Saturday, November 19, 2011

Troubled Childhood - The Breeding Ground for Adult Sexual Abuse


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.

Thursday, November 17, 2011

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


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?

Wednesday, November 09, 2011

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


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.

Tuesday, October 18, 2011

How to Manage our Hard-Wired Youth


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.

Tuesday, August 16, 2011

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



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.

Sunday, July 10, 2011

10 Insights to Help Couples Resolve Conflict


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.

Tuesday, July 05, 2011

Filling the Feeling of Boredom with Meaning


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.

Sunday, June 26, 2011

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



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.

Wednesday, June 22, 2011

Clinging to the Comfort Zone: Our Belief in Beliefs




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.

Tuesday, June 14, 2011

How to Break Out of the Perplexing Parenting Trap



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.

Saturday, May 21, 2011

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



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.

Sunday, May 15, 2011

Leaving Behind the Love Affair with Misery


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.

Friday, April 22, 2011

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


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.

Tuesday, March 01, 2011

What to Do When Kids are Sad


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.

Saturday, January 29, 2011

Recovery is Possible for Adverse Childhood Experiences



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.


Monday, January 03, 2011

Americans' Problem with Troubled Childhoods


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.






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Troubled Childhood, Triumphant Life: Healing From the Battle Sca... by James P. Krehbiel






Troubled Childhood, Triumphant Life




by James P. Krehbiel






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