• Watch the video on Dead Parents of the Narcissist

Question:

How do narcissists react to the death of their parents?

Answer:

The narcissist has a complicated relationship with his parents (mainly with his mother, but, at times, with his father). As Primary Objects, the narcissist's parents are often a source of frustration which leads to repressed or to self-directed aggression. They traumatise the narcissist during his infancy and childhood and thwart his healthy development well into his late adolescence.

Often, they are narcissists themselves. Always, they behave capriciously, reward and punish the narcissist arbitrarily, abandon him or smother him with ill-regulated emotions. They instil in him a demanding, rigid, idealistic and sadistic Superego. Their voices continue to echo in him as an adult and to adjudicate, convict and punish him in a myriad ways.

Thus, in most important respects, the narcissist's parents never die. They live on to torment him, to persecute and prosecute him. Their criticism, verbal and other forms of abuse and berating live on long after their physical demise. Their objectification of the narcissist lasts longer than any corporeal reality.

Naturally, the narcissist has a mixed reaction to the passing away of his parents. It is composed of elation and a sense of overwhelming freedom mixed with grief. The narcissist is attached to his parents in much the same way as a hostage gets "attached" to his captors (the Stockholm syndrome), the tormented to his tormentors, the prisoner to his wardens. When the bondage ceases or crumbles, the narcissist feels both lost and released, saddened and euphoric, empowered and drained.

Additionally, the narcissist's parents are Secondary Narcissistic Supply Sources (SNSSs). They fulfil the triple role of "accumulating" the narcissist's past, evidencing the narcissist's grand moments ("live history") and providing him with Narcissistic Supply on a regular and reliable basis (Regulation of Narcissistic Supply). Their death represents the loss of the best available Narcissistic Supply Source and, therefore, constitutes a devastating blow to the narcissist's mental composure.

But beneath these evident losses lies a more disturbing reality. The narcissist has unfinished business with his parents. All of us do - but his is more fundamental. Unresolved conflicts, traumas, fears and hurts seethe and the resulting pressure deforms the narcissist's personality.

The death of his parents denies the narcissist the closure he so craves and needs. It seals his inability to come to terms with the very sources of his invalidity, with the very poisonous roots of his disorder. These are grave and disconcerting news, indeed. Moreover, the death of his parents virtually secures a continuation of the acrimonious debate between the narcissist's Superego and the other structures of his personality.

Unable to contrast the ideal parents in his mind with the real (less than ideal) ones, unable to communicate with them, unable to defend himself, to accuse, even to pity them - the narcissist finds himself trapped in a time capsule, forever reenacting his childhood and its injustice and abandonment.

The narcissist needs his parents alive mostly in order to get back at them, to accuse and punish them for what they have done to him. This attempt at reciprocity ("settling the scores") represents to him justice and order, it introduces sense and logic into an otherwise totally chaotic mental landscape. It is a triumph of right over wrong, weak over strong, law and order over chaos and capriciousness.

The demise of his parents is perceived by him to be a cosmic joke at his expense. He feels "stuck" for the rest of his life with the consequences of events and behaviour not of his own doing or fault. The villains evade responsibility by leaving the stage, ignoring the script and the director's (the narcissist's) orders.

The narcissist goes through a final big cycle of helpless rage when his parents die. He then feels, once again, belittled, ashamed and guilty, worthy of condemnation and punishment (for being angry at his parents as well as elated at their death). It is when his parents pass away that the narcissist becomes a child again. And, like the first time round, it is not a pleasant or savoury experience.

next: The Narcissist's Dead Parent

Chapter 11

At the beginning of life, the dominance of the innate mental equipment is overwhelming and the hegemony of the subsystem of the basic emotions is nearly complete. The brain structures of the basic emotions are repeatedly activated by innate programs of their own. At that stage, the emotional repertory is quite simple and nearly every inconvenience of substantial impact causes the baby to cry.

Combined with the physiological processes of maturing, the accumulated experiences result in the building of new programs. A number of the new emotional programs built are only more flexible versions of innate ones. A number are those the fresh aspect of which is the result of the inclusion of options (and inhibitions) that are based on the maturing of the body and the cognitive ability.

Other supra-programs are based to a large extent on acquired knowledge and skills. They seems to be entirely new, and it is hard, at first, to find which of the more primitive programs were used as their "building materials".

Over the years the relative weight of accumulated experience in the building of programs, increases immensely. Consequently, most of the new programs of adults are based on stored information accumulated during the actual activation of ad hoc programs which were based on previously built supra-programs.

Though all programs are related to survival, and thus to emotion, not all of them are colored so much with emotional factors accessible to awareness of the individual or to those who observe him. Thus it is a common custom to distinguish between the two kinds and call "Emotional" only those which are obvious or which defy simple logic.

As a result of the maturation and the accumulation of supra-programs, the rigid automatic innate mode of operation for the activation of the brain structures of the basic emotions, is abolished. This causes changes to the way each of the various components of each of the basic emotions function. It also changes dramatically the relations and interactions between these components which become very flexible.

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For instance, using a supra-program, the integration processes of basic emotions can be inputted and influenced by other than the innate perceptual patterns. They can be influenced by word, memory, thinking, perception of signs or symbols or other things, that are connected with the specific basic emotion by association.

The most striking example is the ability of colored pieces of paper, (treated as money) or memories and imagery about them, to influence the emotional climate of people. They can change the mood of a person, from the positive pole of the basic emotion happiness v. sorrow to the opposite pole and vice versa. (This power is especially potent when the colored-pieces of paper are inscribed with a number followed by many zeros, which with luck one may receive, or unfortunately, may have to give.)

During maturation and socialization, the reflex like manner in which the primary patterns of stimuli of a basic emotion influence the integration processes and activate their other components, progressively diminishes. The original activity of the basic emotion, internal, external and communicative, also loses its cohesiveness and semi-automatic mode. Even the ability of the processes occurring in the integration component of each basic emotion to create feelings of the subjective experience of that particular emotion is no longer automatic and unconditional.

The building, updating, upgrading, mending, and other changes entered into the activation programs of the emotional system are, in principle, more or less the same as the changes responsible for practical activities. Initially, they are based, like all other activities of the mind and brain system, on innate programs. However, it seems that in this domain, the basic building blocks come less from the senso-motoric repertoire and more from the small number of complex innate programs of the basic emotions.

For instance, most of the older generation still remember the feelings of disgust (and the tendency to vomit) engendered by cod-liver oil given to them in childhood to correct vitamin D deficiencies. This initially automatic activity of the basic emotion of Disgust v. Desire (or Attraction v. Repulsion) was aroused at first by the mere smell. However, after lots of pressure and bribes from mothers and other caring persons, this pattern gradually faded. After a while most of us ceased to spit out or vomit this "medicine" or even stopped feeling revulsion, and a few of us even got used to it.

During life, individuals acquire (learn) new sub-components and patterns that are integrated into the regular activities of each of the basic emotions by means of emotional supra-programs. These new components act as additions, variations or even substitutions to innate patterns and sub-components. The individual acquires supra-programs that culminate in the ability to activate deliberately the basic emotions - as a whole or certain parts of them - in ways that differ widely from the innate patterns.

Sometimes, the acquired changes are expressed whether unconsciously or involuntarily in an instinctive-like fashion, in such a way that it is hard to distinguish from the innate mode.

For example, people can intentionally activate their desire versus disgust basic emotion - the desire pole mainly - by memories of sexual activities or by imaginary ones. The initiation of these "unreal activities" can happen spontaneously during dreams. They can be activated intentionally or spontaneously or even reluctantly during daydreams, by the sight of a passerby, or an association.

The deviation of these patterns from the original ones (of the basic emotions involved) may or may not reach our awareness, and the resulting sensations and images appear with varying degrees of vividness. These may or may not be accompanied by voluntary or spontaneous activity of one kind or another.

Throughout his life, the individual acquires the ability to influence the components of the basic emotions responsible for initiating activities, which were originally under the strict control of the integration components. Usually he also acquires some proficiency in executing them.

This proficiency enables the average person to activate various processes: intra-organismic, behavioral and communicative, even without a previously achieved suitable integration. Not only professional actors can simulate emotions successfully, even young children can do it.

The subjective experiential component is also not immune from the interventions and variations induced by supra-programs. The social environment greatly influences the shaping of this component, mainly by means of modeling, education and socialization.

During, and as a result of these processes, the individual also acquires a proficiency which may be used to divert the emotional experience. This proficiency is constantly expressed, deliberately or automatically, and with various degrees of awareness of the processes that divert the subjective experience from the innate course.

For instance, people learn to halt laughter or crying, by contracting the face muscles involved in the expression of these emotions. For thousands of years, people have been listening to and performing certain melodies to change their whole emotional climate. All of us are aware that we can change our mood just by changing the contents of our thoughts.

People posses a whole range of natural measures capable of inducing change in the emotional climate. Prominent among the behavioral alternatives are those that are included in the innate repertoire or appear automatically when one is sufficiently mature. In addition, there is a huge number of measures acquired from being subject to cultural customs of upbringing, and from divergent individual solutions found to common developmental problems, which were encountered on the way to adulthood.

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The four main branches of this group of measures are:

1. Natural behavior that satisfies different desires and needs like eating when hungry and drinking when thirsty.
2. Behavior corresponding to the basic emotion most active at the given moment, like weeping when suffering and staring when interested.
3. Regarding the specific feelings, emotional experiences of a certain moment, moods and other felt sensations of the body, as announcing the prevailing conditions at the time of their occurrence and as recommending a specific reaction. For instance, the treatment of the feelings of fear in dangerous circumstances as a recommendation to leave rapidly.
4. Treating the feelings and sensations of the emotional process as a "call to arms" directed to brain and mind systems, or at least as an invitation to pay them attention.

The essence of this book and the manual in chapter 5, form a technique for the management of the emotional system and climate, which is based on improving and enhancing this fourth natural behavior pattern. (It seems that this is the best method of enhancing the activity of the internal maintenance processes of the updating, mending, and building of supra-programs of daily use, and especially the more emotional ones.)

next: The Cover-Programs

Thoughtful quotes about wealth and poverty.

Words of Wisdom

"Paying attention to simple little things that most men ignore makes a few men rich." (Henry Ford)

"The real measure of our wealth is our worth if we lost our money." (author unknown)

"It is only by spending ourselves that we become rich." (Sarah Bernhardt)

"The dignity of man depends on creating and not on possessing." (Theo Spoerri)

"The best things in life are free but it costs you a lot of time and money before you find this out." (author unknown)

" There is nothing in the nature of money to produce happiness. The more a man has, the more he wants. Instead of filling a vacuum, it makes one." (Benjamin Franklin)

"Enough money always means more then you have now." (Author unknown)

"The world is full of men making good livings but poor lives." (Author Unknown)

"I want you to know that possessions have made more people unhappy than happy, because they define the limits of your life and keep you from the freedom of choice that comes with traveling light upon the earth." (Ken Nerburn)

"...I have become all the more convinced that the most valuable fortune anyone can amass during a life time is not material wealth but the things he learns." (Eric Sloane)

"Everyone who has ever struggled with poverty knows how extremely expensive it is to be poor." (James Baldwin)

"He profits most who serves best." (A.F. Sheldon)

"Poverty of purpose is worse than poverty of purse." (Author Unknown)

next: Wholeness

Reproduced from page 222 of the book: Uncovering the Mystery of MPD;
Its Shocking Origins... Its Surprising Cure

next:  Inner Faces Of Multiplicity: Contemporary Look at a Classic Mystery

Most people with bipolar disorder suffer relapses, a return of bipolar symptoms. Learn how to keep bipolar relapses at bay.

Bipolar disorder cannot be prevented, but often the mood swings can be controlled with medications, if you take them regularly as prescribed by your doctor.

About 1 in 3 people will remain completely free of symptoms of bipolar disorder by taking mood stabilizer medications, such as carbamazepine (Tegretol) or lithium, for life. (read more about medication compliance here)

Other ways to help prevent a depressive or manic mood episode include:

• Eating a balanced diet.
• Exercising daily.
• Avoiding extensive travel into other time zones.
• Getting approximately the same number of hours of sleep every night.
• Keeping your daily routines similar.
• Avoiding alcohol or drugs.
• Reducing stress at work and at home.
• Seeking treatment as soon as you notice symptoms of a depressive or manic episode coming on.

Changes in your sleep patterns can sometimes trigger a manic or depressive mood episode. If you plan extensive travel into other time zones, you may want to call your doctor before you leave to discuss whether you should make any changes in your medications, and what to do if you have a manic or depressive episode while you are away.

Home Treatment

Home treatment is important in bipolar disorder. In addition to taking your medications every day as prescribed, you can help control mood swings by:

Family members often feel helpless when a loved one is depressed or manic. Family members and friends can help by:

• Encouraging the person to take his or her medications regularly, even when feeling good.
• Learning the warning signs for suicide, which include:
  • Drinking heavily or taking illegal drugs.
  • Talking, writing, or drawing about death, including writing suicide notes.
  • Talking about harmful things, such as pills, guns, or knives.
  • Spending long periods of time alone.
  • Giving away possessions.
  • Aggressive behavior or suddenly appearing calm.
• Recognizing a lapse into a manic or depressive episode, and helping the person cope and get treatment.
• Allowing your loved one to take enough time to feel better and get back into daily activities.
• Learning the difference between hypomania and when he or she is just having a good day. Hypomania is an elevated or irritable mood that is clearly different from a regular nondepressed mood and can last for a week or more.
• Encouraging your loved one to go to counseling and join a support group, and joining one yourself if needed.

Mood stabilizers, especially lithium and divalproex (Depakote), are the cornerstones of prevention or long-term maintenance treatment. About 1 in 3 people with bipolar disorder will remain completely free of symptoms just by taking mood stabilizing medication for life. Most other people experience a great reduction in the frequency and severity of episodes during maintenance treatment.

It is important not to become overly discouraged when episodes do occur and to recognize that the success of treatment can only be evaluated over the long term, by looking at the frequency and severity of episodes. Be sure to report changes in mood to your doctor immediately, because adjustments in your medicine at the first warning signs can often restore normal mood and head off a full-blown episode. Medication adjustments should be viewed as a routine part of treatment (just as insulin doses are changed from time to time in diabetes). Most patients with bipolar disorder do best on a combination or "cocktail" of medications. Often the best response is achieved with 1 or more mood stabilizers, supplemented from time to time with an antidepressant or possibly an antipsychotic medication.

Continuing to take medication correctly and as prescribed (which is called adherence) on a long-term basis is difficult whether you are being treated for a medical condition (such as high blood pressure or diabetes) or for bipolar disorder. Individuals with bipolar disorder are often tempted to stop taking their medication during maintenance treatment for several reasons. They may feel free of symptoms and think they don't need medication any more. They may find the side effects too hard to deal with. Or they may miss the mild euphoria they experience during hypomanic episodes. However, research clearly indicates that stopping maintenance medication almost always results in relapse, usually in weeks to months after stopping. In the case of lithium discontinuation, the rate of suicide rises precipitously after discontinuation. There is some evidence that stopping lithium in an abrupt fashion (rather than slowly tapering off) carries a much greater risk of relapse. Therefore, if you must discontinue medication, it should be done gradually under the close medical supervision of your doctor.

If someone has had only a single episode of mania, consideration may be given to tapering the medication after about a year. However, if the single episode occurs in someone with a strong family history of bipolar disorder or is particularly severe, longer-term maintenance treatment should be considered. If someone has had two or more manic or depressive episodes, experts strongly recommend taking preventive medication indefinitely. The only times to consider stopping a preventive medication that is working well is if a medical condition or severe side effect prevents its safe use, or when a woman is trying to become pregnant. Even these situations may not be absolute reasons to stop, and substitute medications can often be found. You should discuss each of these situations carefully with your doctor.

Sources:

• Sachs GS, et al. (2000). Expert Consensus Guidelines Series: Medication Treatment of Bipolar Disorder.
• Sachs GS, et al. (2000). The treatment of bipolar depression. Bipolar Disorders, 2(3, Part 2): 256-260.
• Glick ID, et al. (2001). Psychopharmacologic treatment strategies for depression, bipolar disorder, and schizophrenia. Annals of Internal Medicine, 134(1): 47-60.
• American Psychiatric Association (2002). Practice guideline for the treatment of patients with bipolar disorder (revision). American Journal of Psychiatry, 159(4, Suppl):1-50.

next: What Recovery From Bipolar Disorder and Depression Means to Us
~ bipolar disorder library
~ all bipolar disorder articles

The time has come for me to let go of the past. I've carried this realization for a while now. I've grieved over the past long enough. The time to say goodbye, once and for all, has arrived.

Am I rejecting my past? No. Part of letting go is accepting and admitting the past is over, done, finished, and complete. Nothing is left back there for me to do. Nothing is left back there for me to cling to, except some wonderful memories. But life is about making memories. So life is quietly urging me to move on, embrace the future, and create new memories. Life is asking me to look ahead, rather than looking behind. All that I have been and once was is important, but now, it is more important for me to forge onward, to grow, into all I am capable of becoming.

Getting to this point was not necessarily a conscious goal on my part. The process required many months of preparation—working all the way through my pain, false hope, anger, frustration, humiliation, discouragement, and disappointment. My recovery lesson is to learn that letting go cannot be forced. Letting go must come easily, naturally, at just the right time. I cannot let go until I am fully prepared to let go. I cannot let go until hanging on causes more pain than letting go.

Clinging to the past has become far too painful to me. Yesterday's solutions and answers to my life problems no longer work. New solutions, new answers, new situations—a new life awaits me. What's over the next hill? Only God knows. But I'm keeping a prayerful, positive, hopeful, attitude. I'm patiently anticipating the future, rather than obsessively trying to control it. I'm waiting to see what will happen next, moment by moment by moment.

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next: Letting Go of Outcomes

High dropout rates from cognitive-behavioral treatment for bulimia nervosa have been noted in the literature. Zachary Steel and colleagues from the University of New South Wales in Australia sought to identify those characteristics that would predict treatment dropout; their findings have been published in the September 2000 issue of the International Journal of Eating Disorders.

These researchers evaluated 32 consecutive referrals to their mental health service for bulimia nervosa treatment. Most of the individuals studied were female (97%) and averaged 23 years of age. Subjects had experienced bulimia symptoms for an average of five years prior to presentation.

Of this group, 18 individuals (57%) completed the treatment program, attending an average of 15 treatment sessions, while 14 individuals (43%) did not. In this latter group, the average number of treatment sessions attended was seven.

When comparing those who left treatment early with those who did not, there were no differences in core demographics or initial symptom severity. Those who dropped out of treatment did, however, manifest higher levels of pretreatment depression and hopelessness, as well as elevated feelings of ineffectiveness and a greater external locus of control than those who completed treatment. Together, these parameters could predict which individuals would end treatment prematurely with 90% accuracy.

Steel and colleagues suggest that interventions targeting depressed mood and hopelessness may assist in the retention of bulimic clients in treatment and should be administered in advance of standard cognitive-behavioral intervention for bulimia.

Source: Steel, Z., Jones, J., Adcock, S., Clancy, R., Bridgford-West, L., & Austin, J. (2000). Why the high rate of dropout from individualized cognitive-behavior therapy for bulimia nervosa? International Journal of Eating Disorders, 28(2), 209-214

next: Causes of Eating Disorders: Factors Responsible for Cutting Down Eating Habits
~ eating disorders library
~ all articles on eating disorders

Laboratory studies and other medical tests may be helpful in determining the diagnosis of bipolar as well as the extent of any medical problems resulting from the disorder.

Lab Studies:

• Tests for substance and alcohol abuse usually prove necessary initially to exclude drugs and alcohol as causative agents for behavior.
• No specific blood or other laboratory tests are available to aid the mental health professional in diagnosing bipolar disorder.
  • Of interest, serum cortisol levels may be elevated, but this is not of diagnostic or clinical value.
  • Thyroid studies may help assure the clinician that an altered mood is not secondary to a thyroid disorder.
  • The clinician may order serum blood chemistries such as basic metabolic panels and liver function tests to help assess renal and hepatic health before starting or continuing to administer certain medications to help regulate or ameliorate bipolar symptoms.
  • Mania and depression both may involve states of malnutrition secondary to the psychiatrically diminished awareness of or ability to maintain one's health and well-being. Thus, a metabolic panel along with, in extreme cases, levels of thiamine, albumin, and prealbumin may help determine the extent of self-neglect and compromised nutritional state.
  • Once pharmacotherapy has been implemented, periodic laboratory tests may be required to monitor drug levels and to ensure that no adverse response to the medication is harming renal or hepatic function.

Imaging Studies:

• Neuroimaging modalities are currently not helpful in making the diagnosis of bipolar disorder. Rather, the clinical presentation of symptom clusters as defined in the DSM-IV TRplus family and genetic histories guide the mental health clinician when diagnosing psychiatric conditions.
  • Neuroimaging studies of child and adolescent patients with bipolar disorder are few. Magnetic resonance imaging (MRI) studies of children and adolescents with bipolar I disorder have shown enlarged ventricles and an increased number of hyperintensities compared to healthy control subjects. The pathologic and clinical significance of these findings is unknown.
  • MRI studies performed by Dasari et al (1999) found that the area of the thalamus is significantly decreased in youth with either bipolar disorder or schizophrenia compared to healthy control subjects; adult studies revealed similar findings. The diagnosis of either bipolar disorder or schizophrenia cannot be made based on this volume difference as revealed by MRI. Nonetheless, reduced thalamic volume is consistent with clinical symptoms of poor attention, difficulty in filtering simultaneous stimuli, and dysregulation of mood—symptoms found in patients with both of these major mental illnesses. Whether a structural or functional deficit within the thalamus may be causal or contributory to the pathophysiology of these mental disorders remains unknown.

Other Tests:

• A baseline electrocardiogram may be needed before starting a psychotropic medication because some are known to alter QT intervals or other cardiac rhythm features.

Sources:

• AACAP Official Action. Practice parameters for the assessment and treatment of children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. Jan 1997;36(1):138-57.
• Dasari M, Friedman L, Jesberger J, et al. A magnetic resonance imaging study of thalamic area in adolescent patients with either schizophrenia or bipolar disorder as compared to healthy controls. Psychiatry Res. Oct 11 1999;91(3):155-62.

next: Age of Onset and Gender Issues in Bipolar Disorder
~ bipolar disorder library
~ all bipolar disorder articles

Self-Therapy For People Who ENJOY Learning About Themselves

If you've never been in therapy you might wonder what people talk about week after week in those oh-so-private little offices.

That's what I'm going to tell you.

If you are in therapy now this topic can help you to decide what to talk about if you ever feel stuck.

WHO IS RESPONSIBLE FOR WHAT?

It's not the therapist's job to tell you what you should change. It's the therapist's job to help you to change what you WANT to change. And it's your job to tell them what that is.

Don't expect the therapist to kind of take you on a "tour of your life" to point out everything you could possibly change. You need to look at these possibilities yourself and tell your therapist what you discover.

ABOUT THIS LIST

This list is presented in order, starting with the most important items.

But anything you find on this list is well worth telling your therapist about. (Talking about a problem near the bottom of the list often leads you to recognize other problems nearer the top.)

YOUR BODY

Tell your therapist about how you take care of your body.

If you think of suicide,
if you don't eat or sleep enough,
if you hold off on going to the bathroom,
if you purposely or repeatedly harm yourself in any way at all,
you must get help with these things.

YOUR SELF-WORTH

Your therapist always wants to know how much you value yourself.

Pay attention to the self-talk that goes on in your head. If you have thoughts like "I'm worthless"
or "I'm no good" or "I should just hide," or if you frequently have milder thoughts like "What's wrong with me," your therapist needs to know.

And if you are badly mistreated by others and you just "take it" - without leaving their presence
and maybe even without even demanding that they stop - this also shows a big self-worth problem.

Your therapist needs to be continually aware of where you are along a continuum from the horrors of self-hate to the calm self-assuredness of self-love.

MISTREATMENT OF OTHERS

If you find yourself being cruel toward others, even if you regret it afterwards, tell your therapist.

If you do too much of this you can end up desperately alone. (If you have this problem you probably already feel alone most of the time.)

ADDICTIVE BEHAVIORS

Anything that you think you must do that isn't a biological necessity may be an addiction.

Some of these things are serious and life-threatening and others aren't even a problem. But since addiction always includes some level of denial, tell your therapist about all of them.

FEELINGS THAT LAST TOO LONG

Feelings like sadness, anger, scare and even intense joy and excitement are supposed to be short-lived. They are supposed to change regularly, in reaction to the actual events in your life.

When you feel any of these emotions continuously for days, weeks, or months, something is wrong. Your therapist can help you find the core of the problem and fix it.

THOUGHTS THAT LAST TOO LONG

Some people "think too much" in a general sort of way. They say it seems like their head is always racing and they just can't turn off all that thinking.

Other people "think too often" about specific things. They need to find out why they keep thinking about that thing that happened to them years ago,
or that mistake they made,
or that mistake they might make,
or that thing they saw on TV last month.

Anything you keep thinking about over and over contains important clues about what you need
and how you can improve your life.

IMPORTANT EVENTS

Tell your therapist about major happenings in your life and what they mean to you.

They need to know about big problems, promotions, demotions, fears, and achievements at work.
They need to know about major events in each of your important relationships. They need to know when you are strongly affected by news events.

Anything that has emotional impact in your life is important to talk about, good or bad.

TALK ABOUT YOUR SUCCESSES

Therapy is not just about problems!

After the first few meetings you and your therapist won't always be talking about problems. You will be talking more and more about how you use your newly enhanced ability to overcome problems and to take greater advantage of opportunities

As good therapy moves along you will see problems from an "I-can-handle-it" perspective and you will find more and more reason to brag about your accomplishments!

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: Were You Loved As A Child?

Self-Therapy For People Who ENJOY Learning About Themselves

This topic comes from an e-mail letter I received a few months back. I've only done some minor editing.

THE LETTER I RECEIVED:

What is the job of a therapist? To listen? Anybody can do that, and for free!

I've had two therapists that just stole my money.

What is the job of a therapist? Are they supposed to give advice or just sit there? Are they supposed to help you?

I want you to answer these questions!

MY RESPONSE:

This is a great question, and I do want to answer it clearly and thoroughly for you.

The basic answer is: A therapist's job is to help you to change the things you want to change.

So the first thing a therapist does it to ask you what you want to change, and this can sometimes be a very difficult first step.

For example: Some people come to therapists without wanting to change anything at all. Some clients are ordered into therapy by a court. Other people are also sent against their will (for instance when spouses insist that they get help under threat of a divorce.) These people may not want to change at all. They might even be furious that they have to be sitting there talking to the therapist. When people come to a therapist against their will, the therapist's job is to simply hear that they don't want to change, allow them to quit if they want to, and to also encourage them to consider that they can change and that they can make wise decisions about whether to work at their changes in therapy. So, the first reason you might have had a bad time with therapists is that maybe you didn't really want to be there in the first place, and the therapists were essentially "fishing around" to see if you would change your mind.

Another reason you might have had a bad time with the therapists is that there are many different kinds of therapy.

Some therapists are "non-directive." They believe that the best way to help people is to simply allow them to talk and gather insight about what they want to change and about their own abilities.

Other therapists are very "directive" (me, for instance). They are very free with their opinions and they have ongoing and sometimes quite intense conversations with their clients. They believe that change comes partly from "supportive confrontation" (pointing out things that they think the client should consider changing, while sincerely respecting their right to their own choices).

Maybe you ran into some "non-directive" therapists. If so, they certainly were not a good match for you since you want a therapist who interacts with you more.

That leads to yet another reason you might have had trouble with your therapists. The therapists simply might not have been a good match for you. Clients have to take responsibility for finding a therapist who is a good match, and for moving along to other therapists when they run into someone who doesn't feel right to them. (Some men don't work well with female therapists, or with males. People of different cultures might have widely different values than the therapist. Nobody is a good match for everyone.)

Another big problem that frequently happens has to do with addictions. People who are strongly addicted to alcohol or drugs often have to overcome these addictions first before they are good candidates for therapy. Since the addiction is so strong, they often come to therapy with a chip on their shoulders and are very well prepared to defend their right to continue drinking or using. The therapist knows that they can't get better very fast without first giving up their crutch. But the client believes he needs his crutches. So they tend to go round and round without appearing to get anywhere for a while. (What's actually happening during all this time is that the client's trust in the therapist is building very slowly.)

Yet another problem has to do with managed care. Some therapists work for insurance companies who won't send them clients unless they are very quick at finishing with every client! In these cases the therapist may be more concerned about trying to convince you that you don't need to come back than he is in actually helping you!

Of course, the final reason is simply that there are a lot of lousy therapists (including the ones who follow the insurance company's orders instead of focusing on their clients).

But whether you ran into two lousy therapists, or whether the problem was one of the other things I mentioned, the thing you need to remember is that IT IS YOUR LIFE... and if you want to get professional help you simply must go through as many therapists as necessary until you find the one who is right for you!

I will warn you, however, that even after you find a therapist who is easy for you to trust and who seems competent and ethical, there will still be times when you and the therapist feel "stuck" for a few weeks or even months. Every client has quite a few "plateaus" during which nothing seems to be changing, and they get back to making big changes after that. You will have to tolerate these plateaus along the way. It is just part of the process.

So now I have given you a very thorough answer to your question.... and it's time for you to get on the phone and call another therapist to see if they are a good match for you. (You might want to read: "Are You Considering Therapy?" at my site first.)

Believe it or not, you are the first person to ask me this question in about seven years of answering these letters! I'd be very interested in hearing from you about what I've had to say. I think I'll turn this letter into one of the topics at my site eventually, and hearing back from you about what I've said might help me when I write the new topic....

So thanks again for an excellent question!

Tony S

HIS RESPONSE:

I know I saved a copy of this man's response letter, but I can't find it now.

I'm almost positive he wrote back to apologize for "venting" on me in the first letter, and to say that he was thinking about how the things I said applied to his experiences with his therapists.

I also think he said he would try again to find a therapist who was a good match for him. (I'm not so sure of this part. Maybe it's just wishful thinking...)

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: Who Is A Therapist?