Psychology Today Blogs - Don't Be Swayed

Is 'Experience' all it's cracked up to be?

Rom Brafman, Ph.D. — Wed, 17 Sep 2008 22:29:38 -0700

When I was fourteen I was brave enough to start taking guitar lessons. I've never really been the musical type, I had zero guitar experience, but I always liked the instrument. So when my mom suggested/pushed me to give guitar playing a chance, I went for it. For a whole year, every Saturday, I walked to the community center carrying my guitar to join a few other teenagers who came together to learn.

My progress was slow but steady. I learned all the basic chords, advanced to the bar chords, and even memorized Canon in D Major and 'Holiday' by the Scorpions. I stuck with learning to play the guitar and it was paying off.

Then one day, about a year into my guitar playing lessons, in came a new student. He was younger than me, probably only twelve, and he also had no guitar playing experience. I don't remember his name, but I remember that he was super nice. Well, only a couple of weeks later he had already mastered everything I had learned in an entire year--and, to top it off, he was able to hear a song on the radio and immediately play it on the guitar. Unbelievable. What can I say, the kid had talent. And it didn't take a genuis to notice that my year's worth of experience didn't amount to much when you compared it to his abilities. Now, it's not that there was any competetive energy between us, he was the most genuine and down-to-earth person you can imagine. But this marked the first time when I realized that experience has its definite limits.

The forumula for success, at least according to my teachers, had always been that if you put your heart and soul into what you loved doing, and if you kept on practicing--if you gained experience--then you could master absolutely anything. And, when you're young it seems to work, whether with learning how to read or finally figuring out how to factor algebraic equations. But when it came to playing the guitar, I realized that although I could improve if I continued to practice (and, yes, there was definitely a lot of room and potential for improvement), I could never be as good as the kid who had the natural knack for it. That shouldn't stop me from playing and having fun, but my guitar talent was limited. Experience could only take me so far.

You hear a lot of talk about experience in the news these days. First it was Obama who didn't have enough of it. Now it's Palin. But the media is confusing experience with skill. If you wanted to put together a band and you had to choose between me who had a whole year of experience and the new kid who only had a couple of weeks but was already better than me, you'd be crazy to choose me. Or look at Donald Rumsfeld. He had decades of leadership and political experience that did him and the rest of the country absolutely no good when he was Secretary of Defense. I'm sure he has many talents as an individual, but when it came time to put together a working plan for dealing with Iraq, his skills were about as promising as my guitar playing abilities.

When I was in graduate school training to be a psychologist, I was also a memeber of the univeristy's swing dancing club. I love dancing and, as an aside, it was the perfect way of getting to release energy from all the academic demands I had to deal with. I got better and better as I danced, but as far as skill went, it was like guitar-playing dejavu. I'm not a natural guitarist nor a dancer. Not surprisingly, several new swing dancers were able to surpass my level within a few short weeks. My lack of knack for swing dancing didn't stop me from having fun and enjoying myself--and I still love to dance--but I remember thinking of how interesting it was that when it came to learning the skills of therapy it was a completely different world for me. It felt natural, I didn't have to think about it. It just flowed. But with swing steps, like guitar chords, I had to learn them over and over and over again and still didn't manage to master them.

It's not that experience doesn't matter, but it makes a difference intra-personally. In other words, if I now decided to pick up the guitar and play for a few hours every day, I'm sure I'll get better. But when we compare across people--whether who's going to be the best guitarist, dancer, president, or therapist--it's the skill level that counts. It's about how comfortable the person feels in the position--does he or she have the "it" factor? If they do, experience becomes secondary. And if they don't, then experience can never make up for it.

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Empathy and the Sacred Space in Healing

Rom Brafman, Ph.D. — Tue, 02 Sep 2008 23:06:46 -0700

You know when you watch a movie and you get to the part where a character is about to get hurt—where something bad is going to happen—and you can't help but wince and turn your head away? Although we know it's a movie, and we know that it's fake, somehow it still gets to us. There's something visceral that acts on a deeper level than conscious thought.

A team of psychoneurological researchers wanted to get to the bottom of this. They invited volunteers to step into a functional MRI machine and look at some pictures. Half the volunteers were shown photos of arms and legs. Nothing out of the ordinary. And, as expected, their brain images, which were recorded by the fMRI, didn't reveal anything unusual. The other half of the group, though, saw pictures that were similar in nature but which indicated pain. In other words, these volunteers were exposed to images of arms and legs situated in such a position that would indicate discomfort and physical pain.

When the researchers looked at the fMRI brain scans of the volunteers who saw the "painful" pictures, the part of the brain that is associated with the experience of pain lighted up. Although the volunteers themselves did not experience physical pain, the mere act of witnessing an image of someone else's painful experience elicits a neurophysiological pain reaction. When we see others in situation of pain--even when we know that pain is just an image and real--we still physiologically experience a reaction.

Empathy is wired into us. And it also plays a very important part in the process of psychotherapy. Psychologist Carl Rogers (who played a pivotal part in starting the humanistic school of psychotherapy) was a pioneer in emphasizing the importance of empathy on the therapist's part. In other words, Rogers claimed that a good therapist is one who's able to share--at least on a certain emotional level--the emotional experience with a client.

It's what psychologist James Bugental referred to as "presence." It's the ability to relate to a client not only on an intellectual level but also to really be there experientially. To allow yourself to empathize and relate on a deeper level.

There's a subtle but very powerful difference between remaining scientifically theoretical and allowing yourself to relate on a more genuine level. I know that when a client comes in and shares something that comes from their core, the entire energy of the room shifts. It's the difference between an academic understanding of what goes on in therapy and seeing it take place in front of you. Academically and theoretically, you can point out, "Oh this person is experiencing this and that because of these different factors in their lives." But when you're there in person with the client and you hear the story, there's something very sacred about it. The client is sharing with you some of the most precious aspect of who they are as a person. And as a therapist if I can stay on that level, if I can hold the space and be there, that's where the real healing takes place.

I call it a sacred space not because of any religious reason. It's sacred because it's real. And it can very easily dissipate if I don't honor that space. This is how it relates back to empathy, the ability to partake in the experience that your client is having, to really be there. It doesn't mean that I experience the full range of emotions that my client is feeling, but I'm aware of them and they become precious.

Tornadoes, Depression, and Emergence

Rom Brafman, Ph.D. — Wed, 27 Aug 2008 23:07:59 -0700

Back in the 1800's, scientists marveled at the movement of large flocks of birds. Imagine hundreds of birds all taking flight at the same time. The patterns that the flock generates are amazing, shifting and transforming from one shape to the next. It makes you wonder how each individual bird can possibly play a part in engineering these complex flight movements. It's as if the birds somehow collaborated, like synchronized swimmers, to put on a show of wonder.

These early scientists were so buffled that they theorized that perhaps there was a certain collective force that dictated the movements, a special animated spirit, if you will, that emerged when all the birds came together.

Nowadays, scientists know that this 'emergent' phenomenon, although it seems magical, is simply a collection of individual patterns that react to nearby cues. Think of a crowded subway platform, packed with people trying to get onto an escalator. From afar, it almost looks like grains of sands floating through an hourglass (which is also, by the way, an example of emergence). Each individual person--just like a grain of sand in the hourglass or a bird in flight--is moving in relation to the individual/particle/bird next to it, and these seemingly coordinated movements produce complex patterns.

And that's the property of emergence. Complex phenomena emerge from simpler "things" that come together. There's nothing extraordinary about a bird flying, but put hundreds of them together in close proximity and you have all these intriguing patterns taking shape.

Or think of a tornado. You have this cone-shaped twister wreaking havoc, and it's basically made up of water droplets and wind currents. There are certain things that must be in place in order for a tornado to form. You need to have a merge between a cold front and a warm front, you need to have a thunderstorm cell develop, and if you get a certain particular rotation going, then a tornado forms. It's impossible to predict exactly when and where a tornado will develop (there are too many changing variables in play), but as meteorologists and storm chasers know, when all the "right" conditions are present, there's a decent chance that a tornado will emerge.

Depression is also an emergent phenomenon. Psychologists can't predict where or when it will manifest, but we know that given a certain array of conditions and stressors, depression is more apt to occur. Life circumstances (e.g. losing a job, divorce, lack of friends), unpleasant events from the past (e.g. family discord, abuse), strong negative feelings (e.g. sadness, emptiness) and personality predispositions (e.g. being sensitive) can all come together to produce depression. And just like only certain thunderstorms ever produce depression, these psychological factors don't necessarily result in depression. There's a lot of variability from person to person and situation to situation. But the emergent phenomenon of depression, once it is formed, has a lot of distinct characteristics.

Most people who are not familiar with depression assume that it is a state of feeling really, really sad. All of us have felt sad before, the reasoning goes, but depressed people feel super sad. But that's like saying that a tornado is a really strong thunderstorm. In a way that's accurate, a tornado takes thunderstorm to an extreme, but that description loses sight of the emergant properties. No one who's lived through a tornado would describe it as a "really bad thunderstorm." There is something other-worldly about a tornado. It's a monster all to itself. And the same thing is true about depression. Yes, people who feel depressed also feel sad, but there are other elements involved that make the experience very distinct from sadness as we know it:

- Depression has a long-term component to it. A person who feels depressed is operating under the belief that he or she is going to remain depressed for a very long time, if not forever.

- People who are dealing with depression blame themselves for what's going on, through guilt (i.e. anger turned on the self), self-deprecation, or regrets.

- Depression depletes motivation to complete daily tasks.

- And depression also takes away the "natural rhythm" or "voice" of a person. People who feel depressed begin to doubt their own selves. "I'm not sure anymore what I really want or what I really believe in."

And these are some of the emergent properties of depression. That's the difference between someone who's simply gone through hard times or experienced bad luck and someone who feels depressed. You're never going to meet a depressed person who'll tell you that they know that their situation can be significantly improved in a relatively short period of time, that it's not really their fault, that they feel motivated in their life, and that they are as clear about what they want in life as they've ever been.

And that's key to battling depression. Just as if we had control over the weather we could dissasemble a tornado (e.g. move the cold front away from the warm front), being aware of the emergent phenomena of depression is very helpful when it comes to the healing process.

As a therapist I most often try to get at the core voice or "authentic self" of the person. In the case of depression, that core voice gets usurped by a meaner, more cynical, critical black-and-white thinking perception. As a psychologist, if I can understand the initial "simple" factors that contributed to the depression--in other words, the stressors that acted on the person--and how these are feeding the meaner voice, then I have a lot to work with. Just like a tornado is "fed" by the collision of the cold and warm fronts, depression is also fed by the connection between the life stressors and the interpretation of the distorting voice. Fortunately, the underlying logic of this connection is weak. It usually takes a few weeks or a few months to shift gears and get the authentic voice back into place

And to me that's the promising aspect of depression. Just like it has the power to emerge, under the right conditions, depression can also be deconstructed and curtailed.

The Virtues of Being Picky

Rom Brafman, Ph.D. — Sun, 24 Aug 2008 23:37:36 -0700

What can I say, I enjoy Woody Allen films. And when I recently watched his latest, "Vicky Cristina Barcelona," it made me think. I'm not going to spoil the plot for you, but there's a key question that runs throughout this film. This is by no means the first movie to explore this question, but somehow Allen captured it on a visceral level in this one. And here it is: When it comes to romance, is it better to go for someone who's safe but a bit dull or is it better to set your expectations high and shoot for a partner who's exciting if unpredictable?

This is one of those questions that you can ponder from different angles, compare the pros and cons, and still not be able to arrive at a perfectly sound answer. Philosophically, it's complicated. But there's a certain catch to the question. If I shift gears and think about it as a therapist, I start seeing it as a trick question. So let's say a client came in and asked me, "OK, there's these two people I'm thinking about dating. One is really nice but can be a little boring sometimes, and the other one is really interesting but is all over the place--which one should I go for?"

In that case the question loses its inherent ambiguity. My instant answer, at least in my own head, is "Neither one sounds good." After all, why would you want to go out with someone who you're already perceiveing as boring? And, as for the other one, if you're picking up signs of unpredictability and being all over the place so early on, what's up? Why not look for someone who's safe, nice, exciting and interesting? In other words--Why settle?

When I share these thoughts with clients, I often get a response of, "Well, I don't want to be too picky."

And I come back with, "But I want you to be picky. I want you to find a good match."

When I prod, I learn that the "Don't be picky" advice is often traced back to an old relative, a nosey roommate, or an antsy friend: "My grandmother told me I should give people a fair chance;" "My roommate says my standards are too high;" "My friend tells me I expect too much of others." And of course the list of sources is not limited to these acquaintances. Even parents have been known to meddle: "My mom's afraid that if I don't find somebody soon, I might end up with no one."

As a therapist, though, I can't imagine encouraging a client to date a compromise. Over the years, I've heard many stories from clients who settled for someone who's "OK, I guess" only to end up regretting their decision: "What was I thinking? I should've known better..." But I've never heard anyone say, "Boy, I should've settled more. I really should've lowered my standards."

So what's going on here? Why does being picky carry such a negative connotation?

I think compromise and settling is a crucial part of being a successful person. Maybe this driver took my parking spot, but I'll swallow my pride and settle for another. Maybe my coworker took on the good project and left me with the so-so one, but next time I'll make sure I get first dibs.

But with finding the right romantic relationship, it's different. When people compromise their standards, they do so because of loneliness (e.g. "I really want to be with someone"), time pressure (e.g. "I'm getting older, and time is not my friend"), and opportunity cost (e.g. "If I say 'No' to this one, I may not be able to find someone better.") It comes down to fear: the fear of being lonely, the fear of running out of time, and the fear of missing out on an opportunity. And then it's no longer about who I'm dating, but it becomes about what I stand to lose. Dating takes on the feeling of a chore.

Instead of a fear-based motivation, I'm always curious to hear my client's description of who they're really interested in. "If you could go out with someone who'd really be a good fit, the ideal person, what would that person be like? Describe them to me."

It can be difficult to pin down because a lot of times we don't even take the time to ask ourselves what we really want. Is it important to me that the person be creative? That they're outgoing? What's my type as far as looks go?

A lot of times people don't like thinking about the physical qualities. "I don't want to be shallow." But physical attractiveness is not just about looks, it's about how the person is coming across. If the person's nice but there's no attraction, well, they might make for a really nice friend, but it wouldn't be fair to you or to them to pretend you're feeling it.

When the right person comes along, there's excitement and it's thrilling and you don't have to convince yourself that you should go out with them. Fear, though, sneaks back in--on a completely different level. And then we wonder, "Well, what if I ask them out and they say, 'No.'?"

The dreaded "No." I think it all comes back to Jr. High and High School. It's the fear we had when we were young that if we asked out the wrong person, then everybody would know and we'd become a running joke. Now, the thing is, that if you're being really picky, chances are you're going to get many more "No's" than you will "Yes's." After all, you're taking a chance, and the person might already be in a relationship or they might just not be interested. But that's the whole point: you're not going for the sure bet.

It basically means taking a leap. You're going for your dream partner. It's like what the Danish philosopher Søren Kierkegaard said, you take a leap of faith and you may not make it, but at least you took that leap. And here "not making it" simply means dealing with rejection, which makes us stronger in the long-run anyway.

This reminds me of a group therapy I co-led a long time ago for people who were dealing with shyness and as part of the group we did all these embarrassing activities out in the "real world" of singing songs in public or trying to sell a free daily newspaer for $20 to curious passersby. (No, no one ever took the bait). The whole point was to get rejected and see that the world doesn't end when that happens. All of us, including the therapists, took part in these activities, and I remind myself of it whenever I find myself in a situation where I might come across as being ridiculous. Hey, it builds character. People don't care as much as you think they do.

But being picky instead of operating out of fear becomes a completely different way of thinking about relationships. Instead of trying to find someone who's going to "work," you're searching for someone who's going to mesmerize you. And if you can get into that spirit, the process itself of finding that person becomes exciting in its own way.

Of course, sometimes you think you found the right match, but when you get to know them better you figure out they're not everything you thought they'd be. Well, that's when you have to stay picky and re-evaluate what's going on. It's not easy, but if you see it's not working, it's time to walk away. Being picky is not just about the initial asking out part, it's about the entire process of getting to know someone. And that's why being aware of former patterns in relationships comes in. If in the past I used to date people who had a quick temper, then let me make sure this time that this person doesn't show signs of being curt or easily angered. Or if I was attracted to people who were distant, and this person shows signs of being cold, let me re-consider what's going on.

Here's the thing about being picky: it forces you to have high self-esteem and you build a great connection with your own self: you build your own voice of what you want and what works for you. Yeah, it does take patience and some time to find the ideal person, but it's one of those instances when it's totally worth it.

'Editing Away' Depression

Rom Brafman, Ph.D. — Fri, 22 Aug 2008 02:12:55 -0700

When the Chernobyl nuclear disaster happened in 1986, the tragedy made headlines in all Western newspapers. But the Soviet press burried the story in the back pages. In fact, your entire perception of the world during the Cold War would have been markedly different if you had received your news from an American newspaper or a Soviet publication. But it's not just capitalism versus communism. Even today a story that makes the headlines in one newspaper can receive little fanfare in another. When it comes down to it, the editors--whomever they might be--get to decide what information makes for important news and how the story is conveyed. And because this selection process has a subjective element to it, it's impossible to get 100% objective news. The editor's own "bias" slips through, no matter how scrupulous he or she might be.

What's really interesting to me is the way each of us edits our own personal "newspaper." We have all this information that keeps streaming into our lives, in the form of feelings and thoughts and ideas. Some of these informational pieces are pretty ordinary and usually get burried in the back pages: "I can't believe the summer is almost over;" "I need to water the plants;" "What was the name of my third grade teacher? It's on the tip of my tongue..."

Other, more pressing information, might get brief headline status: "Whoa, my credit card statement is almost overdue;" "I'm really excited about the date I have lined up for this weekend."

Although headlines shift quite regularly, on occassion, if something major happens, e.g. "Sweet, I just got a promotion at work!!" the headline sticks around longer and has more of an effect on us.

But when a person gets depressed, something different happens. The entire process is turned upside down. It's as if the regular editorial personnel gets fired and replaced with a totally new team with completely different notions of what makes a headline. The first thing that happens is that the headline becomes very negative in substance and very general in scope. An ordinary enough headline (e.g. "Time to change the car battery") gets pushed to the back, and taking its place are a new line of headlines: "Life feels like crap;" "I don't have any energy anymore;" "Things will always be this way." The thing about these type of headlines is that they make you feel pretty helpless and hopeless, they suck all the energy away, and they're so general in scope that it's difficult to challenge them. For example, it's easy enough to say, "Maybe I'll have my friend help me change the car battery instead." But it's a lot tougher to come back and retort, "No, my life is actually pretty meaningful if I stop to think about it."

To further explore this metaphor, you see the same shift on a national level when a country is hit by a disaster, whether a financial one or surprise violent attack. All the other stories get pushed to the back, the entire mood shifts, and day after day the headlines deal with the same subject matter. But as a country, at least we go through it together. Each of us felt the pain after the attacks of 9/11, but it was also comforting to know that we were going through it as a nation. I remember that for two weeks after 9/11 I didn't feel productive, but no one expected me to be. It was understandable. I didn't have to explain myself or to feel bad about it. My headline of sadness and lack of energy matched what everyone around me was feeling.

But when someone feels depressed--and all of a sudden their personal headlines become negative and catastrophic--it feels very isolating. These are your personal headlines. There's no national event that you can point to.

And, to make matters even more complicated, unlike the normal rotation of our mental "newspaper" headlines, depression headlines stick around for a long time. So much so, that it often feels like they're going to be there forever. These headlines are so extreme that they're always wrong in their conclusion: An otherwise innocuous event (e.g. "I forgot to pay my electric bill on time") takes on catastrophic proportions (e.g. "I can never do anything right.") Another commonality I've seen with these types of "headlines" is that they're of a self-blaming nature and they often have an underlying component of guilt.

As a therapist, I see my role, to use the metaphor I've employed here, as restoring the "real" editorial team into place. I don't usually talk about it using the headlines metaphor, but it's a very good way of understanding how depression takes over a person and what can be done about it. As a therapist I try to restore the rightful team, the original core or "true self" into place. But I can't just argue with my client. I can't say, "You know what, your 'headlines' are all wrong. I disagree with your perception." Then I'm just using force to try to get my way.

But because the headlines are extreme in their stance, I can start by challenging their content, using actual examples from my client's life: "You say that nothing's going right in your life, and I know that you feel that way, but the way you describe your relationship with your friends, it sounds like you're there for them and they're there for you. I'm getting the sense that it's really important for you."

Depressed people don't give themselves enough credit. They perceive themselves in such negative terms that they simply forget about their good attributes. A lot of times this process ends up in a debate. I argue for what I believe is a more balanced and accurate view, and my client feels I'm being overly kind and optimistic. But to me, I'm just calling them as I see them. And if I can show my client that the headline is not accurate, if I can challenge the headlines--over and over again-- then I can start to use "evidence" from my client's life to disprove the headlines.

But the question still remains: Where did the new editorial team that came up with the depression headlines come from? Who are these 'new reporters'? And in my experience they're always internalized voices from the past. Something that my parents used to say, or a teacher repeated. So if my dad was a nice man but when he got upset he'd call me "selfish" and then a couple of my teachers also repeated that, and my last ex broke up with me and blamed me for not being caring enough, then the headline, "I'm self-centered and cruel" can take over. It's these type of messages, that get internalized, balloon, and then get plastered as absolutes. Even though logically I may know that these statements are too extreme and innacurate, they feel like they're accurate descriptors. And that's why it's so hard to shake them off.

In a way, I think this is true for all of us--as it is true for any newspaper--we all have times when some extreme headlines that are not fully accurate creep up. But when there's a barrage of them, if I'm going through a rough time and they pop up, it's a lot more difficult to deal with them and restore order. It then becomes easier to buy into the headlines and this is what leads to depression. But the good thing, and that's what I've learned from doing therapy, is that just as a headline can gain durability, it can also get shaken. And the space of therapy helps the restoration process. Of course, a good therapy-client team is not the only way to overcome depression, but I think what tragically happens is that most people who feel depressed try going at it alone, and that makes it a lot more difficult. The unfortunate thing about depression is that when you're in it, it's really difficult to believe that it's possible to combat it. I often find myself reminiscing with clients:

"If I had told you two months ago, when we first started working together, that you'd be feeling differently in three months' time, that you'd be feeling the way you're feeling today, what would you have said?"

"I would've said that's impossible. I would've said that you're crazy."

The Value of Being Impatient

Rom Brafman, Ph.D. — Tue, 19 Aug 2008 11:06:09 -0700

When I was in graduate school I had to take a "History of Psychology" course. It's a prerequisite mandated by APA and although the course has a reputation for being blah--it's mainly a collection of names, dates, and the now mostly obsolete tools and theories they developed--the professor did his best to interject humor and share fun factoids along the way. Three times during the semester we had an in-class test that constituted of 20 short-answer questions. In a class of 25, I was always the first one to finish the test. I never got the highest score, but my goal was to answer as many questions in adequate fashion to make sure I did well enough, then I'd pack up my stuff, hand in the test, and go off to get lunch.

I must admit that there was a certain amount of fun associated with finishing first. It was almost like I was in a race (unbeknownst to my classmates) to get the test over with as soon as possible. It's the closest I've ever come in graduate school to feeling like a race car driver.

You can also argue that I was impatient. And indeed, the thought of picking my brain to squeeze out all the information that was there and then to proceed to write it all out in order to shoot for a slightly higher grade drained my energy. So let me go ahead and own it: when it comes to doing things I don't find valuable, I get impatient.

I feel the exact opposite, though, when it comes to doing things I love. I'm more than happy, for instance, to carry a good, deep conversation for hours. I don't get tired, I feel energized. And it's the same thing when I do therapy. Even when my clients and I seem to be having the exact same conversation about the same topic for the tenth time, I enjoy it immensely because it's part of the process. It's part of the push and pull. We hit a new challenge, a resistance area, and we're engaged until we can reach a new plateau.

Here's what I've learned about impatience: It's an indicator telling me that I'm either doing something I don't particularly care for (e.g. taking a History of Psychology test) or that I'm not fully engaged in what I enjoy doing. If I find myself getting antsy when I'm talking with a client, for example, it means that something is not running on all eight cylinders. There's something about the process that needs attention. Why am I not feeling present? What buttons does that interaction push in me? Do other people in my client's life also feel that way when they interact with him or her?

The other thing I've come to realize is that impatience goes hand in hand with intensity. If you're an impatient person, you're probably also an intense person. I think impatience is intensity that has gotten blocked or channeled into the wrong stream. When I first started being a therapist, a couple of supervisors gave me feedback that I was "intense." I took it as a compliment. I want to be fully there for my clients, to be present in my interaction, to create an open space where all the feelings and emotions and insights get explored. Sure, it can feel intense, but that's where the healing happens. I often have clients who complain about former therapists: "All she did was nod her head." "He hardly ever challenged my viewpoint or engaged me in real conversation." And they're talking about a lack of intensity. And, of course, I bet that there are therapists who hear the opposite from their clients: "I was looking for someone who'd be quieter and just listen." I think that intensity is not for everyone, but if I can be accepting and intense and join forces with my clients (i.e. have an alliance) then therapy becomes very powerful.

A lot of times, in the beginning stages of therapy, a client will say to me that they don't want to feel depressed or anxious or down anymore. They often qualify it with, "I know I'm being impatient, but... how long do I have to stay depressed for?" A classic answer is to emphasize the importance of being patient: "I know you're feeling this way, but you need to give it time." That doesn't work for me. If anything, it stifles the intensity. I much prefer to build on the intensity that the client is communicating, "I'm also impatient by nature. And it makes total sense that you're feeling impatient about getting better. Let's work together to do everything we can to move forward; of course there'll be times when things feel like they're stuck or even getting worse, but we'll join forces to make headways. And if for any reason we see we're not moving forward, we'll explore all other options and see what we can do."

I like impatient clients--and not just because they remind me of myself. They bring energy and intensity and purpose to therapy. They're motivated. They have an agenda to get better and that's exactly the energy I'm looking for. I think all of us have that intensity, to some degree, but we've learned to mask it. And in my experience as a therapist, more often than not, suffocating the intensity is a large part of why a person is feeling bad in the first place.

Does Authenticity Lead to Happiness?

Rom Brafman, Ph.D. — Mon, 18 Aug 2008 03:53:58 -0700

Humanistic psychologists (I identify myself as one) are fond of talking about authenticity. Mention the words "genuine," "real," or "deep" and you'll see our faces light up. I ran a therapy group not so long ago and during the last session a few of the participants teased me about my oft-repeated catch-phrase: "Keep it real and go deep."

But before I continue, let me define some of the terms I'm using here. Humanistic therapy refers to a strengths-focused approach (as opposed to a pathology-based one) that aims to increase a client's awareness of subjective meaning, enhance personal growth, and encourage a genuine and trusting relationship. In other words, instead of emphasizing what's wrong with a client, a humanistic psychologist tries to understand and empower the client's full sense of self. Psychological maladies (e.g. depression, anxiety) are seen as symptoms of a lack of congruence or authenticity in a person's life.

Authenticity is a little trickier to define. In a way, we all know what it means, but how do you conceptualize it psychologically? To the humanistic crowd, being authentic means that I'm aware of how I'm really feeling and that I can communicate that to myself and others, if I choose to. So, as a therapist, if I'm in a session with a client and I find myself feeling sad when I hear my client tell a story, I want to stay connected to that feeling. I want to stay present with my client, with the story, with how the client is feeling, and with the thoughts and emotions that I'm experiencing in the moment. In that way I'm brining the full me, my real self, into the room (instead of aiming to remain a detached expert who only thinks intellectually). A long time ago I got to observe a therapist who was conducting an intake with a new client. The therapist looked at her clipboard, read out questions, and took notes. It was a rather formal/standard procedure, but as the client answered the questions, she started tearing up and soon began crying. The therapist stopped the quenstioning, looked up, and quizzingly asked the client, "What's the deal with the tears?" So that's an example of not being authentic. (And I was disturbed seeing that interaction take place. I found it very difficult keeping quiet, but my role was very clearly laid out: to be a silent observer. In that scenario I didn't get to communicate as authentically as I wished...)

So humanistic psychologists have been preaching the value of being authentic for decades. As a therapist, it's not just about being authentic myself, one of my goals is to work with my clients to form an authentic and meaningful relationship and assist them in developing an authentic sense of their own selves. If my client shares something that comes across to me as deep and real, but if the client seems somehow disconnected or not fully giving themselves credit, I'll say something. I might say, "You know, that was such a meaningful and powerful thing for me to hear, and I feel like I got a real sense of you as a person, but my sense is that you're not experiencing it fully, or that you don't realize the full power of what you just said."

It's not that humanistic psychologists are the only ones who value authenticity. There are many therapists from other theoretical fields who value it strongly. But for the humanistic camp it's one of our defining elements: being humanistic means valuing and encouraging authenticity both in ourselves and in our clients.

Authenticity sounds nice, but mainstream science sometimes pooh-poohs on its relevance. If I decide, hypothetically speaking, to apply for an NIH research grant and I use the terms "going deep," "keeping it real," or "being authentic," I'm not very likely to be taken seriously or receive any funding. And you hear many modern-day psychologists say, "Well, of course you want to be authentic, but there's a lot more to therapy." There's a sense out there that the authentic stuff is not much more than a touchy-feely sort of concept with not much meat.

Humanistic psychologists will tell you that authenticity is a tremendously important factor. That it's a huge element in the process of healing. It's not just a prerequisite, it's one of the chief goals of therapy. And as a client becomes more and more authentic, they become happier and their psychological well being increases.

Fortunately for us humanistic folks, it turns out that the empirical data lends support to the authenticity hypothesis. Just last month, a small group of psychologists from England published a study in the prestigious Journal of Counseling Psychology. The study empirically examined the effect of authenticity on people's lives. The researchers (Alex Wood, et al) asked people from different walks of life about the their authentic qualities: self-awareness, communication style, and openness to others' feedback. These authentic measures appeared solid (e.g. they did not correlate with any other likely confounds like the Big 5 Personality traits or social pleasing). But what was really amazing was that the researchers found that that, in general, the more a person acted authentically, the more likely he or she were to be happy and experience subjective and psychological well-being. These results might appear self-evident from a humanistic perspective, but there's a lot more there than meets the eye. The researchers shed light on an area of study that has been empirically neglected. Being authentic is not just a nice-sounding catch phrase. It's an important part of personal growth that carries beneficial values. It might be simple, but it's also profound.

What's Really Behind a Question?

Rom Brafman, Ph.D. — Sat, 16 Aug 2008 01:04:26 -0700

One of the main reasons I chose to attend my graduate program at the University of Florida--and the reason I chose to apply there in the first place--was because I wanted to study under the professor who would eventually become my advisor, Franz Epting. Unfortunately Franz is now retired (and I use the word "unfortunately" because Franz has many unique humanistic qualities that make for a great advisor) but we still keep in close touch. If you want to get a mental image of Franz, you will need to picture Alec Guinness in his role as Obi-Wan Kenobi in the original Star Wars trilogy. Franz doesn't only bear an uncanny similarity to Obi-Wan in appearance. He also shares Jedi-type qualities: he's unassuming, patient, sharp, and humble.

Franz regularly weaves in stories into his conversations. He can share a memory from his childhood growing up in Mississippi, only to shift topics and tell you about a small interesting restaurant he visited the week before, and then pepper in some comment or observation relating to psychotherapy. If you're not careful, it's easy to simply enjoy the conversation and not think too much about the ramifications and significance of some of Franz's insights. But if you listen carefully when Franz talks, from time to time he'll mention something, maybe a little sentence or two--almost as an aside--that can really shift the way you look at things. It's not Franz's style to be pedantic, and if you're not fully tuned in, it's easy to miss it completely. Having known Franz for many years now, I can confidently say that Franz doesn't plan all this out: if an insight comes up, he'll share it, without any strings attached or expectations about what you'll do with it.

During my first year of graduate school, when I was brand new to the whole world of therapy, Franz supervised my very first client and, as part of that process, we watched together a tape of my session with my client. Because Franz's style isn't intrusive, he didn't interject often, but from time to time he'd share his thoughts with me. There was one segment in the tape where I asked the client a simple question. I don't remember precisely what I asked, but it was something along the lines of "Do you think this is a good idea?" This question caught Franz's attention and I remember him mentioning that it seems like I knew the answer to the question before I even asked it, and if this was indeed the case, it would probably have been better to turn the question into an observation or rephrase it so it's really asking a question. And then we continued watching the tape.

And this was one of those moments where I learned a lot from Franz. It completely changed the way I approached therapy.

Here's why I value it so much. As a therapist it's easy to pick up the habit of asking questions really as a way of communicating information. You ask a question--albeit a loaded one--but you don't come across as too confrontational. You're not giving unsolicited advice. And the question--at least on the surface--appears to be innocent. But many of these types of questions communicate a strong message:

"Are you sure you want to do this?" really means "I wouldn't be doing this if I were you."

"Do you really think it's going to work?" is another way of saying "I doubt it'll make much of a difference."

And "Can you think about the situation differently?" translates to "I think it will be better for you to shift your perspective."

It's not that the underlying statments are necessarily wrong. It's just that the questions are a thinly veiled effort of communicating across something that the client might not want to hear. The idea is that somehow, by turning a statement into a question--a skill that we therapists appear to share with Jeopardy contestants--we're being gentler. But we pay a price when we do that. And that was Franz's point. When I ask a question I already have the answer to, I'm not being fully genuine. I'm not placing all my cards on the table. I'm not being present with my client. Instead of my questions communicating a sincere wish to find out new information (e.g. "How did your presentation go?" or "What was it like to have said that to her?"), it becomes a tool of communicating my own ideas or values. The client begins to learn, albeit unconsciously perhaps, that when I ask a question, I'm not 100% interested in what the client has to say. I'm more interested in communicating what I want the client to think. And that's patronizing.

So let's say that my client just got out of this long-term relationship and he's thinking about dating someone right away, and I'm not sure if it's a good idea. I could ask him point blank, "Do you think it's a good idea dating someone so soon after you got out of this long-term relationship?" But then my question is really just a statement. This doesn't mean that my concern is not necessarily a valid one. But it's about how I communicate it. The point is to be genuine, sincere, and say what I mean. I could, for instance, say something like, "I see that you're excited and I also found myself thinking, as you were sharing this with me, about the timing of everything, given that you just got out of a relationship recently. Those were the thoughts that were floating around my head and I'm not sure what's your take is or if you had a chance to think about everything. I'd like to hear your thoughts."

Obviously I'm still influencing the conversation: after all, I'm still brining my own perspective into the dialogue, but at least it's out on the table. The client knows what's going on in my head. And I try not to be too dominating or too overwhelming (it's always a tricky balance). I really want to know where my client is at. And he might say that he thought a lot about it and that would be interesting. Or maybe he hasn't even thought about it at all, and that would be equally interesting and we can talk about it together.

When I ask a question that's sincere and not loaded, it's a lot easier to really listen to what the other person is trying to say and to find out where they're at. I'm still learning to own what I have to say and I try not to slip it in as a form of a question. And not just in the realm of therapy. I find that when I ask a question that I already have the answer to--whether to a client, a friend, or a family member--it's usually because I have an agenda I'm trying to push. And if I can share the agenda openly and limit my questions to actual curious requests for finding out what the other person is thinking, then things go a lot more smoothly. For one, it's a lot easier to establish trust. And if I'm sincere and direct, the other person doesn't have to read into what I'm trying to say.

And shifting gears a little bit, I wanted to thank all the readers who took the time to leave the nice, thoughtful comments on my last entry. Thank you for taking the time to do so and it was really nice to see. I'm glad that sharing these experiences is helpful and it's always easier to write when you have an audience that you know is engaged. And if anyone has any specific requests or questions that you'd like me to explore, I'd be happy to do so.

Until next time....

Rom

Therapy from the Therapist's Angle

Rom Brafman, Ph.D. — Thu, 14 Aug 2008 23:06:26 -0700

There are a few things that I didn't expect when I first set out to be a psychologist. One of them is seeing just how quickly and powerfully people can transform when therapy is going well--I'm still awe-struck when I look at the progress clients make during a relatively short period of time. It's like you get to see a totally different person in front of you, or more accurately you get to see more of the real person. It's difficult to put into words, but instead of someone being overwhelmed with old fears, misplaced notions, or an innacurate self-perception, you're looking at someone who's more "grounded" in who they are. It happens when there's a strong alliance and the client feels comfortable with the process. And this is a hugely rewarding part of being a therapist: witnessing that "magic" taking place. When I first started doing therapy I expected people to heal and get better, but I didn't expect it could be that powerful or happen that quickly. (This is not the case, obviously, for every client, but it's amazing how often it does happen).

Another unexpected feature of therapy is how much I'd be learning from clients. During the process, clients seem to tap into their own wisdom and insights, and as a therapist it's something that really affects you. You learn about life and you learn about yourself as the client discovers their inner self. In this sense, therapy is definitely not a one-way process. Even though the client's life is the focus, I indirectly benefit from all the learning that takes place.

And the third aspect--and I think this one came as the greatest surprise to me and I think it's also the most powerful--is the reason I wanted to write this blog entry. Because I think it's not just something that surprised me, I think that most clients are not really aware of it either. And here it is: the connections that I developed with my clients, even years ago, are just as meaningful and precious to me now as they were back then. Even years later, after having no contact with a particular client, I can still think back to the work we did together and the memory is sitting right there next to my heart. I'm not talking about the intellectual process of recalling old facts or data. And I may not remember clients I only saw for two or three sessions (although I remember many of them). I'm talking about something deeper. I'm talking about the connection that we formed and that memory, that essence, is still there. There's not a day that goes by that it doesn't come to me. Maybe while I'm taking the train, something that an old client said pops into my head. Or I have a conversation with a friend and a phrase a client used comes up. Or I go for a walk and something a client said at the end of our last session together comes to mind. But it's more than just those bits and pieces. It's the feeling, the presence, the connection, that comes back. It's remembering the face or their expression or the way they'd speak and communicate. And these times are bittersweet. Because there's a part of me that misses the person, that knows that I'm probably never going to see them--but it's also sweet because of t the appreciation of having had that experience. It's like taking a walk along the streets and pathways of your old neighborhood where you grew up, and you just take it all in, and you observe and think, and every corner you turn brings up a new set of feelings, and you wonder where some of those people might be, and you wonder how many years it's been, but underneath it all is that feeling of connectedness and appreciation for all those moments.

And I think sometimes when I start work with clients, they wonder, as it makes sense for them to wonder, "Is he really listening to me or is he just doing his job? In the end of the day, am I just another client?" And this startles me because it's so far off from what I feel. But still, these are valid questions and they reprsent very valid concerns. And I've learned that sometimes I really need to say it out loud and share it because even if now it's obvious to me, I myself didn't know it was going to be like this when I first got started, but these conversations and moments and connections--they're gold.

What REALLY makes psychotherapy work?

Rom Brafman, Ph.D. — Wed, 13 Aug 2008 22:54:30 -0700

When you try to think about it logically, there's something a little strange about the process of psychotherapy. You go see someone, a total stranger, usually once per week. That person listens, asks questions, maybe shares insights. But it's one-sided: You only talk about yourself.

There is a strong level of closeness, trust, and rapport that makes it unlike any other relationship. A therapist might feel like a friend (but it's not a buddy-type relationship), a family member (though you're unrelated), or a teacher (but it's not a formal educational relationship).

So here's this unusual situation. But somehow it works. It can alleviate virtually any psychological malady we know about. It's as effective--and some would argue even more effective--than any psychotropic drug that we've been able to manufacture. But the question remains: What is it about that mysterious process of therapy that makes it work?

Extensive research (www.shef.ac.uk/content/1/c6/07/82/32/Bruce_Wampold_pres.pdf) shows that the main factor at play is what's known as therapist-client "alliance." In other words, the degree to which you feel comfortable, connected, and part of a team with your therapist determines how effective therapy will be for you.

In a way, this makes sense. If you go to therapy and you just don't hit it off with the therapist--e.g. he doesn't get you, she's too quiet, he talks too much, she gives too much advice--then the work might suffer. But most people don't really think about alliance when choosing a therapist. We think of experience level, gender, age, style, theoretical orientation. But all these factors matter only to the degree that it helps you click with your therapist.

How do you know when you have a good alliance with your therapist? You look forward to your sessions. You leave therapy feeling like you've done a lot of good work and made progress. It's easy to open up and talk with your therapist. And, perhaps more importantly, you feel that your therapist really gets you. And studies show that by the end of the third session--yes, that early in the process--you should start feeling that bond taking place.

A lot of times clients end up with the "wrong" therapist. He might be kind and polite. She might be trying to be helpful. But for whatever reason, the connection is not there. But clients carry on hoping that things will improve with time, or they blame themselves for therapy not going well. The thing to remember is that not all good therapists are good for all people. Your best friend might swear by her therapist, but maybe for you it wouldn't be a good match.

If you think about trying out therapy, be extra sensitive to the alliance factor. Make sure that you feel comfortable around your therapist and energized by your interaction. And if the "magic" is not there, strongly consider starting with a new therapist. And if you've been seeing a therapist for a long time and you still don't feel comfortable with them, either bring it up with them or think whether it might make sense to switch to someone you might hit it off with better.

And if you're afraid of hurting your therapist's feelings--don't worry about that. All therapists have had situations where clients have left. It's a normal part of the process. As a psychologist, I encourage my clients, especially new ones, to ask themselves how the sessions are going, how they're feeling, and to make sure that they keep the bar high as far as alliance goes.

Now the next mystery is what is it about alliance that makes healing happen? What is it about that bond that allows the magic to unfold?