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.

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.

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.

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.

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.

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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

by James P. Krehbiel

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The Fugitive Game: Coming to a Town Near You

{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

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

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

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

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

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

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

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

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

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

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

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

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

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.