Tag: Trauma

Tell Us What You Think | Ask Questions | Get Feedback From Your Peers

How will what you heard today change the way you practice? Is there a particular technique you plan to try? Do you have specific questions for the presenter? Join the conversation!

If you have any technical questions or issues, please email support@psychotherapynetworker.org.

Bill DohertyEsther PerelWe’re halfway through State of the Art 2013! How’s your conference experience going so far? Have you had a chance to fill out your community profile, connect with other attendees, or ask questions to our presenters? If not, we hope you’re enjoying the sessions or looking forward to watching them on demand over the next five months!

Yesterday, you had the opportunity to watch the premiere event “Commitment and its Challenges in 21st Century Couples” and pose questions to the presenters. Though Esther Perel and Bill Doherty seem like very different couples therapists at first blush, they found a lot of common ground when addressing the present day tensions couples face between adventure and stability, fidelity and eroticism, and individual fulfillment and responsibility. We can’t wait to see how Esther and Bill respond to your questions!

You can tune in today for another brand new session with Mary Jo Barrett and Dick Schwartz on “Treating Trauma: A 30 Year Perspective.” They’ll be delving into the latest advances in trauma treatment and what the future holds for trauma specialists. They’ll also be taking questions for their follow up session next week!

Today’s agenda also includes some Symposium classics: “Coming to Our Senses” with mindfulness-based stress reduction developer Jon Kabat-Zinn, and “Cyber Intimacy and Cyber Solitude” with MIT psychologist Sherry Turkle. All sessions are available at 1 pm Eastern!

Also, take a look at the latest conversations in the community forums if you have a chance.

Need help during the conference? Be sure to check out our virtual conference FAQ and contact support@psychotherapynetworker.org for technical assistance.

Tell Us What You Think | Ask Questions | Get Feedback From Your Peers

How will what you heard today change the way you practice? Is there a particular technique you plan to try? Do you have specific questions for the presenter? Join the conversation!

If you have any technical questions or issues, please email support@psychotherapynetworker.org.

Tell Us What You Think | Ask Questions | Get Feedback From Your Peers

How will what you heard today change the way you practice? Is there a particular technique you plan to try? Do you have specific questions for the presenter? Join the conversation!

If you have any technical questions or issues, please email support@psychotherapynetworker.org.

Rich SimonIt’s a cliché phrase by now, uttered by every health professional at some early point in their careers, but I became a psychotherapist because I wanted to help people. Why else do any of us do it? For many of us, being able to provide support and guidance to people who are moving through the darkest periods in their lives is what keeps us returning to our offices to sit with even the most difficult clients. Read more

Finding the Hero Within with Ken Hardy

Exploring the link between trauma and oppression

By Ryan Howes

One of the hallmarks of the family therapy movement of the ’60s, ’70s, and ’80s was the exploration of the power of social issues like race, class, and ethnic background in clients’ lives. Leading figures in this movement, like Salvador Minuchin, Braulio Montalvo, Marianne Walters, and Monica McGoldrick, were outspoken about the importance of paying attention to the impact of social issues in the therapy room. But these days, we don’t hear much about the connection between psychotherapy and the larger social issues of the day. It seems that, for most therapists today, multiculturalism is a required, four-hour CE workshop, not a cause worthy of attention. One exception is Kenneth Hardy, a professor of family therapy at Drexel University in Philadelphia, who’s dedicated himself to working with troubled inner-city adolescents and keeping alive psychotherapy’s social conscience.

——

RH: You once said: “My training prepared me to be a pretty good white therapist.” Could you elaborate on that?

HARDY: I did my graduate training in the early 1980s at the Medical Research Institute in Palo Alto, and spent time at the Family Therapy Institute in Washington, D.C., with Jay Haley. I learned a great deal at both places, but there was little that spoke to me as a person of color. Whatever discussion there was about race or culture tended to pathologize people of color without seeing their inherent strengths. When I left my graduate program and got a job at a psychiatric outpatient clinic in Brooklyn working with a population that was largely people of color, I saw the first day that there was a massive disconnect between what my training had taught me and what they needed from me. While I’d been well trained, I felt like I was a white therapist in black skin.

RH: Has training changed since that time?

HARDY: Well, I think there’s been improvement. You’ll certainly find more faculty of color in training programs—not a substantial number, but one or two people. You’ll find some course content focused on themes of race, class, and ethnicity. But when I talk with students of color, the kinds of experiences they describe today are chillingly similar to the ones I experienced some 30 years ago. They still don’t feel entirely safe bringing up issues of race or ethnicity. Is it better than when I was a student? Absolutely, it’s better.

RH: You described the shift in your work with inner-city teens as moving from, “What’s wrong with you?” to “What happened to you?” Could you elaborate on this?

HARDY: Lots of the young people I see have been perpetrators and done some pretty horrific things in the world. But as a therapist, I’ve found it most useful to start by getting curious about what happened in their lives that contributed to their violent behavior or other aspects of who they are. I see them not just as perpetrators, but perpetrators who were themselves victims before they became perpetrators. So I typically ask early on, “Who were you before you became who you are today?” I want them to think about the events in their lives that reshaped them and led them to be where they are today.

The lives of these kids are filled with trauma, and trauma can reshape every aspect of our lives. As a therapist, I begin by looking at what happened along the way to clients that’s incited this shift in them. I’ve found that doing that is a much more helpful place to begin than trying to decide what’s wrong with them.

RH: What does this approach look like?

HARDY: The kids I see are coming in for things like robbery, violent crime, or chronic truancy. I’ve found again and again that trauma provides a powerful backdrop to those presenting problems. It’s really important not to start the relationship by focusing on their criminal activity. So I’m asking them to talk about their experiences of being poor, black kids in a poor neighborhood of Philadelphia, for example.

RH: You mention that a big part of your work with these young folks is affirmation. What do you mean?

HARDY: I once overheard someone talking about how a periodontist had to impact his gum and create some sort of synthetic gum. Something like that happens in psychotherapy. Often we have to build up the underdeveloped parts of people and find strengths where we can—to lay a foundation for growth. Affirmation starts to rebuild or restore what’s been destroyed, to create a foundation from which therapy can actually take place.

That’s not always so easy, especially if someone’s life narrative as a result of trauma is that “I ain’t nothing.” That can be difficult to rewrite. If I dare to see something redeemable in such people, they may think I’m trying to manipulate them. How could I honestly see something valuable in them?

RH: You like to talk about seeking out our clients’ “untapped heroism.” What does that mean?

HARDY: It comes from my deep conviction that no matter how egregious our behavior, we still have in us some redeemable qualities—something that sets off a flicker of light in the midst of everything that’s awful. So I’m always looking for that quality of what I call heroism in these young people—that part within them that’s managed to survive against tremendous odds. Heroism is this undying will to keep on keeping on, despite all kinds of adversity.

Whether you find that quality in your clients depends on what you look for. A therapist who looks for pathology sees it. A therapist who looks for strength finds it. You have to change what you look for in order to change what you see.

Ryan Howes, Ph.D., is a psychologist, writer, musician, and clinical professor at Fuller Graduate School of Psychology in Pasadena, California. He blogs “In Therapy” for Psychology Today. Contact: rhowes@mindspring.com; website: www.ryanhowes.net. Tell us what you think about this article by e-mail at letters@psychnetworker.org.

What Causes Borderline Personality Disorder?

By Jared DeFife

Do childhood trauma and a chaotic family environment cause adult borderline personality disorder (BPD)? Common clinical wisdom says yes, but new results are leading some researchers to insist that it’s more complicated than that.

Investigators from the Minnesota Twin Family Study, first begun in 1983, collected data about childhood abuse and adult personality from 1,382 pairs of same-sex twins, followed over time from ages 11 to 24. By examining differences in abuse exposure and genetic overlap (whether the twins were identical and thus had the same DNA, or fraternal, and thus had only about 50 percent genetic overlap), the authors, led by Marina Bornovalova of the University of South Florida, concluded that childhood abuse in itself isn’t a direct cause of adult BPD traits. But since childhood abuse is seen so frequently in individuals with BPD (some studies suggest in as much as 90 percent of cases) why the overlap? According to the study, common genetic factors contribute to both childhood abuse and BPD.

The researchers suggest two possible genetically influenced reasons for the connection between childhood abuse and adult BPD. In the first model, called “passive genetic mediation,” children not only inherit genes from their parents, but are raised in an environment that’s an expression of the parents’ own genetic influences. In this model, children inherit genetic tendencies toward aggression, impulsivity, and emotional dysregulation from their parents and are raised by parents who are themselves aggressive, impulsive, and dysregulated. Abuse and BPD are thus different manifestations of the same emotionally dysregulating factors.

In a second, more controversial scenario, known as “evocative genetic mediation,” children who inherit difficult genetic temperaments from their parents tend to behave as moody or impulsive children. Emotionally intense and difficult to raise, these children strain their parents’ own genetically limited coping resources, contributing to parenting failures characterized by childhood abuse and neglect.

If the second scenario sounds like blaming the victim, the authors are quick to point out that their results “don’t support the idea that [childhood abuse] is inevitable, justified, or without harm.” However, their work raises possibly provocative questions about the causes and effects of childhood abuse and adult borderline personality disorder, once again putting science at odds with facile, politically correct perspectives on complex psychological phenomena.

Resources

What Causes Borderline Personality Disorder? Journal of Abnormal Psychology, doi: 10.1037/a0028328.

Diana Fosha On Bring Out Clients’ Dormant Resilience

Read more

With Donald Meichenbaum

Read more

Latest Advances in Trauma Treatment

Read more