Monday, September 30, 2013

Breaking Bad

Breaking Bad is not about meth. It is about unleashed destructive forces. That is the common theme in all that Breaking Bad is about.
It is about cancer. It is about the suppression of anger. It is about not stopping in expressing one's destructive forces.
The TV series Breaking Bad has stirred many people, including me. Why does it have such a great impact on so many of us?
Cancer is rampant. So is suppressed anger. Suppressed aggression.
When one lives a life of unexpressed aggression and stifled anger it slowly but surely builds up. The toxic residue keeps building up inside while the outside shows a mellow, subdued, sophisticated surface.
We as a society do not know how to express anger appropriately. We do not know what to do with our aggression and destructive forces. We have no outlets. Some people find some creative ways to allow their anger express itself and some of us are better than others in recognizing fear before it builds up to a level that it evokes anger and tangible sense of aggression.
Most of us have learned to suppress and cover up all these undesirable emotions - fear, aggression, anger.
Cancer is an aggressive force that spreads inside the body until it attacks all areas of the body and destroys it. It is an angry, aggressive force. The series of Breaking Bad followed the implosion of aggression in the form of cancer `and then the explosion of aggression in a person, not unlike many of us.
The degree of destruction that the six seasons followed in the world of crime and drugs, captured the degree of unexpressed aggression throughout the life of a common person.
Destruction went rampant while the person's physical body became more alive than it was throughout his whole life.
Creative self expression and finding a way to not suppress our anger are big tasks in this society that does not welcome expression of destructive forces.

Process groups are one of the few places I have encountered striving towards healthy expression of our own destructive forces. In our everyday life we suffer without being aware what ails us when we are kind and good. Anxieties, depression, anger outbursts, interpersonal trouble keep popping up in our life and we don't know where to look for the solution.
I believe that finding ways to express one's wide range of emotions is a crucial part of a healthy, well-balanced life. Anger and aggression are just as part of that broad palette of emotions as all others. Process groups can create a safe container for us to examine our anger, fears, and aggression and learn to expresse them in a non-destructive way.

My view of the parallel between the body and mind - aggression turning inward in the form of cancers - comes from my homeopathy background. The solution of participating in groups set up with the intention of understanding and releasing our interpersonally stuck expressions comes from my current interest in group therapy.
I believe that the creators of Breaking Bad showed the viewers a very vivid and compelling picture of this process unfolding.


Saturday, June 29, 2013

Symptoms emerge in the bigger whole

As I continue my explorations of group therapy, I am struck by my experience of the healing forces and my witnessing the process of what is emerging.
A way I have conceptualized it recently is this: I see symptoms come to the surface of our awareness in the homeopathic case taking, the body, the mind and emotions produce symptoms that we discuss and listen to, in the homeopathic process. The symptoms come to a level of expression where they create a new map of themes. The bodily symptoms and mental-emotional symptom express a similar pattern, one, which we call the vital sensation level in homeopathy. When we arrive on this level of awareness of our symptoms, there is a chance to bring about healing on this level, which, in return will affect the body and mind symptoms.
In group therapy there is a similar phenomena that emerges if we pay attention to the process among group members. As people talk and participate in the group process, their essential themes come to the surface, the force of the group process and the presence of other participants encourage this emergence. Vital aspects of each person come to surface and create the "group as a whole" in which these themes can be looked at and dynamically processed by the help of the others.
My experience as the group leader - or the homeopath - is the witnessing and encouraging the emergence of the vital level description of symptoms or the essential themes in every participant. Once these levels are unveiled, the channels to healing are open. Our natural tendency towards harmony and balance picks up the rest of the work. As long as we are active participants and active listeners to our awareness, and in group to the overarching process and feedback from others, we will experience corrective, healing events and our body and mind will have the chance to regain balance and clarity.
Experiencing the honesty and openness among a small group of people can be extremely healing. The work I   witnessed and called out for in homeopathy, resonates well in the interpersonal matrix of process group therapy. People bring out themes in each other, like the emerging symptoms and themes in the homeopathic process in the individual. The whole of the group resembles the holistic in homeopathy.

Friday, February 15, 2013

Group therapy

In homeopathic treatment we utilize the observation that underlying, essential themes pop up anywhere and everywhere in one's life and we use this fact to explore the person's life, different areas of their interests, fears,  difficulties and find so called global themes of their sensitivities.
In group psychotherapy, the same idea plays out in an experiential way. I have found the power of process among the participants gives a different flavor and angle to look at the very themes that lay at the bottom of one's difficulties  Since we, humans are social beings, our interpersonal communication and relating style accounts for a great majority of the struggles we face in our day to day life. It is just one aspect of one's life but it is a very important aspect. In group therapy these struggles come to surface with surprising ease, as if every relational interaction would be an opportunity for growth and healing. With a skilled and compassionate group leader, the therapy group can be the most personal and experiential laboratory to find one's underlying themes and experience one's own reactions and responses to the outside world as they respond to their difficulties.
This is what I strive to help my patient experience in the groups I lead.

Friday, September 21, 2012

Defenses

Our best strengths that help us achieve in life are at the same time our worst enemies and most painful weaknesses. Why is that?
In homeopathic case taking I listen to the person's experiences in life and the way they describe these. Often it is clear that the same patterns that create the helpful, positive, unique strength in the person in one end of the spectrum, in one extreme, the same pattern is recognizable at the other end of the spectrum where the person is struggling with the same patterns, qualities, experiences. while the pattern is the same, it can be helpful in one extreme and unhelpful in the other extreme. I think that in psychotherapy we see these as the person's defenses. These are behaviors, patterns, unconscious anxieties and drives that makes the person move and act and protect himself. On the other hand, the same person cannot shed this pattern and behave well other times. The same pattern will create the negative and the unpleasant, as well as the passionate and creative behaviors.

Mindfulness

In discussion with Renee, a Mindfulness therapist in Palo Alto, the question arose about the here-and-now nature of Mindfulness techniques in therapy and the issues that tend to come up in therapy about the patient who names tendencies, recurrent patterns of thinking that are unhealthy and as such the therapist would aim to help the patient create a new, healthier narrative to their story. Often, psychodynamic therapists would explore with the patient the history of the thoughts and shed light onto the unconscious patterns that govern those conscious troubling thoughts. I appreciated Renee's thinking about this issue: the exploration of the patient's mind and body in the here and now sets the stage, creates the space that is needed for the unconscious to find its way to the surface and be cleared off. This way, instead of thinking with the thinking mind about the unconscious, the body gets involved and finding the calm, relaxed state of the unthinking mind allows the contents of the unconscious to surface and clear. The issue can be named, and the body can be invited to access the underlying thinking patterns, taking the thinking out of the equation and allowing the process to happen.
For me, at this juncture the body-mind modalities meet and allow the space to open up in a very real, authentic, close-to-home way. Focusing and Mindfulness techniques are wonderful tools to access the below  the conscious layers.

Sunday, June 24, 2012

The story the body tells us as it moves around in the consulting room


The other day  a psychotherapist friend shared a story about one of his patients who came for a session and she talked openly with him but while showed good insight, had peculiar behaviors, like straightening the tissue box on the table, moving her chair and then rearranging the position of the ottoman at her feet. Not only these but she then got up and rearranged the curtain, covering a different part of the window. The therapist observed these actions and when the patient shared that her loved ones have been complaining about her controlling nature, the therapist knew exactly how they felt. The patient seemed completely unaware that her actions of manipulating the environment to her taste and satisfaction seemed like a controlling behavior to others. The therapist shared this story with me as he was wondering what went wrong in this session as his patient did not return anymore after this visit. He concluded that in his comments he “fell for” this patient’s story of being controlling. He, too, just as the patient’s friends and family, assumed that the patient was controlling her environment, manipulating its pieces into a situation that suits her needs, according to her logic without questioning others’ needs and stance. He wondered with me, what would have been a more clinically correct response from his end in this situation. He thought the issue was deeper seated than a control issue but he did not realize it during the session and he felt he got sucked into the interplay this patient has been manifesting with so many other people in her life.
This story made me think of my homeopathic case taking technique, where I follow the person’s body language, not only the hand gestures but also the body’s physical manifestations of the person’s disharmony. I take this therapy patient was showing something with her gestures, actions. In a non-directive case taking method one would have wondered with curiosity what she was doing. Without the judgment that her actions were driven by and leading to a sense of control, one could ask her about the actual actions: “I noticed that you moved those pieces of furniture”… “Tell me more about your thinking and feelings around closing the curtains….” While the person might even come to the conclusion that they want it according to their control, I would even question that: “Please describe that need. What is that about?”
In all situations we tell the underlying story with our word choice and actions. And as I learned in the sensation method case taking, the most relevant part of the story telling is when the words don’t match the story being told. When the body language and actions and behaviors are peculiar. These are the most important times to be non-judgmental, and not only asking this from ourselves but also our patients: do not assume that you do an action because you have been told endless times by your relatives you were controlling. A patient might come to see us and say that their relatives demanded they seek therapy for their controlling behaviors and while the patient on the surface disagrees with these statements, they have internalized this understanding to the degree that they display and judge their own actions as controlling. Yes, if we are curious enough, we can find a gold mine of depth and new understanding beyond the doors that are opened up by simple actions like moving a tissue box in our office.

Thursday, February 23, 2012

A blog entry about work at a high school

This was a blog entry at the Adolescent Counseling Services blog on 2/13/2012

By: Ildiko Ran
On-Campus Counseling Program Intern at Menlo-Atherton High School

“I feel so much better that I got all that off my chest. I can go back to class now” – said one of my clients after a session when she unloaded the overwhelming stress that surrounds her everyday life. She keeps up the appearances, her impeccable school performance and her friendships, yet she appreciates the oasis, the safe place where she can be truly herself, which she found in this unexpected place: my quiet office nested among the busy guidance counselors’ offices.

I started as a trainee at Menlo Atherton High School in 2010 and returned for a second year as an intern. I love working with teenagers and the diverse population of this school has given me ample opportunity to see and work through many different problems and circumstances with teens and their families.

Working with teenagers is a challenge that can be greatly rewarding: their everyday experience is on the verge between childhood and adulthood – if they feel lost, it can be devastating for them and their families. When counselors listen to them without an agenda other than keeping them safe and helping them finding their own way, it can be an empowering experience for teens. I appreciate the opportunity that I can provide this service to my clients day after day.

As an ACS counselor, I fill up most of my days seeing clients, who come weekly for several months, some for the whole school year. In fact I have two students who decided to continue with me for the second consecutive year. There is also ample opportunity in our on-campus work to check in with students who are in various crisis situations – suicidal thoughts, angry outbursts, urge to run away from home, or being devastated over a loss of a loved one– are among situation I have dealt with in the past year.

As part of the teens’ treatment I usually meet with their parents a couple of times. These meetings are very different from the sessions with the teens: it includes psycho-education and parenting information. In exchange for their insights about their children, I encourage them to continue parenting with the love they feel, armored with some understanding of their adolescents’ needs.

Our ACS office doors are always open (when we are not sitting in session with clients), so students are familiar with the ACS counselors. “No, it is not mandated. No, it is not punishment. It is your decision to show up. Once you commit to it, the only way to make it work if you are serious about it.” – I often repeat these cautions and clarifications.

I enjoy seeing my clients engaged in their sessions, taking it seriously, appreciating the time they spend thinking about their own feelings, thoughts and actions, in an honest, open way. Teenagers call us adults out on our phony behaviors and in return they really appreciate when we do the same for them. Not only am I happy to see that I can be helpful for my students but sometimes I sense an inward smiley feeling that I have honored my own high school teachers and counselors who did just that for me – genuine, respectful relating. Teens can do wonders with it.

Ildiko interns with Adolescent Counseling Services’ On-Campus Counseling Program. Through this program, ACS provides free counseling to students and their family members at 9 schools in Santa Clara and San Mateo Counties.

For more information about the On-Campus Counseling Program, please visit our website: http://www.acs-teens.org/programs/campus_counseling.php