TROUBLED CHILDHOOD, TRIUMPHANT LIFE

Troubled Childhood - The Breeding Ground for Adult Sexual Abuse

2011-11-19T18:51:00.000-08:00

The very institutions that are supposed to protect our citizens from harm are now embroiled in conflict as they contend with the secrecy and shame of sexual abuse. The fabric of our culture has been shaken to the core by the perpetration and deception surrounding sexual assault.

What needs to be a healthy sexual instinct and act has become a deadly, destructive weapon when it is used by those who are not conscious of the depth of their inner-darkness. One’s "seedy-side," in need of transformation, remains sublimated rather than redeemed. Twisted thoughts, urges and behaviors get linked to sexual desires that should be wholesome and foster a positive connection with our most intimate, significant others.

We have been down this path before, and yet continue the destruction. Sexual abuse and secrecy have rocked the Catholic Church, and more recently, educational entities and institutions such as Jerry Sandusky and Penn State University, and governmental entities and individuals, such as the alleged activities of presidential contender, Herman Cain.

I believe this sordid mess starts as a family problem. A troubled childhood is the breeding ground for most adult sexual abuse. What doesn’t get processed in the past, gets replayed as a toxic narrative in the here-and-now. The same worn-out scripts or adverse childhood experiences get activated and are linked to inappropriate, stunted sexual development and behavior. Adult perpetrators of sexual abuse are not able to stop their activity, because they have never responsibly addressed the full emotional impact of the abuse directed towards them.

Like a bad video, sexual abuse gets passed down from one generation to the next unless the process is consciously altered. It takes supreme courage for those who have been abused, through parental neglect and aggression, to deal with their own fallout so they don't offend others in adulthood. It is every adult’s responsibility to seek help for their own troubled childhood experiences.

Sexual abusers experience fallout from bad parenting, with characteristics of extreme power and control, emotional unavailability, hostility and aggression, and harsh, critical treatment. Some are exploited sexually, but many are wounded in other ways. With their spirit broken from childhood, these to-be-offenders are primed due to angry, shame-based feelings connected to childhood trauma.

Adults who have experienced abuse during childhood can process the past and learn to release the shame and blame that haunts them. With support, they can learn to reframe their present thinking and behavior and treat themselves and others in a healthy manner.

If our society is to be restored from the vestiges of sexual abuse, we must all be committed to preventive strategies and interventions, and vigilant reporting, to make sure that our citizens, including children are shielded from potential harm of sexual predators.

Pennsylannia, Penn State: Living in the Land of an Altered Reality

2011-11-17T19:48:00.000-08:00

Denial is a powerful thing. It is a reaction to painful, disturbing realities that are seemingly too great to bear. For the short term, it appears more emotionally palatable to live in the land of an altered reality than to confront one's inner demons and courageously process them.

The stakeholders in the state of Pennsylvania and Penn State University appear to be living a lie - a massive fabrication filled with ineptness and endless cover-ups. In typical fashion, the perpetrators of childhood sexual abuse, and those who suppress it, have their power and control protected at the expense of our young people. The innocence and trust of our children continue to be shattered as those in a role of authority find ways to irreparably damage them.

The state of Pennsylvania is in no position to effectively address the Sandusky problem, since their laws and execution of them are at the core of the scandal. It is a kin to asking the Catholic Church to police its own ranks. Only the judicial department of the federal government can sort out this mess and clarify for all of us what happened and how it played out.

The state of Pennsylvania is culpable based upon its ambiguous statutes regarding mandated reporting of abuse. In most state statutes "all individuals" are to take responsibility for reporting suspected child abuse to child protective state agencies and the police. Severe penalties for not reporting eyewitness accounts and alleged information about sexual abuse are a punishable offense. In some states, failures to report suspected sexual abuse is considered a felony. The impotent Pennsylvania law permits reporters an easy excuse by merely requiring that those working in institutional settings pass the alleged information along to immediate superiors. Apparently, this latest version of the Pennsylvania statute was supposedly considered an improvement over the previous child abuse reporting law. This doesn't bode well for the competency and insight of Pennsylvania legislators. The statute is set up for failure. It allows those individuals with powerful information to begin the denial process by using the passing of time and the mechanism of one’s selective memory to spring into action. It was the responsibility of Mike McQueary to immediately call the police and child protective services regarding his eyewitness account of Jerry Sandusky's locker room rape of a young child. The archaic Pennsylvania statute allowed professionals at Penn State University to play "hot potato" with the lives of our children. By the time the information reached the university president, we can only speculate on how deluded the toxic message became.

McQueary now wants us to believe that he contacted the police and tried to stop the sexual abuse as indicated in an email he sent to a friend. Had he merely picked up the phone on day one and called the police or child protective services, they would have asked him a host of questions to get to the bottom of Jerry Sandusky's behavior towards the child in the Penn State locker room. Rather than make the contact, McQueary met with Joe Paterno, whose remarks before the grand jury about Jerry Sandusky's behavior had already been toned down and compromised. It appears clear that through minimization and deception, Penn State University officials, from the top down, felt the need to protect their football culture from a sordid affair perpetrated by a coach who no longer works there.

If anyone has doubts about Jerry Sandusky's culpability in abusing children, one only needs to listen to the interview with Bob Costas of NBC Sports. When Costas asked Sandusky if he had a sexual affinity for young boys, Sandusky repeated the question several times and dodged and weaved through each response. It was an awkward interview, set up by an obvious inept attorney in hopes of doing damage control.

Furthermore, due to a judge with a conflict of interest, Jerry Sandusky is free on $100,000 bond without even meeting the minimal court requirements for alleged sex offenders of an ankle bracelet. Jerry Sandusky appears to have used the power of his volunteer organization dedicated to working with-risk kids, to sexually prey on the neediest of children.

At every level, this tragedy represents a breakdown consisting of denial and deception within Pennsylvania government and the Penn State University institutional setting. To create a sense of civility, responsibility and accountability, all entities dealing with our children must courageously step forward to encourage, support and protect those who have the most to lose - our children. When will we learn to face boldly, the ravages of childhood sexual abuse? When will we stop the denial and deception and quit living in the land of an altered reality?

Penn State, Joe Paterno and the Pennsylvania 'Pass the Buck' Law

2011-11-09T16:48:00.000-08:00

We live in a culture riddled with secrecy, denial and childhood sexual abuse. The revelations and reality about the pattern of institutional cover-ups at Penn State University underscore the nature of the problem. The voice of children, who are the victims of sexual abuse, are often disregarded and invalidated. The power of denial transcends the painful reality of violating our most valuable, yet vulnerable resource. Often, parents, schools, community caretakers and agencies are more interested in protecting the perpetrators of abuse than in seeing justice rendered. It's unfortunate, but in a litigious society the wheels of justice are more likely to be granted to the most powerful players.

Unfortunately, it is human nature for those who are first-hand witnesses of sexual abuse to deny, minimize, or avoid its impact; this is also true for those who are potential reporters who have been provided with first-hand information regarding suspected sexual abuse, such as the case with Joe Paterno. Rather than standing tall as a mandated reporter (along with assistant Mike McQueary), he decided to follow the letter of Pennsylvania law, absolving himself of responsibility by seeking to pass the information along to "higher authorities."

Most states have mandatory reporting laws that address this problem of potential reporters trying to shirk their responsibility. In Arizona, the key phrase in the mandatory reporting law is "any person” is obligated to report suspected abuse. In other words, most everyone constitutes a mandated reporter and penalties for not reporting are severe.

It appears that in the Pennsylvania mandated reporting law, those individuals who work in institutional settings are provided an "out" by merely mandating that personnel such as educators pass suspected abuse information to their superiors. This distinction in the Pennsylvania reporting law creates a loophole, which is disturbing. At Penn State University, rather than holding first-hand responders responsible for reporting suspected abuse, the Pennsylvania statute let Paterno and McQueary off the hook and gave them the opportunity to dilute the information as they passed it on to their administrative superiors.

I am not suggesting that Penn State administrators, including the university president, are not culpable for what occurred. Rather, I am making a case that Mike McQueary and Joe Paterno had a legal and ethical responsibility to report suspected abuse and were provided a legal escape through Pennsylvania law.

According to Mike McQueary, he witnessed a horrific scene within the locker room at Penn State University. He viewed a child being sodomized by former assistant football coach, Jerry Sandusky. He supposedly found the situation so repulsive, that he fled the locker room. Due to his eyewitness account, McQueary had the most significant role and obligation to report the alleged sexual abuse to the police and child protective services. Joe Paterno received first-hand information about the alleged sexual abuse from McQueary and should have collaborated with him to report it. According to most state’s child protective service protocols, "any person" should be obligated to report suspected child abuse - including Joe Paterno, who had first-hand knowledge relayed to him about the heinous acts of Jerry Sandusky.

Once again, we are witnessing the ugly side of college sports and institutional cover-ups. It is obvious that the NCAA is being tarnished by the behavior of many players and coaches. I find it mystifying and yet understandable, that the Penn State University administrators, including the president, have taken the fall for the legal and ethical cowardice of a coach who plans on leading his team onto the field this Saturday for a game that most people will find repugnant.

How to Manage our Hard-Wired Youth

2011-10-18T13:38:00.000-07:00

A friend of mine who is a high school English teacher in our local schools has been perplexed by the behavior of some of her current students. She said, "Help me understand why a third of my students can't sit still in their desks? They wiggle, they squirm, they tap their pencils and their feet and are constantly in motion." She is experiencing a dose of today's "hard-wired" youngsters.

Although some of this student behavior is developmentally appropriate, our society has rapidly experienced a metamorphosis that fosters and perpetuates the kind of fidgety behavior that my teacher friend is observing. Our fast-paced, complex culture places stress and strain on all of us. Many times our children feel overwhelmed by the "juggling act" that is performed in trying to keep their lives in balance.

What are some of the factors that create an environment of over-stimulation and hyperactivity among our young people? Some clinicians in the field of behavioral health suggest that Attention Deficit Disorder accounts for most of our restlessness in children. However, many of our hyperactive students do not meet the criteria for ADHD. I believe that children are suffering from agitation, restlessness and hyperactivity due to other situational factors.

What is it about our culture that contributes to the restlessness experienced by our youth?
• Violent lightening fast-paced movies and videos. I believe that students who are consistently immersed in watching movies and videos filled with acts of violence are much more susceptible to restless agitation. Many children are unable to detach themselves from the overstimulation of violent behavior in the media. As they absorb multiple acts of violent sociopathic behavior, they are unable to process and disengage from the material without it affecting their current behavior.
• Excessive involvement with video games and computers. Many children become obsessively connected to electronic gadgetry and it may have a direct link to the quality of their mood, level of concentration, and quality of sleep. Some children use the electronic media as a means for avoiding more meaningful activity such as socialization with age-mates. Electronic stimulation may be referred to as the "companion symptom." Children can carry it around like a friend and the activity takes on a life of its own.
• Extensive use of cell-phones, including text-messaging. Kids lose focus and concentration as they ritualistically use these tools to connect with others.
• Loud, hard-wired music. Have you ever pulled up next to a car that was blasting the radio playing heavy metal or rap music? Did it sound like they were having a peaceful experience? Children are not always aware of the effects that certain styles of music can have on the sympathetic nervous system. These children may complain of irritability, moodiness and agitation as a result of this exposure.
• The problem of over-scheduling activity. Many children are unable to find a balance between creative free time and structured activity. Although karate and dance lessons may be important, children need time to play creatively. This may include artistic activity, hiking, camping, cycling, playing board games or doing nothing. The excessive activity level of many students makes it difficult for them to complete school responsibilities, such as homework, creating unnecessary stress and anxiety. Parents may perpetuate the problem by insisting that their children "stay on the move" at all times. Excessive preoccupation with activity creates overstimulation. How many birthday parties does your child need to attend before you say, "enough is enough?"

Several years ago my wife and I toured the nation of Israel with her family. I recall being in the mountainous village of Safed that is home to an artist colony. I remember a young boy who was using an easel to draw some ancient ruins. He looked serene and content. I asked him if I could take his picture and he agreed. He smiled and I snapped the image. I think it was his innocence and creativity that sparked me to want that image. I mentioned the encounter with our tour guide and he replied by saying, "The entrepreneurs in America have ruined a whole generation of children with their electronic gadgetry." Although his point may be overstated, his premise is accurate.

As parents, it is important to guide your children in setting reasonable limits regarding exposure to the media and activity. This can be accomplished by monitoring your children's level of electronic exposure and degree and quality of structured activity. Parents can help their children develop an awareness and appreciation for the connection between excessive media stimulation and over- involvement in activity and the symptoms of irritability, agitation, and hyperactivity that may develop.

Fibromyalgia: It's in your Head but it's not your Fault

2011-08-16T18:27:00.000-07:00

Fibromyalgia syndrome (FMS) is the medical terminology used to represent a complex clinical disorder of symptoms characterized by soft tissue pain, stiffness, and altered deep pain threshold with psychological fallout. It can mimic or accompany symptoms of joint injury, but it is not an arthritic or neurological condition. The disorder affects between 3 to 6 million people – or as many as one in 50 Americans. About 80 and 90 percent of those diagnosed with fibromyalgia are women. I am one of the 10 percent of men afflicted with this disease.

There is usually an emotional overlay of depression and anxiety that affects the sufferer. There are numerous reasons why this is true. Many within the medical community have discounted fibromyalgia as a bona fide disease. Patients have been told that they are over-dramatizing their pain and that the stiffness or soreness has been psychologically induced. Others have been told that the condition was fabricated for attention or perceived by health providers as feigned helplessness. These assertions from medical experts make patients with FMS feel ignored, mistrusted, alone and without support. Patients often turn to self-blame, which fuels the pain cycle. A supposedly reputable physician once told me that “I just didn’t have a strong tolerance for pain.” I never saw him again.

The pain and symptoms of fibromyalgia are real and have a definite physical basis.
There is no known cause for fibromyalgia. Some researchers have speculated that physical trauma or viral influences have triggered FMS syndrome in many patients. There are no known abnormalities in the muscle tissue of fibromyalgia patients that would account for the disease.

Current research has focused on regions of the FMS patient’s brain and the susceptibility of certain brain locations to pain sensitivity. The brain receives a pain signal from the muscles and stays in a state of alert. For unknown reasons, the brain fails to let go of the pain signal and sets up a chronic pattern or pain syndrome. The brain stays in a constant feedback loop, consisting of a system of amplified pain signals.

Recent brain scan research studies have shed new light on this disorder. Results published in the May 2008 edition of the Journal of American College of Rheumatology shows that neuroscientists have been able to conduct scanning technology to areas of the brain affected by fibromyalgia. Mild pressure on trigger points of the patient has produced measurable brain response in processing the sensation of pain. The elevated response of pain in FMS patient’s brain scans was significantly different from those in the control group of the study. This is one of several studies that validate the reality of fibromyalgia as a disorder affecting the brain's response to muscular and neuropathic pain. Hopefully, future studies will lead to new treatment options.

Currently, treatment options consist of the use of a multidisciplinary approach. Medication management, physical therapy, meditation, exercise, alternative therapies, and cognitive-behavioral therapy are useful. CBT is a valuable therapeutic treatment option for those suffering from pain syndromes. One of the byproducts of pain can be the escalation of anxiety and depression. Likewise, anxiety and depression can intensify the impact of pain and make it more debilitating. Therapist must be familiar with the diagnosis of fibromyalgia and help patients accept the physical limitations that accompany a chronic pain disorder.

Cognitive-behavioral therapy’s goal is to teach the FMS patient to embrace pain rather than fight it. Cognitive distortions, such as magnification and “catastrophizing” need to be addressed so that patients learn to de-escalate fueling the pain process. How one thinks about his pain affects its impact. One can learn to rationally respond to pain by saying:
• "Although this problem is difficult, I can learn to manage it."
• "What's the use of getting all upset about my pain, it won't help anyway."
• "If I relax and walk into my pain, maybe all this will feel less troublesome."
• "I'm not alone in this. I have the support of my family and friends."
• "I'm not helpless, I have many strategies I can try to minimize the effect of my pain. Just keep moving!"

Therapy can assist the fibromyalgia patient to identify stressful triggers that exacerbate pain. This may involve examining family struggles, exploring inner-conflict, and working with core, self-defeating assumptions that affect thinking and behavior. Teaching the patient mindfulness meditation as a way of relaxing the sympathetic nervous system is beneficial. The goal is not to try to fix the unfixable, but to help patients manage their distress.

A therapist can provide the fibromyalgia patient with structured homework assignments that will help pain sufferers to experiment with new behaviors such as increased involvement and activities. Motivating the client to set realistic goals for everyday functioning can be helpful. Encouraging a multidisciplinary approach involving exercise, physical therapy, rehabilitation and medication management are essential.

Fibromyalgia patients fear that their disorder will cause them to lose the ability to function at work and at home. Teaching patients to focus on what they can do rather than their limitations is important. There is a tendency for fibromyalgia patients to distort reality by focusing on negative perceptions to the exclusion of the positive. Helping the patient and family to accept physical limitations is a necessary component to successful treatment.

Fibromyalgia patients can easily get enmeshed in a cycle of pain and associated emotional symptoms. It is the goal of any approach to assist the patient in coming to terms with his disorder and making plans to manage it. This is accomplished through acceptance and teaching the patient positive ways of thinking about his condition and multiple ways of treating it. As many in the medical community have insisted, fibromyalgia patients are not making it up. It’s a relief to know it’s in their head, but it’s not their fault!

James P. Krehbiel, Ed.S., LPC, CCBT is an educator, writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in treating anxiety and depression for adults and children. He served as a teacher and guidance counselor for 30 years and has taught graduate-level counselor education courses for Chapman University. In 2005, he self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is about the impact of adverse childhood experiences on adult functioning. He offers solution-focused strategies to assist adults in overcoming the perils of the past.

10 Insights to Help Couples Resolve Conflict

2011-07-10T12:58:00.002-07:00

Many couples get caught up in arguing over the typical problems that plague relationships. A list of topics that couples encounter is actually quite simple. Couples feud over finances, household tasks, in-laws, parenting issues, lack of trust and so on.

Partners tend to play out a relationship dance as their way of managing the stress associated with the aforementioned themes. They will press the play button and chronically create the same interactional pattern of behavior. The conflict generally takes on a life of its own and leads to a heightened state of reactivity or passivity. One partner may be visibly angry, while the other mate shuts down and distances from the conflict.

It is not unusual for partners to become aggressive or fluctuate to the other extreme by passively pretending that the conflict does not exist. In their denial they may say, "I don't know what our problem is; I don’t see it because we never seemed to argue."

Continuous silence and avoidance are not impressive qualities of a healthy relationship. Learning how to fight appropriately is an integral part of promoting understanding among couples. Assertive, honest communication involves sharing intense feelings that validate a partner’s concerns. Couples must learn to feel safe enough in a relationship to allow for the expression of difficult thoughts and feelings. Here are some insights that may assist couples to fight more constructively and bring healing to their relationships:

• Recognize that some conflict is inevitable, an avoidable by-product of any meaningful relationship.
• Learn to respond rather than react. Reactivity is borne out of stress and anxiety. Promote understanding in the relationship by remaining calm, listening carefully and asking your partner questions for clarification.
• It's perfectly acceptable and understandable to disagree, at times. You don't always have to be right! Accept and respect differences in your partner's opinions.
• Listen carefully to each other without making value judgments. Respect differences in perspective.
• Avoid getting defensive and intent on justifying your point of view.
• Avoid shutting the conversation down unless you sense you're navigating a slippery slope and need a time out. Mutually decide when to resume conflict resolution toward closure.
• Stressors, including unresolved family-of-origin issues, can affect current communications. Recognize the stressors, acknowledge them to your partner and refrain from using them as psychological weapons.
• Avoid manipulating your partner, by bringing up issues involving family history. This pattern only exacerbates reactivity and defensiveness.
• If you get off track in your communications and you feel unsafe, call a truce and resume your discussion later.
• Reinforce one another when you are successful at processing conflict into closure.

Communicating through conflict takes courage, patience and perseverance. Remember, that conflict is inevitable, and that one’s style of relating may affect the outcome. Unfortunately, temporary hurt is often the byproduct of honest, forthright communicating. However, if couples can learn to make their point in a kind, considerate manner, that will help foster successful conflict resolution and heal troublesome emotional scars.

2011-07-10T12:58:00.001-07:00

Filling the Feeling of Boredom with Meaning

2011-07-05T13:08:00.001-07:00

Several decades ago, I was privileged to attend a presentation in the Chicago area held by psychiatrist Victor Frankl, author of Man's Search for Meaning. Frankl's family members were the unfortunate victims of the Holocaust during Nazi Germany's reign in Europe. His family was killed, but he spent years in a concentration camp and survived. Frankl's foundation for therapy was based on his experience and desire to see his patients develop a sense of meaning and purpose for their lives. I recall him saying, "When everything was taken away from me, all I had left was my attitude about was happening; I made a conscious choice not to be bitter."

Often I deal with people who claim they're bored with life. They complain incessantly about their relationships, prior history, level of activity, children and the vacuum that they feel within. There is no sense of direction or structure to their lives. Often, they turn to various forms of self-medicating or chronic activity to fill the void. Also, they may tend to derive their feeble sense of satisfaction from being an extension of other people's lives. They have an exaggerated need to control or "fix others" and idealize about those who appear to have their lives in order. They're fascinated by "heroes" and elevate them at the expense of their own self-identity.

There are little ways for all of us to find meaning and purpose for our life by becoming less self-absorbed. In the process of genuine involvement or sharing, it is important to remember that meaning is derived from what we accomplish, not because others choose to reciprocate. Sometimes the right thing to do is to be compassionate to others, whether they appreciated it or not. Finding meaning and purpose is about our responsibility, not how others react to us.

It is important to do the right thing because it makes us feel grateful, empowered and creates integrity. There are many ways all us can feel connected to the larger global community. Here are some examples:

• Attend worship services and pray for the needs of others.
• Treat people that annoy you with respect.
• Volunteer time and service to community agencies, such as libraries, nursing homes and political organizations.
• Give charitable donations to relief projects.
• Give to the needs of those that are less fortunate.
• Learn to be tolerant of other people's perspectives that vary from your own.
• Donate to breast cancer walks and other promotions for serious illnesses.

It is important to get your thinking in perspective. Look around you and then ask yourself, "How bad do I really have it?" If you're whining or complaining, you may need a dose of reality by connecting with those who are vulnerable and less fortunate. Remember, doing good deeds is about deriving meaning, not focusing on the reactions and responses of others. Those who are involved in helping others and give graciously will find a sense of joy, purpose and satisfaction they never thought possible. All we have left when all is said and done is the content of our character and the quality of the relationships that we leave behind.

Triumph over Troubled Childhoods: Krehbiel's 10 strategies to Help Adults

2011-06-26T20:45:00.001-07:00

According to recent conclusions from a decade-long study by the Center for Disease Control and Kaiser Permanente Hospital, 60% of American adults were affected in some way by adverse childhood experiences. ACE’s were defined as dysfunctional behaviors displayed by parents, such as emotional and physical abuse or neglect. ACE’s leave an imprint on children and impact their ability to cope effectively in adulthood.

Negative childhood experiences leave scars in need of healing. Some adults are capable of processing their past more adaptively than others. Often, adults will cling to childhood scripts that no longer are necessary or helpful. Some of these basic childhood assumptions that get activated are:

• I must perform admirably at all times.
• I am responsible for all the bad things that happened to me and I should be blamed for them.
• I must avoid conflict at all costs because it is risky.
• Other people's opinions and beliefs are more important and convincing than my own.

Adults from troubled childhoods need to learn how to process the perils of their past as opposed to denying one's story or ruminating about it. This search to heal from the vestiges of worn out thinking and behavior takes courage and persistence. Here are 10 strategies to assist adults in leaving behind the negative interpretations of childhood:

1. Give up the magical illusion that somehow your parents will morph and become the loving, caring adults you have always yearned for.
2. Write a letter to the abusive parent. Share your deepest feelings about what you experienced as a child. Don't hold back. Do not deliver the letter. This exercise is designed to therapeutically assist you in releasing pain from the past.
3. Consider your earliest childhood recollection. Where were you located? Who was with you? What were you wearing? How did you feel? What beliefs about your life are captured in your story.
4. Listen to your inner critic. This is the voice (derived from a parent) that speaks in harsh tones and provides disparaging messages. Let it speak and learn to understand the nature of its noise. Learn to detach from its contents.
5. Rationally respond to the inner critic. If it says, "How could you do such a stupid thing," respond by exclaiming, "We all make mistakes. This experience doesn't define who I am. I will do better next time."
6. Learn to make realistic appraisals about who you are and what you do. Leave behind, the tyranny of the, I should have, I ought to, I must not, and so on. Think in terms of preferences rather than absolutes. For example, "It would be nice if my business partner thanked me for a job well done, but is not essential." Another realistic, thoughtful appraisal might be, "What role did I play in this problem, if any?" Get out of self-blame because it is not helpful in solving problems and only serves to victimize you.
7. Learn to set more realistic boundaries. Quit giving your power away to other people. Start asserting yourself, telling others what you need and want. If you confront potential conflict, people will respect you, not abandon you.
8. Your troubled childhood was not your fault. Let go of the need to blame yourself for a problem you didn’t create. It never was about you!
9. Find supportive friends that you trust that can help you role-model more intimate, connected behavior. Understand that your past doesn't need to have power over you in the present. Remember, your friends are not your parents. You can learn to selectively disclose information to others, letting yourself be more emotionally transparent.
10. Forgiveness is a process, not an act. Hopefully, at some point, you will be able to forgive your parents for being less than perfect and causing you harm.

Overcoming a troubled past and learning to live a triumphant life takes time and patience. Seek counseling support if you feel stuck in trying to handle your thoughts, feelings and relationship issues. There is hope and healing for those who courageously seek to transcend the difficulties of a troubled childhood.

Clinging to the Comfort Zone: Our Belief in Beliefs

2011-06-22T12:43:00.000-07:00

John came to therapy as a troubled young man. In every way, his life was a series of successes. He was a kind, caring individual who was passionate about life. In spite of the emotional unavailability of his parents, he cruised through high school with exemplary grades. He graduated at the top of his class in undergraduate school and entered a law program. He completed his law degree and easily passed the bar examination. He fell in love with Kim, who was completing her MBA and was successfully working for a computer software company. They planned a huge wedding with the support and blessing of Kim's parents.

John's parents were dead-set against the marriage. His mother was morally outraged that John and Kim were cohabitating prior to the wedding. John was deeply disturbed by his mother's attitude and made numerous overtures to explore the issue with her. Although neither parent attended church, they were adamant that living together out of wedlock was religiously immoral and offensive. Through a flurry of e-mails, John's mother made disparaging comments toward John and rambled on about his fiancé being nothing more than a low-class tramp.

John's parents were indignant and cut off contact with John and clearly indicated that they had no intentions of coming to the couple's wedding. Sadly, their beliefs had rigidly risen to the level of taking precedence over their connection with their own son and future daughter-in-law. They clung to their beliefs in such a way that the rules mattered more than their most intimate relationships.

Beliefs can be defined as preconceived notions about the way the world works that lead one to rigidly embrace a value system to maintain living in a comfort zone. John's parents clung to certain beliefs that reinforced a worldview that was inconsistent with most people’s reality. In other words, they believed in a belief, because they internalized it as an altered form of reality. Their belief kept them feeling safe until it came in conflict with their son's experience. Now it served to sever their relationship with their only child.

We can see this cognitive dissonance (conflict between belief and experience), in many different situations. We have CO2 emissions pouring out of the smoke-stacks of factories, while reactionaries maintain that climate change is not connected to human behavior. We have clear-cut evidence to support evolution and yet there are those who espouse contrary theories to minimize their inner conflict.

Beliefs play a role in keeping life simple and explainable. Faith, however, operates differently. Faith is an unreserved opening to the truth wherever it may be found. Faith requires questioning, being open to complex challenges, and grappling with conflict and paradox. With faith-based thinking, we cannot always reconcile various pieces of reality.

People who cling to their beliefs rather than faith lack depth. They are afraid to step outside the confines of their preconceived assumptions. Such rigidity provides a false sense of security in an insecure world. To demonstrate integrity, one must let go of belief-based tunnel vision and transcend religious dogma in the pursuit of finding the truth in one's experience.

An example of this is the fundamentalist Christian, who has believed all his life that homosexuality is an abomination to God. During early adulthood, one of his children gathers the courage to come out and tell his father that he is gay. How does this father reconcile his beliefs with the nature of what his son has told him about his sexual identity? This is a difficult spiritual and emotional dilemma. This father has several options to consider in making a decision about how to view this problem. Do I disown my own child for revealing his true sexual orientation? Do I admonish my son to seek reparative therapy to change his sexual feelings? Do I take the position of hating the sin, but loving the sinner? Do I let go of the need to reconcile my son's identity with my religious beliefs, and try to enlarge my spiritual map to include the possibility that God's grace may transcend my conflict? Faith always leads us to enlarge our vision of the truth and hold conflicting ideas in tension as we seek to pursue personal growth in our quest for answers.

Like John's parents, beliefs tend to define us and our reality in a constricted manner. The rules become more important than our search for the truth and affect those we seek to hold accountable to them. Beliefs keep things clear-cut and simple in an altered reality that often doesn't match one's experience. Those who embrace such reactionary thinking are dangerous because they are unable to problem-solve from multiple perspectives and consequently have the potential to hurt people. They are unaware of the missing pieces in any argument. There is only one side to their story, and the believers embrace it wholeheartedly without doing due diligence to grapple with difficult problems and polar perspectives.

Note: This case is a composite drawn from my practice as a psychotherapist. It has been altered to protect the individual’s right to confidentiality and privacy.

How to Break Out of the Perplexing Parenting Trap

2011-06-14T18:38:00.000-07:00

Melissa frequently screamed at her children. This impulsive, angry behavior would occur over the tiniest of infractions - spilling things, making messes, and forgetting chores. She felt guilty for mistreating her children, but was incapable of changing her perplexing parental pattern.

Parenting is an art. The role comes with no manuals. Often, adults have no perspective on how to raise their kids. Melissa had no role models or prior emotional experience to prepare her with the tool chest of strategies to use in addressing the needs of her children. She felt alone in her new responsibility.

Melissa's own childhood was troubled. Her father was emotionally vacant and her mother was aggressive, harsh and critical. She recalled her mother calling her out when she came home with less than an A on her report card. Melissa was a superior student who outperformed other family members, completing her MBA and working as a corporate manager. She was an anxious achiever, who performed to please, hoping to get the admiration and validation of her emotionally unavailable parents. As Melissa worked harder without gaining parental recognition and support, she turned her thoughts and feelings inward, believing that she was defective. Her disappointment fueled her to try even harder to win her parents’ approval.

By the time Melissa came to counseling, she was exhausted. She was tired of pleasing others, being aggressive with her kids and mistrustful of disclosing her feelings with friends and family. When Melissa attempted to confide in her mother, the conversation got flipped as her self-absorbed mom proceeded to explore her drama from everyday living. Melissa learned to keep her distance.

In the search for adulthood, children from troubled families must give up the illusion that someday their parents will morph and become the loving, caring adults they always yearned for. After much soul-searching, emotional upheaval and grieving, Melissa would need to swallow the bitter pill, recognizing that her parents would never meet her needs. Only then, could she let go of her perplexing dilemma of internalizing her parents’ negative energy. Through processing, forgiving and releasing her past, Melissa was prepared to undertake a journey to learn new, more adaptive thinking and behaving in the here-and-now.

Melissa no longer allowed her parents to have power over her present experience. She was now capable of listening to the inter-critic, a representation of her mother's complex of thoughts and feelings. She learned to detach from the contents of the critic by rationally responding with positive self-talk that was genuine.

No one emerges from a troubled childhood without the battle scars to prove it. Melissa confronted her wounds and found healing and new hope for the future. She became aware of childhood interpretations that haunted her, and no longer allowed them to get activated with significant others. Here are a few core beliefs that got triggered:

• I must perform admirably at all times.
• I must always try harder to please others.
• If I share my honest feelings, people can't be trusted to listen without judgment and maintain confidentiality.

Instead, she learned to reinterpret these childhood scripts with more adaptive assumptions:

• It's okay to slack at times. I can be less than perfect.
• I don't always need the approval of other people in order to feel good about myself.
• I can selectively choose friends to confide in. I need to allow others to experience the essence of my true self.

Adults tend to replicate the past, unless they process it. Melissa left the magical illusions of childhood behind in search for authentic adulthood. She developed more patience with her children and learned more effective parenting skills by:

• Creating more emotional involvement
• Setting consistent consequences for positive and negative behavior
• Establishing better boundaries
• Learning to take care of her own needs as a parent
• Becoming more supportive and encouraging to her children.

Melissa broke the perplexing parenting trap. Adverse childhood experiences had affected her ability to cope appropriately with her children and family. No longer believing she was at fault for what had happened to her as a child, she was released to devote more positive energy to parenting her children with success.

Note: This case is a composite drawn from my practice as a psychotherapist. It has been altered to protect the individual’s right to confidentiality and privacy.

James P. Krehbiel, Ed.S., LPC, CCBT is an educator, writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in treating anxiety and depression for adults and children. He served as a teacher and guidance counselor for 30 years and has taught graduate-level counselor education courses for Chapman University. In 2005, he self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is about the impact of adverse childhood experiences on adult functioning. He offers solution-focused strategies to assist adults in overcoming the perils of the past.

What Do We Have Left When All Is Said and Done?

2011-05-21T11:50:00.000-07:00

Life is time-limited. The years slide by with haste. There is no way to bargain with the aging process. We can get our skin tightened or use popular potions that promise to return us to our youth, but it's all an illusion. We are in a here-and-now, and the longer we live, the faster our remaining years seem to vanish.

We spend our childhood playing, coping with parents, feeling immortal and wishing that we were grownups. We envision the promises that the freedom of adulthood affords. We want to be powerful and confident, and believe that the rite of passage from adolescence will make us less vulnerable. We long for the days when we can tell others what to do and make changes without constraints. We are tired of trying to please the adults in our lives and are ready to do it our own way.

As adults, we become immersed in goals. Most of us enjoy the safety, security and predictability that is associated with creating a new family and focusing on a career. We bury ourselves in work, believing that performing to please will provide the satisfaction and power necessary to bring meaning. At times, we may question our career path or wonder about our choice of partners and will wrestle with determining our future. At some point within adulthood, we may become disheartened by all the energy we've expended caring for others over our job responsibilities and family obligations.

The need for play, spontaneity and creativity may clamor for attention. We recall these feelings from childhood, as they once again compel us to listen to their yearning voice. . They have been at war with our pusher-driver, the side of us that performs to please in order to get the validation of others. Our playful side is irresistible and requires expression - we must provide ourselves with what we need and want. Thus, we give up the compelling drive, the heavy script that is inconsistent with our authentic self.

A renewal that takes us to our truest self is what moves us toward our elder years. We no longer need the toys, cars and houses to make us happy. Our meaning is not derived from things. If we only pursue what money can buy, it will leave us feeling empty.

What can we count on to bring us feelings of triumph and success? What do we need that ultimately will provide us with peace as we play out our remaining years? Hopefully, we have set the stage for the most important possessions that we can call our own. As we let go of our story as we have known it, we can hold on to these qualities to sustain us. The cycle of life requires us to grasp these very precious treasures.

What do we have left when all is said and done? I believe we have the content of our character and the quality of our most prized relationships. What more could one ask for? We must truly seek to live with integrity, never elevating, demeaning or comparing ourselves with others. We live the life we are given with as much honesty, compassion and responsibility as we can. We take nothing for granted and appreciate everything. We are proud of who we have become.

We also cherish our family relationships and most devoted friends. We have committed our life to the well-being of a partner or children and reap the rewards of their affection and connection to us. We can't lose them no matter what happens to us. We have the memories of everything that has been done to connect us with our loved ones in a way that cannot be severed.

All we have left, when all is said and done, is who we have become and those we cherish as our closest friends. This realization brings us peace and hope as we continue on our road to learn and fulfill life's purposes.

James P. Krehbiel, Ed.S., LPC, CCBT is an educator, writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in treating anxiety and depression for adults and children. He served as a teacher and guidance counselor for 30 years and has taught graduate-level counselor education courses for Chapman University. In 2005, he self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is about the impact of adverse childhood experiences on adult functioning.

Leaving Behind the Love Affair with Misery

2011-05-15T17:18:00.000-07:00

Sadness can represent more than a feeling. It often signifies a way of thinking and behaving that leads us down a self-defeating path. Our familiarity with a depressive mood becomes a way of being and a style of relating. Sadness becomes a companion symptom that we carry around as our false self - it is not authentic.

My patient Anna was enveloped by a melancholy mood. Her husband had recently declared that the relationship was devoid of passion and he wanted out. His feelings caught my patient off guard. How could Bob be willing to throw away 10 years of marriage? What was behind this erratic edict?

There was no exploration of Bob's pronouncement that his marriage was over - and there was no exit strategy. In response to his decree, he became anxiously avoidant and hid in his work and his night classes. He was stressed by the emptiness of his life.

Anna internalized Bob’s projected frustration and began taking self-inventory to assess where she'd gone wrong. She had always been supportive of her husband but had noticed his recent unhappiness. She began contemplating, "What did I do to create this wreckage? How could Bob arrive at this disturbing, unilateral conclusion?" The more Anna ruminated about her marital woes, the more despondent she became. She was immersed in the feelings of her husband and carried the burden with her. At no time did she inquire, "What's this convoluted conduct all about? As an equal partner, do I have any say in this?" Instead, she perseverated about her husband's unhappiness and her role in disappointing him.

As is often the case, Anna’s pattern of getting hooked by the feelings of other men was embedded in an adverse childhood experience. Her father was in the military and served during World War II. She had strong recollections of a strained relationship between her father and mother. Her home was thick with negative energy. The air was sterile and stale. Her father stayed to himself, rarely interacting with family members in a warm and caring manner. Anna viewed him as "troubled" and stayed clear of his path for fear of aggravating him. At an early age, she knew her father's behavior was not normal and viewed him as being an emotionally detached, unfulfilled man. He was always "into his head," rarely demonstrating any emotional connection with others.

One time, Anna had watched a History Channel segment about the Holocaust experience. Anna was fascinated by the plight of the Jews and told her father about her newly acquired knowledge. She was taken back as her father came alive for the first and only time in their relationship. He was able to provide her with a first-hand portrait of the way in which he and his comrades had made valiant efforts to protect Jewish families from the Nazi’s. Although the connection at that moment was profound, she realized for the first time how the ravages of war had blunted her father's emotional experience.

Anna felt sorry for her father. She felt obligated as a daughter to wear her father's depressive feelings as her own. She viewed it as a responsibility to protect him by sinking into the "dusty corners" of his sadness.

As Anna and I continued our therapy, a core interpretation derived from adverse childhood experience began to crystallize. Anna's coping strategy as a child was, "I must take responsibility for others' feelings in order to protect them." As a kid, Anna performed to please, in a valiant effort to try to wish her father's pain away. As she realized that she was incapable of impacting his mood, she unknowingly took on his sadness and branded herself as defective for not being able to make her father feel better.

Anna’s dysfunctional, interpretive script would come back to haunt her during adulthood - she would maintain her love affair with misery. In response to her husband's abrupt declaration of dissatisfaction with his marriage, Anna easily latched onto her self-defeating childhood coping script. In treatment, our approach was to make Anna aware of her negative interpretations related to taking on the burden of significant other's feelings. As she learned to acknowledge and be conscious of this maladaptive way of relating, she learned new skills to refute the pattern and respond more rationally. Anna worked to establish the following self-nurturing patterns:

• To make more realistic self-appraisals of her thinking and behavior
• To learn emotional detachment from the burden of others' feelings
• To give up the need to please others as a means of trying to fix their feelings and behavior
• To get in touch with the kind of transformative anger that leads to self-empowerment - "I deserve better than this!"
• To set appropriate boundaries
• To learn assertiveness skills as a style of relating - "I can tell others what I need and want"

Anna began detaching herself from her husband's burdensome feelings. She appropriately confronted him about his marital dissatisfaction. In order to maintain power and control, he dismissed her request to explore his marital unhappiness. With that in mind, Anna began working to protect and support herself by not playing into the verbal antics of her husband. Like it was as a child, Anna learned that other people's responses and feelings are not her fault. While experiencing significant relief, she will continue her journey to leave behind her love affair with misery.

Note: This case is a composite drawn from my practice as a psychotherapist. It has been altered to protect the individual’s right to confidentiality and privacy.

James P. Krehbiel, Ed.S., LPC, CCBT is an educator, writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in treating anxiety and depression for adults and children. He served as a teacher and guidance counselor for 30 years and has taught graduate-level counselor education courses for Chapman University. In 2005, he self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is about the impact of adverse childhood experiences on adult functioning.

Processing the Pain of the Past to Teach Your Child in the Present

2011-04-22T15:07:00.000-07:00

When Alex was a kid, he recalls his father chastising him for not washing the car properly. Alex volunteered his services as a five-year-old child, but his dad showed little appreciation. On the contrary, when he "missed a spot," his father would berate him by calling him stupid. He was a sensitive child who wanted to please his father, but ended up feeling devalued.

Over time, Alex associated his less than perfect performance with his personal identity. If what he did was less than acceptable, then by all means he must be defective. His father never encouraged or coached him on a better way to wash the car, so he was left to feel inadequate about any task he attempted.

Alex evolved into a self-critical, angry youngster. In Little League, he excelled as a player. He was known for his outstanding skills and performance. Nevertheless, he berated himself, other players and the umpires during his occasional unsuccessful at-bats during games. He recalls running feverishly towards first base, being called out, and throwing his helmet, stomping his feet and raging at the officials. Although he was conflicted and confused about his poor sportsmanship, he wasn't capable of stopping his inappropriate behavior. His parents never got involved, intervened and discussed the "why" of his self- defeating thinking and behavior nor tried to correct it.

In adulthood, Alex was able to trace his painful memories of personal performance-related criticism and anger through the filter of his son’s experience. His son, Damon, was a very talented basketball player. Alex was perplexed because he never recalled Damon losing his "court presence" during a game. His son was grounded, focused and in control. These qualities actually helped enhance the level of his game. Alex was thrilled that the legacy of persistent perfectionism never created a problem for his child.

As he sat in the stands and watched one of his son’s tournament games, Alex recalls reflecting on what parenting skills he had implemented with Damon that were different from the way in which he was raised:

• Like Alex, his son was very sensitive. Alex made sure that he never harshly scolded him.
• His form of discipline was facilitated through coaching, instruction and encouragement.
• He always let Damon know that he was proud of him.
• He believed that mistake-making was a necessary part of child-development.
• He challenged his son to excel without motivating through intimidation.
• He remained involved with Damon and attended his activities at school and in the community.
• Alex's limits were firm, but reasonable with logical consequences for positive and negative behaviors.
• He always differentiated Damon's behavior from his personal worth.

Alex gave his son what he found difficult to provide for himself - support, soothing, comfort and affirmation. Ironically, he learned through role-modeling his son’s behavior how to begin parenting himself. The process of learning to self-nurture involved facing his past, grieving and releasing its emotional impact while creating fresh interpretations of his thinking and behavior.

He cut into the "pedestal of perfectionism" and learned to allow himself the freedom to perform less than admirably at times. He practiced selective mistake-making as a way of giving up some control and allowing for a measure of vulnerability. Alex worked on being less self-critical and judgmental of others, and eventually learned to hold the identity of imperfection. He learned to push less, and relax more as his performance, like his son’s, actually improved.

James P. Krehbiel, Ed.S., LPC, CCBT is an educator, writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in treating anxiety and depression for adults and children. He served as a teacher and guidance counselor for 30 years and has taught graduate-level counselor education courses for Chapman University. In 2005, he self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is about the impact of adverse childhood experiences on adult functioning.

What to Do When Kids are Sad

2011-03-01T13:21:00.000-08:00

One could easily say that Nathan was born into the wrong family. Had he been raised in the family next door, things might have turned out differently. Nevertheless, I was faced with a teenager whose sadness was overwhelming. He was immobilized by a deep depression that was affecting his motivation to perform quality work at school and to connect appropriately with age-mates.

On the day that Nathan visited me for therapy, he was particularly disturbed. After being awakened on a school day by his alcoholic father, he was told that he was "worthless" because he was unable to fix the glitch in their computer system. Such derogatory comments were common-place and colored Nathan's relationship with his dad. Over time, he began to internalize and believe his father's voice - that he was an overweight, incompetent slacker. Obviously, there was no evidence to support his father’s erroneous, abusive, mean-spirited assessment of his son.

While many depressed kids have parents who are not a major factor in their child's disorder, it is not unusual for parents to play a role in creating toxic environments at home. A child may internalize the stress of parental feuding, drinking or abuse and act out in response by being overly-compliant or pushing back with anger toward authority figures.

Depression in children may be a metaphor for what is occurring within his/her family system. There may be a bio-chemical predisposition to depression within the child’s family. Adverse childhood experiences as a result of parental abuse, domestic violence, excessive drug and alcohol issues, marital and family conflict and neglect may play a role in generating depressive thinking and behavior in kids. A parent may engage their child in therapy (without adult participation) in hopes of relieving the effects of depression. In such cases, the parent avoids involvement, and places the burden on the child to get the problem resolved.

On the other hand, some children experience depression that is not related to or caused by family factors. Such causes may include:

• A continuous problem with teasing and bullying
• The breakup of significant friendships
• Grief associated with the loss of loved ones and pets
• Reactions to a new location and school
• Physical and hormonal changes occurring in adolescence
• Trauma due to major illnesses in children
• Rejection in activities, such as sports and clubs
• Failure to achieve academic success

Depression often goes under-diagnosed among children because of the covert nature of the symptoms. It is not usual for features of depression to be displayed through certain self-destructive and/or acting-out behaviors. Hopelessness and anger are at the core of childhood depression. Kids may feel stuck in situations they are unable to change or lack the capacity to push back against adults or peers who try to diminish their worth.

Typical characteristics of depression in children consist of energy depletion, anxiety, lack of motivation, feelings of shame, helplessness and anger. These depressive symptoms are often camouflaged through purposeful behaviors aimed to get the validation and nurturing of significant adults. In an effort to soothe their psychic pain, children and teenagers may self-medicate, act out against authority figures, and dabble in criminal behavior.

Parents need to be aware of the following signs that indicate a possible problem with childhood depression:

• Significant avoidance of family and friends – withdrawing to bedroom, excessive use of electronic gadgetry, obsession with violent video games, refusing overtures from friends for involvement in activities, shutting down emotionally, avoiding any family contact
• Signs of drug usage - dilated eyes, erratic behavior, mood swings, escalation of anger, drug paraphernalia, dramatic drop in school performance
• Self-harming behaviors - self-cutting, refusing to eat, neglecting personal hygiene
• Acting out toward authority figures - school detentions/suspensions, negative reports from school, calls from school personnel about behavior
• A lack of involvement with school - not involved in school clubs, sports, music/arts
• Outbursts of mood - anger, rage, bouts of crying
• Sexual promiscuity - obsessively preoccupied with a partner, finding condoms, sneaking out of house, changing wardrobe, finding birth control pills
• Poor eating habits - refusing to eat with family, reducing food portions, changing dietary habits, exclusively eating alone

In order for parents to recognize and act on the signs of depression within their family, they must become more conscious of the behavior patterns and needs of their children. There are multiple steps that parents can take to assure that the well-being of their children is addressed:

• Seek family counseling - recognize that a child's experience with depression may be a symptom of a larger family problem.
• Take your child's symptoms of depression seriously - recognize the ‘red flags’ and stay out of denial.
• Promote non-evaluative exploration - explore your children's needs and feelings without imposing your own will or advice-giving and lecturing.
• Encourage and support your child's positive efforts - the power of positive reinforcement shapes behavior.
• Stay involved - attend activities that your children participate in and maintain open communications.
• Major in the majors - don't focus on battles that aren't as important as others, such as hair color, school clothes and homework; rather, emphasize character traits that promote civility, motivation and a positive attitude.
• Reflect on your own childhood - were there times when you felt trapped, angry, helpless and sad? Who was there for you?
• Role-model positive, energetic, involved behavior.
• Set reasonable positive and negative consequences for behavior.
• Get your child involved in sharing household tasks.
• Stay out of self-blame – blaming yourself for your child's depressive mood and behavior will change nothing. Accept responsibility for providing your child and family support in times of need.

We live in a fast-paced complex world filled with multiple stressors. Invariably, at some point during our life most of us may experience a bout of depression. This is particularly true for the most vulnerable citizens - our youth. Children are trying to balance responsibilities at school, home and in the community. Likewise, physical growth and hormonal changes also affect our kid’s way of reacting to life stressors. If parents remain aware and involved, the impact of depression on our kids can be minimized and corrected.

Note: This case is a composite drawn from my practice as a psychotherapist. It has been altered to protect the individual’s right to confidentiality and privacy.

James P. Krehbiel, Ed.S., LPC, CCBT is an educator, writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in treating anxiety and depression for adults and children. He served as a teacher and guidance counselor for 30 years and has taught graduate-level counselor education courses for Chapman University. In 2005, he self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is about the impact of adverse childhood experiences on adult functioning. He can be reached through his website at www.scottsdaletherapy.net.

Recovery is Possible for Adverse Childhood Experiences

2011-01-29T10:25:00.000-08:00

Tales of a Troubled Childhood
One afternoon I received a telephone call from an anxious young man in his mid-20s. He wanted to see me for counseling regarding a relationship problem. I asked him the typical scheduling question - "Tell me what might work for you in terms of availability?" His response was "How about in an hour?"

Fortunately, his urgent request worked for me. Alex was a massive-sized former Big-10 football player who came for the first time to therapy to find answers to his problems. After getting comfortable in my office, he said, "I'm so upset because my partner just broke it off with me; "She says I'm too intense - she's probably right."

I never had a chance to respond to his presenting problem. Without taking another breath, he continued - "And my father died suddenly." - "I'm sorry to hear about your losses - "How long ago was your dad's death?" "He died of a heart attack 15 years ago and it was devastating." The tears started flowing. “Do you think there's some connection between my two losses?"

Is there a Relationship between a Perilous Past and the Present?
Such wondering about one’s troubled past and the present was validation of what I had discovered from other patients. That is, that troubled childhood experiences have a significant impact on adult functioning, including relationship wreckage.

Many adults from troubled childhoods want to know, "Why do some adults remain mired in the turbulence of adverse childhood experiences, whereas others are able to navigate the problems of family history and lead productive lives?" Through my clinical practice and writings, I have sought to answer this question in a meaningful, hopeful manner.

After the death of Alex’s father, the dynamics and energy within the family system dramatically shifted. There was no mourning, grieving and no exploration of the family's loss. His mother turned inward, becoming self-absorbed and avoidant and compulsively buried herself in work – she never grieved. All three children took their cues from mom, and chose to suppress their feelings, creating a conspiracy of silence. Alex learned to care-take for his emotionally absent mother by being compliant, trying to make her happy, and seeking to minimize the significance of everyone's grief.

What is the Magical Illusion of Childhood?
This is how many kids cope in response to adverse childhood experiences. After his father's death, Alex began performing to please in order to gain the validation and love of his emotionally frozen mother. Ultimately, when his mother's emotional availability was not forthcoming, and his needs were unmet, he unknowingly came to a conclusion - "I guess there's something wrong with me, I must be unlovable." By internalizing the dilemma, Alex could assume the blame and let his mother off the hook. Alex began to feel defective. Kids from troubled families typically carry a magical illusion and believe that somehow, in some way their parent will morph and become the loving, nurturing person they have always yearned for. Alex longed to have his family back the way he once envisioned it.

What are some Unwritten Family Interpretations?
It was my responsibility to help Alex to process his past so that he could make sense out of his present troubled relationship. After his father's death, there were a number of unwritten rules that governed his dysfunctional family system. These interpretations were:

1. I must behave admirably at all times
2. It is my obligation to take care of my mother
3. The family appearance that all is well is more important than my feelings
4. I must avoid conflict at all times
5. Life must always be taken seriously
6. If I deny my grief and loss, it'll go away
7. If I don't watch my step, someone or something could hurt me

These underlying assumptions derived from childhood adverse experiences affected Alex's closest relationship - an intimate three-year connection with his partner.

What are some Personal Qualities, Borne out of a Troubled Past that create problems in the here and now?
Here are some personal characteristics that led to Alex's relationship wreckage that were fostered by adverse childhood experiences:

1. The inability to be assertive
2. The need to take life too seriously
3. Emotional mood swings due to unresolved grief
4. A lack of emotional expressiveness
5. Trying to fix others problems
6. Self-preoccupation
7. Poor boundary setting
8. Social anxiety
9. Idealizing a relationship
10. Being overly-responsible for problems

What is the Backdrop of the Patient's Problem?
Alex and his partner lived together in an apartment that he was renting and paying for. Alex had moved to Arizona from the Midwest to commit himself to Tammy. Frustrated and shocked, he was faced with a mate who suddenly confronted him and said she was finished. However, she wanted to remain friends with Alex, stay in his apartment indefinitely until she could find a new place. She was reluctant to move in with her parents, because it was inconvenient for her. She invited Alex to Thanksgiving dinner with her parents in order to maintain civility and reduce her guilt. Alex was devastated by the loss of Tammy and was conflicted about continuing to share living space with her in his apartment. He put up with it because he was still hoping that he could win her back - the worse she treated him, the more he was determined to change her mind – he kept trying to please her, maintaining an illusion that she would go back to the way things were.

The Key to Change is processing the Past
In order to change our adverse childhood experiences and the impact on current behavior, we must process the past. Most people with troubled childhoods either avoid the past through mechanisms such as intellectualizing, by keeping overly-busy schedules, or numbing out through self-medicating. Others choose to deal with the past by victim-posturing through self-pity and blaming others rather than taking responsibility for their own behavior.

Processing adverse child experiences is the key to a hopeful, productive life - processing entails facing the full emotional impact of the way things were and the way things are. Courage is a quality that Alex needed to address his issues. After all, he had three losses to grieve - the finality of the death of his father, his mother as he once knew her, and the woman he dearly loved.

With much support and encouragement, he accomplished this task. He did what was necessary – he learned to accept life they way things were – he grieved and mourned his losses – he released them and began to reframe his thinking in the here-and-now - his grief work helped him come to terms with all that had gone wrong. As he felt more empowered, he began making other changes:

1. He set more appropriate boundaries with his mother- more emotional detachment from her distressful feelings.
2. He let go of false hope for his partnership and gave her an ultimatum to leave
3. He began asserting himself with others, and quit allowing others to control and manipulate him
4. He began listening to his own voice and gave up the burden of owning other people's feelings
5. As he reinvented himself he began looking to the future with hope and confidence
6. He became more emotionally expressive with others, learning to feel empowered yet vulnerable when appropriate

Specific Strategies used to Assist Alex
Alex and I worked on specific strategies to modify his thinking and behavior in the present. We worked on cultivating unexpressed emotion, reframing negative thinking and modifying underlying interpretations. Some examples of strategies we used are:

1. Cultivating unexpressed grief. Write a letter that you do not deliver.
2. Teaching assertiveness skills – Exploring styles of relating, including passivity, aggressiveness and his right to express his needs and wants
3. Identifying cognitive distortions - Are you personalizing events? Do you accentuate the negative and minimize the positive? Do you “catatrophize” about difficult situations?
4. Reframing underlying assumptions/thoughts. "I must perform admirably at all times. - It's okay to be less than perfect. I must avoid conflict at all costs. Confronting conflict is empowering and necessary to managing relationships.
5. Rationally responding to distortions with a reasonable appraisal - "Where is the evidence that this problem is so awful? What's the worst thing that can happen?"
6. Providing homework assignments with accountability

“It’s not your Fault”
In my practice, when I tell a patient that their traumatic childhood experience was not their fault, it is powerful. When I tell them they had no control over what happened to them as a child, the healing begins:

1. It never was Alex's fault that his father died of a heart attack
2. It never was his fault that he was shielded from the details of the death
3. It never was his fault that his mother insulated herself in response to her loss
4. It never was his fault for not having the guidance and support of a father during childhood
5. It never was his fault for having a mother who need to be nurtured
6. It never was his fault for the emptiness, depression and anxiety he experienced within his home
7. It never was his fault that he was unable to take the risk to share his feelings

With the relief that it never was about them, comes the reality and responsibility for adult victims to process the past, picking up the pieces toward a more meaningful, productive life. This is the hopeful message we must provide in helping individuals release their troubled past, finding more adaptive ways of living in the present.

Note: This case is a composite drawn from my practice as a psychotherapist. It has been altered to protect the individual’s right to confidentiality and privacy.

Mental Health & Counseling Classes | Add your site

Americans' Problem with Troubled Childhoods

2011-01-03T10:14:00.001-08:00

According to a recent collaborative health officials report conducted by an Adverse Childhood Experience Team from the Center for Disease Control and Kaiser Permanente, almost 60% of American adults have been affected by troubled childhoods. Problems ranged from various forms of parental abuse and neglect.

My recent release, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth was written to underscore Americans’ problems associated with the impact of troubled childhoods on adult functioning. I offer solution-focused strategies, based on the principles of cognitive therapy, to assist adults in overcoming the perils of their past.

It is interesting to note that most adults affected by troubled childhoods believe that they were responsible for creating their own childhood misery. When adults feel emotionally frozen due to a history of childhood troubles, I urge them to give up the interpretation that they held any responsibility for what happened to them as children.

Kids who endure troubled childhoods tend to perform to please in order to gain the love and validation of their parents. When emotional affirmation is not forthcoming, children become disappointed and turn their anger inward, holding themselves accountable for the parent’s neglectful behavior. By owning their parents problems, kids can maintain the magical illusion that their parents behavior is adaptive, thus minimizing the pain of their dilemma.

As troubled children enter into adulthood, they typically maintain the illusion that someday their parents will morph and become the loving caregivers they've always wanted. When adults finally grasp the concept that a troubled childhood was not their fault, there is usually an emotional reaction. This realization often leads to a flood of feelings about the unfairness of what they experienced. Sadness, hurt, disappointment, loss and anger follow. As adults grieve the loss associated with a troubled childhood, they are forced to "swallow the bitter pill" and begin a process of reframing and rebuilding their life. Through learning to accept, grieve, process and release a troubled past, adults can move forward and lead a productive life by reframing the past and rationally responding to life in the present.

Goodreads Book Giveaway

Troubled Childhood, Triumphant Life

by James P. Krehbiel

Giveaway ends February 01, 2011.

See the giveaway details
at Goodreads.

Enter to win

Mental Health & Counseling Classes | Add your site

The Fugitive Game: Coming to a Town Near You

2010-09-17T13:28:00.000-07:00

{Recently, a newspaper columnist asked me to weigh in on a new teenage version of tag, called fugitive. I provided her with some insights. Upon further reflection, I have penned this parody, an intentional mockery of this game].

It started as a West Coast phenomenon. It caught on, and now the excitement and anticipation is electric as an updated version of the game “tag” is sweeping the country. Who could have foreseen that a simple game played out by generations of Americans would make a stunning comeback?

The fugitive game is not for the weak-at-heart. This is the personification of extreme tag, created by and for upperclassmen in today's high schools. Some of our most distinguished high school students put their heads together and developed a novel, proactive sport’s activity. The concept is rather complex. A group of kids meet at a central area, such as a neighborhood parking lot. For starters, some teenagers run from the area while other players chase the runners in cars or on foot. The fugitives get a head start, while the chasers pursue them until they are caught. Here's where the rules become tricky. Task completion must be accomplished without cheating, such as avoiding the use of interstate highways, and gamers must be back to their destination within 45 minutes. Creativity is built into this innovative version of tag, because fugitives can trespass into neighbor's backyards, hiding in bushes to camouflage themselves from the chasers. If a neighbor calls the police department, fugitives must figure out how to duck the consequences.

Licensed teenage drivers, using only insured vehicles, typically have someone riding shotgun ready to jump out of the car and tag the runner or call out his/her name when identified. Unfortunately, once the fugitive is caught, she must get into the car until the game is completed. The game is played with the utmost in caution, avoiding potential risks of automobile collisions, running into the innocent bystanders, and tearing up people's personal property. Regardless of any risky twists and turns, the game must continue to completion even if the police are called by neighborhood residents, who feel their rights have been violated,

Communities are just beginning to weigh in on the virtues and liabilities of the fugitive game. Most parents wholeheartedly support their teenager’s new effort to put play into their lives. One insightful parent said, "Hey, it may be a little risky, but it sure beats having my kid hooked on cocaine or dropping out of school." Another community member said, "Even if a 911 call goes out on my son, I'd prefer having him outside the house hanging out rather than sitting in the house playing video games."

Student groups participating in the fugitive game are tickled about their new, exciting venture. Many have described the results as similar to a rush experienced during a bout of self-medicating on marijuana or alcohol. The biggest enticement that increases the games enjoyment is inciting the police or irate neighbors into playing the game with them.

Community mental health providers view this game as a rite of passage for our teens. One psychologist noted, "It provides our kids with an opportunity to take out their frustrations by pushing back against authority figures; testing the limits to the max is their way of navigating adulthood - it's a healing process."

The fugitive game, founded by today's teenagers, is the trendy tag of the future. It's coming to a town near you. It is creative, complex, filled with risks and adventure as a wholesome outdoor sport. Before your child hits the streets to play fugitive, make sure you have that parent/child talk to promote understanding about a new, fascinating way to play an old favorite that has entertained young people for decades.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in working with children and adults who experience anxiety, depression, grief and pain management issues. His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is now available through Barnes and Noble and Amazon.com. James can be reached at www.scottsdaletherapy.net.

Troubled Childhoods Can Be Riddled With Addiction

2010-08-14T13:08:00.000-07:00

According to James P. Krehbiel, many children are raised in families where the effect of alcohol abuse is rampant. At night, kids may wait anxiously for a parent who comes home after stopping at the local bar and drinking too much. For these children, nervous anticipation, sadness and disappointment are an every day reality - they live in a secret bubble of shame.

The chronic nature of addiction takes its toll as kids develop coping strategies to deal with the impact of alcohol abuse. Children do the best they can, but develop unhealthy ways of reacting to a parent who drinks excessively. These problematic patterns leave children susceptible to long-term emotional damage, particularly in relationships.

Some of the toxic characteristics of an adult/child of an alcoholic are:

• Mistrust
• Avoidance of conflict
• Performing to please
• Excessive caretaking of others
• Fear of abandonment
• Emotional detachment
• Anticipating the worst
• Being overly-critical towards self and others

These destructive qualities are internalized and carried around as adult baggage. They are easily activated in adulthood in response to relationship issues. Adults who have experienced a troubled childhood can find hope, healing and a triumphant life by processing the pain of their past. This worked can be accomplished through recognition, grieving, releasing and letting go, and creating new, more rational ways of responding to problems and people. Krehbiel's new book, Troubled Childhood, Triumpant Life: Healing from the Battle Scars of Youth provides solution-focused strategies for adults in their searches to leave their perilous past behind in pursuit of a brighter future.

Cognitive Therapy and Sleeplessness

2010-06-24T20:42:00.000-07:00

It appears that "as the world turns" many are having a difficult time falling asleep and/or staying asleep. Our fast-paced lifestyle can leave one feeling fatigued, apathetic and restless as a result of a cycle of sleep deprivation. Some turn to sleep medications as a way of rectifying the problem of insomnia. Others look for naturopathic remedies to provide respite from a sleepless night.

Certain chronic insomniac conditions that result from pain-related problems may warrant the use of sedating medications. Other cases, however, may respond to various non-medicinal treatments, including the use of cognitive-behavioral therapy.

Cognitive-behavioral therapy is at the forefront of treatment for various disorders, including depression, anxiety, pain management issues and insomnia. Insomnia may be caused by life stressors, physical illness, emotional discomfort, environmental factors, self-medicating or disruption in one's sleep pattern due to work-shift changes or jet lag.

CBT seeks to work with insomniacs through their thought processes, ways of viewing the world and underlying beliefs about sleep. Many adults become anxious about their lack of sleep. They may ruminate about the horrible things that they believe will happen to them if they fail to promptly fall asleep. I often tell patients, "Where is the evidence that not sleeping tonight will cause you undue harm? What's the worst thing that will happen?" Frequently, it is the anxiousness about not sleeping that sets up a self-defeating dynamic of frustration and restlessness.

CBT uses paradoxical intervention strategies for dealing with sleeplessness. I recommend that patients who experience insomnia stay awake as long as possible prior to going to bed. Individuals should be sufficiently fatigued and drowsy before lying down. The bed should always be used for sleep purposes and never used for reading, relaxing or ruminating. If the patient's sleep is interrupted, the sufferer should get out of bed and read, watch television, until sufficiently tired enough to resume sleep.

Often, people do not realize that the human body will automatically self-regulate. If one only gets three hours of sleep on a given night, the body will automatically compensate, eventually providing appropriate rest. It is the fear of not sleeping that sets up a negative dynamic for the insomniac. Individuals may set up a self-defeating cycle by remaining in bed as they ruminate about sleeplessness. Ironically, this process only compounds the problem by leading to further restlessness.

Learning to relax the body and mind is important to getting quality sleep. Learning mindfulness meditation helps the insomniac to calm the sympathetic nervous system, setting the stage for restful sleep.

What people do with their time prior to going to sleep is important. Playing stimulating music, working at the computer and using alcohol will negatively affect one's ability to sleep. Learning to let go of work-related stressors is imperative. Individuals who are "pusher-drivers" are more likely to carry their workday into the night.

Patients, who experience insomnia, generally suffer from the following self-defeating thoughts and assumptions:

• "If I don't sleep, something awful will happen to me."
• "I must sleep or else I won't be able to function anymore."
• "I'm afraid to go to sleep because something might happen to me."
• "If I don't fall asleep promptly, there must be a problem."
• "I have so much work to do that I don't have time to sleep."
• "I must stay in bed until I fall asleep."
• "Worrying about things helps me to control my life."
• "I must complete everything on my list, especially work tasks."
• "Being alone at night is a scary thing."

Assisting patients to reframe negative thinking is essential to treatment for insomnia. Anticipatory anxiety in the form of negative self-statements must be replaced with more adaptive ways of thinking about sleep. By employing strategies that emphasize the “reverse-effort” of not trying to fall asleep, patients learn to relax their bodies through passive volition and secure needed rest.

Media Generates Renewed Interest in Troubled Childhoods

2010-05-04T14:49:00.000-07:00

There is a groundswell of renewed interest in the impact of troubled childhoods. The movie Blind-Side, starring Sandra Bullock, portrays a strong-willed mother whose care, compassion and involvement affects the life of a homeless, athletic teen. Precious provides us with a snapshot of the horrors of parental abuse perpetrated on battle scarred youth. Now, Todd Bridges, actor of Different Strokes has opened up about his perilous past in a new autobiography, Killing Willis.

These narratives, launched through the media, underscore the need to help today's adults and children find ways to say goodbye to troubled childhoods in search for a brighter future. Respected author and psychotherapist, James P. Krehbiel lays the groundwork for renewed hope in his book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press). He offers goals for assisting adult readers in untwisting their horrific histories and finding answers for productive living in the here-and-now. After each chapter, the reader is provided with workbook-like helps with chapter reflections and strategies for changing negative thinking and behavior.

Troubled Childhood, Triumphant Life comes at a time when many in the media are re-focusing attention on the vulnerabilities of high profile adults. These celebrities’ real-life experiences are metaphors for many adults whose current problems have been activated by unmet needs during childhood. Krehbiel's work, Troubled Childhood, Triumphant Life provides hope and healing for adults struggling with the obstacles fueled from a troubled past.

Creating Civility in an Uncivil World

2010-04-05T12:02:00.000-07:00

The late psychotherapist Sheldon B. Kopp said, "No one is any stronger or weaker than anyone else." This profound statement is a call to civility. It means that we should never attempt to elevate ourselves while trying to diminish others who we believe are more vulnerable. Our society is riddled with examples of ways in which those who assume power try to demean those who can't defend themselves.

This unfortunate fact calls to mind a recent tea party rally in which a gentleman with Parkinson's disorder was bullied by an event advocate. The perpetrator chose to hide behind his ideology and mob/group mentality to make his point to a defenseless person. He later apologized for his hostile, embarrassing behavior.

Without a call to civility, we will continue to groom homegrown terrorists whose thinking and belief systems are filtered through the prism of anger and radical ideology. The "axis of evil," (via George W. Bush), is not merely within the jihadist movement, but in the hearts and minds of all those who would prey upon others using power and control to intimidate those who share different values, behaviors or lifestyle.

We have lost our way. Rather than civil discourse and promoting understanding with those holding polar perspectives, we have embarked on a course to inflame our differences and have launched a campaign to use inflammatory rhetoric and bullying behavior to muzzle those with whom we disagree. We often justify our distasteful behavior in the name of religion, politics and personal piety.

Civility begins in the home and in the institutions of our society. We must teach our children to respect and value those who are religiously and ethnically different and embrace those who have special needs or are less fortunate. I believe that civility should be the most important value we impart to our children.

Education is of little value if, in the midst of the learning environment, children are being taunted by their peers, and with resignation lose the will to live. This pattern is currently happening within our schools. It was psychologist Arthur Combs who said, "Perhaps the most important single cause of a person's success or failure educationally has to do with the question of what a person believes about himself." Without civility training at home or in our schools, our children will enter adulthood educated "from the neck up" as people who find it convenient to prey on others who share a different world-view.

We know that our children role-model what they see in the behavior of their parents. If our kids have been exposed to opinionated, hostile caretakers who disrespect the rights of others, they will follow suit. If parents teach their children to respect and embrace all people, regardless of their orientation and lifestyle, we will observe the power of civility at work in creating harmony and peace.

Right now, I believe we live in a country that hasn't been this divided since the Civil War. We will either find common ground, or further polarize our positions by using inflammatory, hateful rhetoric and behavior to intimidate our supposed "enemies."

The foundations and institutions upon which our country is rooted are being weakened due to a lack of civility. Even our religious institutions have not been spared; witness the devastating effect of child abuse within the Catholic Church and radical religious organizations demonizing others over issues such as abortion and gun rights. Religion is often used to justify our most uncivil instincts within our families and institutions.

Civility involves the promotion of multidimensional thinking. We must learn to explore issues in a non-evaluative manner and learn to assess the merits of a point of view from various perspectives. For example, if we are "pro-life," it is important that we can see the world through the lenses of those who are not in order to create civil discourse and learn to live with integrity in our position. Civility means that we are able to suspend our position as we seek to find the truth wherever it may be found. For truth-seekers, there is no preconceived notion about how the world works.

Those who embrace civility understand their own humanity, filled with frailty and weakness. They are able to connect with others who are vulnerable in their own way. To act in a civil manner, they choose not to control or change people, but to accept them without qualification, regardless of one's differences.

As M. Scott Peck explored in his book, A Different Drum, we need to refashion our culture based upon a sense of community. Community-building is an outgrowth of a pattern of creating and implementing programs based on civility. If we continue on our current course of inflaming our ideological and religious passions and distinctions, we will weaken our personal and institutional connections. Only through the process of promoting civility, will our society regain a sense of inter-relatedness and global harmony.

Author James P. Krehbiel Reflects on his New Book - Troubled Childhood, Triumphant Life

2010-02-28T17:08:00.000-08:00

When I was a kid, my parents would tell me stories about Uncle Eddie who always wanted to be a writer. According to my mom, Eddie had created a manuscript and he would talk endlessly about its potential and his desire to get it published. However, my dad said Eddie was a "dreamer" who never took action to get his work in print. On occasion, my parents would jokingly convey anecdotal comments about Eddie's lack of ambition and unrealistic fantasies.

Life stories have the power to alter one's behavior. Little did I realize at the time that the narrative about Eddie would serve as a catalyst to propel my writing career.

In September of 2005, I self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). My mother carried it around in her walker, and was the best marketer a guy could have. She sold copies to whoever would listen to her spiel.

Unfortunately, over the period of several months in 2008, I lost three loved ones including my mother. Needless to say, I began to consider my mortality. I started to reflect on the urgency of life and recalled reading a quote that resonated with me. The author said, "maybe the greatest sin we can commit is being underutilized." It struck me that in response to that quote, I had a responsibility to use my talent to finish what Eddie had started - to continue to create publishable works.

In the midst of my losses, I was looking for a way to refocus my energy in a constructive fashion. A common theme began emerging in my counseling practice and I decided to explore the principles as a foundation for a new manuscript.

When people come to counseling with distressing presenting problems, they often begin revealing powerful assumptions which originate from troubled childhoods. In my experience, individuals are not aware that the unfolding of powerful, painful content from a troubled past has a direct connection to the present.

I could see this interrelationship between the past and present in those who sought my help. In response, I began to glean some insights into the question, "Why do some people navigate the perils of childhood effectively as they move into adulthood, whereas others tend to repeat the same worn-out, self-defeating behaviors?"

I discovered that adults tend to either avoid or dwell on their past without processing it. This leaves them feeling victimized and stuck and creates a pattern of self-defeating thinking and behavior in the present.

Processing problems is different. This involves the courage to squarely face issues and to comprehend the full emotional impact of an event. As children, we are often forced to make assumptions about life that are erroneous. If not rectified, these core interpretations are carried into adulthood and negatively affect our thinking and behavior.

Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press, 2010) is a book that guides the reader in correcting negative beliefs from the past, so that bad thinking doesn't continue to be activated in the present. Since core assumptions are powerful, they involuntarily get triggered in the present without any proactive intervention to stop the process.

Troubled Childhood, Triumphant Life offers solution-focused strategies to help adults leave behind their perilous past and reframe their thinking in the search for a brighter present and future. The search for adulthood is a continuous process of learning that involves thinking and behaving more adaptively. Best wishes in your search.

James P. Krehbiel, Ed.S., LPC, CCBT is a licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He treats children and adults experiencing anxiety and depressive disorders. He can be reached at www.scottsdaletherapy.net.

Shedding Self-Doubt, Creating Confidence

2010-01-27T13:13:00.000-08:00

After discussing the creation of clear boundaries with Mark, he responded with, "I'm confused." This reaction typifies those with self-doubt who have troubles with sorting and sifting. They don't trust their instincts to generate an empowering decision. Rather, self-doubters cling to their cocoon in an attempt to avoid the inevitability of appropriate action.

Mark’s grown children disapproved of a new, intimate relationship that was very important to him. Mark’s narrative was one of being intricately entwined with his children and ex-wife in a codependent relationship. In the midst of the mess, his children had become caretakers to their parents. In this way, they could soothe the emotional pain that all of them felt over the divorce. Neither Mark nor his ex-wife had processed their anger over parting ways and had leaned on their children as a means of coping.

Now, with the introduction of a new woman in Mark's life, the pot had been stirred. Mark, his ex-wife and kids aligned themselves against his new love and began sabotaging the relationship. Mark felt caught between the burden of his children’s feelings and his devotion to his girlfriend. The old "nuclear family" was coming apart, as everyone felt betrayed. In response, Mark's girlfriend began to experience the angst of split-loyalties and started revolting.

Indeed, Mark was confused. He felt caught, trapped in the middle of the maelstrom surrounding him. In sensory overload, he retreated inside looking for a place of solace. Instead, he began grappling with self-pity as a sense of victimization caused him to unravel within.

For the self-doubter, there is no centered-self. Mark would continue to internalize everyone's feelings but his own. He was too frightened to take responsibility for what he believed to be true, instead deferring to the needs and approval from others. Mark was too terrified to do the very thing that would have fostered freedom - that is, speak the truth about what he needed, whether his children liked it or not. It is the fear of rejection and abandonment that binds us from the liberation to love. Most people have not learned this truth, and consequently end up in a heap filled with great suffering, conflict, aloneness and self-blame. They miss out on life's precious pleasures because they fail to take the risk of loving seriously.

How do we shed our self-doubt and move in the direction of creating confidence? How do we find our loving, centered-self in the midst of troubles and conflict? Here are some conclusions that I've gleaned about this process:

• Set clearly defined boundaries with others.
• It is not "essential" to be loved and valued by all the significant people in your life.
• Learn to differentiate who you are from others. You can ask, "How to I feel? What do I feel? What is my perspective on things? What are my reactions to these events?"
• Recognize that pleasing others is a preference or choice, not an obligation.
• Prepare for a counter-reaction when you stick up for yourself. If others do not like what you express, learn to hold our ground.
• Never justify your perspective and refrain from over-explaining beliefs.
• Recognize that it is the fear of losing that binds us. People may disapprove of our truth, but generally will not abandon us.
• Individuate. In your search for adulthood, find out who you are a part from all the significant people in your life, including your parents.
• Practice choosing. Even if you make a wrong decision, you will feel empowered and primed to make a better one.
• Hurt and disappointment is inevitable. That being said, you might as well take the risk of loving - it feels better.

There is no need for Mark to continue to act confused. He doesn't need to choose between his new love and his grown children. He's needs to make clear to his children that he has entered into the new relationship chapter in his life and he's asking for their acceptance. If they can't grant it, he must make it clear he will not tolerate any self-serving, sabotaging behavior. Initially, his kids may react, but ultimately will gain respect for a father who knows what he wants and stands up for it. Gaining confidence over self-doubt is trusting our instincts to move forward toward what we need and want in spite of the fear of disapproval.

When the Landscape of Loss Lingers

2009-10-23T12:32:00.000-07:00

Within the period of three months, I lost three loved ones. Two of them died three days apart. Although I knew the end was eminent as I processed each situation, my knowledge and anticipation did not soothe me - it only served to bring me closer to the inevitability of my own mortality.

Some say that God will never burden us with more that we can endure - those words seem like idle chatter - it was all too much to bear. I braced myself for the predictability and shock of my pain and sought to manage its effects. There has been no single road that has brought me solace. Each day I meander within trying to find a place of peace or respite from it all.

I'm supposed to know this stuff. As a psychotherapist, I teach people how to grieve. It's different, however, when you are the patient rather than the teacher. You become as everyone else, relying on your instincts, courage, hope and faith to guide you through the darkness. What good is it to recite Elizabeth Kubler Ross’ stages of grief when you are the griever? Talking about loss is not the same as experiencing it.

Each of us, in our own way is frail and vulnerable. As psychotherapist Sheldon B. Kopp used to say, "No one is any weaker or stronger than anyone else." Each of us has a story, some of it wondrous and much of it challenging. Our narrative is about learning, and our losses teach us about the meaning and value of life - to cherish every single moment. Grieving our losses gives us an opportunity to take stock and review our life direction. We hopefully assess what really counts and focus our attention on that which lasts - the content of our character and the quality of our most precious relationships. That is all we have.

Unfortunately, as we age, our losses mount. We grieve the loss of youth, physical prowess, time, missed opportunities and fading friendships. Each must grieve in his own way. I have learned that there is no such thing as closure - some wounds never heal.

I have told others that we don't need to stay stuck in our pain. All of us can find ways to manage our grief so that even if it lingers, it doesn't overwhelm us. Like others, I must remember to:

• Seek the emotional support of friends and family.
• Acknowledge and embrace my pain rather than minimize its significance.
• Refocus attention on activities that bring pleasure.
• Learn this self-nurture. Treat myself the way I would a dear friend.
• Keep the positive memories of loved ones alive.
• Try not to fight my way out of depression. It will lift.
• Live in the present and re-evaluate life priorities.
• Rely on faith to provide me with hope.
• Realize that being vulnerable makes me more human and is a connecting asset.
• Learn to leave the self-pity behind. Accept the fact that I am a grown-up who experiences life as unfair. There are no sufficient reasons why certain things have happened to me.

As a grieving patient, I have a better understanding of what it takes to wind oneself down a path of profound loss - no words are adequate to describe the experience. Contrary to what others think, I do not believe that what I have encountered will make me stronger. I only hope that my experience with lingering loss will make my vision clearer as I look through the eyes of those who have suffered and continue to seek my help.

James P. Krehbiel, Ed.S, LPC, is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine. He has contracted with New Horizon Press to publish his latest work entitled, Troubled Childhood, Triumphant Life. This book is about the impact of “unavailable” parenting on adults and the people they become. His book will be available March 1, 2010 but now can be pre-ordered through Amazon.com. James can be reached at KrehbielCounseling.com.

Eradicating Depression Through Schema-Focused Therapy

2009-09-07T18:46:00.001-07:00

Samantha moved to a large sprawling city to join her boyfriend. They carried on a long-distance relationship prior to her decision to move in with him. Unfortunately, the relationship did not last long, and she felt stuck in a city without a plan to move forward in a positive direction – she sank into a deep depression.

This young lady had parents who were extremely passive and detached. Having lived in a rural town, her options for activity were limited. Her parents never encouraged involvement in outside interests. She lacked confidence and was timid around age-mates. Having moved numerous times during childhood, it affected her ability to build trust and closeness. She felt alone in managing her problems.

Samantha came to therapy looking for a way to lift her debilitating depression. She felt sad, grief-stricken, hopeless, unmotivated and unwilling to seek out new friendships. She was troubled by a set of underlying schemas (assumptions) that clouded her worldview and activated depression. These schemas crystallized in response to unmet needs derived during childhood. The schemas were activated anytime that Samantha encountered problems associated with negative beliefs. The schemas that activated depression were:

• "I'm all alone in my problems."

• "I'm not good enough."

• "I don't trust that others will be there for me."

• "Life looks bleak. I feel hopeless."

These core schemas around the theme of depression were activated when my patient encountered the following life situations:

• Trying to establish friendships

• Pursuing intimate relationships

• Facing new problems

• Attempting to change directions in her life

• Trying to get motivated professionally

• Envisioning a positive future

Samantha worked diligently in therapy to alleviate her depression through untwisting her negative thinking. We gently challenged her core schemas by looking for evidence to the contrary. She gained hope in eradicating her depression as we refuted faulty schema-based thinking. She eventually began to respond more rationally and adaptively:

• "I can manage this friendship-making business."

• "I'm not ready for an intimate relationship now, but when I am, I’ll feel confident and will be more selective."

• "I can cope with and manage new problems."

• "I am certain that I can re-create my life."

• "If a chunk things down into smaller pieces, I can set goals and get motivated."

• "The future holds new opportunities."

Samantha "connected the dots" by understanding the relationship between her core depressive schemas and current behaviors. As a result, she was able to modify her current thinking to make it more hopeful and less depressing.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine. He has contracted with New Horizon Press to publish his latest work entitled, Troubled Childhood, Triumphant Life. This book is about the impact of “unavailable” parenting on adults and the people they become. James can be reached at www.krehbielcounseling.com.

Her Mother and Malia

2009-08-14T18:48:00.001-07:00

It is highly unusual for my daughter to ask me for advice. Until recently, I can only remember a few occasions when she sought my wisdom regarding the profundities of life. Maybe denying the need for help from parents is mapped in our genetic code. I never asked for much assistance from my own.

However, recently Amy came of age. At 36, she finally decided it was time to lean on dear old Dad. On this rare occasion, during a recent phone call, a bombshell was hurled. Amy retorted, "Dad, what can I do to rein Malia in a bit? My feisty four year old daughter is wearing me out!"

As a psychotherapist, with plenty of parenting expertise, I'm sure that Amy was waiting for my most profound response. However, my spontaneous reaction took both of us off-guard. Impulsively, I replied with, "I don't know Amy - I sure as hell didn't know how to cope with you - maybe it's payback time."

We both had a good laugh as we processed the parallels between Amy and her precocious, pesky daughter. Here are a few of the significant similarities:

• They both are a strong-willed handful.
• They became non-stop talkers before they were developmentally capable of walking.
• They both love to carry the show with intensity - camera, anyone?
• They are both too smart for their own good. Going to school comes disgustingly easy, but is filled with the challenges of unmet academic needs.
• They both are similarly assertive, bordering on aggressive; please look out when they're unhappy!
• They both appear affectionate, but seem to be overly-sensitive to other’s feelings.
• They are extremely independent people. They know what they want and you don't dare hinder their progress!

One area of temperamental variance is worth noting. It is a fascinating distinction and the area where I believe my daughter is being punished for her past. Malia insists on wearing pink clothes and accessories at all times. Malia has a pink handbag, beret’s and beads to match her feminine looking clothes. This fashion statement, required by Malia, is a foreign concept to my daughter. At first, Amy tried to encourage Malia to wear different colors, but to no avail. Malia resisted wearing anything but pink.

Amy wonders where she went wrong. She was the queen of the Gothic look, wearing black as her only color scheme throughout school as a theater buff. However, when Amy came home from the first semester of college, a miracle occurred. I found a pastel colored sweater lying on her bed. “What are you doing with this pretty sweater?” I replied. Amy laughed and said it was a new day in her life.

When I see Malia, I see the wonderful reflections of my daughter. I see the smile, the passion, the precociousness, and the personal need to be understood. They are versions of the same person. Being out-of-state, I don't see Amy or Malia that often, but when I do, I'm so grateful that my granddaughter has not forgotten who I am. She's a slice of my daughter and a good one indeed!

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine. He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood: Saying Goodbye to the Magical Illusions of Childhood. This book is about the impact of “unavailable” parenting on adults and the people they become. James can be reached at www.krehbielcounseling.com.

The Search for Adulthood: Grieving the Past and Embracing the Present

2009-08-05T19:50:00.000-07:00

Learning to process and accept our past is a necessary step in one’s search for adulthood. Instead, people often choose neurotic suffering as a way of coping with painful memories. Neurotic suffering consists of coping mechanisms that put a salve over our wounds. Rather than confront one's painful past, adults will convert their grief into physical symptoms, and mask their losses through over-activity, intellectualization, avoidance, self-blame and projected anger.

Neurotic sufferers ignore the stop signs, transcending their grief as if it weren't there. They pretend that everything is running smoothly, ignoring what their bodies, mind and feelings are trying to tell them. They diminish the truth in the pursuit of coping, choosing to ignore their emotional distress.

Holding Ourselves Together

Anxious sufferers hold themselves together like a ball of yarn. They fear that if one strand were pulled from the ball, they would slowly unravel into a mound of scattered threads. However, protecting oneself from the realities of the past eventually creates insurmountable fatigue. One's sympathetic nervous system reacts to the stress of trying to ignore the reality of stored and unprocessed psychic pain.

We must move through our grief and loss in order to get to the other side. There is no substitute. We cannot short-circuit the grief process without paying a price consisting of unnecessary suffering. Grieving our pain allows us to legitimately navigate our loss, finding closure over past perplexing problems.

Mourning and releasing our losses takes time. There is no way to short-circuit the process. There are strategies that we can employ to facilitate moving through the grief process. Here are a few ideas:

• Share one's painful narratives with friends.
• Seek the emotional support of family.
• Journal one’s thoughts and feelings.
• Write a letter (not to be delivered), focusing on the impact of a significant other as you grieve the loss. Explore difficult emotions and thoughts.
• Give up the illusion that people (particularly our parents), will change into the people we have always wanted them to become.
• Face our mortality by grieving the aging process and its affect on us.

Learning to Get Our Power Back

Once we face our grief, our past will no longer have power over us. We are freed from being straddled with false guilt, remorse, regrets, and the inability to connect on an emotional level with others. Grieving is like peeling an onion. There are layers, and it takes patience and persistence to navigate through our turmoil.

If one holds tightly to metaphors of pain, refusing to acknowledge its presence and impact, the lack of resolution creates the conditions to foster self-defeating thinking and behavior in the present. Often, individuals who have thwarted the grief process, continue to play out interpretations and narratives of behavior similar to scripts present during childhood. Individuals may have failed to squarely face their painful past - as interpreted through the eyes of a childhood burdened by emotionally unavailable parents. They may never have come to terms with the pain generated by those who failed to love them unconditionally.

Saying Goodbye to the Magical Illusions

People, who experience the pain of a turbulent childhood, often cling to the illusion that someday their parents will magically morph into the loving parents they longed for. Rather than swallow the "bitter pill" of how our parents dealt with us, we continue to hold out hope that someday, somehow, they will change. By holding out false hope, we minimize the significance of promises un-kept, thus cutting ourselves off from the part of us that needs individuating.

The search for adulthood involves recognizing the power of our painful past, creating and releasing it, and learning to rationally respond with fresh interpretations in the present. The search for adulthood involves finding integrity, authenticity and adventure. By appropriately grieving roadblocks from our painful past, we are able to move forward and become adaptive, functioning adults in the present.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine. He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood: Saying Goodbye to the Magical Illusions of Childhood. This book is about the impact of “unavailable” parenting on adults and the people they become. James can be reached at www.krehbielcounseling.com.

The Hazzard of Dichotomous Thinking within the Therapeutic Community

2009-07-31T10:55:00.000-07:00

In cognitive therapy, cognitive distortions represent the lenses out of which we view the world and filter our version of reality. In light of recent developments among some therapists, dichotomous (either/or) thinking has emerged as a professional hazard. I recently attended a national mental health conference. I was intrigued as presenters and colleagues alike made comments that presented a distorted perspective regarding some significant behavioral health issues.

As M. Scott Peck eloquently articulated in his work, The Different Drum, it is important that as thinkers we look at problems multi-dimensionally. We must not get trapped by any one side of an argument, but stay open to multiple sides of an issue; by doing so, we show integrity. Staying open to the truth wherever we find it allows us to be more grounded, rational and informed.

Within the last several years, many clinicians within the counseling profession have started to under-cut the role of prescription psychotropic medications as a facet of treatment. Some of the arguments from these naysayers of medication management are:

• There is no evidence that serotonin or norepinephrine levels affect mood.
• A quality therapist’s treatment is sufficient to free us from the dependency to psychotropic medications.
• Primary care physicians and psychiatrists have a propensity to push medication, thus justifying the need for their professions.
• Touting the use of antidepressants and other mood-stabilizers is primarily a marketing ploy.

Lately, high profile cognitive-behavioral therapists have been down-playing the efficacy of antidepressants and other mood-elevating medications by stating that CBT is sufficient to "cure" any problem without a crutch, thus “ditch the Zoloft.” Although many research studies support the synergistic effect of cognitive therapy and antidepressants, CBT therapists are dismissing such findings as misguided.

Existential therapists are also following suit. Since they believe that all suffering is legitimate, using medications to stabilize mood remains unnecessary. In fact, existentialists believe that taking antidepressant medication thwarts the grieving process, thus delaying the natural progression of growth. According to their viewpoint, we must not pathologize the human experience.

I believe that a more pragmatic, balanced and useful position is to acknowledge the legitimacy of psychotropic medications in curbing anxiety, depression and other disorders of mood. We should accept these medications because for many sufferers they work. Antidepressants serve as an aid, an emotional "floor" while patients undergo therapeutic treatment to derive more long-lasting benefits in coping with emotional distress. Furthermore, it is essential that those suffering from bipolar disorder take mood-stabilizing medication to treat their symptoms. There is no other viable option for treatment.

Why is it that many therapists now embrace a philosophy which discounts the use of psychotropic medications? It is true that people generally do what’s in their best interest, and many therapists hold a position which dismisses the legitimate use of medication for several reasons:
• It enhances their belief that their therapeutic orientation is unique and sets them apart from the competition.
• It increases their ability to generate income. Therapists postulate that marketing an approach that will fix you without the use of medication (prescribed by a PCP or psychiatrist), is more enticing and potentially lucrative.
• Therapists, who disown the use of psychotropic medications prescribed by physicians, are driven by their feelings of exclusivity about their approach, coupled with the desire to market themselves. The practicalities of what is in the best interest of the patient are ignored. Marketing takes precedence over pragmatism and utility.

Another danger involving dichotomous thinking relates to mind-body therapies. Holistic thinking has taken root in the mental health profession. Many therapists integrate alternative therapies that claim to remedy behavioral and emotional conditions. Some of the treatments are evidence-based, but many cannot be supported empirically. Case in point is reflexology and therapeutic touch, which claim to explore and heal energy systems. The therapeutic community needs to do a better job of ferreting out modalities that have functionality versus those which are of questionable utility. Once again, in the process of propagating the mind-body connection, we may error on the side of discounting physical medicine, including psychotropic medications.

As a therapist, one must carefully weigh all sides of an issue before making value judgments. Therapists must be honest and informed when making statements about psychotropic medications and the mind-body connection. At a recent mental health conference that I attended, a participant claimed that she was dismayed by the over-use of stimulants for students experiencing ADD. However, it is clear that ADD has been under-diagnosed, not over-diagnosed, and those who receive treatment with stimulant medication in concert with therapy do significantly better than those prior to treatment or without treatment.

It is imperative that therapists represent their profession appropriately. This means that we take a carefully crafted approach to treatment based upon sound research and a sense of balanced thinking and integrity. Being blinded by any one perspective only polarizes the profession. Theory and practice must come together in a way that provides our patients with the best chance of making improvement. Part of the answer is to offer our clients a multipronged approach with the best quality evidence-based theory, medication management (if needed), and alternative adjunctive treatment modalities that have a history of demonstrated effectiveness.

The Identity of Imperfection

2009-07-20T16:35:00.000-07:00

When Alex was a kid, he recalls his father chastising him for not washing the car properly. Alex volunteered his services as a five-year-old child, but his dad showed little appreciation. On the contrary, when he "missed a spot," his father would berate him by calling him stupid. He was a sensitive child who wanted to please his father, but ended up feeling devalued.

Over time, Alex associated his less than perfect performance with his personal identity. If what he did was less than acceptable, then by all means he must be defective. His father never encouraged or coached him on a better way to wash the car, so he was left to feel inadequate about any task he attempted.

Alex evolved into a self-critical, angry youngster. In Little League, he excelled as a player. He was known for his outstanding skills and performance. Nevertheless, he berated himself, other players and the umpires during his occasional unsuccessful at-bats during games. He recalls running feverishly towards first base, being called out, and throwing his helmet, stomping his feet and raging at the officials. Although he was conflicted and confused about his poor sportsmanship, he wasn't capable of stopping his inappropriate behavior. His parents never got involved, intervened and discussed the "why" of his self- defeating thinking and behavior nor tried to correct it.

In adulthood, Alex was able to trace his painful memories of personal performance-related criticism and anger through the filter of his son’s experience. His son, Damon, was a very talented basketball player. Alex was perplexed because he never recalled Damon losing his "court presence" during a game. His son was grounded, focused and in control. These qualities actually helped enhance the level of his game. Alex was thrilled that the legacy of persistent perfectionism never created a problem for his child.

As he sat in the stands and watched one of his son’s tournament games, Alex recalls reflecting on what parenting skills he had implemented with Damon that were different from the way in which he was raised:

• Like Alex, his son was very sensitive. Alex made sure that he never harshly scolded him.
• His form of discipline was facilitated through coaching, instruction and encouragement.
• He always let Damon know that he was proud of him.
• He believed that mistake-making was a necessary part of child-development.
• He challenged his son to excel without motivating through intimidation.
• He remained involved with Damon and attended his activities at school and in the community.
• Alex's limits were firm, but reasonable with logical consequences for positive and negative behaviors.
• He always differentiated Damon's behavior from his personal worth.

Alex gave his son what he found difficult to provide for himself - support, soothing, comfort and affirmation. Ironically, he learned through role-modeling his son’s behavior how to begin parenting himself. The process of learning to self-nurture involved facing his past, grieving and releasing its emotional impact while creating fresh interpretations of his thinking and behavior.

He cut into the "pedestal of perfectionism" and learned to allow himself the freedom to perform less than admirably at times. He practiced selective mistake-making as a way of giving up some control and allowing for a measure of vulnerability. Alex worked on being less self-critical and judgmental of others, and eventually learned to hold the identity of imperfection. He learned to push less, and relax more as his performance, like his son’s, actually improved.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine. He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood: Saying Goodbye to the Magical Illusions of Childhood. This book is about the impact of “unavailable” parenting on adults and the people they become. James can be reached at www.krehbielcounseling.com.

Make Way for a Different Kind of Thinking

2009-07-12T07:29:00.000-07:00

I distinctly recall when Nathan began seeing me for counseling. He was a skinny, sensitive kid with a big heart. At age 13, he struggled in the midst of a tumultuous custody battle that left emotional scars. My job was to prop him up - to give him hope that things would change for the better - and they did.

Nathan came back to see me three years after he had "graduated" from therapy. He brought his new guitar and treated me to few melodies in the privacy of my own office. He was serenading me - it was a gift for being there for him. However, Nathan's visit took on a more important purpose. He came to tell me, in so many words, how he had become a different kind of thinker - the type of young person who inevitably would change the very foundations upon how we view matter and energy and life itself. At age 16, Nathan had graduated from a college preparatory high school and made his way to a prestigious university to study nanotechnology.

As I intently listened, Nathan explained that nanotechnology will allow us to snap together the fundamental building blocks of nature more easily, more cost effectively, and in a way that is permitted through the laws of physics. Nanotechnology has the ability to transform our thinking about science, physical health and disease, emotional well-being, computer programming, and travel to outer space. Not only was Nathan "studying" this complex, molecular thinking, but he was actually conducting research with the world's greatest scientists in this technological field.

Like an H. G. Wells of his time, Nathan passionately projected what the world would look like in the next 15 years due to his work. His words seemed prophetic and powerful, and I sense that I was sitting before one of a new age of young people - the dreamers, the problem-solvers, the visionaries who would create a new way of thinking about thinking. These are not “egg-heads,” but balanced, well-rounded kids who have the capacity to not only reflect on problems but to communicate about how the world will dramatically change due to their influence.

Nathan represents an influx of thinkers among thinkers, who will quietly work behind the scenes to make things happen. These are not our future leaders or managers, but those who empty themselves of all internal clutter or preconceived notions about how the world works. By staying open to the truth, wherever they may find it, new, exciting discoveries will be made that will impact all aspects of the human condition.

Like Nathan, our future thinkers can recognize the qualities and significance of emptiness. They can handle the perplexing nature of uncertainty and ambiguity. They understand that there are multiple dimensions to any problem with conflicting and paradoxical meanings. They are willing to surrender conventional notions about how the world works in order to make room for the new. By cutting a path through the clutter and letting go of a traditional means of thinking, these talented young people will open themselves up to what Robert Schuller referred to as, "possibility thinking."
In the midst of all the incivility and strife that we are faced with, Nathan will make a difference. He has not forgotten what it was like to stand face to face at a young age with problems that were bigger than he was capable of solving. He will use that experience to empower and propel him in a direction to bring peace as he thinks about and humbly solves problems that raise hope and healing for all humanity.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine. He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood: Saying Goodbye to the Magical Illusions of Childhood. James can be reached at www.krehbielcounseling.com.

2009-07-01T16:02:00.000-07:00

href="http://www.desitabg.com/">DESITABG.com - free web directory

From Alcoholic Enmeshment to Rational Recovery

2009-06-28T12:01:00.000-07:00

Todd came to see me at the encouragement of his mother. He "talked the right talk" about leaving his drugs and alcohol behind, although he had a long track record of failed attempts. Todd had been in and out of residential treatment programs without success. This young man looked to me and rational recovery as his last chance to live a lifestyle free of the ravages of addiction.

I pushed Todd to explain to me, in every conceivable manner, how "this time" things would be different from all of his other failed attempts at sobriety. In a straightforward, yet probing way, I took him apart in the process of working to hold him accountable for his wasted life. Fortunately, he didn't run away from therapy.

Todd came to see me every week as we combined my cognitive-behavioral treatment with a local outpatient rational recovery program. Since the efficacy of inpatient substance abuse treatment programs is marginal, I felt that this would be a more effective treatment approach. This two-pronged strategy appeared to be the perfect mix. Naltrexone, a medication employed to stop the urges and cravings of alcohol was used with my patient. The goal of treatment was to focus on his lifestyle of excessive drinking and to rationally, reconfigure patterns of behavior that were consistent with a lifestyle of sobriety.

Todd began drinking when he was eight years old. His father would take him on camping trips and would provide him with hard liquor during their journey. Todd recalled his father handing him small, open alcohol bottles for consumption which had been purchased from the airlines. Todd reminisced about how he would eventually end up vomiting during stops along the way to the camping sites. According to Todd, his father was too "wasted" to be of any assistance to him.

This father and son drinking dynamic went on throughout Todd's adolescence. Todd began being admitted to residential treatment programs by the time he was thirteen years old. Each time Todd was placed in a rehab program for drugs and alcohol, Todd's father would make a special effort to visit him during recovery. Ironically, he would wish his son well and then would depart. On one occasion, Todd remembered his father drinking and smoking pot with him in their car just prior to his being admitted.

I found it fascinating that Todd never thought about the peculiar, symbiotic, outrageous abusive nature of his father/son relationship until we began exploring it. Even then, Todd deflected the experience through anxious laughter. As I "turned up the heat" on the emotional impact of what he experienced, Todd's vision of his past became clearer. He began to understand the betrayal, shame and humiliation foisted upon him by his father’s alcoholic enmeshment. It was painful for Todd to learn to hold his father responsible for the hurt, disappointment and destructive behavior he created.

As we moved through therapy, Todd was afraid of his anger and where it would lead him. We addressed that fear along with ways of coping with his enfeebled, alcoholic father in the present. Todd set more appropriate boundaries related to any contact with his father, and on several occasions broached the subject of his father's past behavior to no effect.

Todd learned to accept the fact that his father would never change, and that he would need to grieve and release a history filled with horrible memories. Todd's rational recovery, based upon cognitive-behavioral therapy, is working. He has a positive support system, medication for his urges and cravings, and takes full responsibility for his recovery. Every day is a choice about whether to allow his father to continue to have power over his life or to choose to forgo a pattern of drinking that started many years ago during his father/son camping trips.

{Note: This narrative is a composite. It has been deliberately altered in order to protect an individual’s right to confidentiality and privacy.}

Cognitive Therapy and Sleeplessness

2009-06-21T19:32:00.000-07:00

Cognitive Therapy's Application to Tinnitus

2009-03-16T16:28:00.000-07:00

Lisa was referred to me by a physician who specializes in treating ear disorders. The neurologist was familiar with the efficacy of cognitive-behavioral therapy and its application in treating pain-related syndromes. This patient was referred to me as a part of a multidisciplinary approach to managing tinnitus.

Tinnitus is a ringing, swishing or other type of noise that seems to originate in the ear or head. Nearly 36 million people suffer from this disorder. Many factors, such as certain medications, ear wax, fluid, infection or disease of the middle ear bones or eardrum can cause tinnitus. As with any pain syndrome or disturbance, emotional factors can exacerbate the disorder.

Lisa complained of a loud, swishing sound emanating from both ears. The disturbance was significant enough that it began affecting her ability to function in a meaningful manner. At home, while preparing dinner, she found herself shifting her head in an unusual position toward her right shoulder in a ritualistic attempt to minimize the annoying vestibular volume.

Her bodily compensation reminded me of a clutched position that battle-scarred soldiers assume in combat that represents a way of warding off impending doom. In reality, such posture actually symbolizes the heightened hypervigilance experienced by those who have been exposed to physical and emotional trauma.

It has been my experience that a pain syndrome often serves as a mysterious metaphor for the way we relate to the world. M. Scott Peck, author of the Road Less Traveled, used to talk about the nemesis of his neck pain. Although he sought surgery to rectify his condition, he viewed his problem as a more complex pattern. The origin of his neck stiffness transcended bones and tissue. Peck often said “he was afraid to stick his neck out." His malady was a metaphor for holding things in and avoiding conflict at all costs. Learning to assert himself paid dividends, and further minimized the significance of this problem.

As Lisa and I explored her problem, I began to see a thread that linked her nonsensical noise into a self-defeating cycle. "The volume was chronically turned up in Lisa’s life and it made her head spin." She often affirmed this impression through the narrative of her life’s experiences.

Lisa had always done what others required of her. Her earliest recollections of this behavior occurred when walking home from school on a rainy day with several friends. As a mean-spirited lark, her friends asked her to stick her feet into a large puddle of water soaking her shoes and socks. She obliged her friends so as not to disappoint them. She felt humiliated as her school-mates looked on and mocked her. From that moment forward, the power of pleasing others emerged as a benchmark for how she would conduct her life.

Alfred Adler used to say that our earliest childhood recollections embody a constellation of beliefs, thoughts and feelings that have the power to profoundly impact one’s future behavior. Lisa’s experience in a mud puddle would fuel her later behavior within adulthood.

Lisa worked as a full-time tutor. Her students loved her. One day, she taught ten students in a row, driving to and from each student's house. She then went home, did her chores and prepared her evening meal for her husband. It was typical for her to push to accomplish tasks for others without ever setting appropriate boundaries for herself. She never requested or required anything from others – finally she gave in to exhaustion.

As Lisa began to disclose more freely in therapy, her story of unyielding sacrifice for others at her own expense became more evident. All the money she earned went to subsidize her granddaughter, who refused to work. Lisa disclosed that her granddaughter had a $200 a month smoking habit. Although she was conflicted about supporting her granddaughter’s addiction, she paid her the money to cover the cost. Lisa’s showed regret rather than appropriate resentment for enabling her granddaughter’s behavior.

In order to decrease the background noise in Lisa’s life, we worked on the following issues:

• Balancing the need to please with a sense of personal protection

• Learning assertiveness skills

• Requesting and allowing others to care-take for her

• Letting go of the need for frenzied activity

• Listening to her body and honoring it by slowing down

• Learning to get un-trapped from the fear of abandonment

• Learning to never do for others what they can do for themselves

• Relaxing the sympathetic nervous system through exercise and meditation.

In order to address the above issues and decrease the volume of her tinnitus, I work with Lisa on her thoughts, distorted cognitions and underlying assumptions about life. I taught her to rationally respond to self-defeating thoughts and behaviors. Some of the types of thoughts we reframed were:

• "Where is it written that people can't get along without me?"

• "If I say no, and people don't like it, it's their problem."

• "It's okay to have abandonment feelings, just don't act on them by trying too hard.”

• "I need to focus in the moment, rather than stressing about things I can't control. If certain things don't get completed, it's not the end of the world."

• " I need to treat myself as if I were a dear friend.”

• "If I give in to others, I'll only resent it later.

• What's the hurry, anyway?"

As a result of the modifications in her thought-processes, Lisa began to make progress with her tinnitus and she learned that self-defeating thoughts were a metaphor for self-defeating assumptions which aggravated her ears. These were factors that complicated her condition by creating unnecessary stress.

[Note: This case is a composite drawn from my practice as a psychotherapist. It has been altered to protect the individual's right to confidentiality and privacy.]

The Magic Embedded in Life's Stories

2009-02-15T18:46:00.000-08:00

Recently, my wife took an introduction to genealogy course at our local library. She was interested in gathering more information about her family history. She found the class very useful in filling in some missing pieces about the story of her parents.

One way of generating genealogical information is to download census data, in this case dating back to the 1930’s. My wife was very excited about her discoveries and the process had piqued my interest. I wondered what I might find out about the life of my 93 year old mother.

I pulled up the fifteenth census of the United States, completed on April 17, 1930. My mother was raised in Richwood, West Virginia. She lived with her grandparents during her pre-adolescent years. She and her grandparents lived on Boggs Street with her grandfather working on a dairy farm.

Although I was aware that my mother lived in West Virginia and resided with her grandparents, some of the census information was new to me. When I mentioned that I discovered that Mother’s grandfather was a dairyman, she perked up and began telling me stories about how she helped out on the farm by feeding the animals and milking the cows. When I mentioned to my mother that she lived on Boggs Street, she drew a blank. However, hours later, she called me back with renewed excitement to share her story. The street was named after the Boggs family who were their only neighbors on top of a hill in rural Richwood.

Life is a tapestry of memories, some which unfortunately go unspoken. Stories define the nature of our life, and link us to our history and our future. Memories are made of the stuff that illuminate our legacy.

Family stories help people become three-dimensional. They make our loved ones more than what we see on the surface. They change our perception of significant others. Memories clarify the experiences of our families, making our loved ones appear fuller, richer, with more emotional depth.

Family memories provide everyone with recollections that are treasures that can be recaptured. They can be entertaining, informational and fill in missing pieces about the nature of our history. Sharing stories can be therapeutic for the story-teller, helping them get closure regarding prior life events.

The story-teller passes down to other family members’ information and experiences that provide links to those who came before us. As we intently listen, we are able to integrate information which broadens our heritage and identity. We feel more complete as we gain new knowledge about traditions, experiences, and values from those who shaped our family heritage.

Family members who share their stories enrich relationship connections. Story-telling is an emotional experience and creates an opportunity for healthy bonding to take place. We only truly know an individual based upon the degree of emotional expressiveness disclosed. Story-telling provides ample opportunity to make this process happen.

When our parents or other family members share their recollections, it provides us with clues to the social-cultural history that serves as a foundation for our family heritage. We also get a glimpse of what our loved ones were like during different periods of their life. We are able to get a sense of how our family experienced life when members were younger or lived in a different era.

The expression of memories provides us with the wisdom of our parents. Stories are a catalyst for pulling our family history together so that it makes sense to us. We become more personally integrated, authentic and complete, while we are enjoying the fun of listening to interesting experiences from the past.

The Mystery of Fibromyalgia and How Cognitive-Behavioral Therapy Can Help

2009-01-29T09:24:00.000-08:00

Fibromyalgia syndrome (FMS) is the medical terminology used to represent a complex clinical disorder of symptoms characterized by soft tissue pain, stiffness, and altered deep pain threshold with psychological fallout. It can mimic or accompany symptoms of joint injury, but it is not an arthritic or neurological condition. The disorder affects between 3 to 6 million people – or as many as one in 50 Americans. About 80 and 90 percent of those diagnosed with fibromyalgia are women.

There is usually an emotional overlay of depression and anxiety that affects the sufferer. There are numerous reasons why this is true. Many within the medical community have discounted fibromyalgia as a bona fide disease. Patients have been told that they are over-dramatizing their pain and that the stiffness or soreness has been psychologically induced. Others have been told that the condition was fabricated for attention or perceived by health providers as feigned helplessness. These assertions from medical experts make patients with FMS feel ignored, mistrusted, alone and without support. Patients often turn to self-blame, which fuels the pain cycle.

The pain and symptoms of fibromyalgia are real and have a definite physical basis.
There is no known cause for fibromyalgia. Some researchers have speculated that physical trauma or viral influences have triggered FMS syndrome in many patients. There are no known abnormalities in the muscle tissue of fibromyalgia patients that would account for the disease.

Current research has focused on regions of the FMS patient’s brain and the susceptibility of certain brain locations to pain sensitivity. The brain receives a pain signal from the muscles and stays in a state of alert. For unknown reasons, the brain fails to let go of the pain signal and sets up a chronic pattern or pain syndrome. The brain stays in a constant feedback loop, consisting of a system of amplified pain signals.

Recent brain scan research studies have shed new light on this disorder. Results published in the May 2008 edition of the Journal of American College of Rheumatology shows that neuroscientists have been able to conduct scanning technology to areas of the brain affected by fibromyalgia. Mild pressure on trigger points of the patient has produced measurable brain response in processing the sensation of pain. The elevated response of pain in FMS patient’s brain scans was significantly different from those in the control group of the study. This is one of several studies that validate the reality of fibromyalgia as a disorder affecting the brain's response to muscular and neuropathic pain. Hopefully, future studies will lead to new treatment options.

Currently, treatment options consist of the use of a multidisciplinary approach. Medication management, physical therapy, meditation, exercise, alternative therapies, and cognitive-behavioral therapy are useful. CBT is a valuable therapeutic treatment option for those suffering from pain syndromes. One of the byproducts of pain can be the escalation of anxiety and depression. Likewise, anxiety and depression can intensify the impact of pain and make it more debilitating.

Cognitive-behavioral therapy’s goal is to teach the FMS patient to embrace pain rather than fight it. Cognitive distortions, such as magnification and “catastrophizing” need to be addressed so that patients learn to de-escalate fueling the pain process. How one thinks about his pain affects its impact. One can learn to rationally respond to pain by saying:
"Although this problem is difficult, I can learn to manage it."
"What's the use of getting all upset about my pain, it won't help anyway."
"If I relax and walk into my pain, maybe all this will feel less troublesome."
"I'm not alone in this. I have the support of my family and friends."
"I'm not helpless, I have many strategies I can try to minimize the effect of my pain. Just keep moving!"

Cognitive-behavioral therapy can assist the fibromyalgia patient to identify stressful triggers that exacerbate pain. This may involve examining family struggles, exploring inner-conflict, and working with core, self-defeating assumptions that affect thinking and behavior. Teaching the patient mindfulness meditation as a way of relaxing the sympathetic nervous system is beneficial.

Through the use of CBT, a therapist can provide the fibromyalgia patient with structured homework assignments that will help pain sufferers to experiment with new behaviors such as increased involvement and activities. Motivating the client to set realistic goals for everyday functioning can be helpful. Encouraging a multidisciplinary approach involving exercise, physical therapy, rehabilitation and pain management are essential.

Fibromyalgia patients fear that their disorder will cause them to lose the ability to function at work and at home. Teaching patients to focus on what they can do rather than their limitations is important. There is a tendency for fibromyalgia patients to distort reality by focusing on negative perceptions to the exclusion of the positive. Helping the patient and family to accept physical limitations is a necessary component to successful treatment.

Fibromyalgia patients can easily get enmeshed in a cycle of pain and associated emotional symptoms. It is the goal of cognitive-behavioral therapy to assist the patient in coming to terms with his disorder and making plans to manage it. This is accomplished through acceptance and teaching the patient positive ways of thinking about his condition and multiple ways of treating it.

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at www.booklocker.com.

Are You Anxious About Your Anxiousness?

2009-01-11T13:19:00.000-08:00

Excessive anxiety is troublesome. For many, it can be an immobilizing experience. Anxiousness can be associated with social avoidance and withdrawal, can be a factor in relationship difficulties, can create painful symptoms, and trigger a need to rehash issues related to our past and future. Anxiety triggers the "fight or flight" response, ramping up our sympathetic nervous system.
The most successful treatment approach to dealing with anxiety is through the application of Cognitive therapy since anxiety is a reaction to our thinking, beliefs and underlying assumptions about life. It is usually not our primary anxiousness that creates our distress. It is our secondary thoughts and feelings - the "anxiety about our anxiety" that intensifies our symptoms.
Almost everyone experiences anxiety, but not everyone catastrophizes about it. Let's say you are taking a midterm exam in college. There are several ways you might respond when you open the test booklet and note that there are numerous questions that you are not prepared to answer. First, you might respond by saying, "wow, none of these answers look familiar. I don't remember studying for us- I'm going to flunk this test. If I fail it, there goes my grade for the semester. Wait until my parents find out, they will kill me!" Or and alternative, rational response might be, "Gee, I don't understand these first three questions - that's okay, I'll just take some deep breaths, relax and work on the questions that I am familiar with. Then I'll go back and tackle the ones I couldn't answer before."
An individual’s manner of self-talk determines the level of anxiety. When we "awfulize" about anxiety, it tends to intensify it. When we respond rationally to our anxiety, that diminishes its effect. Rationally responding to anxious thoughts is critical to minimizing its effect.
Many people tend to believe that their panic or general anxiety "appear out of the blue." They may feel confused and perplexed by the sudden emergence of their feelings. Cognitive therapists view anxious feelings as a byproduct of faulty thinking. There is no mystery to it. Teaching others to respond rationally to self-defeating talk is the primary goal of therapy.
Individuals who experience panic attacks are usually troubled by symptoms such as racing heart, sweating, fear of dying, hyperventilating and a need to escape social situations. Helping individuals to manage panic attacks takes understanding and patience. Assisting people to realize that their panic is time-limited is important. Since panic tends to take on a life of its own, it is important to address the secondary symptoms or the "panic over the panic." When people panic, they tend to magnify their symptoms through self-defeating thinking, perpetuating the attack. Teaching people to relax into their panic is necessary.
The following are some guidelines for those who experience anxiety and panic:
1. Anxiety is time-limited. It is comforting to know that it always diminishes in its impact over time.
2. Don't fight with your anxiety. It only makes things worse. Lean into your anxiety, embrace it, and it will subside.
3. Schedule a "worry time." Go into a quiet room, relax and try to expose yourself to your anxieties. Try to bring on your symptoms and you will find that it is difficult to do.
4. If you have a tendency to panic, create an exit strategy. Plan a way to remove yourself from anxious situations to bring relief.
5. Refocus your attention away from your anxiety. For example, when people experience panic attacks that involve a racing heart, I might encourage them to do jumping jacks to demonstrate that there is nothing physically causing their symptoms. This strategy actually lightens the situation and their symptoms.
6. If you are anxious, chunk things down into smaller parts. People tend to feel overwhelmed when they look at the entire picture. Rather than clean the entire house, pick a few specific tasks such as shredding a few unnecessary documents.
7. Stay in the present. Don't rehash your history or anticipate your future. Worrying about your future or history serves no useful purpose. You can't control it anyway.

Cognitive therapy emphasizes replacing self-defeating thinking with more rational ways are responding to stressors. Identifying goals of therapy, approaching them in a practical manner, and providing homework assignments are significant ingredients to addressing anxiety.

COGNITIVE THERAPY AND PAIN MANAGEMENT

2008-11-27T10:05:00.000-08:00

Those who work in the field of healthcare have known for some time that a connection exists between our underlying beliefs and thoughts and the functioning of our bodies. Dr. Herbert Benson, in his 1970’s landmark book, The Relaxation Response, articulated the concept that stressors can trigger a “fight or flight response”, an inner startle response that indicates we are about to experience an unpleasant event. Although there is a healthy fear that protects us from harms way, many times how one interprets stressful events and one’s ability to manage it, can affect the immune systems functional capacity. There is now sufficient research to validate Benson’s work, that relaxation techniques such a meditation, can have a direct link to minimizing the effect of a wide range of disorders such as high blood pressure, irritable bowel syndrome, back problems, neurological pain, and headache problems. Relaxation strategies calm the sympathetic nervous system, making it easier for the body to heal.
In Barbara Levine’s book, Your Body Believes Every Word You Say, she explores how our thoughts and underlying beliefs about our physical maladies affect our auto-immune system which regulates our ability to ward off illness, manage pain, and promote healing. In other words, legitimate pain from various illnesses and somatic complaints can be intensified by the kind of messages we tell ourselves. Spontaneous self-defeating thoughts such as, “What’s the use, my body will always betray me and never get better.” can reinforce the pain cycle of making things worse. People with such chronic self-defeating reactions have been shown to create inner chemical changes and constricted blood flow which further erodes the individual’s ability to manage pain. How we respond to our bodily disorders, in terms of core beliefs and inner dialogue, may affect the outcome of our health.
Some time ago, I attended a presentation by psychiatrist M. Scott Peck. He talked with mental health providers about his struggles with neck pain, a problem that had plagued him for years. An operation resolved some of his pain, but he felt that there might be some negative underlying belief that was also contributing to the problem. He ultimately concluded that he was a conflict-avoider, lacking the ability to appropriately assert himself, refusing to “stick his neck out.”
Physical illnesses can be intensified by self-defeating underlying thinking that is a metaphor for the chronic condition experienced. For example, people with back pain may at times lack the “backbone” to express their thoughts and feelings courageously. Individuals with gastrointestinal problems may not be unable to “stomach” certain intolerable thoughts and feelings. People with headache syndromes may experience beliefs and thoughts about events that make them want to say, “Life is making my head hurt.” Eating disordered people may experience core assumptions such as, “I’m so angry that I could just vomit, or if I monitor my weight and eating habits, at least it’s one area in my life that I can control!” People with neurological pain such as inner ear disorders may exacerbate their pain by experiencing thoughts of panic such as, “Oh my God, here it comes again, that nasty, annoying pain. I’ll never get over this because the volume in my life is turned up too high.”
Anxiety, panic, and depression are typical characteristics associated with physical pain. The more effectively one manages these symptoms, the less troublesome the pain may be. Learning to cope with anticipatory anxiety by rationally responding, “Ok, I know that this pain can be troublesome, but when it comes I will do my deep breathing and manage just fine!”, or dealing with panic, “When a wave of pain comes, I’ll just go with it. It’s not a big deal, my scary feeling are time-limited, they’ll be over soon”), and managing depression, “Just because I feel awful doesn’t mean I can’t do things to stay active and make me feel involved” are important ways of adaptively responding to pain.
The following ideas are some guidelines for managing pain more effectively:
· Try to get you pain in perspective. Make a realistic appraisal. “In the scheme of things, how bad is my condition?”
· Don’t fight with your symptoms, it only makes them worse. The more you accept your symptoms, the more they are likely to diminish.
· Use various activities to refocus away from your pain. Dwelling on pain makes it more painful. Stretching, music, swimming, meditation, and other activities are important.
· Seek a multidisciplinary approach to your problem, if necessary. Get a team of healthcare specialists, including a quality physician, psychotherapist, physical therapist, message therapist or other providers of pain management.
· Develop a solid support system of family and friends. Also, there are many support groups in our community for people suffering from a variety of physical ailments.
· Remember, that the things we tell ourselves have an impact on our physical and emotional well-being.
James P. Krehbiel is an author, freelance writer, and nationally certified cognitive-behavioral therapist in private practice in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at http://www.booklocker.com/. He can be reached through his website at jkboardroomsuites@yahoo.com.

Authenticity and the Gay Identity

2008-11-19T19:33:00.000-08:00

Many years ago, when I worked in education, I spent my summers directing outdoor park district activities for kids. The children would come from the neighborhood to play various games. One year I recall a teenage boy coming to the park with a desire to talk with me. He attended a youth group at his church (which was located nearby) and then would meander over to the park facility. At some point in our conversation, he told me that he was gay and that he felt ashamed as a result his church’s anti-gay sentiment. He felt very alone because he had told no one in his youth group of his sexual orientation. His parents were not informed, and would have been mortified had they known of his sexual identity. Each time he came to the park we would talk about his struggles with being gay. Because I had trained student leaders to work with the park kids, I was able to devote some attention to this troubled young man. This was my first exposure in conversing with an individual who professed to be gay. I learned a great deal about a segment of society that played out their lives in agonizing silence.

Over time, I learned that gay people, like other minorities, are used to being stereotyped. Those of us who are straight, perceive gays to be effeminate, flamboyant, impulsive and artsy. Most of the gay people I have met do not fit that pattern. They typically feel isolated because their behavioral patterns are actually heterosexual in nature with the exception of their sexual affinity toward others of the same sex.

With the advent of multicultural thinking, gays are beginning to feel more comfortable and accepted. Their level of confidence affects their relationships and style of relating to the world. The acknowledgement of being gay takes supreme courage. The odds have been stacked against those who choose to make their sexual orientation known. Many adults, now in midlife, are just beginning to acknowledge their true sexual identity. With such exploration comes the awareness that “I feel a stronger sexual connection with those of the same sex.” Such a realization may signal the emergence of terror – “I am not who I pretended to be.”

When you listen to the stories of those who are gay, you get a sense of the conflict and tension they have experienced in their struggle to be authentic. Most have known from an early age that they felt different about their sexual identity. In an attempt to conceal their feelings and behavior, many gays worked feverishly at removing any vestiges of gay traits from their behavior. This is exactly what African-Americans have done as they experienced the distain from those who embraced a Caucasian world-view.

Adolescence is a difficult time of turmoil for most youngsters. Add to that the issue of sexual identification and it certainly makes the process of navigating adolescence that much more strenuous. Many schools are afraid to acknowledge their gay students and provide little or no support for those in need. Ideological and political pressures play a role in keeping school administrators and school board members from stepping up to the plate in support for gay youth.

In my professional counseling practice, I have personally witnessed the anguish and conflict experienced by those individuals who have professed to be gay. I have also observed the courage that many patients have demonstrated in the process of emerging from their silence over their sexual orientation. Learning to be authentic is an important component of counseling and to honestly identify one’s sexual identity may be apart of that process.

Although there is little evidence to support its efficacy, many counselors surprisingly continue to espouse reparative treatment for gay clients. Counselors, who many times disguise their intentions, choose to subscribe to the archaic notion that sexual orientation is a learned pattern or choice rather than a lifelong identity. Reparative therapy views the gay individual as disordered and in need of transformation. Generally, counselors who conduct reparative therapy for gays look for deep-seated traumas as a causative factor in the “identity conflict” of those they serve.

Counselors who insist on touting reparative therapy for gays typically maintain their own biases regarding homosexuality. They carry these biases into treatment and negatively affect the self-worth and integrity of those they serve. Their insistence in curing gays creates a climate of self-doubt and defectiveness among those they treat.

Many in the religious community are unable to reconcile their beliefs and faith and are reluctant to identify with those who define themselves as homosexual. This fact causes many gays to reject their faith or live in a constant state of religious conflict. Years ago, a friend of mine decided to spend a weekend of solace at a religious retreat center. This was to be a time of isolation and reflection. However, her time quickly took on a new meaning. Gay men from churches throughout the country flew into this retreat center. Many of them were board members, elders, and pastors of their congregations. No one knew of their sexual orientation with the exception of the hundreds of Christian colleagues who met at this retreat center to worship together once a year. Every year, these men got together in the freedom of their real identity and worshiped God. They talked with my friend, expressing their sense of liberation and love for the God they embraced. My friend said it was a moving experience as she was asked to join them in their religious services which were filled with energy and passion.

Denial is a dangerous thing. Those who choose to ignore their true sense of self pay a price for their own personal betrayal. It takes courage to live with the way things really are. There are pitfalls along the way, but integrity calls for being true to who we are and who we have become. Those in the gay community have the right to define themselves in a way they desire. Unfortunately, for openly gay people, there are consequences for living with an identity they did not choose.

James P. Krehbiel, Ed.S, LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.jkboardroomsuites@yahoo.com.

It's a Long Way from Richwood to the White House

2008-11-05T18:47:00.000-08:00

Several weeks before her death on July 26th of this year, my mother made an interesting discovery. Here was a 93 year old woman from Richwood, West Virginia, who clung tightly to her conservative Republican beliefs. But on this particular day, she smiled intently at me and proclaimed, "Barack Obama seems like such a nice young man." It was the first moment in my lifetime that my mother and I politically connected.

This country has been down a perilous path in the past eight years. We have struggled through the presidency of George W. Bush, who failed this nation with his lack of integrity, feeble domestic direction and disastrous foreign policy. With Bush at the helm, we fought the wrong war for the wrong reasons and are still paying the consequences in loss of lives and economic calamity.

We are in need of a new direction. Although John McCain stands out as a war hero, he has waged a campaign that is without substance. He has spent more time bashing his opponent than laying out clear plans to get the country moving again.

Barack Obama has the vision, intelligence and judgment to lead our country down a more positive path. His campaign has been steady, and his campaign organization has been stellar. He has been maligned by many, some on this site, who ironically use their Christian faith as the basis for divisive comments. Accordingly, he is the "Muslim," "the enlightened one," "the anti-Christ," "the radical," "the terrorist," and “a Hitler.” He was also deemed guilty by association, as if John McCain didn't have enough affiliations with troubled individuals himself.

Barack Obama's concepts and ideology mirror many valuable Judeo/Christian principles. He is not interested in continuing to feed the pocket-books of the wealthy. He personally identifies and has compassion for those of our comrades in need. He has one wife, one house and tattered shoes. He understands the needs of the middle class and the poor. By focusing on this country's crumbling infrastructure, he will get our people working again. His administration will create new jobs that will spur the economy. He understands that a "trickle down" economic policy does not work because the wealthy are tainted by their greed. He will work toward providing healthcare plans for all Americans. He will prioritize the budget and will eliminate wasteful governmental spending.

His foreign policy will be founded on the principles of diplomacy, not power and control. He will fight the right war in the proper place, on the border of Pakistan and Afghanistan. We will regain our respectful standing in the world through promoting understanding rather than division. His vice presidential selection, Joe Biden, is ready to step in on the international stage. We will regain our credibility at home and abroad as Obama seeks to call out and prosecute those in our government who have shredded the Constitution, needlessly tortured prisoners, demonstrated political collusion, and overstepped executive privilege.

Those Christians who would try to reduce this election to a referendum on abortion are mistaken. Most reasonable Americans do not "believe" in abortion. Rather, they embrace the sanctity of life, and believe that such a concept is much broader than any narrowly focused discussion regarding this complex moral dilemma.

This is the most exciting election I've ever witnessed. For the first time in history, an African-American candidate is positioned to become President of the United States. The first 16 presidents of this country could have owned Senator Obama as a slave! How far we have come as we look forward to a new day in American history. I pray for him and his family as he seeks to lead this country out of turmoil.

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He can be reached at (480) 664-6665.

McCain and the Mob Mentality

2008-10-12T10:31:00.000-07:00

Barack Obama has become a metaphor for those who are considered culturally different. Disturbingly, we have been down this road of hatred and divisiveness before. Who can forget the chilling memories of America's civil rights leaders being slain, segregation being fostered, synagogues being burned, black citizens being lynched, and law-abiding Muslims being shot and killed after 9/11.

This is the dark side of America that I'd rather forget, but once again has reared its ugly head through the campaign discourse of John McCain and Sarah Palin. McCain and Palin’s campaign rhetoric directed against Barack Obama has fueled the basest instincts of many misguided Americans.

McCain's effort to link Obama to a terrorist Muslim script is rooted in the most despicable form of hatred and bigotry. The fire has been stoked, and now his supporters are cheering McCain and Palin with chants of… "Obama is a terrorist, kill him!" Having crossed that ugly line, even the candidates themselves have been unable to stave off the damage they have wrought.

This pattern of inflaming the bigotry of the masses through divisiveness and venom is frighteningly reminiscent of the Nazi regime during World War II. Adolf Hitler and the German Nazis, under the elitism of white Anglo-Saxon Protestantism, sought and successfully slaughtered those who they perceived as ethnically and racially different. As Germany fell on hard economic times during the global depression, they looked for scapegoats to explain their financial decline. It wasn’t long ago that the Jews, those associated with Jews, Russians, the mentally ill, the physically disabled, artists, and the intelligentsia were sent to concentration camps and murdered. The mob mentality had worked and "cleansed" Germany of those who were perceived as funny looking and different.

John McCain and Sarah Palin have sought out the politics of personal destruction. They have willingly tried to demonize Barack Obama by painting him as an evil outsider who is a threat to the security of our democracy. Amazingly, some Christians have made this a personal vendetta by suggesting that Obama is the anti-Christ. On the other hand, other so-called God-fearing Christians have suggested that he portrays himself as a messianic figure.

The myth of moral superiority is that those who lay claim to know it all by smearing and hatemongering behavior, are the ones who need to "take the log out of their own eye" as Jesus suggested. As Sarah Palin lays claim to being the moral compass of the McCain campaign, she has opened herself to scrutiny as a result of unethically abusing her power as governor of Alaska.

When McCain finally called Obama "a decent" candidate, he was jeered by his own supporters. It is this vitriolic venom that should remind us all that this is a country filled with the beauty of diversity, and that we must never allow such mindless people to create another Holocaust, because we turned our back and ignored those who would perpetuate a lie. As we have seen in recent days on the campaign trail, the hate-filled, spiteful mobs are still there to remind us all that we must be vigilant. We must speak out against the threats and fears generated by those who have the power to create the conditions for another genocide.

Maintaining Sibling Relationships As We Lose Our Parents

2008-10-01T15:57:00.000-07:00

We of the baby-boomer generation are feeling the pressure as we provide care for our elderly parents. It is painful as we helplessly watch our loved one’s experience the impact of failing health. We feel powerless against the ravages of deteriorating health and mourn our losses as our parents begin the descent involving their incapacity to live independently. Children undergo the process of grieving as our parents move closer to the end of their lives. Family dynamics may shift.

The process of grieving hopefully may bring healing and closure to children who care-take for elderly parents. However, more typically, it takes its toll in creating upheaval and conflict among the children. As elderly parents come to the end of their lives, the grieving process may serve as a catalyst which affects core issues and dynamics among the surviving children. If there are unresolved issues harbored by any family member, they will invariably surface during this time of distress. Grieving and loss have a way of opening the door for unfinished psychological business that has been “swept under the rug.” One can only hide the pain for so long and then inevitably the truth, wrapped in emotional baggage, will make itself known.

The children of an aging parent are forced to deal with a myriad of new decisions and problems. However, legal, financial, and questions related a parent’s possessions tend to be the focal point for conflict among siblings during the process of parental decline. Children, who face these issues with their unresolved baggage, create tension for the entire family system. Hopefully, parents help minimize the impact of sibling conflict by structuring their will and financial matters effectively.

Quibbling over finances or belongings may represent the way in which children play out their unresolved conflicts toward the elderly parent and their interaction with each other. They may feud over jewelry and other personal possessions belonging to the parent, leaving the elderly parent feeling resentful or guilt-ridden. The turmoil may exacerbate the parent’s declining health. Misunderstandings may exist over who gets what and when. Interpersonal conflict emerges when the grieving process serves as a metaphor for unfinished family business. Although most parents dread the prospects, it is not unusual for children to break communication with each other after the death of their parent.

Because feelings are more intense during the declining health of an elderly parent, the children are more prone to become reactive. Reactivity leads to anxiety, and anxiety promotes misunderstanding and defensive communication. Like the advent of premarital counseling, perhaps there should be therapy for children who are trying to navigate the process of caretaking for an elderly parent in deteriorating health.

What are some of the ways that children can cope more effectively while caretaking for an elderly parent and avoid the traps that cause interpersonal damage?

Make sure that there are legal documents in place, including a will, durable power of attorney, and a trust. They should be updated, particularly if there is any transition from state to state.
Make sure that your parent specifies, outside of the will, items to be distributed equitably to all family members.
Children of the elderly need to work on responding, by promoting understanding, rather than reacting with defensiveness and resentment.
Children should seek professional counseling assistance when they are unable to manage their personal grief and it begins to affect their functioning as well as other family members.
Learn to keep things in perspective. Money and things are not worth severing relationships and causing hurt feelings within the family. Our legacy and our families should be based on the quality of our relationships.

Caretaking for the elderly is a difficult process. It takes patience, wisdom, and the ability to sort out issues related to our parents and siblings. We must take the high road consisting of integrity when dealing with our family members. There are not guarantees that they will do the same. Nevertheless, we must vow to make peace with our past, care for our parents, and let go of our loved ones in a way that will bring peace and healing to our life. In doing so, we will never have regrets.

CHUCKLING YOUR WAY THROUGH THE GOLDEN YEARS

2008-07-03T20:54:00.000-07:00

No matter what the experts say, aging is difficult. It takes a fair amount of luck, good genes, family support and activity to make this journey work. There is one added quality that really lightens the load as the elderly are faced with their "golden years," and that is the capacity to laugh at oneself and life.

As the aches and pains start mounting, and the aged begin to feel alone in their plight, humor is a powerful potion for sustaining an attitude for success. Life becomes a chain of mountains to climb, and the hiking is much easier if the elderly navigate their journey by poking fun at a world filled with challenges. Seniors must learn to float downstream, buoyed by the water as they pass by the twigs, branches and rocks along the current of life.

When it comes to humor, the late George Carlin would have been proud of my mother. At 93 years old, she can take a life event and turn it into an amazing, dramatic story filled with adventure and lessons to be learned. Recently, she had a stint in the hospital due to atrial fibrillation, an indicator of congestive heart failure. Although my mom's heart is pushing enough blood, the upper chamber is showing signs of wear and tear.

When she was released for home from the hospital, my mother graduated from two pills to an assortment of blood thinners as her cardiologist sought to regulate her heart-beat. She stayed in a nursing care facility for awhile and then was sent back to her independent living apartment on a trial basis. Several days later at 5 a.m., she fell in her bathroom and landed on her hip. She had the presence of mind to crawl to the pull-cord to get the attention of the nursing-care staff. They promptly arrived, called me and contacted the paramedics for another round to the emergency room.

When I got to the ER, she dejectedly said, "Son, I'm sorry I messed up." "Did you use your walker to get to the bathroom?" I replied. "No, it was filled with all kinds of papers," she sheepishly disclosed and continued with, "but it was VERY CLOSE to the bathroom,” as if that mattered. They x-rayed her hip and she had fractured it - her femur needed fixing. When she got up to room 2107, the staff moved her onto her hospital bed. An internist promptly visited her and she inquired, "What time is it Doc?" "It’s 8 a.m. young lady. Why do you ask?" “I need to get out of here in an hour. I've got to go to the beauty shop. I can't lay here looking like this. By the way, how do you say your last name?" The doctor spoke slowly…"G-H-I-A-M-A-D-I …GHIAMADI,” he said. "Oh my, that must have been a serious problem for you when you were in grade school," she retorted.

For the next few days, the cardiologists monitored my mom’s vitals trying to get her ready to handle surgery. My wife commented to my mother about the excellent nursing care she was receiving. "You're getting so much attention, Oma." "Yes, and I might even get a tiara at the end of the day if I play my cards right,” she replied.

Several days later, surgery was "all systems go." The launch had been delayed several times, but now we were doing the countdown. Exasperated, my mother put the nursing team on alert. "Let's get this show on the road. Just make sure they "cut" the right leg off," she jokingly said. As they wheeled her down to surgery, she kept it up, "Where are you taking me? It looks like we’re headed for the parking lot. Hey, don't let ‘em stick a knife in me if I'm not ripe enough!"

When we got to the pre-op area, a nurse met us there. When the nurse bent over to take my mother's necklace off, my mother was amused. Hey, I guarantee you it's been a long time since anyone's looked down that area." When the nurse finished chuckling, she asked my mother the critical question. "Which leg is being operated on today?" Mom was playing it coy. "I really don't know," my mother replied. "Is it the left one Gladys?" the nurse said. "I think it is right; I mean, I think it is right that it's the left one … is that right?" The morphine didn't seem to affect her wit. It reminded me of Abbott and Costello, but this one was a monologue.

She took the liberty of putting her surgical cap on before the anesthesiologist came to give her the "juice." The orthopedic surgeon strolled in and asked my mother if she had any questions. "I only have one question for you. Are you REALLY old enough? My daughter tells me you were born in 1970. Is that right?"

The anesthesiologist entered and told my mother that her heart could handle the surgery and he proceeded to inject her in the arm so she could take a nap. "The surgeon looked so young. How old are you?" she asked. The boyish doctor said, "How old do you think I am?" "I think you're about 62," my mom replied. He grimaced and left for a minute and when he came back my mother had adjusted her assessment. "It's in my best interest to say that I'm sorry. With your cap on I thought you were older. You really must be around 45. You see, my son is in his early 60s, and I like him a lot." As I gave her a peck on the cheek, she was off to surgery and as she turned her head I heard her say to me, "Good luck on your new book. I hope it's a success."

I never had a doubt that my mother would make it through surgery. She had successfully created an atmosphere that put everyone in her sphere of influence at ease. She chuckled her way through a revolting predicament and brought everyone with her into her humorous inner world. As my mother always believed, she was making funnies, the tried and true method of traveling through the golden years.

WHY SCOTT MCLELLAN CAME CLEAN

2008-06-05T18:50:00.000-07:00

Most people, familiar with the workings of the George W. Bush White House are not surprised by the revelations of Scott McClellan in his riveting new book entitled, What Happened. His account punctuates the deceit and deception orchestrated by an administration that lied about the run-up to the war in Iraq and the deliberate leaking of intelligence information.

The most pointed question is, why did Mr. McClellan choose to reveal his story? After all, providing the propaganda spin for the White House in no way left him accountable to share his narrative upon leaving Washington D.C. McClellan describes his experience as press secretary as being in a bubble. Within this bubble, he passed along convoluted political spin while remaining in a protracted campaign mode.

As I mention in my book, Stepping Out of the Bubble, staying in the bubble represents the comfort zone, a place where we avoid the challenges and paradoxes of healthy living. The bubble protects us from having to confront reality. It is the place where we minimize and distort the full impact of real-life experience. The bubble is like an insulated cult - it protects us from the truth.

Like a polygamist leaving the sect, McClellan's departure from political life led him to encounter the realities of civilian life as his political perspective subtly began to shift. McClellan was forced to grapple with a huge dose of reality when he testified before a grand jury in the Plame investigation on February 6, 2004. His deposition and grand jury testimony could not have been a comfortable experience. He must have reflected on his prior disclosure in a press conference when he said "the president has made it clear that he wants to get to the bottom of this matter (Plame case), and that anyone who has information that relates to this that can help the prosecutors move forward and get to the bottom of it should provide information to the prosecutors."

I believe that testifying about these Plame-related matters may have forced McClellan to step out of the bubble about what he knew regarding the president's and his subordinate’s role in leaking intelligence information. Once McClellan had been debriefed by the grand jury, he must have experienced immense internal conflict. I believe that he must have felt enormous shame and betrayal and was primed for further disclosure.

I believe that Scott McClellan told his story because he is an intelligent, honorable person who could no longer live with the burden of a lie. If he maintained the lie, he would lose himself. He told the truth, not for monetary gain, but because he was conflicted and wanted to rid himself of the weight of scandalous propaganda and behaviors that he validated as press secretary for the president. The shame of it all caught up to him and his disclosure is a way for him to acknowledge the scripted verse (referenced in his book) on the University of Texas tower which says "Ye shall know the truth and the truth shall set you free."

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at Amazon.com. James is the Shrink Rap columnist for TheImproper.com, an online site in NYC. He can be reached at www.krehbielcounseling.com.

HOW ABUSED WOMEN CAN BREAK THE CYCLE

2008-05-24T20:48:00.000-07:00

Self-destructive Cycle of Victimhood Starts in Childhood

Women, who have a history of mistreatment in relationships, tend to place themselves back into relationships with men that foster further abuse. Often, after the damage, women appear to be mystified as to why they set themselves up. They are easily lulled back into situations that potentially blindside them to personal attacks and betrayal.

Origins in Childhood

So what is the trigger that causes women to repeatedly choose to put themselves in harm’s way? There is a fascinating dynamic that originates when women are victimized by a troubled childhood; in adulthood, they tend to fluctuate between shame-based feelings and a sense of vulnerability to control. Women, who experience an absence of parental validation from childhood, will seek affection and attention at all costs. They will move through every stop sign imaginable in their effort to get "right" what went wrong during their difficult past.

A lack of validation from childhood leads a woman to be vulnerable to emotional hurt which includes self-doubt, shame and blame. This mix of feelings fuels the pattern by attracting men who invade their personal space. The same useless interpersonal dance gets replayed over and over again. Putting themselves back in the fray is a women's way of trying to fix that which remains unfixable - the domination of controlling men.

It’s Never Too Late to Embrace Positive Change

As they reel from additional assaults, these women eventually retreat into their private, emotional world. Then the cycle resumes. Rejection and self-blame lead to anxiety, followed by the quest for validation from those who can't give it. These ladies believe that if they try hard enough, they can fix any damaged relationship. Their illusion about the way things "should be" clouds their judgment and leaves them susceptible to further abuse. How do women break this cycle?

· Let go of the dance and embrace the shame and fear.
· Acknowledge self-blame and discover that the relationship wreckage never was about you.
· Learn to experience the kind of constructive anger that says, "I deserve better."
· Fight the urge to get in harm's way with those who would "flip things" by creating conflict. Stay above the fray.
· Rationally respond to self-blame and vulnerability with positive self-talk.
· Set appropriate boundaries that detach you from partners who might choose to exploit you through intimidation and fear.
· Surround yourself with those who are validating and drop male friends who try to manipulate you as a way of bolstering their own ego.
· Create new, positive goals, relationships and activities.

Women who desire to leave behind their childhood pain must learn to shut down the pattern of being exploited by those who seek to continue the cycle of abuse. Women who have been abused, can learn to take a step back, refusing to “take the bait” while letting go of the patterns that previously put them at risk. Only then can they overcome the emotional trauma of their childhood and get themselves unhooked from the men that repeat it.

MUSINGS ON BEING A CONSERV-ATIVE

2008-04-23T17:10:00.001-07:00

Running for political office has never been a wish that I aspired to pursue. God forbid that I would consider that with all the corruption and mud-slinging that goes on, reminiscent of this election cycle. However, I feel the need to go on record, and confess that I am a compassionate conservative - a progressive sort of conservative. So let me explain…

In my opinion, a true conservative is one who is dedicated to being cautious by nature and in principle. I consider myself a fiscal conservative because I balance my check-book and only spend what is within my means. I don't live extravagantly and have no credit card debt. I don't drive fancy cars and buy over-priced items. Contrary to this country I love, I balance my budget to the glee of my wife. I believe in "paying as you go” for social programs. This concept has worked marvelously for the Illinois Tollway and I believe that once again it should be adopted as a conservative governmental standard.

I believe that if we prioritized better, those who financially suffer could get relief. I am conservatively cautious about going to war. As we know, our current war is costing the taxpayers a lot of money, and I have concerns about why we went into Iraq (not Afghanistan) in the first place. I also wonder why we are still there. Can you imagine what we could do with trillions of dollars to build our country's infrastructure and assist in helping the poor and needy? Our national debt is skyrocketing, and this liberal policy goes against the conservative ideals of balancing the budget.

Conservatism is also about protecting things like the environment. I prefer to call it "creation care." When it comes to global warming, conservatism is at a crossroads. More and more business leaders, evangelical Christians and other progressive conservatives are calling for action to reduce the risks connected to man-made climate change. Unfortunately, more reactionary conservatives continue to attack those who act to reduce emissions, and belittle those who are concerned about our planet. One would assume that environmentalism would make conservatives enthusiastic. The root of conservative and conservatism is directly related to the word conservationism. So why is it that reactionary conservatives such as Ann Coulter, Dick Cheney, James Dobson and Jonah Goldberg are the loudest voices advocating recklessness? What is conservative about “sticking up your nose” at the preponderance of mainstream scientific evidence?

As a conservative, I believe in moral integrity and family values. I don't like politicians who lie and makes it very difficult to decide who to vote for in the upcoming political election. I don't like congressmen, governors, mayors and presidents who lie about their sex lives when it affects the American public. I am also morally outraged by those who use their political power to lie, stonewall and cover-up their egregious mistakes and crimes.

If I were a progressive conservative Christian preacher, anybody could come to my church as long as they left their guns at home. I would welcome the sick, the needy, the gays, the Muslims and atheists. I would preach a Gospel based upon the principles of love, compassion, tolerance and encouragement. There would be no divisiveness in my message. In the pulpit, I would not deliver hatemongering, bigoted snippets like Reverend White, Parsley and Hagee. I would not act morally superior, but show respect for all faith traditions realizing they all share kernels of truths that bind people together. However, I would exercise my right to share truth and faith as I see it (the Gospel) and hope that others would sense the same yearning that I experience for knowing God in a more intimate way. In my church, if a young girl was pregnant, I would welcome her with open arms so that she didn't feel the need to slither away and impulsively terminate her pregnancy - that's pro-life in action.

As a progressive conservative, I feel a need to show by my behavior that I truly believe what I say. I can usually reconcile my beliefs with my experience. However, there’s a disconnect between progressive conservatives and their public voices. True conservatives are not opportunists who play to the crowd and in the process misrepresent others who are more tolerant. I am a progressive conservative who wants nothing to do with those who grandstand by smearing others who share different values, lifestyles and faith traditions. I am not driven by the fear of “rubbing elbows” with those who share a different worldview. I want to be a unifier, not a divider. I hope that this country gets back to sharing my ideal for fiscal responsibility, compassion, tolerance and unity. This is my passionate plea for America.

WHAT DO I KNOW FOR SURE ANYWAY?

2008-03-24T18:49:00.000-07:00

The older I get, the less I seem to know for sure. It's not that I lack wisdom, but life is not a clear-cut, fixed matter, but an ever-changing, fluid experience. Each moment is new and is filled with the wonder and mystery of the unknown.

As a child, life appeared certain. I lived in a comfort zone which protected me from the reality of a world complete with ambiguity, paradox and difficult challenges. As I became older, reality uprooted the foundation of my world. I could no longer hide behind my black and white thinking that served me well as a youngster.

As an adult, I learned to embrace the insecurity that comes with the unpredictable nature of life. According to Alan Watts, holding onto security is like trying to grab water into your hands - it is elusive. Holding too tightly onto matters brings to mind "the law of reverse effort." Hanging on is more likely to make us feel out of control.

Although the very fabric of my life has been shaken, the good news is that things appear adventurous. Every day is a new journey, with excitement as I travel into the unknown. I am on a wild, crazy ride that leads me to conclude, "What do I know for sure, anyway?"

Consider this. One traveler gets on a plane with a destination for home. She is excited about seeing her family. However, the plane goes down in the Everglades of Florida and all passengers are lost. A friend of hers makes a last-minute change in her flight plans, deciding to stay in Miami for another day. She wakes up in the morning and is confronted with the horrible news. Why did she survive, while her friend did not? Some would like to provide us with the comfort of their philosophical or religious explanations. In my opinion, they are not good enough.

A child is raised in a home filled with parental abuse. As he enters into adulthood, he struggles to "find himself" and eventually ends up being a successful partner, father and businessman. His brother grows up in the same environment, and moves into adulthood lashing out at the world, blaming others for his failure to function and achieve. Is there an answer to this dilemma?

I have a disorder called fibromyalgia. Some doctors think it's "in my head." All I know is that I chronically ache all over with trigger points on muscles that hurt on contact. It is painful when my skin is touched. Does anyone know why this happens? There are clues, but no definitive answers and no clear-cut solutions to fix the problem. Women tend to suffer from it more than men. I'm not sure why that's the case and neither are the doctors.

More kids these days are suffering from autistic spectrum disorders. It appears to be a neurologically-based problem which affects children's ability to communicate and establish appropriate social relationships with age-mates. These children appear rigid and controlling in their behaviors and latch onto a topic that they perseverate about. Nutritional clues to this syndrome have not materialized as causes, so we are left with an uncertainty as to why autism occurs and why it is increasing in frequency. There are no easy answers.

Consider this. There are individuals and groups who feel that they know it all. They tend to have all the right answers, and can back their ideas up with "talking points," biblical interpretations, and personal experience. For these people, life appears easier because there are no gray areas or ambiguities in life. They boss-manage and tell others how to believe.

Individuals who always think they are right are frightening to me. Hitler claimed he was right and look what happened as evil impacted the lives of millions. David Koresh believed he was right and what a mess he made. For those who profess to be right, there are no options to their way of thinking. Just recently, I read a politically motivated article in which the author ended with, "Jesus Christ endorses this message." I believe that using religion in this way is disingenuous and blasphemous - but, what do I know?

I wish life was as simple as many make it out to be. I would feel less strife. However, it would not be authentic. It would leave me living in a bubble away from the complex realities of life. The simplicity would also take the adventure and wonder out of living with uncertainty. I do not know why certain things happen the way they do. I can live with that. After all, what do I know for sure anyway?

James P. Krehbiel is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

COGNITIVE-BEHAVIORAL THERAPY AND WEIGHT-LOSS

2008-01-18T20:29:00.000-08:00

The weight-loss industry is alive and well. If one is overweight, the choices of diets, nutritional supplements, herbal remedies, exercise programs, support groups, and motivational programs are endless. If devouring a carton of ice cream doesn’t stress you out, ruminating about one’s weight-reducing options can sufficiently reduce one to tears.

If there is a quick fix to maintaining the loss of weight, I have yet to see it. There are plenty of ways to lose weight, but what about the process of keeping it off? Often people bounce around from one dietary plan to another as their weight fluctuates during their quest for the perfect plan. They may deny the reality that there is no panacea for proper weight maintenance. It is a multi-faceted process.

Often, individuals become obsessive with the weight-loss pattern. Weight-loss and weight maintenance can become a ritualistic, compulsive cycle. Charlie Whitfield, author and addictions expert calls the pattern the “repetition cycle.” Anxiety and depression mount, followed by the urge to eat, leading to self-indulgence, and ending with symptoms of self-blame and guilt. Then the cycle of abuse repeats itself. Paradoxically, those who follow an addictive quest to lose weight may actually end up sabotaging their own goals.

From childhood, we are conditioned to believe that the only way we can change is when we are coerced. Therefore, we learn to mistrust our instincts and believe that if we give ourselves enough rope, we’ll hang ourselves. Without exploring the psychological issues that may be triggering weight problems, most people will be doomed to repeat a pattern of self-defeating behavior. We must understand that we are more than the pleasure center of our brain. We are much more than the darkest side of our soul. Many may say that if I am not intolerant of my mistakes, how will I learn to motivate myself to change? However, real change only occurs when we learn to respect and value who we are with all of our faults.

Because of its value in dealing with an individuals thinking, distortions, and beliefs, cognitive therapy is the most effective therapeutic treatment for those who seek to lose and maintain weight. Cognitive therapy helps people make rational assessments of their weight, and assists people in responding with self-affirmation to their maladaptive thinking about eating and body perception. Whatever one’s demons happen to be, people need to move forward and treat themselves as if they deserve the best things to happen in their life.

Self-defeating thinking and behavior tend to perpetuate the cycle of unhealthy eating. No amount of exercise or nutritional support will address the need for individuals to learn to rationally respond to their maladaptive eating patterns. Unhealthy eaters are typically overwhelmed by self-blame. A downward spiral is set in motion by the way in which the person views himself. Unhealthy eaters will label themselves as being “fat” (whether they are or not), and will chastise themselves for not making progress in losing weight. Viewing oneself as an “overweight louse” is not an effective way of motivating oneself for change. In fact, browbeating oneself for being less than perfect only intensifies the cycle of unhealthy eating abuse. Self-blame is a form of tyranny which keeps one stuck in the midst of the problem.

Cognitive therapy teaches the unhealthy eater to quit the self-blame, realistically assess the problem, and to set practical goals for change. The therapist may say, “Does eating too much make you a horrible person? In the scheme of things, how awful was it that you ate that extra helping of cake?” Realistic appraisal follows, “what do you think you can do next time to make sure that you don’t overdo it?”

Cognitive therapists also assess body misperception. Many people who eat in an unhealthy fashion may tell others that they are fat. Labeling oneself in a negative manner is one of many cognitive distortions that hinder weight-loss progress. In many cases, the individual’s concept of their weight may be exaggerated. The therapist may say, “Does calling oneself morbidly obese change anything? Or where’s the evidence that you are as overweight as you think you are?”

Most unhealthy eaters experience thwarted anger. Rather than direct their resentment at the source of their difficulties, they self-sabotage by internalizing their anger and directing it toward themselves through unhealthy eating. They may feel frustrated by the conditional nature of a relationship, may have a family member who humiliated them about their weight, or experienced rejection through social betrayal. As confidence was stripped away, they developed a negative concept of self which fueled their unhealthy eating pattern. The self-blaming message is usually, “I guess I really am a slob, so the best I can do is to continue to prove it to myself.”

Unhealthy eaters can untwist their maladaptive thinking and meet their weight goals by:

Learning to rationally respond to negative thinking. For example, instead of saying, “I’ll never meet my weight goals, I’m just worthless,” one might say, “Just relax and be patient, Rome wasn’t built in a day.”
Identify cognitive distortions such as castastrophizing, labeling, personalizing, and black and white thinking. An example might be, “If I can’t lose 5 lbs. this week I might as well give up” (black/white thinking).
Instead of being unkind to yourself, talk to yourself the same compassionate way you would to a dear friend who is experiencing the same weight problem.
Instead of assuming your negative thoughts are accurate, examine the evidence that supports your conclusions. “If I don’t lose 15 lbs., will people really think I am hopelessly obese?”
Instead of taking full responsibility for your weight problem, you can assess the many factors that may have contributed to it and address those issues with the support of others.
Set a realistic agenda. Ask yourself, “What would it be worth to me to stop my unhealthy eating? How hard am I willing to work on a rational solution?”
Evaluate weight maintenance progress based upon the process – the effort you put in – rather than the outcome. Your efforts are within your control, but the outcome may not.
Substitute language that is less emotionally loaded. “I shouldn’t have eaten that extra helping” can be redefined as, “It would have been preferable if I hadn’t eaten more.”

Often, people will expose themselves to a diet that will dramatically assist them in losing excessive weight only to have the weight return. Instead of “quick fix” diets, setting a realistic agenda for weight-loss is a more rational, thoughtful approach. A slow, gradual loss of weight helps us to more easily adjust to the psychological ramifications of body perception change. Weight-loss goals need to be established because we prefer the change, not because others want it for us. Feeling coerced to change, or sensing that others acceptance of us is conditional upon weight-loss will lead to resentment and a feeling of helplessness in our quest to change. Instead, we must vow to learn the difference between self-indulgence and self-respect and work to put self-kindness into our everyday experience and choose our relationships based upon these positive qualities.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He is the author of Stepping Out of the Bubble, the story of courage and risk taken by those who seek to better their lives. James can be reached at www.krehbielcounseling.com.

HOW TO RESPOND TO TRAGEDY

2008-01-04T19:22:00.000-08:00

Rabbi Harold Kushner, the author of When Bad Things Happen to Good People, wrote about his response to personal tragedy. His son Aaron had premature aging, and eventually died from this disease. The pain from the Rabbi’s loss provoked a crisis of faith. Kushner wrote his book for those "who have been hurt by life," to assist them in finding a faith that provides reasonable answers to aid them in coping with their suffering. Kushner explores the random nature of life and how certain spiritual explanations for tragedy left him feeling empty.

Recently, I made a trip to visit a friend who has terminal cancer. This was no easy task. I knew that it would be our last visit. I struggled over the issue of what things I wanted to explore to make sure that the time we spent together was uplifting for both of us. I was apprehensive about "saying the right things," but as I drove to her house I kept reminding myself to "just let things be the way they are." It was a time of closure and healing for both of us.

All of us are confronted with times of suffering. It is an inevitable part of the human condition. We are abused by a partner, we lose a job, we are betrayed by bandits who rob our homes, we experience the death of loved ones and we struggle with serious illness. No reasons adequately explain our hurt and disappointment. We are left with our grief.

Often, family and friends make honest attempts to respond to our trauma, but they may make matters worse through insensitive comments. In the name of God, they may make comments that leave us feeling annoyed and misunderstood - the very thing we do not need. Here are some of the unhelpful comments that I am referring to:

God will never ask more of us than we can endure.
Try not to think about it.
God is trying to teach you a lesson.
Don't let it get you down.
Everything that happens in life happens for a purpose.
God has singled you out because he recognizes your strength.
Getting upset about it doesn't do any good.
If you are not healing from your affliction, you lack faith in God.
Just remember, other people have it worse than you.

Trying to figure out why misfortune happens to us is fruitless. Some things appear to happen for no reason. As Kushner indicates, although there is ample evidence of God's handiwork among us, people are unable to accept random acts that occur within the universe. This leaves us feeling deprived of structure and security. I believe it’s not our searching for the reason for affliction that's important, it is our reaction to. This is where our faith in God becomes important. When one is "down and out" here is what you can to say to people:

Tell me how you feel about what happened?
That must feel awful.
It's not your fault that this happened.
Tell me how I can help you?
Would you like to talk more about it?
I am sorry that happened to you.
I'll keep in touch more often.
I'll pray for you and your family.
I'll be there for you.

We need to learn to be more sensitive to those who are suffering. As a partner or friend, our role is not to fix matters, but to learn to become a good listener. We must listen without trying to provide reasons and explanations that are not helpful. As I said, we must "just be there and let things be the way they are."

James P. Krehbiel, Ed.S., LPC, is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

IS JESUS A REPUBLICAN?

2007-12-08T14:40:00.000-08:00

As I ponder decisions on an everyday basis, I ask the question, “What would Jesus do under similar circumstances?” Often, it is difficult to decipher the right answer that would lead me down the path of personal piety.

Recently, I had a dream which had a dramatic impact on my way of looking at the world. During the dream, God clearly conversed with me in an audible tone. I recall what He said because it startled me to the point of waking me out of a deep sleep. When I was finally more lucid, I recall Jesus saying to me – “I am a right-wing Republican, and you have been remiss in failing to follow in my footsteps!”

I immediately sensed that His statement would have the affect of turning my world upside down. I got up, took a shower, had breakfast and contemplated what I should do in response to this perplexing news. Immediately my mind flashed to Pat Robertson, the preacher from The 700 Club who miraculously leg-pressed 2000lbs. If anyone could confirm the veracity of my synchronistic, spiritual experience it would Reverend Robertson. It was Pat Robertson, along with Oral Roberts, Jerry Falwell and others who had ample experience with this issue of divine intervention. So I contacted Pat Robertson to make sure that I was not delusional. Pat emailed me back providing me with confirmation that I was clearly hearing the voice of God.

Trusting Pat’s wisdom regarding my pipeline to the Almighty, I realized that indeed Jesus had talked to me and was staking His claim as a bonifide right-wing Republican. My mind then aimlessly wandered to another thought. What changes was I supposed to make in response to this dramatic disclosure? In order to follow in His footsteps, what issue did I need to proclaim with evangelical fervor? Numerous ideas flooded my mind. If I was to be God’s vessel, I needed to:

Dissociate myself from any vestiges of Hollywood. Burn all of my CD’s with the exception of my Bon Jovi collection.
Renounce global warming since it is the brain-child of internet guru Albert Gore.
No longer watch The Oprah Show.
Practice the word abomination. Write it ten times in a sentence for a week.
Learn to think black and white without being wishy-washy.
Believe in my beliefs even if they contradict my experience.
Embrace the euphemism of pro-life even though it is inconsistent with the eyes of despair and death from pre-emptive war.
Believe that the United States is the only country that receives God’s special blessing and favor.
Profess that the axis of evil only exists in the hearts and minds of other countries, never our own.
Believe that some sins are worse than others, especially the Big Three.
Renounce the concept of separation of church and state because our country was founded on Christian principles. Faith-based initiatives should receive tax breaks even if they are exclusionary.
Keep the government out of dictating whatever people want to do even if it hurts themselves or others.

As I pondered my new list of proclamations, I felt a sense of relief. All of my new “talking points” were simple and understandable. God had delivered His message. Jesus was as right-wing Republican and He had given me a new set of principles to follow. No longer a “bleeding heart liberal,” I made my way out into the community to share my new perspective.

James P. Krehbiel, Ed.S. is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.amazon.com. James can be reached at www.leavingthebubble.blogspot.com. or www.krehbielcounseling.com.

ARE YOU PREACHING TO THE CHOIR?

2007-11-29T20:04:00.000-08:00

Today I read an article by an atheist, which demonstrated more common sense, moral integrity and civility than many within the Christian community. As a Christian, are you preaching to the choir?

Recently, I have read the "talking points" from Christian writers (receiving kudos, by the way) that focus on the denial of global warming, liberal political bashing, the hating nature of God, the "abomination" of homosexuality, and the anti-God movement in the schools. Writers of a similar mentality rally around these folks and pronounce their "Amen’s."

I believe that one of the purposes of writing is to reach a wider general audience, particularly as a Christian writer. As a Christian writer, are you careful and responsible to write only information that is original to you? One can certainly maintain integrity, make a clear statement and accomplish this goal. However, I believe there is a “disconnect” between many Christian writers and the general public. They lack integrity and are preaching to the choir.

Cognitive dissonance is a term which describes the tension that results from a set of beliefs that can’t be fully reconciled with experience. My father believed that African Americans were second class citizens, and yet he treated all people with grace and respect, especially those less fortunate. The distinction between his beliefs and experience was disturbing to me.

Years ago, I befriended a senior pastor of a mega-church in the Chicago area. We went to breakfast together and I served as a needed sounding-board for him. His daughter, who was rebellious, got pregnant when she was 15 years old. He sent her away to live out of state with relatives during the pregnancy and after the delivery of the child. As far as I'm aware, apart from family members, I was the only soul that knew of this man's dilemma.

I asked him why he sent his daughter away. I found his response alarming. He said that he was embarrassed, and that he wanted to protect his daughter from the shame of the congregation! Conservative Christian "beliefs" don't always match experience – this is cognitive dissonance. Oh, we love to go on about "saving babies," but who really wants to care for them, or at least not judge the parent who has had the child out of wedlock? Christians are great in talking about prevention, but not good at teaching responsible sexual behavior and supporting those who have made life-altering mistakes. We must “walk the talk.”

I am a lucky man. This morning I walked out to my backyard. My house is nestled near the foothills of our beautiful mountains. I was disheartened as I observed the haze and smog that clouded my vision of this gorgeous site. My experience tells me that something is horribly wrong. I don't need check my beliefs or Bible to understand this fact. Nevertheless, God has asked me to be a good steward of my body as well as the planet.

Evangelical Christians all over the globe are now on board with "thinking green." Christians have a choice. They can hang on to their “beliefs” and watch the planet continue to deteriorate, or they can follow their common sense. Contrary to some Christian’s beliefs, the concept of global warming is not a liberal conspiracy trumped up by those in the Democratic Party.

Many in the Christian community are unable to reconcile their beliefs and experience as they are reluctant to identify with those who define themselves as gay. This avoidance and judgmental behavior causes many gays to reject their faith or live in a constant state of religious turmoil. A friend of mine decided to spend a weekend of solace at a religious retreat center. It was meant to be a time of isolation and reflection. However, her visit quickly took on a new meaning. Gay men from churches throughout the country flew into this retreat center. Many of them were board members, elders and pastors of their Christian congregations! No one knew of their sexual orientation with the exception of the hundreds of their Christian colleagues who met at this retreat center to worship together each year. These men got together in the freedom of their real identity and worshiped God. They talked with my friend, expressing their sense of liberation and love for the God they embraced. My friend said it was a moving experience, and she was asked to join them in their religious services, which were filled with energy and passion.

As a Christian, when is the last time that you talked to someone who professed to be gay or have you avoided this group because of your belief system? Should the neo-conservative Dick Cheney judge his daughter because she professes to be gay? Can you imagine the conflict he must feel as a father and conservative politician? One’s beliefs cannot always be reconciled with experience. This fact makes life more challenging, confusing and complex. You can’t simplify your experience no matter what you believe.

One of the “talking points” in Christian circles is family values. Many have James Dobson, from Focus on the Family, as their mouthpiece. As a Christian, do you merely believe in family values or do you really embrace them? As Christians, do you support those who have been the victim of family hurt, or do you reinforce those who believe in spirituality and family values but justify their prior experience?

Beliefs and dogma will only carry us so far. As James Fowler, author and theologian states, “faith is an unreserved opening to the truth, wherever it may be found” (paraphrased). Learning to check our beliefs against our experience is essential to a mature faith. Christians need to reevaluate their thinking and quit preaching to the choir. Many potential converts to Christianity are being turned off by the inconsistent and thoughtless manner of those who believe they are expressing the Gospel. Are you preaching to the choir?

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist in private practice in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

What ABOUT Family Values?

2007-11-08T13:40:00.000-08:00

The concept of "family values" has become a catch-phrase. It has been used by many politicians to promote their agenda, particularly among those who consider themselves politically conservative. However, the term has lost its meaning in the process of being politicized.

Currently, the religious right is looking intently at presidential candidates, making sure that their version of family values is embraced by specific nominees. If the politician doesn't align himself with their brand of family values, all bets are off. At this point, no candidate appears to be pleasing the religious right. So calls have gone out for a third-party prospect for president.

In order to truly understand family values, we need to isolate it from the political and religious pandering. Family values are about the support, nurturing and compassion that individual family members demonstrate toward one another. We see it every day in its simplicity.

Family values starts with partners who cherish each other and are committed to their mate’s spiritual and psychological well-being. These are couples who respect, value and trust each other implicitly. A partner does not need to perform to get a sense of approval from their loved one.

If children are involved, these couples develop a consensus on how their children are to be raised. They establish clear, understandable rules which are reasonable. They are extremely connected to their children and share their life through play, instruction, discipline and involvement in their children's activities. Couples cherish every moment with the kids because they realize that someday their children will pull away and move on. Good parents don't resent this detachment, but view it as a form of self-determination. It is a “feather in their cap.”

Even after children have transitioned to adulthood, we stay connected and open to providing support. If we are fortunate enough to have grandchildren, we relish the opportunity to welcome them to the family nest. We support our children in their parenting and look forward to the time when our grandchildren spend time with us under our support and care. We consider it a blessing to have another opportunity to love and cherish our little ones.

The most important value we can teach our family is civility. Civility is learned behavior in which we treat others with kindness and respect. We take special care to treat those less fortunate than us with compassion and support. We seek to understand those who share different perspectives and in a non-evaluative manner explore those distinctions.

Family unity is not a political or religious concept but rather a primal instinct. In all cultures, there is a natural desire to protect and nurture one’s flock. There's nothing new about family values. In our global community, taking care of those we love is all the more important. By compassionate family companionship, we are able to shelter our family from the alienation that is characteristic of today's society.

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

COGNITIVE THERAPY'S TREATMENT OF ANOREXIA NERVOSA

2007-10-25T19:50:00.000-07:00

Anorexia is a troublesome disorder characterized by an obsession with weight and food. With a target group consisting primarily of adolescent girls (80-90%), the anorexic will crave food, but will refuse to eat or retain it because of an overwhelming fear of weight gain. The individual may stop eating almost entirely, and will deny that her behavior is abnormal and that health is deteriorating. Typically, the anorexic will say that “she feels fat,” even when she is obviously underweight.

The behavior of the anorexic may be characterized by a pattern of social withdrawal, rigorous exercise, and ritualistic eating habits. The emotional profile of the anorexic is marked by a pattern of depression, fear of obesity, and loss of self-confidence. Physical symptoms include a loss of menstruation and a weight loss of up to 20-25% of body mass. According to diagnostic criteria, a female patient is clinically suffering from anorexia nervosa when body weight has fallen to 15% below normal and she has not menstruated for at least three months. The same body weight criteria apply to male patients.

Anorexic teenagers are generally unwilling to receive treatment, resisting any attempts at counseling. Those who reluctantly seek treatment begin the process from an adversarial perspective. Developing a collaborative relationship with an anorexic patient is no easy task. It is critical that the therapist develop a warm, friendly, honest and accepting relationship with the anorexic. The quality of the therapeutic relationship will be a factor in determining the individual’s willingness to deal with the terrifying aspects of eating and weight gain.

The relationship provides a means for examining cognitive distortions and maladaptive underlying assumptions that the anorexic applies to her internal world. It is critical that the counselor accepts the individual’s beliefs about body perception as genuine for her. Any attempt to refute, challenge, or devalue the person for holding erroneous assumptions about weight and body misperception is counterproductive. Anorexic teens are used to hearing from significant others that their beliefs are illogical and irrational.

It is the goal of the therapist to enter into a mutual fact-finding process with the anorexic client. By accepting the patient’s belief system as genuine for her, it is possible to introduce doubt about the anorexic’s basic cognitive assumptions. The individual may be encouraged to reexamine core assumptions about the value of thinness. Several lines of inquiry might be, “Is it practical for you to embrace this idea?” or “How does losing weight fit in with other values that you cherish?” Emphasizing that treatment will follow an experimental model is an important notion. The therapist’s approach with the anorexic might be, “Let’s try this out and see what happens.”

Therapy with the anorexic involves challenging faulty thinking and beliefs. For example, if the patient expresses apprehension around the issue of losing competence if she gains weights, the therapist can help her develop a working definition of competency that will establish a concept of whether or not it is influenced by weight changes. Such questions such as, “Would you appreciate your friend more if she weighed less than you?” may help cut into the double standard established by the anorexic patient.

Questioning the anorexic about what would happen if their worst expectations came to pass may minimize the imagined effects of the event. The person who demands “thinness” is obviously anxious when she considers herself “fat.” The counselor may inquire, “What’s the most horrible thing that could happen if you were to gain weight?”

Cognitive distortions are numerous in the anorexic and must be gently challenged. Distortions such as dichotomous thinking, (“If I gain weight, I’ll be considered obese.”), overgeneralizations, (“I will never get any better and my eating will never improve.”), magnification, (“Gaining any weight will be more than I can take!”) must be directly, but gently confronted in counseling. The anorexic is encouraged to design experiments to test the validity of specific irrational thoughts. For example, the anorexic individual may be encouraged to interview her friends for preferences in physical appearance, checking out how often people select a friend based exclusively on the merit of weight.

Body-size misperception is a significant feature of the anorexic disorder. The individual may be asked to reinterpret what she sees. Such counter-arguments may involve the use of reattribution techniques such as, “When I try to estimate my own dimensions, I am like a color-blind individual attempting to create my own wardrobe. I will rely on other’s objectivity to assess my actual body size.”

With the anorexic, maintaining a multidimensional approach to treatment is necessary, focusing on information processing, cognitions, and other strategies such as:
Dealing with family issues. Some therapist’s believe that the anorexic disorder actually acts as a stabilizing force for the family.
Dealing with personal goals and ambitions of the anorexic.
Focusing on issues of control, perfectionism, assertiveness and autonomy.
Dealing with social adjustment issues.
Assisting with problem-solving and coping skills.

Dealing with the anorexic patient is demanding and requires flexibility and creativity as necessary ingredients if the therapeutic process is to be successful. Many anorexic clients struggle with their body misperception issues throughout their life and may need to revisit the counseling process during times of high stress.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. He can be reached at www.krehbielcounseling.com.

THE EMERGING POPULARITY OF COGNITIVE-BEHAVIORAL THERAPY

2007-10-10T10:23:00.000-07:00

Cognitive-behavioral therapy is currently receiving a significant degree of attention as the treatment of choice for individuals needing assistance with a variety of psychological disorders. It is a structured, pragmatic approach to dealing with problems and is appealing to those seeking therapeutic treatment. People in need of counseling are seeking out clinicians who have specialized training in CBT. Understanding the reason for this current trend in popularity of cognitive-behavioral therapy can be found in the unique characteristics which are pivotal to this modality of treatment. There is a simplicity and yet effectiveness in the model which characterizes the concepts of CBT.

Cognitive-behavioral therapy facilitates a collaborative relationship between the patient and therapist. Together, patient and counselor develop a trusting relationship and mutually discuss the presenting problems to be prioritized and explored in therapy. In CBT, the most pressing issue troubling the patient typically becomes the initial focus of treatment. As a result, the patient tends to feel relieved and encouraged that the primary problem that brought him to therapy is immediately being acknowledged and addressed.

Problems are tackled head-on in a very practical manner. The patient is coached on the ABC’s of cognitive-behavioral therapy. The therapist explains the connection between thoughts and beliefs and their impact on behavior. How the patient thinks about problems determines the way in which the individual responds to various issues. It’s the manner of thinking about life’s issues that steers the patient’s way of behaving.

Let’s assume that you work in an office and for an entire week a co-worker has walked past you without acknowledging your presence. Each day you go back to your cubicle and wonder why this colleague is treating you so unjustly. You build up thoughts about her being condescending and snobbish and begin questioning what you might be doing to annoy her. Anger begins to emerge and your start thinking, “How dare she treat me this way!” Eventually, you settle down and start to rationally consider the problem. You think, “This is stupid, why don’t I go visit her at her office and see what’s going on in her life that might be affecting this situation. You enter her office and begin starting a conversation. In the midst of your discussion, she reveals that her son is suffering from depression and needs to see a counselor. Your colleague is disturbed about the situation and confides in you that she has been on edge with everyone at the office. She asks you if you know of a qualified therapist. You give her some ideas and before you leave, she gets up from her chair and gives you a firm hug. This incident demonstrates how our thinking can be faulty and can be based upon some erroneous assumptions.

CBT is effective because it teaches the patient to modify patterns of thinking which affect behavior. CBT is a straight-forward therapy which is designed to alert the patient to self-defeating ways of thinking. Locating distorted or maladaptive thinking is accomplished through an exploratory process which is dependent upon a solid patient/counselor therapeutic alliance.

Cognitive-behavioral therapy focuses on the patient’s negative self-talk, and offers practical suggestions on how to untwist one’s thinking to make it more adaptive. The CBT therapist assists the client in thinking more rationally by examining the individual’s spontaneous thoughts, observing ways in which they may distort reality, and ferreting out underlying assumptions or beliefs that affect ways of thinking and behaving.

Spontaneous thoughts are the nonsensical things that we tell ourselves when we are under stress – “I’ll never get a date, who would ever want me!” Cognitive distortions are the lenses out of which we perceive reality – “You always make me feel like a loser” (either or thinking). Underlying assumptions are the “hot buttons” which crystallize as a way of coping and getting our needs met during childhood – “I must avoid conflict at all costs; I hate disapproval and getting my feelings hurt.”

Cognitive-behavioral therapy seeks to refute the nonsensical things we tell ourselves and assists us in developing more rational ways of responding to our maladaptive thought processes. Since homework is an integral part of therapy, patients will be encouraged to complete exercises designed to change negative thinking. One concrete procedure helps the client to identify current troubling events, negative self-talk, and ways of rationally responding to situations sited. The individual logs difficult situations, identifies self-defeating thinking and refutes the negative thought processes with more rationally, adaptive way of responding to events. During each therapy session, the log sheet is reviewed for patient progress.

With CBT, clients are in control of their own progress. They are aware of the process that is necessary for change, and diligently work at modifying faulty thought patterns. Therapeutic progress is easily monitored through self-inventories and patient feedback. Time is always left at the end of sessions to review the benefits or pitfalls of the counseling sessions. Clients are asked to assess the effectiveness of their counselor’s treatment process.

Patients often ask, “How long will this counseling treatment take?” Although each case is unique, six to eight sessions are generally sufficient to teach clients strategies for reshaping their thinking. CBT is a time-limited, user-friendly, practical process for helping individuals to assess their negative thinking and making needed transformation in the way they respond to themselves and others. Individuals with anxiety, addictive patterns and depressive disorders are particularly well suited to benefiting from this from of treatment. The good news is that many behavioral health disorders can be treated successfully through cognitive-behavioral therapy. NACBT or The National Association of Cognitive-Behavioral Therapy is a good resource for locating counselors who are sufficiently trained, certified, and specialize in this treatment approach.

James P. Krehbiel, Ed.S, LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.amazon.com. James can be reached at www.krehbielcounseling.com.

HOW TO MAKE PAIN LESS PAINFUL

2007-10-09T20:58:00.000-07:00

Those who work in the field of healthcare have known for some time that a connection exists between our underlying beliefs and thoughts and the functioning of our bodies. Dr. Herbert Benson, in his 1970’s landmark book, The Relaxation Response, articulated the concept that stressors can trigger a “fight or flight response”, an inner startle response that indicates we are about to experience an unpleasant event. Although there is a healthy fear that protects us from harms way, many times how one interprets stressful events and one’s ability to manage it, can affect the immune systems functional capacity. There is now sufficient research to validate Benson’s work, that relaxation techniques such a meditation, can have a direct link to minimizing the effect of a wide range of disorders such as high blood pressure, irritable bowel syndrome, back problems, neurological pain, and headache problems. Relaxation strategies calm the sympathetic nervous system, making it easier for the body to heal.

In Barbara Levine’s book, Your Body Believes Every Word You Say, she explores how our thoughts and underlying beliefs about our physical maladies affect our auto-immune system which regulates our ability to ward off illness, manage pain, and promote healing. In other words, legitimate pain from various illnesses and somatic complaints can be intensified by the kind of messages we tell ourselves. Spontaneous self-defeating thoughts such as, “What’s the use, my body will always betray me and never get better.” can reinforce the pain cycle of making things worse. People with such chronic self-defeating reactions have been shown to create inner chemical changes and constricted blood flow which further erodes the individual’s ability to manage pain. How we respond to our bodily disorders, in terms of core beliefs and inner dialogue, may affect the outcome of our health.

Some time ago, I attended a presentation by psychiatrist M. Scott Peck. He talked with mental health providers about his struggles with neck pain, a problem that had plagued him for years. An operation resolved some of his pain, but he felt that there might be some negative underlying belief that was also contributing to the problem. He ultimately concluded that he was a conflict-avoider, lacking the ability to appropriately assert himself, refusing to “stick his neck out.”

Physical illnesses can be intensified by self-defeating underlying thinking that is a metaphor for the chronic condition experienced. For example, people with back pain may at times lack the “backbone” to express their thoughts and feelings courageously. Individuals with gastrointestinal problems may not be unable to “stomach” certain intolerable thoughts and feelings. People with headache syndromes may experience beliefs and thoughts about events that make them want to say, “Life is making my head hurt.” Eating disordered people may experience core assumptions such as, “I’m so angry that I could just vomit, or if I monitor my weight and eating habits, at least it’s one area in my life that I can control!” People with neurological pain such as inner ear disorders may exacerbate their pain by experiencing thoughts of panic such as, “Oh my God, here it comes again, that nasty, annoying pain. I’ll never get over this because the volume in my life is turned up too high.”

Anxiety, panic, and depression are typical characteristics associated with physical pain. The more effectively one manages these symptoms, the less troublesome the pain may be. Learning to cope with anticipatory anxiety by rationally responding, “Ok, I know that this pain can be troublesome, but when it comes I will do my deep breathing and manage just fine!”, or dealing with panic, “When a wave of pain comes, I’ll just go with it. It’s not a big deal, my scary feeling are time-limited, they’ll be over soon”), and managing depression, “Just because I feel awful doesn’t mean I can’t do things to stay active and make me feel involved” are important ways of adaptively responding to pain.

The following ideas are some guidelines for managing pain more effectively:
· Try to get you pain in perspective. Make a realistic appraisal. “In the scheme of things, how bad is my condition?”
· Don’t fight with your symptoms, it only makes them worse. The more you accept your symptoms, the more they are likely to diminish.
· Use various activities to refocus away from your pain. Dwelling on pain makes it more painful. Stretching, music, swimming, meditation, and other activities are important.
· Seek a multidisciplinary approach to your problem, if necessary. Get a team of healthcare specialists, including a quality physician, psychotherapist, physical therapist, message therapist or other providers of pain management.
· Develop a solid support system of family and friends. Also, there are many support groups in our community for people suffering from a variety of physical ailments.
· Remember, that the things we tell ourselves have an impact on our physical and emotional well-being.

James P. Krehbiel is an author, freelance writer, and nationally certified cognitive-behavioral therapist in private practice in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at http://www.booklocker.com/. He can be reached through his website at http://www.krehbielcounseling.com/.

WHY GROWN MEN DON'T EAT QUICHE OR GO TO COUNSELING

2007-08-05T20:19:00.000-07:00

It has been my experience that many men have an underlying set of beliefs that run counter to the notion of pursuing personal counseling. What is it that makes many adult males experience an adverse reaction to the concept of counseling? What holds men back from a process that has the potential to provide support, nurturing and emotional healing?

I believe that men have a cultural and primal predisposition that mitigates against the vulnerability necessary for seeking therapy. The primal instinct of men and male animals in general, has been to seek power, dominate their environment, and to take care of one’s family. This instinctual pattern calls on men to protect and defend. They are the warriors, providing safety and support for their nest.

The “warrior complex” carries over to the way we view men in relation to military service. Men are culturally conditioned to be fighters. They learn at an early age that commitment and self-sacrifice in defending the well-being of one’s community is a noble endeavor. A man’s psychic energy is directed toward the need to protect others from harm – the fight and flight response works on automatic pilot.

As men have been raised in our military/industrial milieu, they have learned basic assumptions about life that promote bravery, strength and courage as all important attributes. There is no room for vulnerability – it is viewed as a sign of weakness and cowardliness not courage.

What are some of the assumptions that men absorb that shape their worldview?
Fighting is the best way to handle conflict.
Anger and rage are the only emotions that are acceptable.
Expressing fear, hurt or sadness is a sign of emotional weakness.
Fixing problems is a primary role for men.
Life is always linear, easy to understand and logical.
Deep feelings are not to be trusted.
Decision-making must always be a rational process, never based on trusting one’s instincts.
Denial, avoidance and deflecting are the best coping mechanisms.
Caretaking for others is more important than taking care of oneself.

If men are the warriors, the protectors or the strong one’s projecting their sense of “machismo,” how do we get men to entertain the concept of attending counseling?
By helping them to reframe their thinking. Getting help is a sign of strength and courage.
Reminding them of celebrities such as Terry Bradshaw who have shared their stories of emotional pain and treatment.
Going to counseling with a partner as a means of introducing them to the counseling process.
Suggesting that men consider attending a men’s retreat to develop a sense of male bonding.
Suggesting a male counselor who has experience in dealing with reluctant clients.

Humans cannot function on the emotional “high road” indefinitely. Invariably, the psychological machinery breaks down and our “dusty corners” are exposed. Witness the battle scars of those men who have valiantly served in the military but suffer from posttraumatic stress disorder and other emotional syndromes.

Eventually, the “toothpaste must come out of the tube.” The dark-side of each of us will be evident for all to see. Behaviors may deteriorate and emotional symptoms may accumulate. It is inevitable; the darkness will manifest itself in some way.

Men are typically not good at accepting the vulnerability which comes over time. But the psychic pain associated with trying to stay in control may overshadow the “self.” It is at this point that a man must ask, “Do I stay in an impasse filled with conflict and pain or do I seek the support and assistance of others who may have the wisdom to see me through the wilderness?” When the pain is too great and we are feeling most vulnerable, it is time for men to reframe their thinking and move in a direction that goes against the tide of their cultural heritage. It is time to give oneself permission to be vulnerable. Helping a man to see this truth may take a significant degree of encouragement from others.

James P. Krehbiel, Ed.S., LPC, is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. Hear his interview with Coach Lee on www.365daysofcoaching.com.regarding the topic of “courage and fear work together.” James can be reached at www.krehbielcounseling.com.

IS THE CHRISTIAN RIGHT "RIGHT"?

2007-06-02T10:46:00.000-07:00

During my undergraduate years in college, I served as student coordinator for Campus Crusade for Christ. At the peak of the Vietnam War and political protests, I participated in a faith-based initiative on the campus of the University of California at Berkeley. The campus was in turmoil at that time due to the firing of the college president, Clark Kerr. We had many speakers involved in our spiritual thrust, including the Reverend Billy Graham. The week-long theme was, “Jesus, the Revolutionary.” I was taken back by the interest that many students demonstrated as they carried signs reading, “Jesus Yes, Christianity No.” The students were open to the teachings of Jesus but were less enthusiastic and rejected many of the values associated with a traditional Christian world-view.

As I conversed with many Berkeley students, I found them to be spiritually open-minded, thoughtful and reflective. These students shared an ideological perspective that was compatible with my own. I found the students to be more spiritually mature than those from the Midwestern University where I attended. My own university school-mates were more interested in what fraternity or sorority they would join as opposed to contemplating in-depth issues regarding the meaning of life.

My week-long exposure at Berkeley got me thinking. Was it true that Jesus really was the revolutionary figure of His time? I concluded that if He were present on this earth today, He would be dismayed by the brand of Christianity professed by many who seek to follow in His footsteps.

Jesus’ teachings and lifestyle went against the grain of the religious establishment of His day. As one reads the Gospel accounts, one is struck by the extent to which He contradicted those who held the religious power of His time. When the religious leaders hid behind their scriptural literalness, He rebuked them for missing spiritual insights. When He was challenged about breaking the religious rules, He proclaimed that the rules were made to aid people, not trap them. When the religious power-brokers accused Jesus of hob-knobbing with the whores, He dismissed their insensitivity for neglecting the poor and down-trodden. He accused the religious establishment of criticizing the sins of others while refusing to “see the log in their own eye.” Jesus reminded the Scribes and Pharisees that the Bible was meant to be a scriptural account which would point people to the Lord. It was not meant to be a guidebook used as a pretense to personal piety. In (John 5:39) Jesus said to the religious leaders, “You search the scriptures because you believe they give you eternal life. But the scriptures point to me.” (New-living translation).

Like the religious leaders of Jesus’ time, today’s Christian Right:

1. Displays rigidity in their interpretations of scripture, rejecting any differences in perspective as “going against God’s will.”

2. Pontificates about the obvious “sins of the flesh” such as drinking and sexual indiscretion while ignoring the other more subtle “sins of the spirit” such as pride, greed, envy and jealousy. This convenient diversion tends to take responsibility away from the more egregious sins of the spirit which we all commit.

3. Places more emphasis on a conservative political agenda rather than their religious beliefs. From a religious perspective, Mitt Romney’s beliefs are antithetical to those of the Christian Right. However, his political ideology is compatible with the Christian Right and most of the religious differences will soon be forgotten as he continues his candidacy for President.

4. Demonstrates a sense of false piety and over-spiritualizes reality. The third Biblical commandment indicates that we should “not use the Lord’s name in vain.” This is called blasphemy. Many of the Christian Right are convinced that this is a commandment about swearing. Although swearing is not desirable, this commandment is broader in scope. The context of the commandment refers to using religious language as a pretense to pious behavior. More specifically, the commandment addresses those who incessantly try to impress others with their overbearing religiosity by over-spiritualizing life. This includes chronically over-used verbiage such as, “It’s the Lord’s will” and those who say, “Praise the Lord,” in every other sentence. God’s name is to be revered, not used lightly in a blasphemous manner.

5. Has an immature concept of God. James Fowler, theologian and author, illuminates this issue in his book, Stages of Faith. Those who embrace an infantile faith appear to view God as the “Cop in the sky” who punishes those who are not obedient to His every command. In my opinion there is a difference between child-like faith and childish faith. Cooperating with God is a more mature way of defining our relationship with the Lord.

6. Uses the Bible as a vehicle for defending their position on many subjects. Like the religious establishment of Jesus’ day, the scriptures are interpreted in a preconceived manner to fit the believer’s convictions. By being overly-literal, the translation is lost for practical everyday living.

The way the Christian Right operationalizes its beliefs reminds me of the religious leaders of Jesus’ day. Those beliefs and behaviors are what He challenged the religious establishment to transcend. It was not the “letter of the law,” but the “spirit of the law” that He emphasized. The spirit of the law represents acceptance, tolerance, love, open-mindedness and personal responsibility. This is the spiritual revolution that we students were talking about so many years ago at Berkeley.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. Are you in the bubble or have you stepped out? See http://www.booklocker.com/. James can be reached at http://www.krehbielcounseling.com/.

HOW TO FEEL GOOD WITHOUT TRYING SO HARD

2007-05-20T09:08:00.000-07:00

Most people want to feel good, but they may hinder their efforts in creating a sense of well-being. In their desire to feel better, individuals assume that they must try harder to create happiness. “Avis, we try harder” characterizes their mantra. Unfortunately, those who strive to feel better, often end up defeating their own purposes.

When it comes to emotional balance, setting the expectation bar too high, excessively pushing oneself, and feeling a need to be in control of all of life’s circumstances can create unnecessary pressure and anxiety. Learning assumptions related to “the law of reverse effort” are important to living a peaceful existence. This calls to recognition the concept of mindfulness, the Eastern philosophy for staying in present experience.

Often, people associate mindfulness with inactivity or passivity although quite the opposite is true. Mindfulness is a proactive process filled with energy and conscious learning. We must take our journey “down stream” rather than continuously striving to force change. We must learn to let things be the way they are.

Often, we view life as a challenging chess game to be mastered. We will talk about doing things the “right” way, fearing and anticipating mistake-making. We may fear that if we were to lose control, our world would collapse like a house of cards. We may fight to stay in control and yet experience the feeling of being out of control. Our personality may be so tightly wound that pulling one string from the ball of yarn may make the sufferer feel like everything is unraveling.

To feel good, we must transform certain underlying assumptions that affect our state of mind:

Cease trying to please everybody because it is impossible.
Give up trying to control every situation because it is unrealistic.
Learn to set limits and back off from performing to get approval from others.
Find inner-validation rather than seeking it from others.
Welcome new challenges and risks and refuse to fear rejection and mistake-making.
Give up the notion that there is a “right” way to do everything.
Life is a series of problems to be solved, not a competitive game requiring closure.
Remove our narrow concept of success. After all, what do we want to be remembered for when we are no longer around? Do we want to be remembered for our exemplary performance or the quality of our character?
Remember that showing vulnerability is not a sign of weakness but of courage.
Replace our either/or thinking; either I must be totally in control of matters or I will be completely out of control.
Forgive ourselves for our past and refuse to anxiously anticipate the future.

Feeling good involves untwisting negative thinking based upon the assumptions listed above. Often, this process does not happen until we “bottom out” with depression and anxiety. We can’t get out of the trap until we sink into it. Overcoming by yielding is the key to our escape from unhappiness. Learning to be kind to ourselves takes practice. It requires a concerted effort to transform our thinking and behavior so that we learn to self- nurture. Unlearning old habits is not easy. However, learning to feel good without trying so hard is worth it.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

FORGIVE ME GOD - THERE WILL BE POTHOLES IN MY LEGACY

2007-04-22T15:14:00.000-07:00

As we unravel the fabric of our personal story, we are left with a mixed bag. This is the time for a spiritual guy like me to come clean – to make amends for unruly behavior. The urgency to make things right stems from an aging process that leaves me feeling vulnerable when I look at the landscape of my life. I need closure from the times in my life when I “missed the mark.”

My children have heard my “sordid” stories because I used them as teachable moments for behaviors to avoid. I typically tried to provide “real-life” stories about my misdeeds and those of others as a way of promoting character-building qualities. This concept failed quite miserably, because my kids followed in my footsteps anyway.
When I was a young teenager, my parents departed for a business trip. I was left behind in the care of my older brother. Like most teenagers, I yearned for the day that I would turn sixteen so that I could move through the rite-of-passage of getting behind the wheel of an automobile. For me, that day didn’t come fast enough and those keys hanging near the front door presented a serious temptation. Without considering consequences (a typical problem for kids), I took off on a joy ride with my friend Chrissie. I was feeling very adult-like until we cruised through a neighboring town as a police officer was traveling toward me in the opposite direction. Chrissie spotted the cop and freaked out. I responded by over-turning onto a side street and nearly ending up in the front yard of a nearby house.

The officer spotted my brilliant move and pulled me over. After asking me the question I didn’t want to hear, “Son, can I see your license?” we were escorted to the local police station. My brother came to the station where we were released into his custody. “Wait until Mom and Dad get home,” Rick kept repeating. I wanted to hide under a rock and stay there indefinitely. I wrote a long “how could I have done this” letter prior to my parents return. I even included various punishment options within the letter’s body. When my parents returned home they received the news from my brother. Although they were not as angry as I expected, they indicated that I was to appear in court to respond to my behavior. I remember that fateful day when my father and I made our way to the county courthouse where I was vigorously lectured by the judge and then released to my father because I said that I would never to stupid tricks again.

Chrissie was a chatter-box, so the news of our adventure permeated the halls of our high school. We instantly became risk-taking, law-breaking heroes. It is interesting how teenagers can reframe things and make behaviors appear so awesome, even back in the days of my youth. I still have my high school yearbook which is full of quips about the “adventure,” “the ride,” and the good-natured teasing about my anti-social behavior.
That same school year, I took Latin because my parents thought it would help me with all those long medical terms. For some inexplicable reason, my Latin class was inhabited by all the “jocks” from every imaginable sport (no girls allowed). Things were complicated by the fact that the teacher was a first year rookie who was also the head cross-country coach. Mr. P. was known by many in the class for his coaching skills. No classroom introductions were necessary. The class period was split due to a lunch period which was squeezed into the middle of Latin.

The split-class option with lunch posed various sneaky “boys will be boys” possibilities. We brought red Jell-O back from lunch and conveniently placed it on page thirty two of Tony P.’s Latin book. I think this translation page was about Caesar’s Gallic wars. I remember Mr. P. retorting in his nasal tone, “Boys, your not being very funny at all.” On another occasion, we tortured our poor teacher by taking the onions out of our hamburgers and putting them in the radiator of the classroom before he arrived. Then we waited… As the aroma permeated the air, Mr. P. responded with, “Boys, I don’t think that was a very wise thing to do.” In spite of our antics, we actually formed a very positive relationship with Mr. P.

In the mid 1990’s, more than thirty years after the fact, I learned how potent a legacy I had left behind. At that time, I worked as Director of Guidance and Counseling for a midwestern high school. I was charged with the responsibility of helping formulate a new comprehensive guidance plan for our school. In order to accomplish the task, a colleague and I visited various exemplary school models throughout the state – one of them which happened to be my old alma mater. As I visited my school as an alumni, memories of my past began to envelope me. When we entered the counseling department office, we were greeted by retired counselors who were volunteering as part of their retirement package. When I mentioned my name and that I had attended the school decades ago, the gentleman laughed. The counselor replied, “We have heard of you and your antics along with some of your classmate’s behavior.” “Throughout the years, your story has repeatedly been mentioned by alumni and the Latin teacher.” I said, “This is quite amazing. “Is Tony still teaching here?” “He certainly is and you will find him in the teacher’s lounge.” the volunteer remarked.

As I entered the teacher’s lounge with my co-worker, I immediately sat down to have lunch. After we ate, I looked around the room to find Tony. I asked a teacher where he was sitting and as I moved toward his table I noticed the older version of my teacher. I introduced myself, but it was unnecessary. Tony grasped my arms and immediately began laughing. It was his last year of teaching and we sat at that table and he reminisced with his colleagues about a story that has touched so many lives.

Forgive me God – there will be potholes in my legacy! All of my memories constitute the nature of who I am. They remind me of my humanity and the ways in which I touched the lives of others for better or worse. I have one story. I don’t have the choice to take parts back. I just hope that in the end that I am appreciated for the sum total of all its parts.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

THE ENERGY IS IN THE NAME

2007-04-13T19:11:00.000-07:00

My name is James P. Krehbiel. One day my dear 92 year old mother called my business office. I can’t recollect what she wanted, but I knew that it had never happened before. I recall that Tammy, my business administrator, was working the switchboard at lunch and took the call. “Is Petey there?” my mother said. Tammy responded with, “We have no Petey that works in our office complex. “Oh yes you do,” my mother replied. “You have a Petey Krehbiel and he is my son.” Tammy, with a bit of laughter and eyes wide open said, “We know your son as James, but I will get your son Petey right away.” From that moment on, Tammy has referred to me by the name that nobody in my professional life had heard - Petey.

Names hold meaning, history, cherished values, and energy. They also may represent, in some symbolic way, the essence of our relationships. Names explain to other people who we are, but more importantly, they provide us with awareness as they distinguish us from others. Our names are reminders of the way we project ourselves to the world.

Maybe I have a split personality? James and Petey don’t carry the same energy. James is the softer, gentler, more professional side of me. Petey is the part of me that likes to take risks, gets feisty, and can be impulsive at times. I think these two energy systems actually compliment one another quite well. I actually believe that we all have various energy systems or subpersonalities that crystallize early in life as way of coping with the world.

Often, certain versions of a name may represent a parent’s desire to maintain their parenting rights. We have Markey, Bobby and Tommy. Unless you live in the South, these names represent a parent’s desire to cling to the connection of one’s child. I think that is why I call my adult son little Peter. Through the use of affectionate forms of a name, parents can sustain a sense of connectedness long after the children have left.

Isn’t it interesting how names can change when people leave one relationship for another? Recently, a woman told me that her first husband called her Barbara even though her family refers to her as Bobbi. Her first marriage was an abusive relationship that fortunately ended. When she remarried, her new husband followed the path of her ex-husband by also calling her Barbara. The energy fostered by that name was too sad and consequently she opted to have her new partner call her the name that characterized the best of her history - Bobbi.

Sometimes names can create embarrassment. People are prone to slips of the tongue and may call someone by the wrong name. To make matters worse, sometimes politicians make goofy comments using wrong names that cause them trouble with the media and adversaries. Have you ever called a friend by the wrong name, because you were too preoccupied? Even more debilitating, have you ever called your partner by another name during an intimate moment?

Did you every wonder why prospective parents spend so much time reviewing names prior to the arrival of a new baby? Names are powerful tools, like words. We want them to characterize our children in a positive light. It’s hard to take a name back, so it is important to get it right the first time. For parents, names are filled with all the hopes, dreams and aspirations for those we love.

There certainly are lots of names. There are trendy names, biblical ones, political names, “cutsy” names, and titles from yesteryear. It’s interesting that many of the names of our elderly are now in vogue! Some people select names based upon the meaning of the words. My daughter’s name Amy means “the beloved.” Her daughter’s name Malia means “peace” in Hawaiian.

Sometimes people hate their names, particularly their last names, and go to the courthouse to change them. Others are fascinated by their last names, and go to the library to search for clues to their family history. People, after divorce, may change their last names to remove any vestiges of negative energy from their past as they build a new beginning.

Our names will be connected to our legacy. People may not remember our professional lives, but hopefully they will remember our names and what we stood for. I like my names. My mother said her grandfather, James, was a kind and considerate man. I like that energy, so I will keep the name along with Petey, the little boy who liked to slide in the street playing a pick-up game of baseball.

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available through www.booklocker.com/books/2242.html. James can be reached at www.krehbielcounseling.com.

IF THE EARRING FITS, WEAR IT

2007-03-21T20:55:00.000-07:00

My personal experience has led me to propose a theory about the life-changing passages affecting my life and other men. Contrary to the writings of those who specialize in adult development, I believe that men are entitled to two mid-life crises rather than the one we all talk about. One transitional passage is not enough for most men. The second passage, not previously explored, allows my comrades to make necessary changes that were not resolved during the first crisis. According to my theory, the first mid-life crisis is designed to provide men with the opportunity to act like rebellious teenagers. It is an emotional transition which grants the experiencer a means for throwing aspects of his life overboard. As he plays with newly discovered toys, he sifts through the “why” of his life and determines what’s worth hanging onto. This existential process which involves reflecting on one’s meaning and purpose may result in dramatic life changes. People in a man’s way may be unintentionally hurt as he reflects on the psychological forces affecting his life.

The second, and milder crisis, is one that has been ignored by scholars who seek to understand human behavior. I call it the “cosmetic crisis.” As a man reaches his AARP years, he begins to get the hint that women are no longer looking at him in an endearing manner. He discovers that his physicians and clients look more like teenagers than adults. He comes to the conclusion that an older man can no longer gauge the age of other people. He finds that his short term memory begins to fade; and as he peers into a mirror, he has images of his parents looking a lot like him not too long ago. His body begins to fail as he finds himself peeing more often, sagging in unappealing places, gaining weight, and growing breasts along with hair in all the wrong places. His eyes appear puffy, his hairline recedes, and he struggles to get out of bed in the morning due to unusual aches and pains. The mid-life man begins to yearn for the days of his youth. He pulls out old pictures of himself which are reminders of his youthful potency. With desperation, he begins the grieving process over the loss of his youthful physical prowess.

These deteriorating changes in physical image ultimately lead to the emergence of the second mid-life crisis. Prior to my 60th birthday, I decided that I’d had enough. I needed a new me. I had seen an advertisement on television touting the benefits of “Hollywood hair.” As the infomercial explained, this was not a hair transplant, but a “hair system” consisting of real hair follicles. I became curious because I liked the idea of being able to make my hair look the way I wanted it to look. After much agonizing, I took the leap and decided to let the hairstylists remake me. My wife supported me in this passage and liked the finished product. She said she thought I looked too cute. My comment to her was, “So what did I look like before this project started?” My clients were somewhat confused because the blend looks pretty natural. Many would say, “I like your new hairdo.” When I told a few of my clients what I had done, they gave the look a thumbs-up.

My next goal was to compliment my new hair with an earring. Why not? I had remembered when my son purchased an earring and how I felt about it at the time. He wore it as he toured the country playing in drum and bugle corp. That way, I didn’t have to see it very often. Now it was my turn. I concluded that it is never too late to turn back the clock. But this venture took immense courage. I stalled for months as my wife kept encouraging me to get my ear pierced. I didn’t even know which ear was supposed to be pierced. My wife said, “If your straight, left ear, if you’re gay right ear.” “But what if you’re not sure? I told my wife.

Earring day finally arrived. We headed for Claire’s Boutique incognito. We went early because I was hoping that no one would be in the store other than the employees. I sheepishly told the clerk what I wanted and she told me sit in a stool which faced the window to the mall – so much for anonymity. To make matters worse, there were two ten year old girls in the store with a mother who wanted to see the “piercing procedure.” Both of these young ladies were contemplating getting their ears pierced and asked me if I would be their role model for this painful process. With eyes wide open, these two darling girls watched the pinching of my ear. I tried to be a big boy and act like it didn’t hurt.

My next mid-life hurdle was dealing with my children’s reaction as they had flown into Scottsdale for my 60th birthday. When my son first saw me, he cracked up. There are no words to express the look on his face. He proceeded to give me my payback for the browbeating I gave him about his adolescent experiment on his left ear. In desperation I exclaimed, “I can do anything I want, I’m 60 years old! My friend did a great job of convincing my 92 year old mother that my mental faculties are still intact. His support helped her to stop perseverating about my well-being.

Men, don’t forget the second mid-life crisis. Although human behavior experts don’t acknowledge this passage, you are entitled to it no matter what others may think. Remember, you can be innovative in recreating yourself cosmetically. It’s never too late to develop a new you.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

IS AMERICA SLEEP WALKING THROUGH ITS POLITICAL ISSUES?

2007-03-03T20:12:00.000-08:00

A patient of mine recently experienced an unusual problem. Apparently, she got out of bed in the middle of the night, walked outside into her garage and entered her sports car. She was changing her car clock when her partner, who was in a panic, located her in the car. My patient was awakened by her partner and was confused and bewildered as they left the garage to resume their evening’s sleep.

Sleep walking is not an unusual pattern. For many, it is an infrequent occurrence, but for others it is a lifelong experience. Recently, I have been wondering about the manner in which many of our citizens are “sleep walking” through the impact of our political landscape. As a society, we appear to be distracted and asleep at the wheel. It seems as if there is a chronic pathology among of our people characterized by naivety, indifference, and a lack of awareness to political and cultural issues.

I recall Jay Leno canvassing the streets of Los Angeles trying to find one American who could tell him how many Supreme Court justices serve on our highest bench and to identify one of their names. The responses were pathetic and called attention to the lack of political awareness of our citizenry. Recently, as my wife and I boarded a plane to return to Arizona, Supreme Court Justice Sandra Day O’Connor was sitting in the third row of the plane. I was not aware of one on-coming passenger who seemed to recognize her or acknowledge her presence. When we deplaned and headed for the luggage area, while other passengers appeared to be oblivious to the relevance of the situation, I proceeded to introduce myself and carry on a brief conversation with her. As one of my 15 year old patients once said, “Why should I care about politics, I can’t change anything anyway.” Nevertheless, it is my belief that feeling powerless is never an excuse for sleeping through the political process.

Although I certainly respect and support our current troops deployed in Iraq and other locations, there is something quite disturbing about the false sense of patriotism displayed by Americans. For example, I believe many of us have trivialized the concept of war through the simplistic use of bumper stickers, ribbons and other insignias signifying troop support. What do these symbols really mean for most Americans? Are they true signs of patriotism by those who fully understand the impact and implications of our current war in Iraq? My brother, who was a Lieutenant and company commander in Viet Nam cringes at the naivety and lack of awareness that many Americans possess about the nature of terrorism, combat and military missions. Maybe if the military adopted a conscription policy, some Americans might rethink their form of patriotism? Maybe if they knew their own children would be subject to going off to Baghdad, they would reconsider the way they demonstrate their loyalty to our military efforts. You might recall what happened when the President tried to make nice with Congressman Jim Webb over the involvement of Mr. Webb’s son in the Iraq war. Congressman Webb bluntly told the President to mind his own business.

Americans tend to believe that if they project an image of patriotism, they are exempt from a deeper understanding of the implications of the war in Iraq. How many of our people are aware of how our wounded soldiers are being treated at Building #18 in Walter Reed Hospital? Do we understand that the hospital is under constant review for improper patient treatment and deplorable conditions? Are we aware that inpatient soldiers have complained about the unsanitary conditions at the hospital including rodents infesting the environment? How many in the Bush administration or Congress are aware of the conditions our soldiers are subjected to and do they care? Would any of us send our loved ones to heal in an environment like that? Is this how we support our troops? Shouldn’t we all be concerned about this issue? Instead we sleep walk through the military and political debate over the mission and purposes of the Iraq war. We believe that the political voices in Washington D.C. are more competent and convincing than our own. We take the easy way out from committing ourselves to being patriotic in the truest since of the word. We must walk the walk through political action, not words.

Will we sleep walk though the debate on global warming as our oil companies try to pay off researchers so they will reinterpret their findings to soften the implications of global warming? We minimize the problem by either ignoring it or by pretending to care by talking about minutiae such as using HOV lanes and not burning wood in our fireplaces as means of eradicating the problem of pollution. Is Al Gore’s documentary, Inconvenient Truth, really that inconvenient that we are willing to deny its truth? Our war in Iraq will continue to kill and maim many, but global warming has the potential to kill us all. Will we sleep walk through this problem by displaying our symbolic bumper stickers or will we attack the problem with action? It will not be the terrorists who do us in, for the enemy is at home.

Americans can no longer afford to sleep walk through the critical political issues that we face globally. Our indifference, lack of awareness, denial, shallowness, and lack of motivation will only serve to escalate the dangers that we confront. It will not be “the axis of evil” that consumes us but our own ignorance and laziness.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.amazon.com. James can be reached at www.krehbielcounseling.com.

THE COURAGE TO CONFRONT

2007-02-22T16:18:00.000-08:00

One of the most significant underlying assumptions that many people internalize is, “I must avoid conflict at all costs; if I let others know what I think and feel, I might get disappointed and hurt. However, “sweeping things under the rug” tends to eventually magnify unresolved interactions and events. Resentment, which looms on the other side of our passive behavior, clouds our confidence and judgment.

I define assertiveness as expressing one’s needs and wants in a way that does not intentionally hurt others feelings. Many of us spend an inordinate amount of energy avoiding the process of telling others what we specifically want from them. As a result, we carry around negative energy as we seethe over what we are missing in our relationships. A friend of mine told me that there is nothing admirable about avoiding hurt. Sometimes emotional pain is an inevitable byproduct of making difficult decisions that involve honest emotional expressiveness. I am amused at couples who proudly proclaim that they never argue or fight but nevertheless find their relationship in jeopardy. Insulating themselves from the inevitability of conflict provides partners with refuge from everyday struggles. However, intimacy requires emotional expressiveness, and many couples either lack the skills or desire to confront life’s problems.

Managing conflict is a process that is uncomfortable for most of us. Many of us have had no role models for understanding how to constructively fight and emerge from conflict to closure. We may have watched our parents suffer in silence and witnessed the resentment that characterized their relationship. Our parents may have used sarcasm, nagging, or open hostility when problems got to the boiling point. They may have danced around issues like two stallions circling each other in a corral. We may have learned to thwart our feelings in response to our parent’s passive-aggressive style of relating.

Many of us are able to confront people and issues in our business life appropriately. We often can assert ourselves with our business colleagues, but feel lost in communicating honestly and openly with those closest to us. We wonder why there is a disconnect between our work persona and our way of communicating at home. The difference exists because it is more frightening to be vulnerable with our loved ones than it is with our business associates. There is more “on the line” with those we care about and therefore we may avoid facing the emotional ramifications of being upfront.

In order to be assertive, we must let go of the power of others approval or disapproval. At times, all of us may be afraid to share our deepest needs, wants, and feelings because of the negative reaction we might anticipate from others. We may assume that our friends will judge us for being authentic. In the 1970’s, Father John Powell of Loyola University in Chicago reflected on this dilemma in a book, Why Am I Afraid to Tell You Who I Am? None of us are comfortable with the feeling of being vulnerable, although it seems that the most confident people are those who can allow themselves to be fragile when necessary.

I often tell people to think of assertiveness the way television detective Colombo responded during his investigations. Occasionally he would respond by saying, “Help me understand something, sir? By the way, can you run that by me once again?” Assertiveness involves respecting and valuing the promotion of understanding. I like to call it non-evaluative exploration. This process involves learning to create dialogue, with true appreciation for differences in opinion. It may also mean learning to say no or setting boundaries that are acceptable and not being manipulated into changing them. It may mean the possibility of getting a negative counter-reaction from others and learning to accept their disapproval. The courage to confront means respecting oneself enough to stand firm on what you want and think without getting caught up in the burden of others feelings.

There is a price to pay for discounting one’s emotional feelings. A number of years ago I heard author M. Scott Peck present to a group of mental health professionals in Chicago. He talked about having chronic neck pain and how troublesome the condition was. After many medical tests, and self-reflection, he came to the conclusion that his problem was primarily a metaphor for his life-long pattern of avoidance. Rather than trying to fix everyone else’s problems, he needed to learn to “stick his neck out” and finally face the courage to confront. Appropriately confronting people and events can be accomplished by promoting understanding through non-evaluative exploration. Through this process, individuals and couples can learn to get closure on issues that affect their everyday living.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

LET THINGS BE THE WAY THEY ARE

2007-02-14T19:19:00.000-08:00

According to Eugene O’Kelly, author of Chasing Daylight, the most difficult task an individual can undertake is learning to live in the moment. O’Kelly should know, since his quest to manage the process of his own death from a brain tumor underscored his intense desire to learn to cherish the moment during his ordeal. Eugene’s story is an inspiration to all of us who seek to understand the practice of mindfulness, the Eastern terminology for staying in the here-and-now.

Our fast-paced lifestyle, filled with excessive activity, multiple deadlines, and over-stimulation counteracts our capacity to relax and let go. Often, we either embrace what’s in the “rear view mirror” or we anticipate the future with much trepidation. Life becomes an anxious proposition when we ruminate about the past and assume the worst about the future.

Often, people get mired in the past because they have failed to emotionally process it. Unresolved grief and psychic pain keeps us immobilized and robs us of energy for the here-and-now. A friend of mine once said, “Never live with regret.” Our past must be appropriately expressed, forgiven, and healed of the impact that it has in keeping us from moving forward with our lives. One’s past is not truly in the past if there are resentments that continue to be projected into the present. One must forgive in order to let go of any painful vestiges from our history.

Often, individuals sabotage their future goals by making erroneous assumptions that shatter confidence. People thwart their ability to make changes by using prior experience as the benchmark for making adaptations. Staying in the moment involves letting go of the past and not making faulty assumptions about the future. All we have is the present. Life is not a fixed entity; it is an ever-changing, fluid experience. We must seize the moment as well as embrace it. When we try to control life, we tend to feel out of control. We must learn to go downstream with the flow of life rather than fighting the rapids. Trying to hang onto life is like attempting to hold water in one’s hands. It is futile. One’s mantra must be, whatever is will be, whether I like it or not.

There are numerous techniques that people can try as ways of learning the practice of mindfulness. Learning them takes patience and persistence. Mindfulness is heightened awareness. For example, when showering, what are most people doing? They are thinking about the activities that will fill their day. Instead, feel the beads of water gently touching your skin. Immerse yourself in the pleasure of the moment. When drinking a hot cup of tea, feel the liquid as it touches your lips. Hold the cup in both hands to better feel the heat that is generated. Practice simple tasks every day until they become a conscious part of your experience.

Meditation is the most effective way to stay focused in the here-and-now. Meditation does not need to be complicated. It involves simple steps:
· Find a quiet place and sit in a comfortable chair with both feet on the floor.
· Work on breathing from the diaphragm (belly breathing).
· Establish a mantra, such as a number, name or religious symbol as you breathe out.
· Focus on your breathing and redirect your thinking when you tend to wander.
· You may prefer to use prerecorded CD’s or tapes that guide you through the meditative process.

The goal of meditation is to relax the mind and body. This increases awareness, energy and serenity. The most difficult task in meditation is to learn to keep one’s thoughts centered in the moment. It is our natural tendency to wander off into past and future thoughts and feelings. Meditation is both a metaphor and a catalyst for learning to live in the moment. As Eugene Kelly has taught, living in the present is a worthy goal that has the rewards of opening us all to the wonder of life through a much clearer window.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com. James can be reached at www.krehbielcounseling.com.

Where Has Common Courtesy Gone?

2007-01-24T18:08:00.000-08:00

Whatever happened to the concept of personal courtesy? I keep waiting for consideration to return, but I’m not holding my breath. The “human touch”, complete with decency, civility and proper etiquette appears to have vanished. Often, these cherished values have been replaced with isolation, unkindness, insensitivity, poor manners, and excuse-making.

Since I am a behavioral health provider, I recently contacted a managed care organization to check on some billing information for a patient. Most MCO’s now have a voice prompt menu which serves to conveniently block the provider from reaching a live customer service agent. The automated menu responds with, “Please say your tax identification number.” I go ahead and provide the number. They repeat the number back to me and then the machine asks me, “Is the tax identification number correct or incorrect?” I respond with “correct.” The prompt responds with, “I’m sorry I did not hear your tax identification number correctly. Please repeat.” I repeat the process and the prompts continue to block me from moving through the system. I finally press the zero key on my phone, hoping to bypass the menu and get an agent, but the system does not permit it. Through personal ingenuity, I finally find a way to reach a human agent. To my dismay, I am asked to repeat any information I provided on the prompts. I am then subjected to a written customer disclaimer script and then my call is placed on hold. This cost containment strategy is one example of the type of incivility that most Americans are exposed to in the process of trying to get their needs met.

There are other everyday examples of individual’s incivility. For instance, what about drivers who tailgate and drive carelessly while using a cell phone? How about those who make mistakes and yet refuse to acknowledge their failures? People rarely say they are sorry for hurting and offending others. What happened to a firm handshake and a smile during an introduction? What about gestures such as sending greeting cards to friends, recognizing family and friend’s birthdays and other special occasions, keeping in touch with loved ones, and learning how to forgive oneself and others for being less than perfect.

Have you ever endlessly waited in a restaurant for a friend to show up? When they arrive, do they provide a volley of excuses for being late? Promptness takes planning and consideration for the feelings of others. Promptness shows our family and friends the degree to which we cherish our relationships.

It seems like Americans are in a hurry. I’m not sure where people are going, but the speed and volume of life has been turned up. The frantic pace of living causes people to become insensitive to others. How many times have people in their haste to get somewhere fail to open a door for others? How many times have drivers forbidden you to make a lane change when they are fully aware that you are signaling for entrance? How many people are inconsiderate in canceling appointments without providing 24 hour notice to service providers? How many children show a selfish sense of entitlement, lacking a sense of gratitude for what they have been given?

Demonstrating etiquette or good manners appears to have been lost in our current way of living. Little gestures like saying “thank you,” showing kindness to others (especially toward special needs individuals), and showing proper manners needs to be resurrected.

We need the kind of civility which requires us to think more about the needs of others than our own desires. That may involve taking on volunteer service, going out of our way for friends and family members, and supporting those who are grieving significant losses. Our care and concern for others must not be conditional. It cannot be contingent upon others responses to our deeds. We need to learn to display care and concern for others because it is the right thing to do, not necessarily because others appreciate our efforts. We act with kindness because it is apart of our character, not because we assume others will value our efforts. We do it anyway, even if our efforts are not always appreciated.

As a society, we need to get back to the basics of kindness, rules of etiquette, sensitivity, and consideration for others. Many of us feel isolated due to a lack of connectedness. In this impersonal world, we must all strive to make us all feel more like a global family. We can accomplish this by showing the human touch rather than the automated responses characteristic of our current culture.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.amazon.com. James can be reached at www.krehbielcounseling.com.

Changing Negative Child Behavior

2007-01-16T09:20:00.000-08:00

I saw a parent in counseling whose 16 year old daughter was using alcohol, was excessively truant from school, and was enmeshed with a boyfriend. The boyfriend had a history of trouble with the law and was suspected of using methamphetamine on a regular basis. On several occasions, the teenage girl had left the house on a Friday evening with her boyfriend and did not return home until Sunday afternoon. The mother was terrified regarding the whereabouts of her daughter, but she decided that the best way to handle the conflict was to invite the boyfriend over regularly and to have him stay overnight at the request of her daughter. On the day I saw the mother she was planning on celebrating her birthday that night. She had plans to spend the evening with her two children, but her daughter insisted that her boyfriend be included in the dinner party. The mother objected, so the teenage daughter proceeded to destroy items in the house. In order to stop the violent temper tantrum, the mother agreed to let her daughter’s boyfriend join the birthday celebration. She left my office in a dejected mood.

The most striking aspect of this story was the mother’s demeanor. She told her story in a nonchalant manner, devoid of any emotional content. My first question was one I often ask parents, “Where is your anger? Where’s the kind of anger that makes you want to stick up for yourself?”

Parenting is an art. No one gave us a manual to assist in this most difficult task. Managing children is a challenging process which requires courage, connectedness, consequences, and consistency. Mistakes are inevitable, but good child caretakers learn from their failures and seek to establish new ways to change negative child behaviors.

Often, parents struggle in their relationships with their children because their own family role models were faulty. They may feel alone in their quest to get it right with their own children because they have had no positive patterns to follow from their own upbringing. It is not unusual for caretakers of children to internalize the bad parenting styles of their own parents and to project archaic, self-defeating strategies onto their children. Regardless, one cannot be excused from learning more adaptive ways of working with kids.

Life appears to consist in polarities. Parents tend to under-function or over-function on behalf of their children. Under-functioning parents are absent. They lack the skills to nurture, encourage, coach, and motivate their kids. Children in such families feel lost and perform to please in order to make a peace offering to gain approval. Out of a sense of abandonment, these children will act overly-compliant (and sometimes rebellious) in order to strive for a sense of approval. If validation is not forthcoming, these children will turn against themselves, internalizing self-blame and resentment.

Over-functioning parents tend to do for a child what he can do for himself. They overcompensate, thus taking a child’s power away. They think, feel and act for the child, rendering the child powerless as the master of his own fate. These are the parents who are terrified of disapproval. In their haste to bolster their self-esteem in the eyes of their children, they create the conditions for their children to lack realistic expectations, appropriate boundaries, civility and compassion. Since these kids have never been appropriately frustrated, enough is never enough.

Since parenting is an art, what parents are doing is always subject to change. As I tell my patients, “If what you are doing is not working, shift gears and try another approach.” Many parents will maintain the same pattern even though it may not be effective. There are no magic bullets or “right” ways to parent.

Changing negative child behaviors calls for a plan and a commitment to follow it to its conclusion. In order to avoid power-struggles parents must learn to “major in the majors.” If you feud about minor issues, you leave yourself open to passive-aggressive behavior on the part of your child. On major issues I recommend parents adopt a process that I call “non-evaluative exploration.”

Non-evaluative exploration means that you resist the urge to pontificate, moralize, give advice or lecture. Such tactics put the responsibility for change on your shoulders rather than the child’s. Instead, explore behaviors with your child, insisting he make value judgments about the issues under discussion. In this way, you “box the child in” requiring him to make assessments about his own behavior. For example, exploration of school issues might include, “How do you feel about your progress this semester? What has been holding you back? What do you think it would take for you to improve? Is your performance on target with your future goals? If not, what do you think you could do about this?”

Some behaviors may not warrant exploration. These behaviors might include one’s curfew, ways of treating others, courtesy to parents, and issues regarding self-medicating. Parents need to state their expectations and adopt logical consequences for such behaviors. Consequences should be reasonable, fit the infraction, and be consistent.

Another way to avoid power-struggles and passive-aggressive behavior is to establish positive consequences for appropriate behavior. As most children already receive an allowance, I encourage parents to tie positive consequences to an earned monetary value. Household tasks and other important household issues can also be reinforced through the use of a goal chart that is checked daily. Negative consequences, when necessary, which include removal of privileges should reserved for major violations.

It is important that a parent’s involvement with a child remain unconditional. This means that a parent must resist the urge to let one’s feelings affect the ability to keep the lines of communication open. Involvement is the cornerstone of parenting, even if the child has chosen a path of detachment. By maintaining a strong sense of involvement with your child, a parent keeps the door open for unexpected exploration and discussion.

Parents may need to adapt their parenting philosophy and strategies to the developmental level of their children. Age differences and variances in temperament may require parents to modify their parenting styles and techniques to meet the needs of their children. Parenting strategies that work for a 5 year old will not affect change in a teenager. Understanding the developmental changes which occur in children is important to the process of parenting. Changing negative child behavior requires parents who are committed to demonstrating courage, connectedness, establishing consequences, and maintaining consistency.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.amazon.com. James can be reached at www.krehbielcounseling.com.

SUPER-DADS AND THEIR SONS

2006-12-27T21:14:00.000-08:00

Super-Dads are fathers who are perceived by their sons to possess qualities and achievements that are unattainable by the child. Super-Dad’s past or current performance seems overwhelming and larger than life. Sons put their Super-Dads on a pedestal and believe that they will never be able to measure up to their father’s expectations.

Super-Dads have a tendency to over-parent and have expectations for their sons that mirror their own achievement. Super-Dads, in an effort to keep their boy in line, will often parent through the use of power and control. When a Super-Dad sees his son straying from the right path, he will typically increase his pressure in an effort to gain compliance. He may lecture, use moral injunctions, or employ “cheerleading” techniques in an effort to get his son to mirror his own behavior.

Often, I may see a depressed and angry teenage boy for counseling at the request of the Super-Dad. However, the presenting problem may be the critical, intimidating behavior of the father. I once counseled a high school senior who was terrified of communicating with his Super-Dad. The father had been a star basketball player and he wanted his son to excel at the sport. The son, who was an average player, confided that he hated the sport and wanted to drop out of competition. However, as trapped as the son felt, he kept going to practices and games. He believed that his father would be crushed if he knew how much he despised playing. He tried exploring his feelings with his father, but Super-Dad insisted that the son continue on the team. The son believed that his desires were being discounted. He was afraid to take the matter into his own hands and quit.

At times, a Super-Dad who excelled academically can overwhelm a son by continuously focusing on school success to the exclusion of other aspects of the son’s life. Super-Dad and son may engage in power-struggles over school performance issues. The Super-Dad will talk to his son through lecturing, advice-giving, chastising, and moralizing rather than exploring issues. The Super-Dad may be oblivious to the fact that his son’s compliant responses are in reality an effort at avoidance.

Super-Dads, in an effort to clone their own behavior through their child, may actually foster conflict and passive-aggressive behavior. Super-Dads efforts may go unrewarded as they sabotage their own goals with their sons. Their son may learn to resent their father’s way of conditionally communicating, and find passive-aggressive ways to pay them back.

Case in point may be the interpersonal pattern of communicating which exists between our current president and his father. President George H. Bush was an exemplary student, an excellent athlete, and a President who made notable positive contributions to foreign policy during his administration. He surrounded himself with talented and knowledgeable statesmen who paved the way for a successful foreign policy, including his mission in Iraq.

I believe that President George H. Bush’s pattern of communicating with his son tended to mirror the Super-Dad syndrome. The harder George H. tried to reach out to George W., the more distance he created with his son. It was not intentional, but the pattern evolved into a self-defeating manner of interacting. It is my belief that President George W. has never been able to live up to his father’s expectations. He has indicated that he never wanted to be President. He started to become rebellious during his adolescent and early adulthood years, and he has continued to demonstrate on-going signs of reactivity and resentment toward his father.

It appears that President George H. and George W. have a strained relationship. President George W. may have created insurmountable wreckage during his presidency as opposed to his father’s successes. In George W’s efforts to compensate for his own insecurity, he has turned his back on his father’s values and ideals. Political analysts believe that he has ignored his father’s warnings, advice, and input. He has detached himself from Dad’s support as he chooses to go it alone. It seems that Super-Dad, George H., grieves the loss of his son, but feels helpless in his efforts to save his son from his own demise.

How do Super-Dads make peace with their sons? They accomplish this by developing unconditional involvement with their sons and explore problems in a non-evaluative manner. Super-Dads encourage their sons to follow their own dreams, not the goals and aspirations of the father. They encourage their children to be authentic, and support them in their vision for the future. Only then can the pattern of relationship wreckage be broken.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at www.amazon.com. James can be reached at www.krehbielcounseling.com.

THE TRUE MEANING OF CHRISTMAS - WITHOUT THE FLUFF

2006-12-17T14:14:00.000-08:00

The meaning of Christmas is not embedded in the holiday tradition itself. Although bumper stickers reading, “Jesus is the reason for the season,” are clearly noticeable, it is significant to note that the early Christian church did not celebrate the birth of Christ. Nowhere is Christmas mentioned in the New Testament as a historical and biblical account. The tradition evolved later in church history. In fact, for these and other reasons, many Christians bypass Christmas as a holiday, preferring to place emphasis on Easter, notable for the biblical account of the resurrection of Christ.

Regardless of the history, I choose not to be so literal about my holidays. In spite of the commercialism and materialism which tarnishes the spirit of Christmas, the holiday does signify some universal meaning. For the Christian community, the meaning of Christmas must take on a broader significance in today’s world. The question we must pose is, “Will I turn inward and be exclusive in my dealings with other people who share different faith traditions, or will I recognize, respect and embrace the richness of cultural differences. This issue is of primary importance in light of recent political/cultural polarization fostered by many in our Christian community and our federal government.

Recently, a story came to my attention about Christmas decorations displayed at the Seattle airport. A Rabbi had made a request, not because of the Christmas arrangements, but because his holiday had been ignored. The Rabbi requested that the airport display Menorahs symbolizing Hanukah. The airport bulked at the suggestion, the Rabbi threatened suit, and the airport proceeded to remove the Christmas trees. The Rabbi had never asked that the trees be removed. I’m sure the airports reasoning went something like, “If we have to display Menorahs, God only knows who else we will have to support!”

As tormented as he is, Rodney King had it right – “Can’t we all just get along.” Herein lays the true meaning of Christmas. It’s not about turning inward, it’s about looking outward. It’s not about merely looking through the eyes of your own faith, it’s about seeing through the eyes of our friends who happen to share a different faith orientation. The true meaning of Christmas is tainted by our need to defend and protect our beliefs. True faith calls for reaching out to others who don’t necessarily share our same beliefs.

The true meaning of Christmas is a call for tolerance, acceptance, and unity. What a wonderful tribute could have been demonstrated in the Seattle airport to the universality of faith traditions had they opened their hearts and minds to a Rabbi, rather than blaming him for stirring up the pot.

What is wrong with us? As Christians, we politicize private medical decisions, expect the world to eagerly embrace our ideals without emulating them, and continue to profile people who share different values and cultural perspectives. We deny our insensitivity, stay within our emotional bubble and celebrate our Merry Christmas with those like us.

The true meaning of Christmas involves “getting our heads out of the sand”, and clearly viewing the world the way it really is. It means joining hands with those who are different than we are, and embracing their right to live freely in this wonderful country. May we all pause this Christmas and take action to support the poor, the needy, the disenfranchised, and particularly our brother and sisters who see the world from a perspective different from ours.

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer, and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at http://www.amazon.com James can be reached at http://www.krehbielcounseling.com

HOW TO AVOID POWER-STRUGGLES WITH YOUR KIDS

2006-12-09T18:58:00.000-08:00

Inevitably, sometime within your parenting career, you will face a power-struggle with your child. If you don’t, you may be too intimidating, your child may be rather compliant, or you have mastered the art of managing conflict. Power-struggles occur due to a variety of factors, but invariably make a parent feel fatigued, frustrated, and helpless.

Power-struggles emerge as a conflict over demands, wants and needs. Parents will attempt to get their child to manifest certain desired behaviors while the child may choose to react to the request in a negative manner. Children demonstrate various techniques for “testing” their parent’s patience. They may cry, have temper tantrums, manipulate, avoid contact, become aggressive, and refuse to comply with expectations. Parents may employ various methods in trying to hold their children accountable regarding their requests. They use control, lecturing, pressure, guilt, bribery, sulking, or aggressive behavior as strategies to get what they want from their children. None of these methods generally work very effectively.

Parents who seek counseling will indicate that they have tried everything in their arsenal in an attempt to get appropriate behavior displayed by their children. Power-struggles may occur over issues such as schooling, household chores, and a child’s desire for more freedom, or a child merely wanting his own way. Power-struggles can be minimized if parents will change their tactics with their children. This process can be accomplished if a parent is open to new ways of managing problems:

Parenting is not about doing things the “right or wrong” way. If what you are doing isn’t working, shift gears and move in another direction.
Most power-struggles can be avoided by establishing meaningful, consistent, logical consequences. Children should be informed regarding the nature of positive and negative consequences. Fight the urge to engage and merely lay out the consequences for appropriate or inappropriate behavior.
Never acknowledge or entertain temper tantrums. Distance yourself and isolate your child (time-out) until she is ready to respond rationally.
Don’t get “hooked” by your child’s behavior. Step back, take a deep breath, disengage, and set logical consequences appropriate to the offense.
Consequences for children should primarily be positive providing a preventative means of avoiding the potential for power-struggles. Unreasonable consequences imparted to a child while a parent is angry will serve to reinforce the power-struggle.
By all means, avoid power-struggles over schooling. Power-struggles over a child’s education are number one on the list. Rather than pontificate with children about grades, capabilities, and school failure, ask them to explore and make value judgments about their performance. On occasion, monitor their performance, but fight the urge to continuously confront them about their failures. Set positive consequences to encourage completed work. Emphasize the quality of their work (process) rather than grades (outcome). Utilize outside resources, if necessary, such as tutors, parent advocates, and counseling services rather than confronting educational issues yourself. Maintain a sense of involvement with your child that is not conditional upon school success. Ironically, it may break the power-struggle and generally lead a child to change his perspective about schooling.
Remember, you are the adult. Kids will always try to test the limits.
Make sure that your logical consequences that are based on negative behavior are reasonable. Consequences are designed to be used until improved behavior is observable.
Always explore problems rather than confront them aggressively. Have your children make value judgments about their behavior rather than you making judgments on their behalf.

Avoiding power-struggles involves setting appropriate limits for your children, being consistent in enforcing them, and being reasonable with the management of consequences. Remember, positive consequences are much more effective in leading to improved behavior and help eradicate power-struggles. Children will respect you more if you are significantly involved in a positive manner in your child’s life and choose to role-model the behaviors that you desire your children to emulate.

James P. Krehbiel, Ed.S. LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at amazon.com. James can be reached at http://www.krehbielcounseling.com/.

THE FOUNDATION OF GOOD PARENTING

2006-12-07T09:11:00.000-08:00

Parents often deal with their kids the way they were disciplined. This may involve archaic notions about parenting that no longer work in today’s world with children. It is not unusual for adults to believe that parenting primarily involves the use of power and control. In William Glasser’s book, The Identity Society, he makes the point that the nature of parenting has changed over the last several decades.

Authority figures are no longer respected by virtue of the role they play. Teenagers are no longer compliant merely because their parents bark out orders. Glasser is very pragmatic about this issue. It’s not a matter of what’s right or wrong with reference to the values of parenting, it’s what works. Typically, using control tactics no longer work with kids. Many teachers have a problem grasping this concept. They believe that they can coerce kids into doing schoolwork. It usually doesn’t impact the child. Parents try to act authoritarian around their children and it backfires. Discipline is about role modeling respect, being firm, setting appropriate limits, and establishing consequences.

The most important step to discipline is creating a positive relationship with a child. Next, one must educate and coach kids on what you want them to accomplish. Developing autonomy within your children involves coaching and educating them to take responsibility for themselves. Respect must be modeled. That’s the way things are within our current cultural setting. You can complain about, say it’s not fair, but it’s the reality. Life is a lot more fun when children like and respect their parents. Most children will do most anything for parents they respect. I realize that there are exceptions, and in those cases parents need not feel guilty for bad parenting. Some kids make poor choices regardless of how connected we are to them.

For parents, “stepping out of the bubble” may mean viewing the parenting process from a different perspective. It may mean giving up the image of parenting that was established during their childhood. Sometimes, parents will internalize the image of parenting that was handed down to them even if that perception was intolerable. Sometimes caretaking for our kids involves doing the opposite of what was done to us. We need to get in touch with the child within us. We need to remember what it was like to play and have fun. If our childhood wasn’t fun, then we need to do some grief work and vow to make things different with our own children. If our inner-parent is critical, we will most likely have unrealistic expectation for our children. We need to listen to the inner-critic and let it speak. We may hear tones of the tyranny of the “shoulds.” The inner-critic or inner- parent is full of moral injunctions. It is the judge and jury of our behavior. Combine that sub-personality with the pusher-driver part of us and you have a toxic combination. The pusher-driver is the inner part of us that says, “What I am doing is not good enough. I must always try harder.” Parents need to get in touch with the inner-critic and the pusher-driver and identify with their contents and then detach. Parents will want to rationally respond to these sub-personalities with more reasonable ways of viewing specific issues. This process of rational responding will assist in clearing up the “muddy water” when it come to coaching and advising our own children.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and cognitive-behavioral therapist practicing in Scottsdale, Arizona. He personal growth book, Stepping Out of the Bubble is available at www.amazon.com. He can be reached at www.krehbielcounseling.com.

Dixie Chicks Light up Phoenix, Dispel Predictions

2006-11-20T10:53:00.000-08:00

The Dixie Chicks seemed surprised at the reaction that they received from their Phoenix fans. Predictions from journalist had the group performing to a half empty crowd. However, a full crowd supported them as fans stood and cheered throughout the concert. The Dixie Chicks have matured in their work and sound better than ever. They played with a passion that reflected their social and political values. I don’t believe in revering heroes, but if I had one it would be the Chicks. They reflect the values that I embrace in my book, Stepping Out of the Bubble. They are not afraid to “stick their neck out” in support of their beliefs. I like that. Their recent track songs, such as “the long way around” remind me of concepts that I embrace in my book about displaying courage and risk in stepping out of one’s psychological bubble. They have had a rough road to travel, but what they said politically has made them look prophetic.

James P. Krehbiel, Ed.S., LPC, is an author, freelance writer, and cognitive behavioral therapist practicing in Scottsdale, Arizona. His personal growth book, Stepping Out of the Bubble is available at amazon.com. James can be reached at www.krehbielcounseling.com or www.leavingthebubble.blogspot.com.

CONFIDENT STAY AT-HOME MOMS

2006-10-11T15:16:00.000-07:00

Many mothers who are stay-at-home parents lose their sense of self in the process of caretaking for their children. A woman’s natural instinct to “protect her flock” may come into direct conflict with developing a strong self-identity.

Often, mother’s “lose themselves” by giving their power away in relationships, particularly with their children. They may develop a connection with their children, but it may be established in an unhealthy manner. One of my parental slogans is, “Never do for a child what she can do for herself.” Mothers may overfunction on behalf on their children, giving away their sense of self while inhibiting their kids’ opportunity to become self directed.

In order to create a positive self-image, stay-at home mothers need to learn to set personal boundaries. Sometimes, parents unknowingly become an extension of their children. They may vicariously live through their children and meet their needs in this manner. An example is the parent who becomes overly enmeshed in their child’s activities. They may inadvertently put pressure on a child to perform admirably to compensate for their own perceived shortcomings.

A confident stay-at-home mother needs to be able to distinguish herself from her children. Personal boundaries should not be blurred. A mother must be able to step back and evaluate her behavior. Are my feelings separate from those of my children, or do I get swallowed up in the burden of how they experience life? Are most of my needs tied up in the caretaking process for my children? Do I have separate wants, desires and needs apart from those of my children?

I think an empowered mother must learn what I call “detached identification.” Mothers are responsible to their children, not for them. Understanding this distinction determines whether a stay-at-home mother will cultivate a vital sense of self. Often parents are unable to distinguish their thoughts, feelings, and behavior from the pattern of their children. They may worry endlessly about their children instead of demonstrating appropriate concern. Worrying erodes confidence. Appropriate concern empowers a mother to problem-solve new ways of assisting their children in managing problems.

Some mother’s groups advocate what I call “extreme parenting.” The parental bonding process does not take into consideration the mother’s well-being and personal identity. There are groups that advocate that the stay-at-home co-sleep with her children on a regular nightly basis as a connecting experience. In my opinion, this practice is unhealthy for the child as well as the mother.

At times, a mother will pursue her children when it would be better to fight that urge. Recently, my daughter visited me along with her toddler. We were walking down the street during a shopping trip and my granddaughter fell down at one point. I reached over to pick her up and my daughter intervened. “Dad, leave her alone. Let her handle this by herself.” My daughter was right. Malia was not hurt and was capable of getting up on her own. Step back, fight the urge to pursue and let children handle their journey to learn new skills.

It is imperative that stay-at-home moms create a life apart from their children. Developing a business from home, joining parenting support groups, spending time with adult friends and volunteering a small amount of one’s time are important ways of refocusing one’s energy and validating personal identity. Finding someone to caretake for the children may be difficult, but necessary. Hopefully, a partner is a team player in this regard and provides the mom with time away from her children. This is in the best interest of the adult relationship as well as the adult-child relationship. Mothers may make excuses as to why a baby-sitter doesn’t meet their expectations. Part of maintaining a self-identity for the mother is learning to let go of the children and allowing the children to be “raised by the village.” If a stay-at-home mother desires to create a healthy sense of self, she needs to learn to entrust her children to significant others.

Suggestions to assist stay-at-home moms in creating and maintaining a strong self-image are:
Don’t be an overly-possessive mother. In doing so, you give your power away to your children.
Listen and respond to your own needs. This is not being selfish but honest and empowering.
Always trying to please your children will backfire. They will not respect you and you will not respect yourself.
If your children make mistakes it is not a reflection on you. Remember you are ok as long as you allow children to become self-directed through learning from their own experiences.
Create a life for yourself apart from your children. Involve family, friends and significant others to support you in your self-rewarding activities.
Eradicate the words “selfish” and “guilty” from your vocabulary. They are words that diminish your worth and keep you from developing confidence.
Recognize the harsh reality that your children don’t always need you. It’s amazing what they can do for themselves.
Let go of the illusion of being the perfect mother. Parenting is an art. Having to be perfect puts an unreasonable burden on you.

Stay-at-home moms can develop confidence and feel empowered if they can learn to meet their own needs apart from their children. Setting appropriate boundaries, being assertive, and giving your children appropriate space with encouragement will enhance a mother’s sense of self-determination and confidence.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book Stepping Out of the Bubble is available at www.amazon.com. Now you can "ask James", through an interactive forum for parents at www.theparentstation.com.

HOW TO MANAGE OBSESSIVE-COMPULSIVE BEHAVIOR

2006-09-23T18:41:00.000-07:00

For many people, obsessive-compulsive disorder responds well to a combination of antidepressant medication and cognitive therapy. Most people with OCD appear to be predisposed to the symptoms. Usually you can find other extended family members who share a similar pattern of ritualistic behavior. Therapeutic treatment involves the following process: relabeling, reattribution, relaxation techniques and refocusing strategies. Relabeling and reattribution techniques are designed to assist in objectifying the disorder and realizing that people are more than their obsessions. For example, I teach people to internally respond by saying, "A part of my brain works in ways that make me repeat things continuously. This is merely my disorder speaking; I am more than my disorder." This way of perceiving one’s obsessive features helps people to detach the nature of their problem from their sense of self. Relaxation techniques may involve exercise, music, message, meditation and vacationing in a soothing environment. These strategies slow down the sympathetic nervous system minimizing anxiety and making it easier for people with OCD to manage their thoughts and behavior. One’s level of anxiety is directly related to the impact of compulsive behavior.
Refocusing techniques refers to assisting patients to shift from obsessional thinking and behavior to other more self-rewarding activities. A change in activities lessens the impact of the OCD thinking and behavior. For example, a child may have a ritualistic pattern of continuously changing the television remote control in a certain order. A therapeutic goal might be to get the child to leave his obsession by getting up and leaving the room, possibly departing the house for a brief walk. I have people track the intensity of their anxiety during the time that they are away from their ritualistic behavior. When removed from an obsessional behavior, anxiety initially becomes worse and then dissipates in strength over time. Once the child returns to the obsessional pattern after voluntarily leaving it, it usually has decreased in its impact and intensity. The child may say, "I was able to keep from repeating the pattern continuously. I only did it twice!" Reinforcement and encouragement are important for people attempting to minimize obsessive patterns.

Those who experience OCD are typically anxious about their symptoms and fight to get rid of them. It is essential that those who suffer from OCD learn to accept their symptoms rather than struggle with them. Acceptance of any form of anxiety helps one to minimize the symptoms. For example, one might say, “Here come those “crazy feelings” again. They sure are annoying but they won’t hurt me. If I learn to “let them be” they will eventually dissipate in their effect on me.”

It is important for those who experience OCD to share their problem with a close friend or therapist. Expressing one’s feelings about the pattern may help in dealing with any feelings of shame or embarrassment. For the OCD sufferer, it is significant to remember that most people experience features of the disorder. All behavioral problems lie on a continuum. Struggling with OCD is no exception. When we share our problems with others, we realize that we are not alone in our difficulties. It takes courage to admit that we are less than perfect and to allow ourselves to share our humanity with others. When we learn to quit fighting with our imperfections, the issue eventually seems less troublesome.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at www.amazon.com. Now you can "ask James" through his interactive forum at www.theparentstation.com.

DEALING WITH POST-TRAUMATIC STRESS DISORDER

2006-09-11T13:53:00.000-07:00

Many people have experience Posttraumatic Stress Disorder symptoms. One of my patients was in a highly abusive relationship with a man who physically beat her. This went on for some time as she allowed herself to remain in a pattern to be re-traumatized. Currently, relationships still terrify her. Due to mistrustful feelings, she pushes men away with her anger and rage. Then she becomes upset with herself for behaving in impulsive ways. The key to treatment for her is to isolate the traumatic feelings, explore the pain around them, and to teach her new ways of behaving that are based on rational thinking. She no longer needs to view herself as the victim in relationships. She needs to expand her psychic map to include new feeling, thoughts, and behavior. This exploration process is painful, but it will free her of the need to continue victimizing herself. She needs to flush out the negative energy that has allowed her to be re-traumatized. The cycle can be broken with proper therapeutic intervention.

Clients who suffer from Posttraumatic Stress Disorder experience the effects of psychic numbing. These people also tend to suffer from anxiety, depression, panic, anger and rage and startle response. A friend of mine, who was a Lieutenant during the Vietnam War, experiences features of this disorder. When the snowplows rumble through his hometown during a major snowstorm, it is not unusual for him to be awakened in the early morning by the sounds. Sometimes, he jumps out of the bed in total confusion and panic. It’s as if he back in the rice paddies of Vietnam waiting for the next mortar found to explode. What he is experiencing is the startle response or hypervigilence. Isn’t it amazing how the brain works? After thirty years loud noises still take him back to a place where psychic numbing was necessary for survival. All of the painful psychic energy is stored in our bodies and mind. Many times I recommend message therapy as an adjunct treatment to clients who have stored painful feelings, because it is one more entry point for ferreting out troublesome emotional energy.

It is important that we do not forget those of have been the victims of PTSD. Now that the dust has settled, do we still remember that we have an obligation as a country to treat those who have suffered for this disorder as a result of war and natural disasters? Let us not forget our families who have suffered from the ravages of our current struggle in Iraq, “the war on terror,” and those who endured Hurricane Katrina.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. His book, Stepping Out of the Bubble is available at www.amazon.com. Now you can “ask James” through his interactive forum at www.theparentstation.com.