Albert Ellis

In my post “The Gloria Sessions” I wrote about a three-part video series titled “Three Approaches to Psychotherapy”  in which a brave young single mother named Gloria had brief therapy sessions with three of the twentieth century’s giants of psychotherapy. The three therapists were Dr. Carl Rogers (client centered therapy), Dr. Fritz Perls (gestalt therapy), and Dr. Albert Ellis (rational therapy). Little did I know  when I saw the series in grad school that I would actually meet two of these luminaries. I’ve already described my encounter with Carl Rogers. I’ll conclude this post with an account of my brief exchange with Albert Ellis.

Ellis is best known as the creator of Rational Emotive Behavior Therapy (REBT), and is widely considered one of the most influential psychotherapists since Freud. I first came across his work as a teenager, when I read his 1958 book Sex Without Guilt, which made the case that guilt about responsible sexual behavior is irrational. This was my first introduction to rational thinking, which made a lot of sense to me. However, parts of the book were (in retrospect) just his claptrap notions, like his theory of homosexuality – which was still considered a mental illness back then. He corrected his errors in later editions of the book.

Ellis was a foundational pioneer of what is now known as cognitive behavioral therapy (CBT), and I consider his A New Guide to Rational Living to be his single most important book. (He wrote or co-authored more than eighty books and many academic papers.) When I watched him in “Three Approaches to Psychotherapy,” I didn’t like his therapeutic style. He was the opposite of sensitive, gentle, avuncular Carl Rogers; he was a fast-talking, abrasive New Yorker, who seemed impatient in his dealings with Gloria. But I couldn’t argue with his logic, and Gloria seemed to get something from the session.

Although behavioral therapies weren’t popular in my humanistic Masters program, I started learning and practicing rational thinking in the eighties, and began teaching it in my clinical practice. Being a rational thinker has spared me a lot of unnecessary pain, and I’ve been known to say that if I had a Gospel to preach as a therapist, it was the Gospel of Rational Thinking. REBT focuses on the rational analysis of irrational and self-defeating beliefs and behaviors. Ellis continued to write and lecture and do therapy until shortly before his death in 2007, at the age of 93. He has been charitably described as having a “provocative personality.” I was in the audience for several of his presentations at Evolution of Psychotherapy conferences over the years, and witnessed his provocative style first-hand.

For one thing, his presentations were laced with profanity, and his response to any objections about his language was usually  along the lines of “F _ _ _ you!” If you didn’t like the words he chose, that was your problem. He was still the abrasive stereotypical New Yorker I’d first seen on videotape in grad school; but I’d come to appreciate his personality and his delivery, as well as his contributions to psychotherapy. He made the point in his public speaking that it’s what you say that  matters, not so much how you say it. In his own way he echoed Fritz Perls’ idea, “I am not in this world to live up to your expectations and you are not in this world to live up to mine.”

At an Evolution of Psychotherapy conference I happened to find myself on the same elevator as Dr. Ellis and his small entourage. Seizing on the opportunity, I asked him, “Dr. Ellis, didn’t you write a book titled Sex Without Guilt?” “Yes I did. Did you read it?”  “Yes I did.” “Did it help you?” “I’ve read several of your books and I think I’m a better man for it.” Dr. Ellis grinned at me and said, “I’ll bet you’re a sexier  man for having read Sex Without Guilt, too!”

I don’t know about that, but I do know that Ellis’ influence made me a better therapist. He enhanced my ability to reach some clients, helping them to understand that they didn’t need to feel guilty about being a sexual person, with sexual feelings and needs.

High anxiety

A certain amount of anxiety is normal and inevitable in every life. It ranges from free-floating anxiety – unattached to specific issues or situations – and performance or situational anxiety, to deep existential anxiety. It can cause the same physiological responses as fear. With fear, you know what frightens you: a charging bear in the woods, an earthquake, a cancer diagnosis. Anxiety, on the other hand, may result from cumulative stressors in your various life roles. It’s a cliché that we live in the Age of Anxiety, due to the complexity of modern life. The average person’s stressors are many and varied.

In Western society we have a history of regarding the body as separate from the mind, but this dualism can be misleading. Much modern science supports the notion of a bodymind – a unity of embodiment and consciousness. The physiology of anxiety is a hard-wired stress response. I’ve written previously about the fight-or-flight response that we experience when we perceive ourselves to be in danger. In situations where we find ourselves in physical danger, the instant physiological response – rapid breath and heartbeat, increased blood pressure and blood sugar, tense muscles, etc. – can prepare us to fight or flee, as the situation requires. But sometimes this automatic physiological response can cause us to “choke,” to feel paralyzed or out of control. And if the perceived threat isn’t something you can fight or flee from, your bodymind’s response can be feelings of high anxiety. Triggers for anxiety (or fear) don’t even have to be actual threats. Sometimes they occur simply because we feel threatened or inadequate, even if we’re not truly at risk.

Mild-to-moderate anxiety can sometimes be helpful, if it motivates us to effectively address its causes. You can reduce your anxiety about an upcoming exam if you study hard for it. However, avoidance also works, if only in the short-term, to reduce performance anxiety. But whether anxiety is a spur or a hindrance, it’s never a pleasant  experience.  One manifestation of high anxiety or fear is phobia – an irrational fear – which often leads to avoidant behavior. The power of phobia is contextual. A phobia about crossing bridges may not be a big problem if you live in the desert Southwest, but may cause significant problems if you live in the Florida Keys. Another common symptom of anxiety is panic attacks, which can also lead to avoidant behavior.

Anxiety rises to the level of pathology when it impedes or disables us. Some people are crippled by their anxiety. I believe that there’s a physiological basis for clinical anxiety, and that people with anxiety disorders shouldn’t be blamed for their disabling symptoms. But I also believe that, to some degree, anxiety is something that we unconsciously do, not just something that happens to us. Irrational thinking is a significant factor that contributes to both normal and pathological anxiety, and cognitive behavioral therapy is an effective treatment for many anxious people. Anti-anxiety drugs like Valium and Xanax can be helpful in the short-term, but long-term reliance on pharmaceuticals (or recreational drugs) to control anxiety only leads to chemical dependency.

To a certain degree we create our anxiety by the way we think. I’ve written about how, when facing a challenge or an upcoming performance, we can either mentally rehearse for failure or for success. And we can make pessimistic assumptions about things we don’t really know, and fear things that don’t really present a threat. Our physiological response to a perceived threat can be identical to our response to an actual threat.

Cognitive behavioral treatment of anxiety disorders involves teaching clients about both the physical and mental aspects of anxiety, and teaching them to distinguish their rational thoughts from their irrational thoughts. The treatment may involve the technique of exposure, where the client is exposed to the thing she typically avoids, or does the thing he usually avoids doing. Treatment often involves “homework” assignments – things to be worked on between therapy sessions – that will help the client to develop new skills and establish new mental habits. The development of insight need not precede relief from anxiety symptoms. Positive behavior change often enables a client’s development of insight into how, and to what extent, he was “doing anxiety.”

Sexuality and guilt

I was raised a Christian and most of my values are congruent with Judeo-Christian values, but one concept I’ve never bought into was Original Sin. Many Christians believe that we’re born into Sin and therefore require divine Redemption. I tend to distrust organized religions, as most of them seem to me to be rigid patriarchal hierarchies that claim the authority to be the only authentic interpreters of the ancient texts on which they’re based. Most teach that any sexual activity not sanctified (usually in heterosexual marriage) by their religion or sect is innately sinful. I believe that such teachings have fostered widespread sexual repression and shame in many cultures and have damaged a lot of lives. As a psychotherapist I worked with a lot of people who’d been taught that their sexual feelings were somehow innately sinful, and who felt guilty for perfectly normal sexual thoughts, especially if they acted on them.

“Normal” is a statistical concept, not a moral one. Homosexuality is only “abnormal” in the statistical sense. It’s a sexual variation, not a deviation, and occurs in every known culture. Among the people I worked with on sexual issues were people who thought they might be gay and were terrified by the prospect. Because of their education by homophobic role models in a sexually-repressed society, they didn’t want to be gay; but they felt what they felt. Sexual orientation isn’t a matter of choice. I’m happily heterosexual, but it’s not because I chose to be. It’s just  part of who I am. My brother is gay, and his sexual orientation wasn’t a matter of choice for him any more than mine was for me. I don’t think God condemns anyone for who they’re sexually attracted to.

Masturbation is undeniably a normal behavior. In fact, it’s quite popular. I believe that what somebody fantasizes about when he or she masturbates is their own business and nothing to feel guilty about – as long as it doesn’t lead to irresponsible, exploitive, coercive or violent sexual behavior. (For some sex offenders, masturbation can be a mental rehearsal for things they intend to do; and part of sex offender treatment involves their learning not to indulge in fantasies of criminal or exploitive sexual behavior.) And yet many good, decent people feel terribly guilty for sexual thoughts and fantasies that they would never act out, or even want to act out. The only bad thing about masturbation, as one of my cousins told his son after his ex-wife caught the boy in the act, is getting caught doing it.

Despite outward appearances we live in a sexually-repressed culture, where erotica is a guilty pleasure, nudity is inevitably sexualized, and the display of breasts is okay in advertising and commercial TV shows, as long as no nipples are exposed. I’m concerned about the effects of the widespread availability of porn to young people online; but it might be the inevitable backlash of societal sexual repression, enabled by capitalism and modern technology. I consider “reality TV” shows that attract viewers with the lure of nudity, but blur out the breasts and genitalia, to be more obscene than outright porn – because of their hypocrisy.

In my career I had to educate many people about the normality of their sexual thoughts and behaviors because few of them had received any meaningful sex education, either from their parents or at school. Many women told me that when they had their first period, they didn’t know what was happening. Gay, bisexual and transgender people were often in despair because society had labeled them as “deviants.” Sexual fetishes such as cross-dressing may not be normal in the statistical sense, but as long as such activities involve consensual acts, and nobody is coerced or violated, they aren’t blame-worthy.

One of my “standard raps” to clients who were fearful or guilt-ridden about their sexual predispositions went something like this: “I get it. You don’t want to be gay (bi/trans, etc.), but you feel what you feel. For the time being, there’s no pressing need for you to put a prefix on your sexuality. What we know is that you’re a sexual person, just like everyone else, and that’s okay. Maybe someday you’ll be able to identify a prefix that fits; but when you do that is up to you, not other people. Only you can know what’s in your heart of hearts. What’s important now is that you’re a sexually responsible person. That means you don’t take advantage of other people sexually, don’t have sex with children or other people incapable of giving consent, don’t coerce anybody to do things they don’t want to do, and practice safe sex. Nobody can put a label on your sexuality unless you give them that power. As long as you’re sexually responsible, you don’t have to justify your sexual identity to anyone.”

For me, the next stage of therapy with a person who responded, “But I can’t be gay!” was teaching rational thinking: “I know it’s tough being gay in this society, so I can understand your resistance to considering that you might be gay. But I invite you not to catastrophize. Good things still happen to gay people, things that couldn’t have happened without their knowing who they are. Being gay isn’t awful or terrible unless you make it awful or terrible by your thinking. And it’s better than living a lie.”

It’s my belief that people shouldn’t be judged or condemned for what they think and feel, but only for what they do. And yet a lot of sexually responsible people feel guilty about sexual feelings or fantasies they’ve had. My behavioral prescription for this, as with other self-judgments, is “Learn to distinguish your rational thoughts from your irrational thoughts.” As long as nobody was exploited or hurt, such guilty thoughts are almost always irrational.

Mood, disposition and disorder

In a previous post I referred to suicide as a “mood-specific” behavior, and I feel the need to clarify this statement. I wrote that nobody suicides when they’re in a happy mood, suggesting that if people in a depressed mood can “ride out” the mood without doing something lethal, the urge to end their lives will pass when their mood changes. Moods are transient emotional states that can be prolonged by irrational thinking and by ruminating.

Thoughts such as “My life is my problem; the only way to solve my problem is to end my life” can seem logical to a person in a depressed mood. When the mood passes, the person will likely recognize the thought as irrational – or at least as one that doesn’t have to be acted on immediately. Suicide hotlines have prevented many impulsive (mood specific) suicides by helping people to not act on suicidal impulses and to ride out the depressed mood – or to sober up. This principle doesn’t apply to suicidal people who experience chronic depression.

While moods aren’t enduring emotional states, dispositions are. We each have a unique disposition or set of dispositions. For instance, we’re each disposed to be somewhere on the continuum between optimism and pessimism – glass half full vs. glass half empty. I don’t know whether one’s disposition is a result of nature or nurture, or some combination of the two. Other adjectives I’ve heard used to describe disposition include gloomy, chipper, pushy, cranky, generous, stingy, passive and aggressive. They are a component of our personality. As a psychological construct, disposition has so many variables that it’s hard to precisely define or to measure, so these are just my opinions. Dispositions tend to be enduring traits, but that’s not to say that they can’t change over the course of one’s life. For instance, I think that people who’ve tended to be distrustful of others can learn to be more trusting, given enough positive experiences with trustworthy people.

When anxiety and depression are chronic emotional states that seriously affect our functioning, they’re diagnosable as psychiatric disorders. There’s considerable scientific evidence that there’s a biological basis for such disorders, although irrational thinking patterns can exacerbate them. The key to distinguishing  pathological states of anxiety and depression is impairment. Even during the saddest times in my life, my sleep and appetite weren’t seriously affected, and I was able to function adequately. I cried but didn’t have crying spells, and have never come close to attempting suicide. (I’m  not taking credit for this; I consider myself very fortunate.) During my year-long employment in an extremely stressful job, I suffered sleep loss; but my sleep improved immediately after I quit the job.

People who suffer from chronic anxiety and depression often get blamed for their symptoms, because they’re not understood as the symptoms of a chronic mental disorder. Because of the widespread stigma attached to mental illness, many people don’t feel the empathy they might feel for someone with a debilitating physical disorder. And people who suffer from these mental illnesses often blame themselves, telling themselves they “should be” able to control their symptoms. Others self-medicate with alcohol and other drugs that might give them short-term symptom relief, but only add drug dependency to their list of problems.

It’s hard enough to have a mental illness and to have to deal with societal stigma; but in addition, mentally ill persons are increasingly neglected in this country. The mental health system is shamefully under-funded, which explains why so many people with mental illnesses are homeless, why hospital Emergency Departments all over the country are swamped with people who are experiencing a psychiatric crisis, and why jails and prisons have become major providers of mental health services.

Everybody experiences anxiety and depression, and most of us learn how to cope with these transient conditions, because they’re not overwhelming or disabling. But some people with chronic anxiety and/or depression can’t cope without help from social support systems, whether in the form of professional services or community resources – family and otherwise – that recognize mental illnesses as treatable conditions, and provide needed help.

I’m taking a break for a couple of weeks, but will be back with a new post in early June. In the meantime, you can access other things I’ve written at my website: jeffkoob.com. It features links to my books, samples of my artwork, and a short story, “Demon Radio.”

It’s only Monday if you think it is

This post is one of my occasional philosophical departures from my usual subject matter. Although it isn’t specifically about rational thinking (which I’ve written about in previous posts), it is about mental habits and how they can shape our experience. I even intend to examine what “is” is.

Things that we know and experience through our senses are phenomena: rain, wind, temperature, the day/night cycle, seasons, etc. Mental concepts – noumena – such as justice, authority, honor, nationality and race don’t exist in the same way rain exists. For one thing, they’re not Absolutes; they mean different things to different people. And yet we often act as if certain noumena were as real as rain. Race used to be thought of as a biologically-based reality. Now we know that it’s a social construct based on culture and tradition. All homo sapiens belong to the human race, despite variations in outward appearances.

Days, months and years are all phenomenal, based on planetary rotation, the lunar cycle, and the earth’s orbit around the sun, respectively. The convention of the week, however is noumenal – it isn’t based on any natural phenomenon. The seven-day week has long been the standard way of sub-dividing months throughout the industrialized world, and most of us organize how we spend our time using this noumenal convention.  “Monday” (for instance) is a social construct.  But it’s only Monday if you think it is.

Try this thought experiment: Imagine waking up on the beach, alone, on a desert island. You’ve been delirious with a fever and don’t know how long you were “out of it,” so you’ve lost track of what day it “is.” You have no sensory way of determining it, and it doesn’t even matter in any practical way whether it “is” Monday or Tuesday, because you’re not on anybody’s schedule. Will you arbitrarily choose a day of the week as your baseline and keep track of what day it “is”? Or will you adopt a different mode of thinking and just live each day on the island, without having to give it a name?

Even though it’s just a mental construct that most of us buy into, the day of the week may control our actions and thoughts, and even our moods. You might hear someone who works Monday through Friday complain about having the blues “because it’s Monday.” He’ll predictably perk up five days later because it “is” Friday, the start of the weekend (another noumenal concept). Which brings us to the question of what “is” is.

“Is” can be used to cite a phenomenal reality (it is raining), a noumenal belief (it is Monday), or to state a quality or property of a thing (the apple is red) – the Aristotelean “is of equivalency.” In the first instance, regardless of what I may believe, I’ll get wet if I step outside when it’s raining. As regards the second instance, wars have been fought over where, exactly, the border between two countries “is.” In the third instance, if one person in a room says “It is hot in here” and another person in the room says “No, it’s not,” one of them has to be wrong. What “is” is the basis of many a dispute, whether interpersonal or international. Such disputes can be avoided by dropping the pretense of objective truth implied by an “is of equivalency,” and “subjectivising” the statements: “I’m hot.”/ “I’m not.” No conflict about what “is.” Whether or not Sally “is” pretty can be viewed as a matter of subjective opinion, not of objective fact. Beauty is, after all, in the eye of the beholder.

E-prime – English that omits all forms of “is” – is a tool for learning about the linguistic traps that can be set by its use. Nobody has ever suggested that E-prime should replace English. (It’s often more precise than English, but doesn’t lend itself to poetic word formulations.) But try writing without using is/am/are/were etc. and it will help you to appreciate how much you tend to unconsciously objectivise things you believe to be true or important.

Here are some translations of English sentences into E-prime: English – She is pretty. E-prime – I find her attractive/pretty. English – This is really difficult.  E-prime – I really have a hard time doing this. English – Look, it’s a UFO! E-prime – I can’t identify that flying object. English – Time is money. E-prime – Earning money correlates to a high degree with the way you spend your time. English – This is Monday. E-prime – Because of the social convention of the seven-day week, most people think of today as Monday. English – He is a liar. E-prime – He lies a lot. English – God is love. E-prime – I believe in God as the embodiment of love.

There’s some overlap in the ideas I’ve written about here and my previous posts on rational thinking and cognitive behavior therapy. Linguistic conventions can make us prisoners of language. Wittgenstein wrote, “The limits of my language are the limits of my universe.”

Some irrational self-talk involves the “is of equivalency.” The thought “I am a Loser” presupposes that people are either Winners or Losers and might mean any of several things to different people. It might mean “I think that I lose more often than I should” or it might mean “I’m destined to fail, no matter what I do.” In either case it’s an irrational simplification that can’t help anyone to achieve their goals. “Being a Loser” is a self-limiting noumenal notion.

It’s only Monday (or Tuesday, etc.) if you think it is. Monday isn’t real in the same way that rain is real.

 

Relapse Prevention, Part 2

In my last post I wrote about triggers for relapse and the importance of having a relapse prevention plan, if you’re trying to establish and maintain a clean-and-sober lifestyle. The relapse prevention curriculum I developed in at the University Hospital of the West Indies in Jamaica included modules on stress  management, anger management, and rational thinking – all topics I’ve covered in previous posts. In this post I’ll be writing about other aspects of recovery from addiction.

I’ve met people with serious substance abuse problems who were too  proud to admit that they needed help in their recovery. (“I’m man enough to do it on my own!”) I’ve also known drug abusers who couldn’t imagine talking to other people – especially strangers – about addiction-related things they’d done and were ashamed of. But I’ve never met a recovering addict who got and stayed clean-and-sober without help from others, either in the form of professional help, or peer support groups such as AA. The road to recovery isn’t a road to walk alone.

Although I never saw him staggering drunk, my own father was an alcoholic. A military man who prided himself on his self-control, he once went for a year without drinking, to “prove” his ability to control his drinking. He went for exactly 365 days without a drink, but he hated every day of his self-imposed sobriety. It’s a condition known in the recovery community as “dry drunk.” As planned, on Day 366 he resumed drinking, moderately at first. But within weeks he was back to hiding bottles and drinking at the level he’d been drinking before his year of “white knuckle” sobriety.

There are individuals, I’m told, who’ve regained control of their excessive drinking and become moderate “social drinkers” – but I’ve never met one. “Someday I’ll be able to drink again” is a dangerous thought for people in recovery. Addicts are notorious for irrational thinking and self-deception. Many a relapse starts with thoughts like “I’ll allow myself one beer on my birthday” or “I can still shoot pool with my drinking buddies at the bar, and just drink sodas.” One of the arguments for attending Twelve Step meetings is that in time you’ll come to recognize your own rationalizations, by listening to other addicts who’ve come to recognize their own bullshit. Twelve Step meetings are all about getting real with other addicts who they know won’t judge them, because they’ve been there, done that, themselves.

Some friends and family of addicts don’t want to support their recovery, for a variety of reasons. Other well-meaning people who care about an addicted friend of family member become enablers. With the best of intentions, they try to shield their friends or  loved ones from the natural consequences of their addictions. They think they’re being helpful, but they’re simply enabling the person to continue drinking or using. In order to truly help, enablers need to learn to practice tough love – to stop attempting to rescue the person, and to let them suffer the natural consequences of their substance abuse. A mother practicing tough love won’t bail her son out of jail, because she knows from experience that if she does, he’ll be shooting up again within hours of his release.

Most recovering addicts come to the realization at some point in their recovery that they not only have to stop their drug-of-choice, but all intoxicating substances. I’ve known a number of crack and opioid addicts who initially believed that they could substitute alcohol and/or cannabis for their drug-of-choice, only to find that it was just a bridge back to their preferred drug. Cravings are one of the most common triggers for relapse, and getting high or intoxicated doesn’t improve anyone’s judgment or ability to resist cravings.

In my last post I mentioned euphoric recall (addicts dwelling on memories of the good times they’d had drinking and drugging, before getting addicted) as a trigger. This is one form of rumination, but addicts can also ruminate about how much they’d like to get high right now. This kind of thinking activates cravings that lead to relapses.

I’ve had some personal experience with this, as a recovering nicotine addict. What I found was that when I ruminated on how good it would feel to light up a cigarette, I relapsed time and again. Eventually I was able to identify my ruminations as a predictable relapse trigger, and to stop dwelling on thoughts about how I’d like to have a smoke. I still have occasional situation-specific cravings for tobacco, but I no longer feed the initial thought with more thoughts, and the cravings only last for a few seconds. After years of being  nicotine-free, the long-term rewards of being a non-smoker outweigh any momentary cravings I might have to light up again.

What you’re “supposed to feel”

No matter what kind of family or culture we were born into, we got instructed on what we should feel under this or that circumstance. Some of the instructions came in the form of admonitions (“Of course you love him, he’s your father!”) and some in the form of role modeling. As children, we learn a lot from the behaviors we observe being demonstrated by those around us.

Real love is rooted in a naturally-occurring feeling we have for another person, but love is institutionalized in a variety of ways. New mothers are “supposed to” love their babies, but this isn’t always the case. It may be a hormonal thing, as with post-partum depression, or it might be that the child was conceived by rape; but a mother who doesn’t spontaneously feel love for her newborn is usually judged or blamed. Children are “supposed to” love their parents, but not all parents are worthy of their children’s love.

We all have feelings about our feelings. We may feel ashamed for having been afraid, or angry at ourselves for being depressed. A number of people I worked with over the course of my career felt terribly guilty for not loving a parent or other close relative who had neglected and/or abused them. We can’t choose what we authentically feel about anyone, and nobody has the authority to tell you what you’re “supposed to” feel. Real loving feelings either arise spontaneously, or they don’t. It’s not something we owe someone just because we’re blood relatives.

Gestalt guru Fritz Perls said that most people are socialized to be phony. Ideally, a kiss is a genuine expression of affection or love. But many times in some families, children are told to hug and kiss a relative because (s)he’s kin, whether or not the child feels affection or love for that person. Kissing may become a hollow social ritual, performed because it’s expected. In some family situations, a child may be expected to kiss someone who has abused or neglected them, or whom they find “creepy.” In some cultures a child may be required to kiss a dead relative at a funeral. This sort of thing can be a traumatic experience. It can be a perversion of what a kiss is meant to express. You can’t make yourself love someone any more than you can make someone love you. But you might be put in a position where you feel you have to fake it. When Perls called a behavior phony, he wasn’t judging the client; he was observing that the behavior wasn’t an authentic expression of feeling.

I’ve worked with couples in loveless marriages who reflexively claim to love one another, because that’s what’s expected, when they haven’t felt love for their partner in a long time. It’s not always black and white, however. Observing my father’s parents as a youth, I came to understand the term “love/hate relationship.” Love and hate can be closely allied, and it’s been suggested that the opposite of love isn’t hate, but indifference.

Relationships can be emotionally nourishing or, at the other end of the continuum, they can be toxic. People can change, and family systems can change. Often the goal of family therapy is to change the family system and to promote reconciliation between family members. But this isn’t always possible. Bad marriages can be terminated by divorce, but your parents will always be your parents – for better or for worse. I’ve worked with people who’ve tried time and again to reconcile with family members, only to find that the relationship remains toxic to them despite their best efforts. If a client had gotten to the point where they’d concluded that a family relationship would never be anything but painful for them, I’d suggest that she had the option to “divorce” that relative. It’s a sad happenstance, but it’s sometimes necessary for healing to begin.

I’ve also suggested that not all “kinfolk” need be blood-related, that you might have brothers and sisters you haven’t met yet. There are several people in my life that I consider “found” brothers and sisters. Someone who was abused or neglected by a parent might later find a nourishing relationship with an “other mother” or with a man who feels like the father he wishes he’d had. I’ve seen it happen. The mere fact of blood relationships doesn’t necessarily confer lifelong obligations, and certainly not the obligation to feel a certain way about a member of your birth family. We feel what we feel, and there’s no “should.” Rational thinking can free us from the tyranny of “shoulds.”