Suicide prevention

While the act of suicide is sometimes a long-considered, planned option which nobody can prevent, most suicide attempts are impulsive. According to one study, approximately one quarter of the people who try to kill themselves do so within five minutes of their decision to attempt suicide. Only a small fraction of people who survive a suicide attempt go on to die by their own hand. Throughout my career as a psychologist, I assessed many people shortly after a suicide attempt. A question I always asked of them was, “Are you glad that you’re still alive?” Almost all of them were glad that their suicide attempts had failed. I concluded that most suicide attempts are mood-specific behaviors, often involving intoxication on alcohol or other drugs. Once their mood changes, or they sober up, they no longer want to end their lives.

While in grad school, I volunteered as a telephone crisis hotline worker. I was trained to talk to people who were in crisis, to keep them from engaging in attempts to harm themselves or others. From early in my clinical practice I was called on to evaluate the suicide potential of clients. I learned that many people who attempt suicide are ambivalent about living. “To be, or not to be; that is the question.” At the core of this ambivalence is the issue of existential meaning.

One of the major existential therapists of the twentieth century was Viktor Frankl, an Austrian psychiatrist that I’ve written about in previous posts. His book Man’s Search for Meaning was based on his experiences as a survivor of a Nazi death camp. He observed that in such a hellish environment, those who fought to live were people who had a sense of meaning in their lives. He called his method of psychotherapy logotherapy (logos means “reason” or “plan” in Greek), and his therapeutic approach was to help patients find, or create, meaning in their lives.

Lives bereft of meaning are empty lives, but sometimes the vacuum can be filled. Although I was able to help some suicidal clients to find something to live for, one of my severely depressed therapy clients died by his own hand. It was the worst thing that happened in my career. I really liked “Allen,” saw strengths and personal qualities that he couldn’t see, and worked in therapy to help him find reasons to go on living. I saw him on Wednesday afternoons, and he always kept his appointments. When he didn’t come in one Wednesday, I immediately called his apartment. When he didn’t answer after several tries, I looked up his address and drove to his apartment. When he didn’t come to the door when I knocked and rang the bell, I intuited that he was dead, inside. Sadly, this proved to be the case. It turned out that he’d bought a gun that morning, gone home, and used it. On a Wednesday, instead of keeping his therapy appointment.

I went through predictable self-recriminations and judgments. Could I have done anything differently that would have prevented his suicide? But I recognized this as a question that could never be answered. My colleagues knew that I was grieving as if I’d lost a family member, and supported me in my grief process. A peer review of my clinical records found that I’d done and documented everything properly, in terms of recognizing and dealing with Allen’s suicide risk.

A few years ago a close friend committed suicide. She suffered from bipolar disorder, and had confided in Maria and me that she would take a drug overdose in certain future hypothetical situations. She said it matter-of-factly, and wasn’t depressed when she said it. We knew that there was nothing we could say that would change her mind. We hoped that she’d never find herself in one of those imagined situations.

Philosophically, I’m torn on the issue of the “right to die,” because if suicide were to be legalized, it’s inevitable that some depressed people would convince themselves – or be convinced by others – that it was their duty to die, perhaps because they felt useless, or they wanted to leave an inheritance, rather than spend their money on their own medical care in old age. I’m no longer a therapist, but if I knew that someone was acutely suicidal, I’d do whatever I could to try to prevent an impulsive suicide attempt. (Many times, as a Designated Examiner in the Probate Court, I recommended involuntary hospitalization for suicidal people.) But once a person has suicided, I don’t make judgments about their decision to end their life. I don’t have the authority to judge.

Most people who end their own lives do it to escape intolerable pain – whether physical or emotional. Allen killed himself because he could no longer endure living with severe depression. His life had no meaning worth living for. I tried unsuccessfully to help him find reasons to live. Albert Camus considered suicide to be “the fundamental question of philosophy.” He wrote, “I see many people die because they judge that life is not worth living. . . . I therefore consider that the meaning of life is the most urgent of questions.”

Which takes us back to Viktor Frankl, who found meaning in the Hell of a Nazi death camp, survived, and went on to be a founder of the humanistic psychology movement.

Authenticity and congruence

This a continuation of my last post, “How to be more like you,” in which I wrote about phoniness vs. authenticity. Most of us come by the inauthenticity that Fritz Perls described as phoniness quite  honestly, via the process of socialization. As children, we learn from the adult role models in our lives, and we’re often taught to be inauthentic. The template for prescribed phony behavior might be “politeness,” or religion, or social expectations about “correct  behavior” or even “correct feelings.” I’ve known people who were abused and/or  neglected by their parents who still, as adults, felt guilty about not loving them the way they “should.” Many children are taught who they are “supposed to” love, from grandpa to God. Genuine love can’t be forced.

A kiss that is anything other than an expression of affection or love or sexual passion is a phony kiss. Jane may not have even liked Aunt Sadie, but her parents taught her to give her a kiss anyway, whenever she visited. Children are often given admonitions such as: “Don’t cry! You’re a boy!” and “Don’t you get angry at me, young lady!” and “Of course you love him; he’s your grandfather!”

Some people have jobs that require them to act cheerful, no matter what they’re really feeling. Behavior arising from authentic feelings might be judged by others as impolite or inappropriate in certain situations. We’ve all been in circumstances where we felt the need to hide our true feelings; but some people go through life feeling that way every day. They have their reasons.

Con men, sociopaths and bullshitters are purposefully inauthentic. Others have learned to habitually cover up their true feelings; it’s their default mode. One of the ways I would confront a client who was putting on an act in therapy was, “You’re always on stage, aren’t you?” The look in their eyes (busted!) told me that I was on target, and that this was something they needed to know that other people could see through. People whose default mode is authenticity know themselves better than people who constantly put on an act to win approval. They are also more secure and self-accepting. I know this from personal experience, as I used to be a people pleaser, myself. My phoniness arose from feelings of insecurity.

A related concept that was important to me as a therapist was congruence. There are two kinds of congruence. One has to do with they way you come across when communicating. If someone being threatened says to his antagonist, “You don’t scare me” in a soft, tremulous voice, with body language that indicates fear, his verbal message won’t be believed. It’s incongruent with his other modes of communication. If someone says “I’M NOT ANGRY!” loudly, with fists clenched and an aggressive posture, he’s giving incongruent messages. When a person’s words are matched by her vocal tone, facial expression and body language, her message is congruent. People who are seen as charismatic are highly congruent communicators.

As a therapist with training in gestalt theory, I became very good at spotting subtle incongruities in therapy. In gestalt therapy, incongruent messages get challenged by the therapist. If a client claims (incongruently) that it really doesn’t bother her when her husband calls her stupid, the therapist might ask her to say the opposite: “It really bothers me when my husband calls me stupid!” (“But it really doesn’t bother me!” “Try saying it anyway.”) This technique is very effective in getting clients to recognize their true feelings, which often rise to the surface as the client repeats the opposite of their initial rationalized statement.

The other kind of congruence is role congruence. Do you act like a different person in your different life roles, or would family members and close friends recognize you as the same person they know, if they saw you at work? Obviously, some jobs – like a drill sergeant at a military boot camp – require you to take on a badass role that is (one hopes) incongruent with how he behaves in other situations. But under most circumstances a congruent person is recognizably the same person as a worker, a spouse, a parent and a friend. Incongruent persons are role-bound, and might be a tyrant at home and a reasonable person at work – or the other way around. Congruent people are authentically themselves in all the roles in their lives.

The intrinsic reward for being yourself – warts and all – is that when people who know you give you messages (feedback) about who you are, they’re revealing the things you need to hear, to be self-aware. I’ve written before about the paradox of identity. You can’t have self-knowledge in a social vacuum. We need other people who know us, in order to know who we “really are.” They’ll tell us, and if there’s some disagreement, it’s all grist for the mill. A consensus will emerge over time about who you are.

If you were living alone on a desert island, like Robinson Crusoe, how could you possibly know what kind of person you are? How could you know if you’re generous or stingy, witty or dull? We depend on other people in our lives to have an accurate sense of our own identity. Being authentic and congruent helps us to know who we really are, and what we might like to change about who we are.

Your “self” is either a rigid construct – “that’s just who I am!” – or a work in progress. Whatever your age.

 

Esalen and the human potential movement

In previous posts I’ve written about humanistic psychology, which has been called the Third Force in modern psychology, after Freudian psychodynamic psychology and Behaviorism. The founders – including Abraham Maslow, Carl Rogers, Fritz Perls, and Rollo May – seeing that psychology was primarily focused on psychopathology, wanted it to also focus on psychological health and personal growth. Esalen Institute, an isolated  retreat on the Pacific coast near Big Sur, California, is considered by many to be the birthplace of humanistic psychology. I’ve wanted to visit Esalen, a retreat center for growth and learning, since my graduate education in a humanistic psychology program. I’ve just returned home from a writing retreat at Esalen, and it felt like a weekend on holy ground.

Esalen Institute was founded by Michael Murphy and Richard Price in 1963. The land on which Esalen is located was owned  by Michael’s family for generations, and the two of them had a vision of a center for holistic learning. The place is called Esalen because for thousands of years the area was the home of the indigenous Esselen people. Accordingly, Esalen is considered sacred land, and is treated with reverence by residents and visitors. It’s isolated, far from any town, and doesn’t have cell phone service or television. There are hot springs down by the rocky shore, and everyone knows that clothing is optional at the baths. When I soaked, naked, in a pool, looking out at the Pacific sunset, I had the sense of participating in an ancient cleansing ritual.

Humanistic psychology has also been called the human potential movement. The only required course in my psychology Masters program was “Human Growth and Potential” – known by the students as “Gro and Po.” Although most of my coursework involved psychotherapy and psychological testing, I could understand why Gro and Po was required. Psychology had to be about more than psychopathology and the remediation of symptoms. Indeed, our equivalent of an “Abnormal Psychology” course was “Unconventional Modes of Experience,” lest there be any stigma regarding “abnormal.”

While psychanalytic theory and Behaviorism were dogmatic and monolithic, humanistic psychology was more like a tree, with many roots and branches. It was holistic in its orientation to the study of human behavior, focusing on mind and body as a unity, and exploring the factors that enhance creativity and enable self-actualization. It was holistic in studying both Eastern and Western philosophies and practices, recognizing the benefits of things such as yoga and Buddhist meditation, long before they became popular. Existentialism and phenomenology also influenced the human potential movement.

From the beginning of the movement, Esalen has been its Mecca. Fritz Perls did a five year residency in the late sixties, leading gestalt therapy seminars. Other eminent persons who influenced the development of humanistic psychology and had Esalen residencies were Gregory Bateson, Joseph Campbell, Ida Rolf, Virginia Satir, Rollo May, and Alan Watts. Today people go there to study massage and body work, wellness and alternative medicine, psychotherapy, meditation, and a variety of other subjects. I went there to work on being a better writer, and came home with my spiritual batteries re-charged.

A lot of what was new and esoteric back in the sixties and seventies has gone mainstream. Among the extra-curricular classes available to students in the psychology graduate program at West Georgia College (now the University of West Georgia) were massage, hatha yoga, zen meditation, clowning, tai kwan do, and vegetarian cooking. The program was allied with the Philosophy Department, and there were opportunities to study existentialism and phenomenology. In my therapy courses, I learned about psychoanalytic theory, behavior modification, client-centered therapy, gestalt therapy, transactional analysis, sex therapy, and trance work. Once I was a working psychotherapist, my therapeutic orientation was existential, and I was very eclectic in terms of therapeutic style and techniques. I consider myself very fortunate to have attended the West Georgia College psychology Masters program.

Contemporary concepts like emotional intelligence and positive psychology couldn’t have emerged from Freudian psychodynamic theory or Behaviorism. The humanistic psychology movement created a new paradigm for human growth and potential as a legitimate area of study within the science of psychology. I think that the regard for Freud’s contribution to psychology and psychotherapy will diminish over time, relative to the contributions of humanistic pioneers like Abraham Maslow, Carl Rogers, Fritz Perls, and Milton Erickson.

The concept of emotional intelligence suggests that there are other kinds of intelligence than cognitive intelligence. Accurate empathy and compassion are important factors in human relating, and are deserving of scientific study by students of human behavior. I had initial objections to the whole notion of positive psychology, thinking, “psychology is neither positive nor negative.” But then I came to realize that it’s an outgrowth of the impulses that inspired humanistic psychology. The study of psychological wellness and peak performance, of thriving, of human creativity and the process of self-actualizing, is a legitimate pursuit within the field. Psychodynamic theory and Behaviorism will always have their place in psychology, but they need to be viewed in the context of the psychology of growth and human transformation.

The Gloria sessions

I’ve written posts about my education as a psychotherapist in the humanistic psychology program at the University of West Georgia, and my exposure to a variety of therapeutic modalities. These included Rogerian (client-centered), gestalt, and cognitive behavioral therapy. I remember watching a videotaped film titled “Three Approaches to Psychotherapy” that I’ve always thought of as “the Gloria sessions.” For many years this film was only available for viewing by professional therapists, faculty, and students of psychotherapy; but now all three sessions can be viewed on YouTube.

In 1965 a courageous young woman named Gloria – a divorced single mother – agreed to be videotaped in brief therapy sessions with three of the most influential American psychotherapists of the twentieth century: Dr. Carl Rogers (client-centered therapy), Dr. Fritz Perls (gestalt therapy), and Dr. Albert Ellis (cognitive behavioral therapy). Watching the sessions again, I was reminded of Gloria’s courage and candor. The production quality isn’t always good and following the Perls  session takes concentration, due both to poor sound quality and Perls’ thick German accent. But if you want to see three masters of psychotherapy at work, this film is a treasure trove. Their approaches to working with Gloria are very different.

In each segment, the therapist briefly describes his approach to therapy, then works with Gloria, then comments on the session. In the first segment Carl Rogers says that if the therapist can establish certain conditions in relating to the client, “therapeutic movement” will predictably occur. The first condition is genuineness, and the second is congruence – meaning that your non-verbal communication is congruent with your verbalizations. The third condition is transparency , meaning that the therapist hides nothing and can be easily “seen through.” Rogers states that if these three conditions exist, and the therapist can be in tune with the client’s “inner world” (how she experiences herself in the world) insights and growth will follow.

During the session Gloria keeps trying to get Dr. Rogers to give her advice about making a decision, and dealing with guilt feelings related to the decision. He never accedes to her request, but keeps accurately reflecting on what she’s saying, allowing her to eventually take ownership of the issue, and to trust her own judgment. (Contrary to popular belief, good therapists seldom or never give advice.) Rogers is comfortable with silences, and at one point asks, “What do you wish I’d say to you?” She gets it. In his commentary, he remarks on how her “then-and-there” orientation at the start of the session quickly becomes a “here-and-now” focus. He highlights the “I-Thou” quality of their experience, rejecting Freud’s intellectual concept of transference/counter-transference in favor of Martin Buber’s term for authentic relating. He concludes, “Gloria and I really encountered each other” and says he thinks that both of them benefitted from their brief encounter. Watching again, I can’t help but agree.

Perls puffs on a cigarette while he describes gestalt therapy, and Gloria lights up at the beginning of the session, admitting that it’s a response to anxiety. In his introduction Perls, like Rogers, endorses the I-Thou relating essential to the therapeutic relationship, and the idea that therapy should not dwell on the then-and-there, but should always focus on the here-and-now of direct experience. He states that a gestalt therapist never offers interpretations, but provides clients with experiential opportunities to discover things about themselves, often by interrupting the client’s verbalizations and calling attention to automatic behaviors that the client is usually unaware of. Early in the session Perls labels some of Gloria’s behaviors as “phony” – which has a specific meaning in gestalt therapy. She’s initially bewildered and angry, feeling judged. She’s very defensive, but Perls doesn’t back off, and Gloria appears to catch on to what he’s saying by the end of the session. He was never judging her; he was giving her an experiential lesson in her automatic, typical defenses. It’s known in gestalt therapy as “being on the hot seat.” It was Perls who wrote what became known as the Gestalt Prayer, which starts with: “I am not in this world to live up to your expectations and you are not in this world to live up to mine.”

In his introduction, Albert Ellis expounds upon the notion that – contrary to Freudian psychodynamic theory – the past isn’t the primary determinant of present-day distress or dysfunction. The past may have a role in its formation, but it’s present behaviors that maintain the problem – specifically, the irrational things we tell ourselves about our experiences and their consequences. As I’d remembered, Ellis came across like the  stereotypical pushy, fast-talking New Yorker, but his words were precise and logical. In his short session with Gloria he manages to convey the principles of rational thinking, by applying them to Gloria’s anxieties about dating and seeking a life partner. She appears to grasp the notion that she makes undesirable situations worse by catastrophizing. “Don’t beat yourself over the head or convince yourself you’re a no-goodnik, just because you didn’t get the outcome you wanted.” He explained how he gives his clients behavioral homework assignments to complete between sessions, and suggests that Gloria should set up opportunities to take some small risks, instead of holding back in social situations. Its a behavioral technique called exposure, and Ellis was one of its early proponents.

When I first saw “Three Approaches to Psychotherapy,” I remember that there was a brief interview with Gloria after the sessions; but I wasn’t able to find it online. As I recall, Gloria said that she liked Carl Rogers the best, and learned some valuable things from Albert Ellis; but her session with Fritz Perls was the one she most benefitted from. If you don’t understand the basics of gestalt therapy, what Perls says and does in the session won’t make much sense. It shook Gloria up; but that’s what good gestalt therapists do, and Perls was one of the best. I highly recommend the Gloria sessions to social science students, psychotherapists in training or practice, and people who want to know more about psychotherapy.

Little did I know when I first watched the film that I’d actually meet Rogers and Ellis. I’ve already written about my brief meeting with Carl Rogers. In a later post I’ll describe my encounter with Albert Ellis.

My psychology grad school reunion

I’ve already written about humanistic psychology as the “third force” in twentieth century psychology, after Freudian psychodynamic theory and behaviorism. I recently attended a reunion of my psychology graduate program at the University of West Georgia (West Georgia College when I attended), and I’d like to share with you some of the reasons I’m so thankful for my preparation as a psychotherapist in this particular program.

Dr. Chris Aanstoos, a faculty member for over two decades, wrote that the graduates of the program have gone on to be “not only psychologists and professors, but also city commissioners, college presidents, U.S. congressmen, computer wizards and millionaires, as well as poets, magicians, mystics, theologians and farmers. Essentially they have gone on to become themselves.” To which list I’ll add corporate consultants, business entrepreneurs, and all sorts of holistic healers.

Part of the lyric of the Crosby, Stills, and Nash song Teach Your Children is “. . . and so become yourself/ because the past is just a goodbye.” Their are forces in our society that conspire to make us conform, to be “normal.” Becoming your authentic self and living up to your unique potentials was what the West Georgia psychology department was all about. The program wasn’t organized so much to train you for a specific profession as to help you discover and realize your potentials, and to find your vocation – your calling. Since the inception of the humanistic program in 1967, it’s always been a program freed from the conventional stereotypes of the day, and in it I learned that no scientific or therapeutic model has all the answers for everybody. I learned about holistic health long before it caught on.

The WG psychology program is characterized by cultural diversity (i.e. both Eastern and Western psychologies) and innovation, and was ahead of its time in many respects. Carl Rogers’ client-centered therapy is being re-discovered in the corporate world as person-centered management. Yoga and meditation were validated as ancient transformative psychotechnologies – ways of re-wiring the brain – long before they went mainstream. There was an emphasis on wellness, and the holistic unity of body and mind.

While I received an excellent preparation for a career as a psychotherapist dealing with (for the most part) chronically mentally ill persons, psychopathology wasn’t the primary focus. We also studied creativity, and barriers to achieving one’s highest potentials. We questioned the notion of “adjustment therapy,” asking, “adjustment to what?” (See my prior post, “Who is normal?”) Behavioral psychology was the dominant force in psychology at that time, and the medical model was the unquestioned basis for determining diagnosis and treatment.

No faculty member ever told me what model I should follow or recommended which therapeutic techniques I should use. Although behavioral psychology wasn’t popular in the program, over the years I became a practitioner of cognitive and cognitive behavioral therapies, along with Rogerian,  gestalt, and other therapeutic modalities. My faculty advisor never advised me; he dialogued with me about goals, choices, opportunities. My love of learning caught fire as never before, because I was encouraged to think for myself and choose my own path.

The man who made the WGC psychology department into a humanistic program was Dr. Mike Aarons, and at the reunion I finally heard the full story that I’d heard pieces of over the years. As a child in public school, he was labeled “unteachable/retarded,” and wasn’t expected to be able to complete high school. But he earned a high school diploma and went on to college. Working as a cab driver, he found a book someone had left on the back seat of his taxi. It was Viktor Frankl’s Man’s Search for Meaning, and it changed his life. (See my post, “Freedom of attitude.”) It introduced him to existentialist  psychology, and he found a French mentor in existentialism who encouraged him to apply to the psychology PhD program at the Sorbonne University, in Paris. Mike had no bankroll and spoke no French, but that didn’t stop him. Long story short, he returned from Paris a few years later with a French wife and a PhD from the Sorbonne. His dissertation was on the topic of creativity. He went on to post-graduate studies with Abraham Maslow, at Brandeis University.

Dr. Jim Thomas, a behaviorist in the WG psychology department, had read Carl Rogers and Abraham Maslow, and had a vision of  establishing a humanistic program in the department. He won over some of the other faculty members, then wrote Maslow, asking if he could recommend someone to start a humanistic psychology program. To everyone’s surprise, Maslow answered, recommending Mike Aarons without  reservation.  Mike was hired and set about recruiting a faculty on the cutting edge of the humanistic psychology revolution. The rest is history.

Not only has the UWG psychology department continued to offer an exceptional education in psychology, it has continued to grow. While a Master of Arts (MA) degree remains the only masters degree available for now, the department now offers a Bachelor of Science (BS) degree program. What used to be a Doctor of Psychology (PsyD) degree program is now a PhD program.

The department has drawn students from all over the country – as well as many international students – to the Georgia town of Carrollton. The question I heard most often at the reunion was “What brought you to the program?” I heard story after story about so-called coincidences, “accidental” meetings, and things (usually books) found – like Mike Aarons finding the copy of Man’s Search for Meaning – that pointed people in the direction of the program. What I also heard a lot over the weekend was expressions of gratitude by alumni for having had the good fortune to study in this unique psychology department.

Who is normal?

Nobody is normal.

I think normality is one of the most misunderstood concepts in our culture, in that so many people still nervously ask the question, “Am I normal?” It seems that “normal” has come to be equated with “desirable,” is in ten-fingers-and-ten-toes-on-the-baby normal. But it ain’t necessarily so. I, for one, am unapologetically not normal, and have no wish to be seen as normal, conventional or average. I don’t dress funny or anything outwardly apparent, and my  abnormalities are benign: I don’t follow sports. I don’t own a cell phone.  I create strange art. (Check out jeffkoob.com)

“Normal” is a relatively modern social concept, and is based on a statistical idea. It isn’t found in nature, and like “Justice,” only resides in the human brain. On the street, normal correlates to  average, and abnormal has come to have negative connotations. In statistics there are three “measures of central tendency” (mean, mode and median) that produce what we call averages. But there is no values correlation between average (normal) and good, or desirable. Cigarette smoking used to be a normal adult habit when I was growing up. Obesity is normal in our society, as is divorce. Five hours or more of screen time daily seems to be the new normal. Standards of normality change over time.

There’s no such thing as a normal dog or a normal day or a normal rock, let alone a normal human being. While the average American family may have (let’s say) 1.8 children, you won’t find a single family that actually has 1.8 children. Normality is an abstraction, not a reality.

We increasingly live in a world of manufactured situations and pastimes, with a high standard of standardness.  Fashion choices may seem to set us apart, but following fashion just makes us part of the fashion parade. The mass media promote conformity and superficiality as virtues. It’s easy to see why a person who sees herself as a misfit might  long to “just be normal.” But I agree with Frank Zappa, who said that while many people think normality is grand, “normality is not grand, it is merely okay.”

If you’re conflicted or alienated, you may have an unrealistic vision of normality as a desirable destination. But balance, harmony and serenity are better destinations than normality. You are unique, and you need not be normal to live well and happily. People  who strive to be normal may not recognize or cultivate creative potentials within themselves. Original art doesn’t come from normal thinking, and “thinking outside the box” means not thinking conventionally. Extraordinary people are, by definition, not normal.

In my last post I mentioned the “Unconventional Modes of Experience” course in my humanistic psychology graduate program. It didn’t take the same approach as traditional “Abnormal Psychology” courses, as it didn’t have the current edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM) as a textbook. Instead, the focus was on the phenomenology of madness. I won’t attempt to explain phenomenology in this post, other than to say that its focus is on subjective experience, not objective diagnosis. Crazy behaviors are often the result of unconventional experiences, such as auditory hallucinations. Scientists dismiss such phenomena as mere symptoms. Phenomenologists, like shamans, explore them for meaning.

I later took DSM-based courses and professional development classes to develop my diagnostic skills, but I’ve always appreciated my exposure to phenomenology as an alternate lens to the medical model. A belief underlying my therapeutic practice was that the better I understood each client’s unique experience of being-in-the-world, the better equipped I’d be to help him therapeutically.

I know that gay people didn’t choose to be gay any more than I chose to be straight. Being gay isn’t statistically normal, but it’s a normal variation from the heterosexual norm in every known culture on earth. I worked in therapy with a number of gay people who expressed their longing to be normal, to meet the standards of normality they were raised with in their families and communities. Some knew they’d be shunned if they were labeled abnormal. But what is considered normal is always culture-bound. Arranged marriage is normal in some cultures. That doesn’t mean it’s good or bad, just that it’s what most people do.

As long as you live your life productively and responsibly, and don’t exploit or abuse others, being normal is optional. Being abnormal isn’t necessarily a bad thing, if it’s an authentic expression of who you are. There’s no objective and timeless standard for what’s normal, anyway; so you should feel free to be your unique self. Other people’s judgments may be their problem, and may not have to be yours.

 

First blog post

You don’t have to be sick to get better

 

My psychology graduate program at West Georgia College (now the University of West Georgia) was the only program in the Southeast, in the grad school catalogs I studied, to promote itself as a “humanistic psychology” program. For a while humanistic psychology was anathema to many fundamentalist Christians, some of whom saw it as having Satanic origins and goals. All I’ll say about that is that there was nothing in the humanistic psychology movement that was dissonant with the Christian values I was raised with, and some of my classmates were Christians.

Humanistic psychology was practically synonymous with the “human potential movement” in psychology, and was referred to as the Third Force in psychology – the first being Freudian psychodynamic theory and the second being Behaviorism. It was an umbrella term for new theories and therapies that didn’t fit neatly into either psychodynamic or behavioral theory or practice, and wasn’t grounded in remediation of psychopathology. Many or most humanistic psychologists were interested in psychologically healthy persons, as well as therapies that didn’t rely on psychodynamic interpretations or behavior modification techniques.

Among the theories and therapies in the movement were Carl Rogers’ client-centered therapy, gestalt theory and therapy, Transactional Analysis, William Glasser’s Reality Therapy, as well as various movement therapies (Feldenkreis, Alexander Technique, structural integration), encounter groups, systems theory, Eriksonian hypnosis, and neuro-linguistic programming. I’ll have more to say about some of these theories and therapies in later posts. It was an exciting time to study psychotherapy, and I couldn’t have chosen a better Masters program to prepare me for my career.

Abraham Maslow’s “hierarchy of needs” was an important part of the foundation of the human potential movement. Like all models it has its flaws, but it’s a model that explains how potentials for growth are limited by identifiable life circumstances. It isn’t grounded in psychopathology; everyone can be located somewhere in the model. Maslow described a universal hierarchy of needs, generally depicted as a pyramid. The most basic human needs are physiological, such as the need for air, food, water and shelter. According to Maslow, if these basic survival needs aren’t being met, you stay stuck in survival mode and can’t grow, or meet higher-level goals. Once these needs are met, you have the potential to grow.

Next up on the pyramid are safety needs. If you aren’t safe or secure in your life, you have to devote your efforts to security issues before you can move on and try to live up to your potentials. The third level of needs according to Maslow is social needs – healthy relating with family and friends. Our relationships are an integral part of who we are, and without them we’re incomplete. Maslow suggested that once we’ve met our essential needs up to this level, we can work on esteem needs: self-esteem, confidence, competence and achievement. Those who’ve reached this level in meeting their hierarchal needs have the potential to rise to the highest level: self-actualization.

Self-actualization is a process, not a goal. People who have their physiological, safety, social and esteem needs adequately met can devote their energies to personal growth – which may involve helping others and/or developing new competencies. Self-actualizing people can be authentic and spontaneous in relationships, and can follow their creative impulses, doing what they most want to do to the best of their ability. Of course life circumstances and obligations can limit what self-actualizing people are able to accomplish in terms of self-expression and achievement, but they can continue to grow and learn until they either lose their capacities or die.

Just because you’re grown up doesn’t mean you have to stop growing. Growth can be a life-long process if you cultivate the garden of your unique life. My next few posts will be about factors – including thoughts and beliefs – that can either facilitate or impede personal growth.