Sep 14

Confidentiality: Keeping Secrets (Or Not) In or Out of Therapy

Most people, whether ever in therapy or not, are aware of the code of confidentiality. As therapist Daryl states to a client in my novel Minding Therapy, “Keeping secrets about you not keeping secrets is one of the therapist’s main obligations…”

From GoodTherapy.org:

Confidentiality includes not just the contents of therapy, but often the fact that a client is in therapy. For example, it is common that therapists will not acknowledge their clients if they run into them outside of therapy in an effort to protect client confidentiality. Other ways confidentiality is protected include:

    • Not leaving revealing information on voicemail or text.
    • Not acknowledging to outside parties that a client has an appointment.
    • Not discussing the contents of therapy with a third party without the explicit permission of the client.

For licensed mental health professionals, confidentiality is protected by state laws and the Health Insurance Portability and Accountability Act (HIPAA)

One of the main reasons it’s so important not to breach confidentiality is because therapy may be the first, maybe the only, place one’s confidences are disclosed. And people need to feel their secrets are in good hands.

This is not to say that everyone divulges all their private thoughts to their shrinks. For good or for bad, often there are things kept out of sessions. What to divulge is an individual choice based on any number of factors.

Even therapists in therapy might hold back. Andrea Rosenhaft for one. She’s a clinical social worker who calls her own years of omission “living heavy” and states on her Psychology Today blog:

I regret all the deceit, the secrets, and the manipulation. The blatant lies, the lies of omission have come back to hurt me in the form of the hands of the clock making endless rounds. I alienated psychiatrists, therapists and nurses with my calculating actions designed to mislead.

If I had been forthright, as difficult as that would have been, if I had simply told the truth, my treatment would have progressed much faster and perhaps I would not still need to be in therapy.

The jaunty song “Secrets” by singer/songwriter Mary Lambert (of “Same Love” and “She Keeps Me Warm”), on the other hand, is about things she would appear not to be keeping under wraps. These include personal tidbits involving such matters as the status of her mental health, her family issues, and her personality weaknesses.

She’s saying, in fact, that she doesn’t care if the whole world knows her secrets. (Which makes them no longer secrets, of course!)

 

The first verse and chorus of “Secrets” by Mary Lambert are as follows. See the rest at Genius.com or watch the lyric video above.

I’ve got bi-polar disorder
My shit’s not in order
I’m overweight
I’m always late
I’ve got too many things to say
I rock mom jeans, cat earrings
Extrapolate my feelings
My family is dysfunctional
But we have a good time killing each other

[Pre-Chorus]
They tell us from the time we’re young
To hide the things that we don’t like about ourselves
Inside ourselves
I know I’m not the only one who spent so long attempting to be someone else
Well I’m over it

[Chorus]
I don’t care if the world knows what my secrets are (secrets are)
I don’t care if the world knows what my secrets are (secrets are)So-o-o-o-o what
So what
So what
So what

Sep 07

Neuroscience For Us All: Three Books

Neuroscience is the backbone of the following three recommended books (some humor included!).

I. The Emotional Life of Your Brain: How Its Unique Patterns Affect the Way You Think, Feel, and Live–and How You Can Change Them (2012) by Richard Davidson (with contribution by science writer Sharon Begley)

Neuroscientist Davidson addresses the concept of us each having an “emotional fingerprint” based on where we fall on six different continuums:

  • Resilience–recovery from adversity
  • Outlook–duration of positive emotion
  • Social Intuition–sensitivity to social cues
  • Self-awareness–awareness of internal signals
  • Sensitivity to Context–ability to modulate emotions according to context
  • Attention–how focused or scattered

Selected quote: “Just as each per­son has a unique fin­ger­print and a unique face, each of us has a unique emo­tional pro­file, one that is so much a part of who we are that those who know us well can often pre­dict how we will respond to an emo­tional chal­lenge.”

Jack Kornfield, Ph.D. calls it “(t)he best book I know on how to use the exciting discoveries of neuroscience to change your life. A fabulous read – a scientific adventure story like Sherlock Holmes meeting Watson and Crick with the Dalai Lama as their advisor.”

II.  Idiot Brain: What Your Head Is Really Up To (2016) by Dean Burnett

If an “irreverent guide to the brain” is what you’re seeking, says Kirkus Reviews, this neuroscience book by Burnett may be it.

Burnett professes the following about the brain: “It’s undeniably impressive, but it’s far from perfect, and these imperfections influence everything humans say, do and experience.”

Some of the interesting conclusions by Burnett (with sources in parentheses):

Less intelligent people are often more confident. (Kirkus)

The Myers-Briggs personality test may not be that useful. (Kirkus)

Motion sickness is caused by the brain reading the mismatch between seeing a landscape move and the body feeling still. (Publishers Weekly)

Anger can reduce stress. (Leyla Sanai, Independent)

The brain often chooses being liked over doing what we believe to be correct. (Independent)

We tend to embellish our memories if we’re telling someone about it. (Terry Gross interview, NPR)

Anything longer than a minute is long-term memory. (NPR)

An interesting point made to Terry Gross (NPR) about the post Burnett considers the most controversial ever on his blog: Not transgender issues or immigration or same-sex marriage, all of which he’s written about, but “whether or not you should put milk in your tea before the water or after.”

Publishers Weekly: “…[Burnett] packs an incredible amount of information into an accessible package with this breezy, charming collection of pop neuroscience musings on ‘how the human brain does its own thing despite everything the modern world can throw at it.’”

III. The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity (2015) by Norman Doidge

Psychiatrist and neuroscience expert Doidge is on the cutting edge of the study of neuroplasticity. Asked by Leigh SalesABC.netto define the term, Doidge broke it down: “Well, neuro is for neurons, the nerve cells in the brain, and plasticity means adaptable, changeable and modifiable. And neuroplasticity is that property of the brain that allows it to change its structure and function in response to activity and mental experience.”

Although Doidge explains in The Brain’s Way of Healing that there are “critical periods of plasticity in early life” he also says “(w)e’re plastic until we die.”

In The Guardian Doidge listed five ways to improve brainpower. Click on the link for details:

  1. Walk two miles a day…
  2. Learn a new dance (or language or musical instrument)…
  3. Do serious brain exercises…
  4. Pay close attention to your voice…
  5. Get the rest your body requests…
Aug 29

Journals: Writing for Therapeutic Purposes

Journals and journal writing have been proven to be therapeutic. But how should you go about it? Do it your own way? Or follow the advice of such experts as social psychologist James Pennebaker? His “rules” (per Susan David, The Cut) include the following:

  • Set a timer for 20 minutes and write freely.
  • “Write just for yourself, and not for some eventual reader.”
  • After a few days or whenever, discard it. Or decide to do something bigger with it.

“It doesn’t matter. The point is that those thoughts are now out of you and on the page. You have begun the process of ‘stepping out’ from your experience to gain perspective on it.”

One long-term keeper of journals, Jamie Friedlander, found that entering therapy automatically decreased her reliance on the form, however. “Speaking to someone about my problems, it seemed, had all but replaced my urge to write about them” (The Cut).

Writing still helps me cope with the little stuff that becomes overwhelming. And jotting down the things I’m grateful for always brings me joy. But I know that for the big stuff — being laid off, feeling frustrated with a close family member, obsessing about my weight — I need to speak, not write.

Therapist Ryan Howes (Psychology Today), on the other hand, emphasizes the benefits of journaling while in therapy:

First, you’ve just taken some time to look at yourself, which continues the flow of therapy and makes you more aware. Second, you’ve begun to organize what can seem like a bunch of disjointed material. Writing forces you to funnel disparate thoughts into one linear stream. Finally, you’re keeping a record of your progress. People who journal for a few months are amazed when they look back to see where they were. Sometimes they’re amazed at how far they’ve come. Other times they’re surprised to find they’re barking up the same tree.

A common resistance among clients is the fear of others finding their words. What I usually say in response is that you don’t actually have to get over this fear. Write stuff anyway, then destroy it; you still get the same effects. Ephrat Livni, QZ.com, agrees:

That final act, tossing the journal, is painful but liberating. Letting go is a Zen exercise. It’s practice in detachment, forcing me to face facts, the simultaneous truths that everything matters and yet, ultimately, nothing does. Shit happens. We keep going. Tomorrow there will be more news.

Another resource is Susan Borkin‘s The Healing Power of Writing: A Therapist’s Guide to Using Journaling With Clients (2014). Although targeted to therapists, anyone can benefit.

One of the author’s suggestions is a guide for keeping track of various internal changes. It’s called ATTEND, an acronym standing for Awareness, Thoughts, Emotions, Intuition, Dreams, and Distractions.

While some are afraid to write in a diary or journal,  Sarah Manguso is one who’s been afraid not to, she explains in Ongoingness: The End of a Diary (2015).

I wrote about myself so I wouldn’t become paralyzed by rumination—so I could stop thinking about what had happened and be done with it. // More than that, I wrote so I could say I was truly paying attention. Experience in itself wasn’t enough. The diary was my defense against waking up at the end of my life and realizing I’d missed it. // Imagining life without the diary, even one week without it, spurred a panic that I might as well be dead.

What Manguso reports, by the way, is that the original anxiety is now gone.

Aug 17

Solitude Vs. Loneliness: Two Nonfiction Books

Solitude is not necessarily about loneliness. It is, in fact, a condition that can be appreciated, cultivated, and enjoyed. Below are two nonfiction books that address the benefits of solitude.

I. How to Be Alone by Sara Maitland (2014)

Kate KellawayThe Guardian, asked Maitland the important question about the difference between solitude and loneliness: “Solitude is a description of a fact: you are on your own. Loneliness is a negative emotional response to it. People think they will be lonely and that is the problem – the expectation is also now a cultural assumption.”

Selected Quotes from How to Be Alone:

Most of us have a dream of doing something in particular which we have never been able to find anyone to do with us. And the answer is simple really: do it yourself.

Remember it is quite normal to be a bit frightened of being alone. Most of us grew up in a social environment that sent out the explicit message that solitude was bad for you: it was bad for your health (especially your mental health) and bad for your “character” too.

…(B)eing alone can be beneficial and it is certainly not detrimental to well-being, provided the individuals have freely chosen it. A good deal of the “scientific evidence” for the danger [of solitude] to physical and mental health comes from studies of people in solitary confinement.

II. Solitude: A Singular Life in a Crowded World by Michael Harris (2017)

Below Michael Harris offers “Five Ways Being Alone Will Improve Your Life” (Time). Click on the link for additional details.

  1.  Politics. Getting our news on social media doesn’t necessarily lend itself to increasing our understanding. “We all need time away from the red-faced online crowds if we want to consider the things they’re shouting. The radical thinkers of tomorrow will be people who know how to remove themselves from toxic pools of public discourse; they’ll be people who have mastered the art of moving back and forth, between crowd and solitude.”
  2. Daydreaming. “Studies show that, when the mind wanders, our brains activate what’s called a ‘default mode network.’ An intense series of brain functions go to work, despite the ‘blankness’ that the brain projects to us…While institutions continue to place an emphasis on concentration and collaboration, it’s worth asking why so many of our greatest artists and scientists make a habit of solitary walks in the woods or through city parks…”
  3. Culture Consumption. Instead of going with the mainstream film, book, and song suggestions that everyone else goes for, do we really know what we actually prefer? “We owe it to ourselves to step away from these crowd-fueled suggestions and foster our inner weirdos instead. What do you really like? There are stranger things waiting to be loved.”
  4. Wayfinding. Now using such tools as GPS and Google Maps, we tend not to get lost anymore. But “feeling wholly alone in an unforgiving landscape, might be better for us than we think.” It’s a skill that can be helpful. “Try taking a drive in a strange town without your phone. Try walking into the woods alone. When we get lost, we have a chance to find ourselves.”
  5. Relationships. “We cannot desire that which we already possess. Three-dimensional love must include periods of separation: as Rilke noted, ‘the highest task for a bond between two people [is] that each protects the solitude of the other’…Walking away from our phones, resisting the urge to Facebook-stalk our boyfriends and girlfriends, composing a single love letter instead of a hundred inconsequential texts, will shake up a relationship more than any ‘disruptive’ technology.”