Category: LongForm

Keys to Wellbeing from an Accountant

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Keys to Wellbeing from… an Accountant? 

I was reading an article about managing personal finance. And, as often happens, it just kept ringing in the resonance of therapy instead. Here’s what I learned about self care from an accountant:

 

  • Live on less than you make
    This is message so many of us need to hear. We are so over-extended that sometimes even self-care seems like one more thing on our plates or something we can’t even cram into our schedules. You only make so much money per month, and there are only so many hours in a day. It’s ok to scale back, so that you are living in a way that is sustainable in terms of your time, energy, relationships, and mental health. Don’t worry – having a meaningful, satisfying life isn’t measured in quantity.

 

  • Pay yourself first
    This is related to the first one, and it’s meant to be a way to help people make sure they have savings at the end of the day – have it taken straight out of your paycheck so you never see it at all! This is a hard one to do with self care, though. Maybe it looks like scheduling all of your physician and dental appointments a year in advance. Maybe it means setting all the house lights on a timer so that it gets dark in the house by 9p? What about prioritizing your self care before you get into a serious relationship, or working that out with your partner before you have kids, so that the expectation is already there? It’s not that you can’t draw on those savings if you need to, it’s just that it’s easier to save when you don’t have to choose to do it every day.

 

  • Build your credit if you can
    If you manage to “live on less than you make,” maybe you can even go one better… what does building credit in terms of energy, time, or relationships look like? It looks like paying IN to valuable experiences, as long as you can afford to. Once your self care is in hand well enough that you have extra energy, what can you invest that energy in that will pay you back ultimately? And here’s an interesting piece of this – when you ask others for help or favors (going into “debt” with them), that can actually solidify a bond as long as the debt doesn’t get out of control and you’re in a position to be able to extend them a loan, as well.

 

  • Don’t rely on willpower
    When it comes to saving rather than spending, willpower is NOT our friend. Some people can manage ok, but most of us don’t make great decisions when something pretty or fun is in front of us. And when we’re struggling, it’s even more important. Put that credit card in the freezer and take cash to the store. Start taking care of your own pool if that poolboy is a yummy distraction to your marriage. Block that friend who always needs a loan who pulls your heartstrings. Move your phone to the bathroom if you can’t stop reading the internet when you should be asleep. Set your grocery app to order only the foods you feel great about eating, then fork over the $5 to keep yourself away from the candy aisle. Use willpower only when you don’t need it, to take small steps that make willpower unnecessary.

 

  • Good investing means NOT listening to your heart
    Emotional investing almost always means poor investing. People get afraid and sell when they shouldn’t; they get excited and buy something that turns out be nothing. When it comes to long-term decisions, even if you’re a feeling-type person, gather as much data as you can. Ask experts. Be conservative. And lead with the prefrontal cortex.

 

  • Never finance a depreciating asset
    “Buy now, pay later” is the always devil talking. And how do we do that with our time and energy? Don’t say yes to something unless you can reasonably predict that it will be worth more to you in twelve months than it is now.

 

  • Never gamble what you aren’t happy to lose
    Actually, this tip is usually worded: “Don’t gamble what you can’t afford to lose.” But in a monetary and an emotional/relational way, I prefer the stronger position. IF you’re going to gamble… make sure it’s truly a game. Can you afford to lose your job? Maybe you can. But don’t take the gamble on dating your coworker or telling off your boss unless you’re *happy* to lose your job. Can you afford to lose your marriage? Maybe you can. But don’t gamble on that flirtation or call your partner something you can’t take back unless you’re *happy* to lose your marriage.

Comment below: What do you think? Any others come to mind for you?

 

 

 

 

Reversing

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Reversing

This is the third blog in the Reversal Theory series – if you haven’t, check out the first one here . And the second one here. 

 

As a reminder, Reversal Theory posits that we each have 4 different sets of states that we are in some combination of all the time – one each from Serious/Playful (also called Telic/Paratelic), Conforming/Rebellious, Mastery/Sympathy, and Self/Other (also called Autic/Alloic). So, at work you might usually be in the Serious-Conforming-Self-Mastery states, and if you are, you’re probably killing it! But, if you’re in the Playful-Rebellious-Self-Mastery states, you’re probably daydreaming about skiing and not getting much done. 

Despite the pervasiveness of the “continuum” in current psychological thinking, the ever-present bell curve, and the call for moderation in all things, the pairs of RT states do not operate this way. The bank of light switches above not chosen arbitrarily! At any given time, the light switch is positioned up or down. If pushed, it will flip to its opposite position. If not pushed hard enough, it will flip back to its original position. It does not rest in the center position. Likewise, a person is in one state of each pair or the other (this is called bistability). Bistability refers to a system which has two preferred ranges rather than one. 

A Necker cube (above) is a good example of reversing. It can be viewed sensibly in two equal but opposite ways, but there is no intermediate position and one cannot focus on the transition between the two states because it happens too quickly. Similarly, each pair of RT states functions as a “bistable” system; one is either in the serious state or the playful state, there is no stable position in between. 

So, how do we switch (or REVERSE!) our states? Three ways. 

 

Contingent reversals are the most common. A contingent reversal occurs based on an event, setting, or other environmental influence. For example, an event that is seen as threatening is likely to produce a reversal into the serious state (e.g., when one is joy-riding and then sees a police officer behind them). An event that is perceived as unfair will likely produce a reversal into the rebellious state (e.g., when a teenager is planning to go out and then is told she has been grounded). Note that it is the perception of the event which is of consequence, as events will be interpreted by different people or at different times in different ways. Another environmental factor that often produces reversals is the setting. A sports stadium may induce the playful state; a nursery may induce the sympathy state; your boss’ office may induce the serious state. Any situational event (e.g., seeing your partner smile, feeling nauseous, music playing in the background) can prompt a state reversal.

Often, the combination of many situational factors in balance determines the state one is in. For example, I may be drinking cocktails and watching football with friends (all paratelic-inducing/playful for me) and see a spider (typically a telic-inducing/serious event for me), but I might not be moved from the playful state due to the influence of the aforementioned factors. In essence, the perceived situational factors may be viewed as if on a scale, or a see-saw. Situational factors may “add up” enough to tip the internal see-saw to the opposite state, or the opposing factors may not be weighty enough, in which case I remain in the state I was in.

 

Another way that reversals are induced is through frustration. If you remember from the second blog, each state has certain kinds of satisfaction embedded within it. 

Telic -> Achievement

Paratelic -> Enjoyment

Conforming -> Fitting in

Rebellious -> Freedom

Mastery -> Power/control

Sympathy -> Care/nurturance

Self -> individualism

Other -> collectivism

 

When this satisfaction is not achieved over a period of time (which varies across times and individuals), the frustration will lead to a reversal. An example of this type of reversing is when, in the telic state, one does not feel they are making progress, cannot bring down their level of arousal, or comes to feel that what they are working toward is not worthwhile. A reversal to the paratelic state may take the form of abandoning the project in favor of something fun or distracting oneself with humor. Frustration-induced reversals may occur in the alloic sympathy state when one has heard quite enough of another’s complaining, in the negativistic state when one realizes that his/her efforts to change the system are not fruitful, or in the mastery state when one becomes exhausted with running on the treadmill.

 

The final factor in inducing reversals is known as satiation. This is hypothesized to be an internal mechanism in which a reversal is induced after a certain amount of time even when one is receiving the satisfactions of the state and in the absence of situational changes. Consider the student or retiree who, after a few hours, days, or weeks of leisure, longs for work. After a time, a loving caregiver who is content to nurture those in her household spontaneously craves some time for herself. In studies wherein participants can choose a telic-task or paratelic task for as much time as they like, will switch tasks without any seeming provocation. The process of reversing through satiation is often compared to the sleep-wake cycle, wherein the body simply recognizes that it has had enough of a certain natural and satisfying state, for reasons that are not entirely clear.

 

Those are the ways that reversals occur, and that’s plenty for this installment! Be on the lookout for #4, because it’s going to tie all of this into a very cool way of thinking about psychological wellness and therapy!

 

Couples Metaphor – Yoga

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Yoga for Couples

Here’s a great relationship metaphor… but be aware that it might not work as well for clients who have no experience with yoga!

 

What about thinking about your relationship the way you think about your yoga practice?

 

  • 1) Set your intention. When you’re tuned in to your practice, mindfully present, your practice goes better. You know it does. When you’re just there because it’s Tuesday morning, when you’re checked out because you have a busy day ahead, when you’re there even when you know that sleeping in would have been healthier for you… your practice suffers.
    • Whether this is about the initiation of a relationship, or about a communication within a relationship you have, being mindfully aware of what you are entering into is crucial.
  • 1a) Be honest about that. It does no good to set your intention to “peace” during your yoga practice when you know you’re too worked up, or if it’s a Hot Power Flow class! You don’t need your intention to be the same as anyone else’s, and certainly not “better” than theirs (as if that’s possible).
    • In your relationship, there’s no point in setting an intention you “should” have, rather than the one you actually do have. Those “shoulds” might come from you, your history, your facebook feed, wherever. But it’s worth it to be honest with yourself about what you’re looking for.
  • 1b) Change if necessary. In addition to being honest, you want your intention to be healthy. If you’ve honestly reflected and your intention for your practice is to look better than the person next you, or to make and hold a pose regardless of your injuries… well, that’s why we set our intentions early in the practice – so we don’t waste all of that time and effort chasing something harmful.
    • Likewise, if you can tell that your intention for the relationship – or the argument – is just to win, to be “better than,” to have something you know will be nice now but damaging in the future… it’s time to rethink. Before that argument starts, preferably.

 

  • 2) Be gentle. We know that gentle stretching increases flexibility safely and – because it doesn’t cause damage – it doesn’t injure us and set us back. Similarly, gently breathing through discomfort and gently encouraging yourself to build strength go a long way toward not just finishing your practice well… but showing up the next day. Being a harsh critic has no place in yoga.
    • When communicating with your partner, always err on the side of gentleness. Clarity is important, yes. But more important is that additional damage doesn’t occur, setting the conversation back further. Going slowly, staying together, breathing through discomfort, gentle encouragement… these are powerful relationship changers, even though they aren’t dramatic.
  • 2a) Don’t expect the same “performance” every time. Every day and every practice is different. Although we tend to grow in healthy ways and make sustainable gains in yoga, what was easy yesterday may be difficult today. For many reasons, a joint may be stiff or a muscle sore.
    • Likewise, there are always multiple factors working in and around us in our relationships. While you can expect pleasant changes over time (in the context of healthy communication and such), it’s a bad idea to “microjudge” yourself or your partner. No need to hold yourself strictly accountable to being exactly the same all the time. 

 

  • 3) Don’t rush to the end. There is no “end.” There’s no winning in yoga. There’s no “being right.” It’s not a competition. It’s a practice.
    • Work slowly and gently, with the process in mind, more than the outcome. Too often, we’ve already decided the only acceptable outcome for us in advance, but then there’s no space to grow.
  • 3a) Don’t work on everything all at once. Building strength and flexibility in one area certainly benefits other areas. You’ve probably been to a yoga class that emphasized “twisting” and on another day emphasized “warrior strength.” And while that might mean that the overall
    • You needn’t cover all the

 

  • 4) Namaste. During the whole practice (and at the end), remember to honor the divine light within you, your instructor, and everyone present. It helps to maintain the growth-mindset rather than the competition mindset.
    • At the beginning, at the end, and whenever you need to in the middle of your communication – remind yourself (and maybe your partner) that this is a fully alive human being, deserving of love and respect. Remind yourself that you are, too.
  • 4a) End with peace. No matter what happens during practice, whether your legs were shaking in crescent, you fell out of tree pose, or anything else… savasana is always there.
    • Sometime when you aren’t in conflict, work out a peaceful place for yourself and your partner. Words you can say to reassure one another, something you can do together, or a place you can literally go that is “sacred” and set apart, that doesn’t involve conflict. Then, you always have something to look forward to. Even if that isn’t possible, make sure you have that for yourself, so that you can rest and recover… and come back the next day.

 

Double Triple Bonus points if you get clients to attend yoga together to enhance the metaphor!

Comment below: This metaphor seems endlessly rich to me! How can you contribute to it?

 

 

 

 

Teletherapy Rant

Ellis1 Comment

Teletherapy Tips (but mostly rant)

(This is a bit long, and you may want to just skip to the end, where there is a client resource that you can check out!)

I’m not particularly new to teletherapy – I’ve done it for a couple of years, though only at need (for example, with a client who traveled out-of-town but in-state to care for her dying father for several weeks). Like it has for many of us, teletherapy has taken a larger role in my practice in 2020, and – as a result – I’ve solidified my relative distaste for it. It’s taken me some weeks to really get a handle on what bothers me about it, and I think I have.

 

  • It’s just not clinically appropriate for some clients.
    • For some clients, coming into the office is literally part of what is therapeutic – for depressed clients who have difficulty getting out of bed, for social anxiety clients who “feel safe” behind the screen, for clients with autism spectrum disorder whose work involves building social skills, for clients with dependent personality disorder/features
    • For some clients (those above, and those with almost any other kind of anxiety), staying sequestered at home exacerbates their symptoms. Consider how many people will have added a “with panic attacks” or “with agoraphobia” specifier to their diagnoses by the end of this time!
    • Perhaps it goes without saying, but managing potentially dangerous situations (e.g., self or other harm) via telehealth is something very few people have been adequately trained in. I have a feeling we don’t really know if we’ve been adequately trained until we’re in the moment across the screen with our client who has the scissors at their elbow.
  • Privacy/confidentiality is our responsibility, and teletherapy makes that much more difficult.
    • Privacy and confidentiality are much easier to manage in our office environments. For therapists who have moved their practice to their homes, unless they live alone, this poses significant challenges (e.g., family members hearing session, Bluetooth devices nearby allowing access to sessions). Also, when records are kept outside of the office, or moved between home and office (e.g., if you use paper records), that adds risk.
    • Probably the larger issue is that we don’t have any control over the environment that the client chooses. We can ask them to provide an optimal environment, but it becomes an ethical dilemma at some point: do we provide (suboptimal!) services when a client is, say, constantly interrupted by their kids, walking through the grocery store, or under the scrutiny of an abusive partner? Where do we draw the line and say it’s not an appropriate environment for therapy? Typically, we honor those boundaries even when clients don’t – when they sit down next to us in a church pew and start to share or even try to continue their session in the waiting room, we actively prevent that and protect their confidentiality even when they don’t.
  • We miss out on the benefit of the “sacred space.”
    • Therapy is special. When people choose to come to therapy, we are supposed to offer them something that is different from their normal lives. That’s part of what helps it to bring newness into their lives. There’s a reason that sacred spaces have existed throughout time – why you build an altar in the desert, why you go to your closet to pray, why you climb a mountain to get clarity, why indigenous healers set up holy spaces. If you think that therapy is just telling people your wise thoughts or finding interesting solutions to problems, maybe it doesn’t matter. But if you practice therapy with the intention to heal, the sacredness of the therapeutic space matters.
    • In a more scientific way, we could say that our internal states are tied to the physical spaces in which they are activated. That is the reason that one of the primary sleep hygiene rules is to only use your bed for sleep – because classical conditioning is a real thing. So, our offices – where clients choose to be disclosing and access emotions, where they feel safe, where they can bring themselves to do hard work – those offices allow clients, over time, to feel safe, disclose, access emotions, and do uncomfortable work more readily. When they do therapy from their homes, offices, cars… we lose the benefit of the therapy space.
  • For many therapists, it seems like it is more difficult for them to keep their professional boundaries.
    • The teletherapy experience seems to be convincing many therapists that they should be in text-contact with their clients much more often than they typically would be. If this is not part of a therapeutic system that a therapist has been trained in (like a Linehan-style DBT program), there are a lot of risks with extending the session beyond the session time. Beyond the risks for clients in believing that you’re always available, and then sending a crisis text while you’re unavailable, how do you take a shower, sleep restfully, or drive safely without attending constantly to the concern that a client in need might be texting you right now?
    • I’ve also been reading about and hearing about the “increased intimacy” of online therapy that some therapists are suggesting is a good thing. There are many therapists who are sharing things with clients that they never would share in face-to-face counseling, like the state of their homes and allowing clients to see them interact with their family members. Likewise, they are experiencing aspects of their clients’ lives that they wouldn’t otherwise experience. My question about this is whether those clients would choose to share those things, if they were mindful about it. Would therapists? We intentionally don’t join a client’s personal book club or speak to them when they’re at the gym. When we begin to do in-home therapy services, we get training in how to interact in a client’s personal space. While I’m sure everyone has good intentions, there’s no data about whether this is helpful or harmful to clients, and it seems to me to blur the lines that we know are helpful to clients.
    • For both of these issues, how clear are therapists being? Are we honoring our professional, ethical obligations to “clarify professional roles and obligations” and “avoid unwise or unclear commitments” (Ethical Principles of Psychologists and Code of Conduct, General Principles)? To what degree are we even maintaining a professional relationship? And make no mistake, the professional relationship is part of the healing process – we have known for a long time and continue to accumulate data that the therapeutic relationship is the primary factor in positive change (not the physician-patient relationship and not “good friendships” – the therapeutic relationship).
  • It’s harder to create a growth-promoting climate because it’s harder to use the basic Rogerian skills.
    • Silence is one of the foundational skills of therapy, and the mediation of the screen and internet connection really diminishes the effectiveness of silence… especially when the client has to ask, “Are you frozen?!” The head nods that we can use to show we’re listening while silent can be problematic; for example, they often seem like agreement to clients, so we don’t want to overuse them. The “mmm-hmming” is often either so quiet that it gets lost or so loud that it breaks the client’s rhythm because they think you want to speak.
    • Eye contact, which is also one of the most basic attending skills, is frankly impossible. If you are watching the client for facial and other non verbal cues, then they can’t see your eyes. If you look at the camera, so that it appears that you’re giving them eye contact, you can’t see them anymore. If you move your camera so far back that you can “fake it,” you’re no longer close enough to see their facial changes well. Not to mention that you need to be monitoring your tiny picture at least some of the time to at least make sure that you’re on screen, clear, and well lit.
    • Pacing is more substantially more difficult online. For one, it’s virtually impossible to see and hear clients’ breathing, which is one of the ways that you know how and when to speak in session, even if you aren’t aware that you’re attending to that. Also, the conversational lag time, even when both parties have a good connection, is unavoidable – that’s why we have to say, “Oh, sorry, you go ahead” so often.
    • Attending to nonverbals is also largely impossible. There are the issues listed above, with clarity of facial expressions and breath, but it’s unusual to be able to see more of the client’s body that you get to see in face-to-face work – wringing hands, tapping feet, holding a pillow across their torso, etc.
    • And it’s less congruent. According to Dr. Marlene Maheu, the leading teletherapy trainer in the country, from the Telebehavioral Health Institute, we need to be about 10% more expressive in order to come across the medium with the same level of engagement. That means that we are either acting (in which case our internal experience will be incongruent) or being perceived as less present (in which case the client’s experience is incongruent with our intention).
  • For me, personally, it feels less rich – the same energy isn’t there.
    • Partly, this is because I am more easily distracted and it takes more effort for me to stay fully engaged through the screen (esp in hour seven!). That may not be an issue for everyone.
    • Partly, it’s because my primary theoretical orientation is existential-experiential with a person-centered foundation, so I utilize the here-and-now and the relational process more often than other therapists might.
    • I really like how psychotherapist Erika Shershun said it, in an interview for The Bold Italic: teletherapy lacks the “refreshing and energizing resonance between two people.”

I know this is going to be a controversial thing to say, but in short, I think that teletherapy is the Standard American Diet of psychotherapy: it’s more convenient, it’s cheaper for the people who provide it, and it will keep you going, but it’s less nourishing and is probably causing problems down the line that we don’t even know about yet.

Of course, it’s also certainly better than nothing. For scenarios that are more like coaching, or brief solution-focused work, I think it doesn’t make much difference. If we do it well, I think it can be helpful. And I think that, in some cases, we can use it to our advantage (e.g., using the out-of-office environment to create different exposure scenarios for clients with OCD).

So, I have tried to channel these feelings into something much more productive than just a rant, and created this tip sheet  for clients doing teletherapy our scouring the internet and my professional community and finding nothing like it. Please check it out! Hopefully, you’ll find it useful and not-ranty, and be inspired to use it or make your own!

 

Thank you so much to my lovely colleague who helped me clarify these thoughts, soften my rantiness, and upgrade the usefulness of the client tip sheet.

 

 

 

More like dancers than statues

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More like Dancers than Statues 

(Introduction to Reversal Theory)

We are more like dancers than statues.

I’d like to spend a few minutes introducing you to a cool little theory that I bet you’re not familiar with. It’s called Reversal Theory and (if you’ll pardon the pun), it’s might just turn things upside down for you.

Let’s start with this – think about the theories of personality you’re most familiar with. Probably Big 5 comes to mind? Maybe Myers-Briggs? Bonus points if Allport or Eysenck popped into your mind first. Here’s the thing – most theories of personality are trait theories. They’re based on how we are, and how we stay the same. They tell us who we are, across time and situations.

Now answer this question: Do you feel like an INFP all day, every day? Aren’t there times when you’re more or less agreeable, more or less open to new experience? (And yes, while all of those theories account for slow, incremental change across the lifespan, that’s not what I mean.) I mean sometimes don’t you feel disagreeable in the morning, and more agreeable after coffee? Don’t you sometimes feel conscientious when you start working on a project and then markedly not conscientious as you slog through it for 5 hours? Don’t you sometimes feel extroverted at the beginning of a party, but just feel yourself retreating to introversion over the course of the evening? This is the aim of Reversal Theory – to give us a structure for thinking about how we are different across time and situations, rather than the same. (Don’t fret! It doesn’t do anything to diminish trait theory – all of that still counts!) 

To begin, I need you to imagine a bank of 4 light switches.

Now, I don’t want blow your mind too much right now, but in Reversal Theory, we’re not going to be thinking about traits on a continuum. We’re going to be thinking about 4 pairs of states, and each of them flips off or on like a lightswitch. (No, not like a dimmer-switch. I know the continuum is our best friend in therapy, but hang in here with me. Just wait until the end.)

Here they are:

Ok, let’s visit these one by one.

Serious-Playful

You don’t get to be serious and playful at the same time. Wen you’re in the serious state, you’re goal-oriented and future-focused. You’re focused on achieving something important and maybe on the consequences of not getting things done. When you’re driving to work for an 8am meeting with your boss to give an update on the progress of your latest project, chances are you’re in the serious state. But when it’s sunny, breezy, and 75 degrees on a Saturday afternoon, and you don’t have to rush anywhere (and also that favorite song of yours from your junior year in high school comes on the radio) – you’re probably in the playful state. In the playful state, you’re in the moment and focused mostly on enjoyment.

Conforming-Rebellious

When you’re in the conforming state, you’re focused on the value of fitting in, doing what’s right, meeting expectations. Lots of people are in the conforming state at school, work, or church. Teens are often in the conforming state, even when it doesn’t seem like it to parents (e.g., smoking to “be cool” or drinking to “fit in,” even though parents might call that rebellion!). When you’re in the rebellious state, your primary motivation is freedom, or individuality. When you spend Saturday doing whatever you want to do, or when you protest an injustice on your own behalf, or when you get a purple streak in your hair, even though your mother, husband, and coworkers might be scandalized, you’re probably in the rebellious state.

Mastery-Sympathy

In the mastery state, you’re primarily concerned with things like doing better, having control, and making progress. In the sympathy state, you’re mostly concerned with taking it easy, being gentle, love and nurturing. Chance are, if you’re at the gym, you either are in the mastery state or you’d certainly like to be. If you sometimes go to the gym for the “princess package” (a gentle swim, then the whirlpool, then the sauna, and end it with a smoothie), you’re probably in the sympathy state.  

Self-Other

The self and other states are probably what you think they are – being focused on you or being focused on someone else. These combine really naturally with the mastery and sympathy states. You might be exercising control and power over self (like when you’re at the gym), or you might be exercising control and power over someone else. For example, you might be bargaining down a salesperson for the best price and you definitely want to “come out on top” or you might really investing in beating your last high score in DoodleJump. That’s self-mastery. But what if you’re tutoring a high school student and really encouraging and empowering them to have control and mastery over themselves and their schoolwork? Any time you function as a teacher, coach, or mentor – you’re probably in the other mastery state, focused on power, control, and mastery…but for someone else. And sympathy works the same way. When you want to eat ice cream to soothe your jangled nerves, take yourself out on a date, choose to watch Netflix instead of push yourself to that deadline, you’re in the self-sympathy states. When you want to give that kind of care, love, and lenience to someone else – helping a friend in need, letting your partner sleep in – you’re in the other-sympathy states. 

Now, for each of these states, you are in one or the other of each pair at any given time. You might be more aware of one or two of them, but you’re in all four. And if you combine the states you’re in with the situation you’re in or what you’re doing, you get different and interesting results. So, you may be writing progress notes and be in the SERIOUS-conforming-self-mastery states. If you are, you’re probably killing it, getting work done, feeling great about your progress. But, if you’re in the playful-REBELLIOUS-self-sympathy state trying to work on your progress notes, I bet you’re not making any progress at all. I bet you’re sitting there, miserable, eking out a sentence at a time, wishing you were done, desperate for a massage or a margarita. See, we’re not always in the optimal states for whatever we’re doing at the moment.

OK, that’s as far as I’d like to bring you for right now. I want to give you a teaser…while you wait for the next post on this, think about what states your clients are in while they’re in session with you. Think about what states they might be in when they argue with their partners, when they’re disciplining their kids, sitting in their school desks, trying to resist peer pressure, or captivated by worried thoughts.

(If you are already in love, and don’t want to wait for the next post, buy this book.)

Comment below if you have thoughts or questions!

 

 

 

 

Seven +/- Two

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The Power of 7 +/- 2

(How Working Memory Works in Therapy)

How many things can you remember to get from the grocery store without writing it down? Well, never mind, I guess I already gave you the answer. Obviously, it’s 7+/-2. Or it is for most people.

And you probably learned about this in your intro psych class in college. But how is it meaningful in therapy, you ask?

It’s meaningful because your brain, and your clients’ brains, are pinball machines. You can really only hold about seven pieces of information in your brain at a time, and relatively small pieces of information at that. And they just “bounce around in there,” ad infinitum, unless we do something intentionally to get them out. And here are three ways that we can capitalize on this quirk of our brains in therapy.

 

#1: Journaling

I know that you already know that journaling is awesome. I know you could extol its benefits to almost any client, I know that you’ve seen it work its magic, maybe in your own life, and (because I’m a therapist, too) I also know that you sometimes recommend it for clients as homework just because you don’t know what other homework to give them. (We all do it!) And that’s OK, because journaling is pretty safe and, let’s face it, it sort of is magic. What you might not realize is how the 7+/-2 function of the working memory plays into the effectiveness of journaling, and how you might be able to use it even more intentionally and beneficially than you have been. One of the ways that we can get those bouncing pinballs inside our brains to get out is to write them down. I’m sure you’ve given this assignment to your anxious clients who have trouble getting to sleep at night because their pinballs are all the worries that they have about the next day. And you encourage them to put a pen and paper next to their bed, so that they can write down any anxious thoughts that they have or anything they need to remember for tomorrow, temporarily letting it go so they can sleep. Great!

Occasionally, that has unintended consequences. And you have a client who, instead of staying up for two hours thinking about the same five worries over and over, stays up for five hours writing down all the worries that came up after they wrote down the first five. And while they don’t like that very much, that’s part of the magic. When those five, seven, or nine thoughts keep bouncing around, they don’t leave any space for anything new. They don’t leave any space for other worries or concerns, and then those get kind of trapped, unexpressed, maybe even living inside and wreaking havoc on the client’s body. (More on this kind of thing in another post.) So they are not aware of, and cannot make you as their therapist aware of, all of their legitimate concerns. Journaling helps them to flesh all of those out. As if that weren’t enough, those seven pinballs also keep other new thoughts from coming in. Hopeful thoughts, new solutions, brilliant ideas, etc. So, one of the ways that we can take advantage of the 7+/-2 principal in therapy is to use journaling in a targeted way, whenever we want to give clients freedom to explore both the true breadth and depth of their concerns and also open them up to new possibilities.

 

#2: Healthy Conflict

Ok, how often have you had a couple in therapy and they’re discussing their latest argument, and the one of them who remembers everything perfectly (because there’s usually one) pulls out some exact quote from the other person that was really hurtful, and then the other person says, “ok, yes, but I was mad, I didn’t mean it!” And naturally this never satisfies the hurt partner, and they don’t believe them.

(Let’s be very honest, how often have you said that? And you know you didn’t really mean it, and your partner doesn’t buy it. And how often has your partner said that, and you didn’t buy it? Hmmmm?)

Let’s put this in the context of 7+/-2. When we’re upset about something, we ruminate. It’s one of the easiest times to see 7+/-2 in action. One thing that our boss/mother/partner/kid/etc. says – we just repeat it over and over along with a refrain of “how dare they,” and a chorus of “I didn’t deserve that.” That’s it. Over and over. And that’s bad enough by itself, right?

But then, we actually bring it up with the other person. And as we are “having our say,” we start with all of those things (pinballs) that have been bouncing around. After we say them out loud… That’s right, they’ve made a way for brand-spanking-new thoughts. Brand new thoughts with brand new words that we haven’t taken the time to decide whether or not we want to say. And because all of those pinballs have just made space, in the heat of that moment, all of these new, unfiltered, unevaluated, and probably regrettable words just fall out. That’s what’s happening a lot of the time when we say “I was mad; I didn’t mean it.” And you know what? It’s pretty much true.

We really don’t want to base our jobs on an unedited report that we threw together at 2am without really thinking about it. That’s not our “real work.” Our real work is composed, thoughtful, edited for appropriateness, thorough, concise, and clear. That’s what we want our bosses to judge us on. Our best. And that’s what we want to give to our partners, and what we want them to judge us on as well. So, you can teach this to couples along with other techniques for conflict management (more on this in another post), and help them to keep their pinballs from falling out and rolling all over the floor.

 

#3: Person Centered Therapy

PCT is just magic right? Right. But seriously, past the humanistic underpinnings, have you ever wondered-in a technical sense-how person centered therapy works like magic? I think I have an idea. Just an idea of mine, mind you. But it’s based on the 7+/-2 principle. And it goes like this:

What are the main techniques of PCT? Silence, reflection, paraphrasing, summarizing. (Remember, in honest-to-goodness Rogerian PCT, even questions aren’t very present.) So, what do these techniques to do? First, silence allows clients space to get the first seven pinballs out of their heads. Then, reflection allows them to know that their pinballs are safe, not going anywhere, and you create a holding space inside the session for those pinballs to live for a while, almost like little sticky notes. Lo and behold, the client suddenly has more access to their own genuine thoughts and feelings that have been locked up behind those first 7 thoughts. Great! So they can put even more pinballs out into the session with you – emotions, ideas, etc. – that they may not have had access to before. Like journaling, that might be therapeutic enough on its own.

But PCT goes further. When several of those pinballs/sticky notes get out into the space between you, it’s time to paraphrase. When you paraphrase, it’s like taking a couple of sticky notes, condensing them, and putting them together on one index card. Imagine, just by paraphrasing, you might take 30 of your client’s sticky notes and turn them into 15 index cards. Then what? Summarizing. When we summarize, and draw together common themes, it’s sort of like taking those index cards, condensing them even more, and maybe stapling them together. So, by the end of one session, you’ve let a client have access to much more of their internal experience, maybe even some of their inner wisdom, you held all of it safely in the session with you, and you’ve condensed it and given it back to them in packages small enough and few enough that they can make a new 7 +/-2 and they can re-organize their internal experience. That gives them more “brain space” for knowing themselves well, entertaining new ideas, in essence… space to grow.

 

Now, go do magic with the power of 7+/-2. Comment with how it works out for you!