern four important aspects of a process. First, while there are certain steps that we can take to facilitate the work, self-forgiveness unfolds with each person according to its own timetable. The other three aspects have to do with using petitionary prayer, the healing power of spending time in nature and the importance of using some guided imagery as a way of tapping into other realms of consciousness.
Self-forgiveness is not a rational process. It cannot effectively be attained through analytic reasoning,some form of intellectual understanding or some other primarily cognitive process. Because forgiveness occurs in the territory of the heart and spirit it can only be accessed in those realms. As psychotherapists and counselors we need to find ways of tapping into those other realms of consciousness that transcend our everyday ego processes.
I encourage my patients to use certain prayers/mantras. Sometimes these prayers are a kind of petition that is reaching out to some external source of forgiveness outside of ourselves. What patients call this source depends on their particular spiritual path. These prayers also attempt to connect us to some internal source of forgiveness. I tell my patients that they are calling on some aspect of their personal consciousness that transcends their everyday mind, a source of deep inner wisdom that knows what is in their best interests. I use the terms Higher Self, Deep Self or Personal Higher Power to give a name to this inner source. When one of those names does not resonate with a particular patient, we find something else.
I write on three separate index cards:
Help Me To Forgive Myself
Please Forgive Me
Help Me To Feel Forgiven
and give them to my patients suggesting that they put them in a shirt/blouse pocket next to their heart, in their car or in some other place where they will see it often. I encourage them to take the cards out and say these prayers/mantras often between sessions. In the first session after I hand them those cards I ask my patients about their experience in using the cards. Most commonly they have used them only a few times often guiltily reporting,"I didn't do my homework". I respond warmly with a smile,"That's what happens with most patients. That's how guilt works - it will undermine our work by getting you not to do what will help you to feel better." And then I encourage them to do more. They usually do.
I also suggest taking the prayers with them on solitary walks to some local nature setting that is special to them. Contemplating the words while walking in the woods, by the ocean, along a brook or on the top of a hill deepens the efficacy of the prayer. I explain to my patients that in many ancient spiritual traditions it was common for people, whenever they needed some deep psychospiritual healing, to go away from the distractions of everyday life and go into the natural world. This form of retreat into some place in nature fostered greater access to other non-rational realms of consciousness both within and outside of themselves.
After several weeks of saying the prayers and visiting their nature place between sessions I begin to use guided imagery. I ask my patient to close their eyes and have them do several minutes of meditational breathing. Then I say," Imagine that you are taking a solitary walk in your nature setting. Remember that this is a safe place where no harm can come to you." For some patients who prefer forest settings I will guide them to a clearing in the woods with an ancient deeply rooted tree in the center; for others it will be a long walk along the edge of the ocean listening to the gentle waves; for others it will be a walk through the woods to their brook or river where there will be a stone to sit on. After a while I will say,"Stop walking. Now begin to imagine coming towards you at a distance that feels safe to you, some image of forgiveness. It is important to trust whatever image shows up at this time, even if it makes no sense to you. Spend some time just witnessing this image. Now begin to imagine opening up your heart and letting in the forgiveness that the image in some way is offering."
In the twenty years that I've been doing this self-forgiveness work I've witnessed a wide spectrum of images. Sometimes what emerges is very personal to that patient - some loved one or beloved pet. Sometimes it will be an image from their spiritual or religious tradition. Sometimes it will be an archetypal image. Sometimes a "presence". Sometimes a warm light or enveloping fog. Sometimes... Since a lot of what happens in this work is mysterious and idiosyncratic to that person, it is important for us to respect whatever image shows up and to quiet down our need to analyze or interpret. Sometimes a patient spontaneously tells why he/she thinks that a particular image occurred. I've learned over these many years that my need to analyze and understand can interfere with a sacred process. So nowadays I rarely inquire - unless I can't contain my curiosity.
Usually there will be a number of these imagery sessions, sometimes in back to back sessions, more commonly interspersed over several months. For some clients the forgiveness image remains the same each time. Often it changes. It is essential to trust how the process unfolds with each patient and to remember that forgiveness does not occur in linear time. You may do this imagery work for weeks and at some point it feels finished. Then for many patients the need for more work becomes clear six months later. In these instances forgiveness needs over time to penetrate through many layers of consciousness.

Of course it is not possible within the limitations of a blog entry to discuss all the ways of working with self-forgiveness in great depth. For a deeper discussion including several examples of particular patients and a description of my personal experience that led to this work take a look at "Wisdom of the Heart: A Therapist's Guide to Heart-Centered Psychotherapy.

I LOVE MY PATIENTS

I love my patients. When I say this it oftentimes makes others uncomfortable.On one occasion I was being interviewed by a psychiatrist on radio and she said,"I read your book and I really liked what you had to say. However, your using the word love made me uncomfortable. I think that I would have preferred the word nurture - I nurture my patients." I responded,"I am aware that it makes people uncomfortable- sometimes it makes me a little uncomfortable too. We need to ask ourselves why does saying'I love my patients' make us feel that way?" One of the reasons is that in our culture the first associations to the word love are usually to sexual or romantic love. Of course,those expressions of love would probably be harmful to our patients. Yet, in other areas there is a wide spectrum of acceptable expressions of that feeling. We can easily say "I love...my children, my wife,boyfriend,friends,animals,home, community etc. Why not include patients?
Another explanation for the internal struggles is that it feels unprofessional to say,"I love my patients." We tend to define professional as objective and not emotionally attached. Yet, in some other cultures that is not true. Several years ago a dear friend,who is a psychotherapist, was on a trip in Cuba sponsored by a social justice organization. On this two week trip she was among a group of health care professionals who were in Cuba to witness how their health care system worked and to interact with Cuban health care professionals. She was very surprised to witness how often and easily the Cubans said,"I love you" and were openly expressive of their love toward their patients. And how openly they expressed that love of their patients at professional meetings. When she returned we had several interesting conversations. We discussed how our training emphasizes this other notion of "professional" as objective and non-attached - more scientific. It led us to recall how important it was for the early leaders of the fledgling fields of psychotherapy to be accepted by members of the medical and scientific community. They felt that in order to establish the legitimacy of this field among the other sciences that it was essential for them to be viewed as objective and emotionally distant. It seemed to both of us that we were still unnecessarily holding on to that earlier model.
When I am asked during interviews how I express my love I reply that, first of all,it is important to state that I am not talking about sexual or romantic or sentimental love. Those expressions of love towards our patients would be unprofessional and harmful. I am talking about open-hearted expressions of praise,encouragement,compassion,acts of loving kindness,warmth,celebrations of growth,consoling touch,non-judgment,caring challenges etc. A common response from other psychotherapists and counselors is,"I do those things too although probably not as often as I feel them and I don't really talk about it with my colleagues. Also, I don't usually think of those things as an important part of the treatment." Yet,according to the research literature about effective psychotherapy, when clients are asked what was most helpful to you in your therapy most frequently people reply that,"My therapist cared about me as a person." Moreover,there is increasing research on brain patterns indicating that compassionate caring over a period of time changes brain patterns in positive directions.
For most of us psychotherapists, counselors, life coaches, pastoral counselors a significant part of our original intentions in doing this work was our heartfelt desire to help people with their problems - to alleviate human suffering. For many of us our training with its emphasis on theories, techniques and professionalism has caused us to suppress those original heartfelt feelings.
A primary motive for me in writing the book,"Working From the Heart:A Therapist's Guide to Heart-Centered Psychotherapy", doing this monthly blog and Twitter, and making my youtube videos is to advocate that we return to our original heartfelt intention by being more openly expressive of our caring. Then our patients benefit not only from our theories and techniques, but also from our open-hearted expressions of love.

THE TOOLBOX

Most of the Patients in my current psychotherapy practice are men. At this stage of the evolution of my professional life, 71 years old with four decades of experience as a psychologist,I have a strong desire to help men navigate the complexity of their emotional relationships with their partners and their children. I view it as a mentoring role within the therapeutic relationship. Most of my patients had fathers and other men in their lives who had limited skills for dealing with emotionally-laden situations.

In talking with my patients about this I find the iconic male image of "the toolbox" a very useful metaphor.For example, during a recent session with Hal, who at 38 is floundering in his efforts to connect emotionally with his wife and two daughters,I said "When your father reached into his emotional toolbox he found only two tools - advice-giving and the hammer of anger. Part of what I will try to do is to give you some additional tools." He smiled and nodded his head. This is a fairly typical exchange. We live in an era in which men are encouraged to connect more with their inner emotional landscape and to enter more into the realm of the heart in their relationships with their partners and their children. However, they have been raised by fathers, grandfathers and uncles from another era. So, while there is a cultural permission to define masculinity in a different way, they still have few models of what that actually means.

When discussing expanding their emotional skills I put my left hand over the edge of my chair, reach down to the floor and say, "Imagine yourself reaching into your toolbox and selecting the right tool that is needed for this situation." Oftentimes men will say that they feel helpless because they don't know what to do. My respond usually is "Often she doesn't need you to do anything. She needs you to be....Sometimes that means being an attentive listener who doesn't interrupt or give advice. Sometimes that means she needs you to be in your heart and not your problem-solving head - to be an open-hearted compassionate presence. Sometimes the tool you need is patience - to give your partner or child the gift of your time while something unfolds." We also talk about being a provider, which is certainly an archetypal male role. The use of that term resonates with my patients at very deep levels of consciousness. However, I'm talking about being a provider not only of their external needs, but also of their inner needs. That means asking the question, "What does my partner or child need from me at this moment to nurture their inner life. Do they need a warm soothing voice, encouragement, some affectionate touch, praise, celebration of an accomplishment ....?

As a way of reminding my patients to respond from their hearts to these emotional situations I recommend to them that they gently touch the breastplate at the center of their chests and do some meditational breathing. I suggest that they tap that spot for several minutes before they enter their home or apartment as a reminder to shift from the problem-solving mode that their work usually requires to the more open-hearted presence that their home life needs. I also encourage them to do that gentle tapping of their heart area during emotional situations at home so that they can respond from the realm of their emotional hearts.

This blog entry is based on the MEN chapter of my book "Working From the Heart:A Therapist's Guide to Heart-Centered Psychotherapy"

Accessing Our Big Hearts

    Once our work day begins we are in the psychological field of whatever each patient brings to us that day. Sometimes what they bring feels enormous and overwhelming: profound sadness or despair, terror or unrelenting anxiety, tremendous rage, or, a huge void. When our patients experience these big feeling states, there is a palpable shift in the energy in the room. In the presence of these states it is understandable that our first response, often unconscious, is to constrict our emotional hearts as a way of protecting ourselves from being overwhelmed.

   On some days there is something occurring in our own lives that makes it very difficult for us to be compassionately present. We are feeling miserable because we have a heavy chest cold or did not sleep well. We're worried about how we are going to pay that huge doctor's bill or this month's rent. We had a big argument with our spouse or partner or adolescent daughter this morning.

   Under these circumstances we may wonder how are we going to get through this evening's work and be present to our patients. In these moments it is important to remember that we all have Big Hearts that are able to transcend the limitations of the small hearts of our ordinary consciousness. How we understand the source of this Big Heart will depend on our cosmology. Yet we all know about the existence of these aspects of our consciousness from personal experience. We all have these periodic moments when we transcend our ordinary love and feel a much larger love for our spouse/partner, for our child, for a dear friend, for a particular place, for a beloved animal, for ..... These are Big Heart moments.  From my perspective my Big Heart is an aspect of my Higher Self. Someone else might postulate that this larger love emanates from their personal Higher Power or Buddha Nature or Christ Consciousness or .....  

The important pragmatic question is how do we access his Big Heart during psychotherapy or counseling sessions? I think that it is very helpful to have some image of this larger heart that uniquely fits for us. Many years ago my wife, Jeanne, gave me a piece of California redwood that had been carved into the wizened face of a bearded old man. I keep this carving in my office in a corner behind my patient's chair as an iconic image of my old friend Wiseheart, my name for my personal Higher Self. I think of Wiseheart as the Big Heart aspect of my consciousness. he is also the container of the enlarged compassion that has developed through my life experiences and the conduit for other sources of deep compassion and wisdom that are available to me through the collective unconscious. I encourage my patients and supervisees to develop their own personal image of their Big Heart. Until that emerges I suggest that they imagine a larger emotional heart that is located near their physical heart.  

   About five or ten minutes before the beginning of my first session, I use a small wooden hammer to tap an antique Chinese bell that sits on the floor inside my office door. This tapping ritual is a symbolic reminder that my intention is to enter a psychological space that is different from the concerns of my everyday life. Then I look at the carving of Wiseheart, imagining that I am connecting to my Big Heart and then I do some meditational breathing. Then I open the door to welcome my first patient.

   During sessions whenever I begin to feel overwhelmed by the bigness of the feeling states that my patient is experiencing or I start to feel myself becoming emotionally distant I again look at the carving of Wiseheart and do the meditational breathing. At these moments I feel that with the in breath I am connecting to my Big Heart and with the out breath I am releasing the energetic vibrations of my patient's large feelings. Then they do not penetrate the field of my consciousness. I can continue to be a compassionate presence for that person and the next and the next. At the end of a morning/evening of work I do not feel depleted.

   I encourage you to adapt these notions about our Big Hearts to your individual cosmology and ways of working.

   These ideas are described more fully in the Small Heart, Big Heart chapter of my book Working From the Heart, A Therapist's Guide to Heart-Centered Psychotherapy    

      

RECHARGING

   Each day as therapists and counselors we are in the psychological energy field of so much suffering and struggle. In one morning or evening of work some patients will be depressed,anxious,grieving, angst-ridden,doubtful,despairing or enraged. Or a combination of those feelings. Our office reverberates  with the energy of those feeling states,day after day,week after week, month after month for years.

   Each of our patients needs us to be a compassionate listener, a source of loving kindness, and a carrier of hope. How do we sustain that level of presence and not become exhausted, emotionally distant or numb? How can we be in the psychological energy field of that amount of suffering and then go home and be emotionally available to our spouses, partners and children? This is one of the greatest personal  challenges of doing this lifework.

   I call the process of replenishing the energy supplies of our emotional,physical and psychospiritual batteries recharging. I have developed ways of recharging myself both outside of and during sessions that I would like to pass on. Before I discuss these it is important that I ask you to consider this question: why are psychotherapists and counselors so good at taking care of others and not good at taking care of themselves? 

   It is important that each of us explore that question in depth in our individual psychotherapy. From my own personal experience, and of working with psychotherapists whom I've had as patients, the answers were found in exploring how the role that I played in my family contributed to my choosing this lifework. As a child being the emotional caretaker of my mother was a reliable source of love and special status with her. That led me to unconsciously take on the role of emotional caretaker of others as a primary source of approval and love from others and self-esteem from myself. In my own psychotherapy I discovered that my struggles in taking care of myself were connected to an unconscious fear that others would no longer love me if I took time away from them to take care of me. That fear made me anxious about and resistant to doing things for myself. I would encourage you to learn what are the psychological roots of your difficulty in taking care of yourself.

   I have found two primary pathways of taking care of ourselves outside of sessions. the first is to take regular solitary time- at least a few hours each week - away from everyone, to do something that is nourishing for you. For me that involves taking a contemplative walk in some local nature setting at least once a week. For other therapists and counselors that I know that solitary time is by riding a motorcycle, horseback riding,spending time in the garden or in an art studio. The essential aspects are that the captivity feels replenishing and that it occurs in some place where no one can access you. Because the nature of our personalities tends to be that when we are with other people we think of their needs before our own it is critical to have regular time when we take care of only ourselves. the second pathway is to regularly spend playful time with playmates. Playmates are people with whom we share a passion and who have no psychological need for us to take care of them. I have friends with whom I share my passions for jazz and college basketball. other therapists that I know are in community theatre. have a weekly poker game, play music or sing with others.

   It is also possible to recharge ourselves during sessions. Within the limitations of this brief blog I will describe effective ways of doing this that I have evolved. Whenever I am with a very fearful patient I spend a few moments looking at a Taoist painting behind the patient's chair. It depicts a man sitting in a small boat in a tranquil lake and to me it symbolizes serenity. It reminds me of solitary time that I've spent by a local pond. As I glance at the painting I take a few meditational breaths - imagining with the out breath that I am releasing any fearful energy from my patient that might have entered my field of consciousness. When I am with a patient who is deeply grieving I look at a wood carving behind the patients chair again with some meditational breathing imagine myself releasing any sadness from my patient that may have entered my field of consciousness. This redwood carving is of the head of a bearded old man - it is my image of Wiseheart, my Higher Self whose Big Heart is capable of much more compassion than my ordinary small heart. When I am feeling depleted or overwhelmed by what a patient is describing I look at a large poster in a corner of my office. It is of a giant redwood - to me a symbol of great strength and stamina. I recall what it felt like to walk underneath those giants and to walk among the big trees near my home. With the in breath I take in that feeling of strength and with the out breath I let go of feelings of depletion.

   Having done this kind of recharging for years I am pleased to report how effective it has been in helping me to sustain a sense of open-hearted compassionate presence for hour after hour and not feel the need to become distant in order to protect myself from the cumulative effect of the enormity of feelings that we are present to in this work. Hopefully this will help you to find something similar that will work for you.

   This entry is based on the Recharging chapter in Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy