WHAT TO DO IF YOUR SELF ESTEEM TAKES A DIVE

People talk a lot about raising self-esteem.  I think self-esteem is a myth.  It is based on doing, not being.  You become a human doing instead of a human being.  This theory of self-esteem is echoed by Albert Ellis, who created the REBT theory for therapy (rational emotive behavior therapy).  This therapy teaches clients about the mind, the feelings, and the behaviors of people and shows them the way to self-acceptance, to unconditional self-love, instead of self-esteem that is based on what we DO.  Self-esteem is a trap.  If we don't perform as we've been taught or conditioned to, we feel like failures in our lives.  In contrast, unconditional self-regard allows us to love ourselves regardless of what we do or who we are.

Self-esteem is one of the most talked about and one of the greatest myths of our time.  Are we not worthy of respect just because we are human beings?  Do we have to prove to the world, to our friends and our family, that we can jump through hoops they value in order to be regarded as valuable?

Improving ourselves is a worthy cause, and, I believe, one of the reasons we are on this earth.  Yet, regardless of what we accomplish, we can still love ourselves.  We just need to divorce ourselves from the conditioning from our societies and families.  "Is, not become": that is the answer!

Can't a baby be loved and respected?  Must he prove to us that he is valuable?  The same can be said of older humans.  Each person has their trials and their limitations.  Does that mean that they should be loved less because they might have impediments that hold them back from accomplishing what we think they should, or what they think they should?

People who claim to be Christians are often guilty (as are non-Christians--but they are taught differently so they are more off-the-hook) of accepting and valuing others depending on what they accomplish in life.  According to most Christians, this life is test to see what we can overcome, what we can learn, what we can accomplish.  These judgments hold true especially for people who are not related to one another.  It seems to be easier to love a child or relative, regardless of what they do in life.

Self-esteem is a myth!  Let us stop talking about self-love and acceptance in this way!!  Because we "are", we are worthy of love.  We must learn to throw away the antiquated ideas of "you are what you do", and supplant them with "you are who you are and worthy of love and respect under any conditions."

Does this concept sound strange to you?  Share your thoughts with us.  Challenge this concept, if you believe differently!

SEE POST:  LOW SELF-ESTEEM

IGNORANCE: TO JUDGE OR NOT TO JUDGE?

I've been reading a long, somewhat confusing thread on ignorance and have distilled these thoughts:

I've concluded (for the time being) that there are two kinds of ignorance. (1) ignorance of ignorance, and (2) awareness of ignorance. I might be mistaken but it seems that those 2 categories cover all types of ignorance. And I think that we cannot be faulted for our ignorance unless it is willful.

I do allow myself to feel disgust of ignorance, but not of the "Ignorant" (though I'm not always successful).

What is the best way to think about ignorance? We cannot examine ignorance without considering another concept called "judgment".

I believe strongly that we cannot fully know others, therefore, we cannot accurately judge others. You might say,  "I know myself better, therefore, I can judge myself."  Well, yes and no. Because we are not objective, can we really know ourselves? Because we live in denial (and need to in order to survive), can we fairly judge ourselves?

Interestingly, the Bible says, "Judge not, lest ye be judged." (One of the wisest statements found in that book, I think.) It doesn't say, "You can judge yourself, but not others."

Because judgment includes concluding what is desirable or not, what is good or not, we risk condemning others (AND ourselves). Considering we all have limitations to understanding ourselves and others, judging has no place in a happy society.

"Ahhh, what about making decisions?" you ask.  "You need to differentiate, use critical thinking skills, come to some conclusion."  Yes, yes, yes.  But we need not judge; we need only decide on what we believe is best for us--and for society, if that is a role that is freely given and accepted.

Absolute, extreme, black and white thinking, poor ego strength, and a host of other aspects all contribute to poor judgments.  

And, as humans, we are just too ignorant to make valid judgments most of the time.

YOU LOOK STRESSED!

If you are stressed, do you like it when others point it out?  Why?
Personally, I don't like it.  It's not a pet peeve of mine.  It doesn't cause a knee-jerk reaction.  It's not a huge thing, by any means.  I just think of all the things a person could say to another, pointing out how bad someone looks is usually not appreciated.

The message being sent is:  you look haggard; you look tired; you don't look so good; your work quality is slipping; or some semblance of the above adjectives. It's generally not positive.

It's bad enough to be stressed out, much less to hear about how it makes you look.  How about some help, instead?  How about suggesting a rest? Or some other diversion?  Like a caring conversation about how they are feeling...

I'm sure that most of these people don't mean anything negative by it.  They're not out to rattle my cage (usually).

It's just that we're conditioned to using certain phrases from our own cultures.  Yet, how many times would it  be better, nicer to have something positive pop out of our mouths?  

PRACTICES PRESENTLY PLAGUING MENTAL HEALTH THERAPY

The following is a discussion/rant of educational requirements and other serious issues presently plaguing the field of mental health.

 

PHILOSOPHY, PSYCHOLOGY, AND RELIGION:  Is training in these fields necessary for ultimate results in therapy?  The concepts of philosophy, psychology and religion are closely intertwined.  If broken into segments, the encompassing “picture” of mental health is lost.

For example, the philosophical concept of dualism vs. monism brings us into the realm of religion.  Therefore, the type of approach or modality used should reflect clients' belief systems.   How much do peoples' beliefs in “good” and “evil” affect their decisions and their moods?  How do these belief systems affect cognition and, therefore, the emotional lives of people?

Understanding the worldviews of clients opens doors to therapists' understanding of clients' philosophies of life.  Simply put, the more therapists know about their clients, the greater the potential to help them.

I believe a truly effective healer, a person needs to be educated in at least two of these three fields. However, this kind of academic discipline is rarely required of students studying to be therapists.  Therefore, their effectiveness is often limited (except in rare cases where the client is exceptionally astute, intelligent, and committed to their own continuing research and education.)

Clients' beliefs regarding philosophy, psychology, and religion helps determine the type of approach used in therapy.  In other words, the theories and methods employed would be those therapists decide are most effective for the particular client.

So how effective can therapists truly be without an education in the liberal arts?  To be a truly competent therapist, I believe (with some reservations), a person may need to be as disciplined and educated as a medical doctor.  (How often does that happen?)  

A common belief is that, in psychology we aren’t dealing with the nuts and bolts of body parts and instruments and, therefore, do not directly impact life and death. However, within the realm of the mental and spiritual life of clients, the therapist can be effective in enhancing the quality of life and even in helping to prevent early death and suicide.  Considering this, appropriate therapeutic methods and qualified therapists are indispensable!

Some therapists appear naturally intelligent and emotionally in tune with others' emotions.  They seem to have incredible instincts when it comes to what to say and do with a particular person.  They seem to have a natural talent.  Yet, without adequate education, I still believe even the most intuitive therapist is at a disadvantage.  

In providing effective therapy, counselors need to ask themselves a number of critical questions.  For example, how does providing therapy affect clinicians' emotions?  (Consider burn-out.)  Can they effectively manage their involvement with others?  Can they keep their boundaries?  Have they learned tools, backed by good research that are most effective in particular cases?  Can they conceptualize their clients' cases more fully due to their additional training in philosophy and/or religion?

Being a therapist is one of the most difficult professions. Considering the financial aspects alone, even if students are minimally trained, the cost of education is daunting and can be at par with training medical students.  

Medical doctors are usually paid well (partly because of the AMA’s artificially limiting the number of doctors allowed to practice and other unsavory practices).  The therapist, in most cases, is ubiquitous and underpaid, and that is anathema considering that they are involved in the delicate process of helping heal human minds and souls.

There are many therapists who do the minimum and who are relegated mostly to social work activities within their community mental health centers.  That is a sad truth.  However, in all fairness, this truth extends to most fields of endeavor.  It is like a continuum, with the least capable, unlucky, or unwilling at one end of the continuum and the brightest, most committed, lucky, political, educated and driven at the other.  

There are, however, exceptions:  bright, committed, motivated therapists who are unwilling to cave into the political expectations of a mental health organization.  There are those who are not willing to bend on ethics, as well.  I guess those therapists go into private practice.

While good and stimulating opportunities for medical doctors are many, therapists’ chances of finding fulfilling work where they can be maximally effective are minimal.  LPC’s and MFT’s are a dime a dozen.  They are usually the last resort of choice when hiring at community mental health centers, licensed clinical social workers (LCSW’s) being preferred.  Even though the state examinations for licensing are the same, the real work and expertise required for therapy differs greatly from social work.

A community health center is a bureaucracy.  That means lots of red tape.  That means lots of paperwork.  That means lots of involvement with other agencies.  That often means money shortages.  

Most therapists’ time (regardless of titles) is spent dealing with these areas.  Can they still be effective in therapy?  Yes and no.  

Those who have enough time and energy to do so, those who are willing to sacrifice personal beliefs, conform, and are capable of working within very political environments seem to be the the ones who are most "successful" at their jobs. It also helps to have flexible values.

At least, therapists are usually able to give much-needed, minimal band-aids on clients' issues.  However, the price therapists pay is often the sacrifice of their personal value systems, significant frustration with organizational politics, dissatisfaction with low-success rates, and paying for their own books and tools, often resulting in career apathy and early burnout.

If clients' issues are minimal, the help they receive is often perceived as great.  However, most clients who frequent MHC's (mental health centers) have grave and complicated issues that most therapists are inadequately trained to deal with.  This situation easily inflates the actual good MHC's do.
  

Another issue is that poorly supervised trainees and interns are often pressed into giving therapy they are not qualified to give, increasing the likelihood of poor quality therapy. Those issues, combined with time constraints (allowing only 6-8 or 8-12 sessions, which is usual), can only serve to scratch the surface of the clients' issues.  If clients are lucky, the therapeutic band-aid is applied, and they generally feel temporarily relieved.

Most clients have additional frustrations with the time limits of sessions (45-60 minutes) and the general structure and artificial nature of conducting therapy in offices with their therapists. The hassles and costs of keeping appointments put an additional strain on clients struggling with just getting through the day.

The effectiveness of therapy depends heavily on the therapist developing a good relationship with the client.  It is estimated that 30-50% of effectiveness depends on this aspect of therapy.  However, trying to establish this kind of relationship in so few sessions is a challenge for even the best therapists.  To complicate matters, many clients have serious trust issues; therefore, more sessions are needed to establish that kind of trust.

To sum up, lack of education, proper training, and time with clients, the structures and constraints of MHC's, and the high cost of education severely limits therapists' effectiveness for those who suffer from mental illness.  

It is past time when society needs to throw out their prejudices about mental illness and therapy and place it on par with medical help, giving therapists and therapy students at least the same level of support.  After all, considering the mind/body connection is crucial to effective therapy.  Poor physical health is often caused by poor mental health and vice versa, either directly (e.g. by self-medicating) or indirectly (e.g. by depression and loss of hope.)

I ask out of frustration, how long will it take before the stigma of mental health abates?  How long before enough money is available to set up effective mental health centers?  

How long before the majority of educational institutions incorporate and require a more thorough, well-rounded education for its mental health practitioner students and train them adequately, thereby treating clients ethically and effectively?

Are you familiar with any of these issues?  Have you ever struggled with the mental health system and the level of therapists expertise?  I am very interested to hear about it.  Please blog your experiences, and share any ideas for improvement in the field of mental health.

Thank you!

COGNITIVE THERAPY: REFRAMING

Some years ago, I was talking to a good friend of mine who asked, "So, how are you feeling these days?"

I quickly answered, without thinking, "Well, I've lowered my expectations, so life is actually more tolerable."

Having struck us so absurdly funny at the same time, we laughed about that for a long while.  After the conversation, I thought my comment sounded negative and morbid--like I've given something up.  And then I realized I did:  my perfectionism.

This is what is called REFRAMING in Cognitive Therapy.  It's a good thing.  But I still think back on that conversation and feel torn.  Yes, I know the world is not perfect and neither am I.  However, when you are young, you have a tendency to look at the future with much more hope and anticipation.  People tell you, "Anything is possible!"

But as you bump along in life, you find out eventually (or very quickly!), that your opportunities are shrinking and life is usually NOT what you had imagined it might be.

This situation can be worse for people who are told they should set goals, and work for them, and they will accomplish their dreams.  Sounds nice--and productive; however, unless you are willing to re-set your goals along the way, willing to be very flexible, life may seem like one disappointment after another.

By middle age, in times of grief and loss, I found myself working hard on looking at the glass half-full, counting my blessings just to stay balanced and not go off the deep end.  It really worked! (Usually...) It got me through some very tough times and I learned to survive.

Now, I'm grateful for knowing how to change my perspectives; I'm grateful that I know perfectionism and rigidity ("thinking errors") are unhealthy, and I can avoid them.  I'm grateful to have found a way to be content most of the time, even though I realize that I am working through my subjective reality and not objective reality.  (I believe there IS objective reality, but who is to say what that is for sure? ;0) But I'm getting Existential again...back to Cognitive!)

Some people are suspicious of reframing, saying that it is just a way of fooling yourself.  If that is how they see it, it probably is--for them.  As a therapist, we try to get clients to see that there are different ways of looking at the same situation.  Certainly, as humans, that is what we all do naturally--we all have our personal perspectives.  Just ask any group of people who have witnessed a car accident...

While it makes sense to me, it can be difficult to teach this tool to some clients who use black and white thinking (another thinking error); things are all one way or the other for them.  Other clients snap into reframing quite quickly.  I have seen the "miraculous results" of cognitive therapy often.  So, I believe in its power.

And yet--I still somehow feel uncomfortable at times trying to teach reframing or reframe things for myself.  If we are recreating our own reality, how far is it from actual reality?  I mean, are we just becoming Pollyannas?

Some of the latest therapeutic approaches emphasize heavily the positive approach--think positive, be positive, avoid negativity whenever possible, and life will become oh-so-wonderful.  When I see people really "up" like that, my first reactions are that they "drank the Kool-aid", that the person is not "genuine", living in a world of their own. (Well, it's THEIR perspective, right--isn't THAT OK?) (I sometimes wonder what would happen if objective reality ever crept into their lives. They might explode--or melt!)

I want to be "realistic" with myself and my clients.  I think a worthy goal, existentially and theoretically speaking, is to bring objective and subjective reality together as closely as possible, so that we can live a practical life in the real world and reduce the denial in our lives.  That sounds harsh, though, too, doesn't it?  For me, it is often a balancing act between Existential and Cognitive principles. (After all, not much occurs in a vacuum.)

It is very difficult to know where to draw the line with others; how much reality can they digest?  Some denial is a healthy stop-gap measure to keep us going until we are ready to face certain realities.  Some people really limp through life, so it is imperative NOT to take their denial "crutches" away from them.  Gently guiding, leading, over time is better.  (Or, in some cases, never may be better.  We don't want anyone contemplating suicide.)

So, maybe reframing can be defined as using a new perspective that is still feels REAL (whatever that is), but feels more HOPEFUL.  I do think we can reframe ourselves to a place close to objective reality, if we do it skillfully in conjunction with the personal issues of the client.

Personally, I continually check myself and weigh sides to make sure I'm not just living in a "fool's paradise".  Cognitive therapy, done well, can be a very tricky road; but until some other better mode of therapy comes along, I'll stay on that highway!

AARON T. BECK, M.D.

"The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers" 
 

^{~ Aaron T. Beck, father of Cognitive Therapy}

See...how philosophy and psychology overlap?

DETOX

PHILOSOPHY OF AMBIGUITY HUMOR

FOR THOSE WHO LOVE THE PHILOSOPHY OF AM          

 1.  DON'T SWEAT THE PETTY THINGS   AND DON'T PET THE SWEATY THINGS.

 

 2.  ONE TEQUILA, TWO TEQUILA,   THREE TEQUILA, FLOOR.

 

 3.  ATHEISM IS A NON-PROPHET   ORGANIZATION.

 

 4.  IF MAN EVOLVED FROM MONKEYS AND APES,   WHY DO WE STILL HAVE MONKEYS AND APES?  

 6.  I WENT TO A BOOKSTORE AND ASKED THE SALESWOMAN, "WHERE'S THE SELF- HELP SECTION?"   SHE SAID IF SHE TOLD ME, IT WOULD DEFEAT THE PURPOSE.

 

 7.  WHAT IF THERE WERE NO HYPOTHETICAL QUESTIONS?

 

 8.  IF A DEAF CHILD SIGNS SWEAR WORDS,   DOES HIS MOTHER WASH HIS HANDS WITH SOAP?

 

 9. IF SOMEONE WITH MULTIPLE PERSONALITIES THREATENS TO KILL HIMSELF, IS IT CONSIDERED A HOSTAGE SITUATION?

 

 10.  IS THERE ANOTHER WORD FOR SYNONYM?

 

 11.  WHERE DO FOREST RANGERS GO   TO "GET AWAY FROM IT ALL?"  

 12.  WHAT DO YOU DO WHEN YOU SEE AN ENDANGERED ANIMAL EATING AN ENDANGERED PLANT?

 

 13.  IF A PARSLEY FARMER IS SUED,   CAN THEY GARNISH HIS WAGES?

 

 14.  WOULD A FLY WITHOUT WINGS BE CALLED A WALK?

 

 15.  WHY DO THEY LOCK PETROL STATION BATHROOMS?     ARE THEY AFRAID SOMEONE WILL CLEAN THEM? 

 

 16.   IF A TURTLE DOESN'T HAVE A SHELL,   IS HE HOMELESS OR NAKED?

 

 17.  CAN VEGETARIANS EAT ANIMAL CRACKERS?

 

 18.  IF THE POLICE ARREST A MIME,   DO THEY TELL HIM HE HAS THE RIGHT   TO  REMAIN SILENT?

 

 19.  WHY DO THEY PUT BRAILLE   ON THE DRIVE-THROUGH BANK MACHINES?

 

 20.  HOW DO THEY GET DEER TO CROSS THE ROAD   ONLY AT THOSE YELLOW ROAD  SIGNS?

 

 21.  WHAT WAS THE BEST THING BEFORE SLICED BREAD?

 

 22.  ONE NICE THING ABOUT EGOTISTS:   THEY DON'T TALK ABOUT OTHER PEOPLE.

 

 23.  DOES THE LITTLE MERMAID WEAR  AN ALGEBRA?

 

 24.  DO INFANTS ENJOY INFANCY   AS MUCH AS ADULTS ENJOY ADULTERY?

 

 25.  HOW IS IT POSSIBLE TO HAVE A CIVIL WAR?

 

 26.  IF ONE SYNCHRONIZED SWIMMER DROWNS,   DO THE REST DROWN TOO?

 

 27.  IF YOU ATE BOTH PASTA AND ANTIPASTO,   WOULD YOU STILL BE HUNGRY?

 

 28.  IF YOU TRY TO FAIL, AND SUCCEED,   WHICH HAVE YOU DONE?

 

 29.  WHOSE CRUEL IDEA WAS IT   FOR THE WORD 'LISP' TO HAVE 'S' IN IT?

 

 30.  WHY ARE HEMORRHOIDS CALLED "HEMORRHOIDS"   INSTEAD OF "ASSTEROIDS"?

 

 31.  WHY IS IT CALLED TOURIST SEASON   IF WE CAN'T SHOOT  THEM?

 

 32.  WHY IS THERE AN EXPIRATION DATE ON SOUR CREAM?  

 

 33.  IF YOU SPIN AN ORIENTAL PERSON IN A CIRCLE THREE TIMES,   DO THEY BECOME DISORIENTED?

 

 34.  CAN AN ATHEIST GET INSURANCE AGAINST ACTS OF GOD?

 35. WHAT HAPPENS IF YOU GET SCARED HALF TO DEATH, TWICE?

SOMERSET MAUGHAM QUOTE

A somewhat troubling notion...and yet practical.  Do you think there are times we must sacrifice principles?  Why or why not?  I'd love to read some examples!

THEORY IN BRIEF: PERSON OR CLIENT CENTERED

NAME OF THEORY:  Person Centered (Client Centered) Theory

BASIC PREMISES AND PHILOSOPHY:  Create a warm, caring, and nurturing environment for clients to facilitate trust and openness to structure a climate for clients to learn. Core conditions for change to take place are:  contact, genuineness, unconditional positive regard, and empathy. Focus should remain on the human experience, not on the problem (person centered vs. problem centered). 

CARL ROGERS

FOUNDERS OR IMPORTANT CONTRIBUTORS:  Leslie Greenberg and colleagues, Robert Carkhuff and colleagues, Carl and Natalie Rogers, Theodore Reik, Otto Rank

COUNSELING GOALS:  To make clients feel valued, understood and empowered. Offer a sense of hope and potential for clients to move past their dilemmas.

ROLE OF COUNSELOR:  Provide warmth and human contact. Be fully and completely attentive. Have and demonstrate openness and unconditional POSITIVE regard for clients. Provide support, trust, and caring through authenticity, warmth, and genuineness. Immediacy—pointing out ways behavior is unfolding in the moment. Demonstrate empathy and congruence. Focus on affect and feelings. Use active/reflective listening.

ROLE OF CLIENT:  Be willing to discuss feelings and develop trust and good repoire with counselor. Be prepared to discuss abstract concepts and explore ambiguity. Be self-directed and motivated.

USEFUL WITH WHAT POPULATIONS AND TYPES OF PROBLEMS:  Best with clients who are willing to take time for therapy and are not as interested in quick fixes or especially goal focused. Also effective for clients who are willing to be self-directed and motivated. Good for a large variety of populations and agencies or environments. Generally serves as an effective basis for communicating with others and problem solving by establishing positive relationships.

HUMANISM POSTER

EXAMPLES OF TECHNIQUES:  Reflective listening; building relationship with trust and authenticity; immediacy intervention (pointing out issues as they arise and are unfolding); focus on affect and feelings. Provide full and complete presence as therapist to the client. Show full acceptance of clients, not necessarily their behaviors; verbally and non-verbally communicate respect and caring.

TERMS:  reflective listening, immediacy, authenticity, empathy, acceptance, unconditional positive regard, person-centered vs. problem centered

EXISTENTIAL QUOTE

Sincerity is everything. If you can fake that, you've got it made.

~George Burns