Maladaptive beliefs and fear of judgment in therapy OR Speed bumps.

Maladaptive beliefs refers to  a term that describes ill formed thinking patterns, mostly negative, behaviour patterns, reaction patterns that may, but not always, have been learned during a traumatic event or childhood. Unsupported irrational thinking or beliefs. False, but accepted by the individual. 

A maladaptive schema clouds self judgment. This can be related to abandonment issues, shame, dependence, vulnerabilities, mistrust and on and on and on..

For a previous post on maladaptive beliefs click here.

In therapy one large stumbling block, is when a patient will conceal information. There are numerous reasons why this could be. Shame, trust, embarrassment, fear, humiliation, there is a long list that becomes more and more technical. 

These are things that cause us to fear that our therapist may judge us if we open up, to reveal. It can also be that the patient does not wish to change what they may be doing.

Or to that speak of it, ratifies it. That it really is a non issue, isn’t it?

There is the fear that they will be judged by their therapist. 

We are quick to self judge and doing so may believe others will do the same of us if information is revealed. 

We are often our harshest critics, our strongest judges of ourselves. As a therapist we are not there to judge but to help you lesson your own critical self judgment. 

In therapy you will often run across something the patient does not wish to discuss, an area of topic or something more specific. An example something more specific is self harm. Both the patient and the therapist may or may not know this is an on going issue, but either way the patient doesn’t wish to talk about it ‘at this time’. They may not really wish to stop practicing self harm or they may find it an embarrassing topic.
This is often because of the fear of being judged. Judged by someone that maybe doesn’t understand, They don’t self harm, so how can they know? Self harm is not understood by most, noses raise, frowns issue, many say ewe or just don’t do that. Easy advice to issue. Just don’t do that.

This can though apply to many issues, “you are not in my place so how can you possibly understand what I go through.” So the patient does not reveal.

It is difficult to provide help, with limited information. Or with a wall that has been built that a patient is unwilling to tear down, or even get close to. Therapy will be never ending when information is withheld or is just wrong.

This fear of being judged is a giant speed bump in therapy. 

Some simple examples, my meds don’t work so I stopped taking them. Perhaps you didn’t mention you drink heavily, or take other narcotics or other meds that you have not revealed. Because this would involve what you feel to be judgment or you have no intention of stopping to drink heavily, so there is no point in admitting that you do.

So to avoid being judged, patients may omit or lie. The patients hope they can receive help and just avoid these areas. Unfortunately those areas are often thorns, sometimes the root of their torment, there is no avoiding some issues unfortunately. 

We don’t take our car into the shop and tell them it goes beep beep boop and then not tell them about the purple smoke that comes out of the dashboard because we want our car to be well again. 

We may lie when we are asked if we are suicidal, because then we fear being placed in an institution for our safety, we don’t want to go there. So we may lie.
A lower self esteem, self worth often contributes to this fear of judgment. A low self esteem is linked to guilt, often this guilt may be associated with past incidents that they blame themselves for. Prime examples are child abuse, sexual assault. The mind can not comprehend how someone can be capable of doing these things, often self blame arises to justify the attackers reasoning. This is when maladaptive beliefs form. This is when it can become quite complex. The fear of judgment from what they may not be revealing may be unjustified. First off the therapist is not going to judge, even though that thought is not believed, second the undisclosed information may be unfounded to some extent, I know this sounds complex and unsorted. Rationality though, is not firm. Clear thinking is not, clear. 

The fear can be powerful too, that discussing the hidden issue, will awaken, and possibly will,  a much too powerful feeling, fear, memory or even an alter. Or cause someone else to suffer, or go to jail. Yes often a patient may be protecting an attacker, living with their attack/s but still protecting them, knowing that to reveal may cause them to be jailed. Working through this with your therapist in a controlled safe environment is the way to peace. 

Judging is a human trait, it is something we do.  A therapist understands, unless they are not worthy, and then you should seek another promptly, judging a patient will be a detriment to therapy. It will create distrust. A therapist will be more aware of this than most and will strive to not show any signs of judgment. But, perhaps there really is no judgment to be made either? Most often, this is the case.

The judgment that is feared, is often not warranted, It may be from maladapted beliefs. Something the therapist will help the patient with, rather than ridiculing them or even judging, as perhaps there is no judgment to make, no ill thoughts, only help.

We can also conceal or lie to impress. We want our therapist to like us, so the truth may be stretched or completely changed to impress. This too becomes complex. Honesty with your therapist will go a long way to your healing. 

There may be other reasons for fearing judgment. Criminal activities being an example. If you tell your therapist, are they going to report you to the authorities? To your partner or parents? The answer too, is not so easy, this varies from place to place, how the laws may protect your privileges, your right to confidentially.

There will be few, if any areas though, that will keep your therapist from taking further action if they fear you are a danger to others or yourself, they have a legal responsibility to take action in that case.

If though, you have gone to the trouble of seeing a therapist, because you have those thoughts. To answer yes, when asked are you suicidal, or not to say I am not fine, when asked how you are. This is going to help you. It may be possible if you answer those questions honestly that more care will be sought for you, it may be possible that, with your therapists help you right that second too, things can turn around and further care in a hospital for example, may not always be needed.

See You have taken the step to seek therapy, to seek help, to feel better, but you have to take the second step too, and reveal with honestly. Speed bumps are for parking lots. Don’t make therapy a parking lot.

 

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Look I am back

Have you noticed Oprah W has a new commercial out?

 

One for weight watchers?

 

It is good timing on her part, many make that New Years resolution to lose weight. When they see Oprah, someone that promotes respectability, pushing a program at weight watchers, they really listen. She sways a lot of opinion. They believe what she tells them.

She has a fireside chat type commercial airing now, without the fire. One where she is just talking to you. This is not an accidental format for the commercial. It lends a lot more sway power to it, you want to join her, she is very convincing.

What seems to have slipped through the cracks here though. Is she is a stock holder in weight watchers.

oops. she didn’t mention this in her commercial. She is not hiding the fact, she was on Ellen talking about how she bought ten percent of the company for forty million dollars. How she made forty five million dollars the next day (I think) as the stock sort of doubled.

But in her commercial, where implied honesty is beaming through, this somewhat important detail is omitted. It is not, hey I liked the product so much I bought the company…

But the honest fireside chat format would be destroyed if she had said, hey I own this company you should try it out. She could have made that work though. It is too bad she didn’t try.

Negative points for you Oprah. 

oh this isn’t a rant, I am just ticked that she did this lol. 

If I was ranting I would be talking about the greedy oil companies that are buying crude oil for $29 dollars a barrel and the prices at the pumps are the same as when it was $100 dollars a barrel. OOPS… more greed is showing. Now that ticks me off a lot.

That would be a rant.

 

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“That is normal”

NORMAL

Normal can be comforting. 

If we think we are odd, to be told that this is normal, this feeling (if we believe it) can be comforting. It is good sometimes to discover we are not “odd”.

In a session, it can be difficult to not say to a patient, this is normal, that is a normal reaction, your feelings are perfectly normal. 

It is true. 

Sometimes it is not what the patient wants to hear. A lot of times, mostly because they do not feel this is the case.

Sometimes because they want to feel that they are not normal.

Or how could there be a “normal” reaction or behaviour, response or feeling, for what they went through?

I have a new patient.  I met her in the hospital yesterday, we spent a lot of time together. Her sixth attempt to end things was just thwarted, barely, she has slipped through the cracks in the “system”. This happens all too often. Not receiving help after her previous attempts, filing some of those attempts away as acting out or seeking attention. 

This too, can be “normal”.  Sad as it is. 

Silent Sessions

I am going to talk, hmm type, about a part of therapy, well a few parts. The quiet parts.

Establishing goals in therapy is important, they can be long range or short term. Goals will change as therapy progresses, often hurdles need to be overcome, so the goals change to help with those hurdles, progressing toward the initial or primary goals we established.

As a therapist we see the goal and know how to reach it, we can just say to the patient, do this, this and this, stop doing this this and this. But this will not achieve anything. It really is not that simple.

Therapy often proceeds at a crawl, slow steps, as many forward as possible but with the understanding there will be many taken backwards too. Therapy is often a retraining, this does not occur overnight.

There will be times when it seems there is no advancement at all.

Sessions become silent

Homophobic?

Someone doesn’t wake up one day and decide from now on they will be homosexual, lets give it a try. They may wake up one day and accept it, they may wake up one day and decide to stop hiding it.

It is not a choice, they are or they are not.

I often read blogs under the same sex marriage tag, condoning, How they carry on is disturbing, one such blog recently was praising homosexual aversion/conversion therapy. This scares me. It doesn’t work, it is very dangerous and it is just WRONG on so many levels. It is also against the law in many places to practice this practice.

These blogs indicate someone that is homosexual is a sinner, their God will deal with them at some point. Wonderful pressure.

Studies now show in zones, states, provinces, countries, where same sex marriage has been legalized, anxiety and stress levels among the homosexual community drop. A LOT. Naturally, is what you should think.

This is too simple.

What does this mean, people are healthier, hospitals are less busy. Isn’t this our goal?

Why should someone, that did not make this choice, be told that some ones God is going to deal with them, or they should undergo homosexual aversion therapy so they can be made “Normal”.

But they are happy, we need to change them. Well happy if accepted, not discriminated against, welcomed. Redhead, blonde, brunette, LGBT or not. Same thing.

Isn’t it?

Left handed, right handed.

Tall, not tall.

Come on!

What is normal? Is normal someone that is content shocking someone, or chemically “adjusting” their behavior?

Personality disorders

Personality disorders

(this is a somewhat lengthy post and not entry level, should you have questions, feel free to ask)

Hollywood and the Media often will portray someone with a “Mental Condition”, often they bandy the term psychopath about. 

The question often arises, are they a psychopath or sociopath… neither term is used any longer, and there was always question between the two, as they were mostly the same. The term used now is Antisocial Personality Disorder. There continues to be, however, arguments and dissension on if ASPD should be all encompassing, or if it should even be considered a mental disorder as it is used so often in court, to escape crimes.

This is not what this post is about however. This is just to define what we now consider to be personality disorders, a basis of understanding about them with the Hollywood hype removed. 

One would think then, that this means the persons Personality is off… This is not quite right though. It more applies to a category of disorders that relate to a maladaptive reaction, belief, thinking or feeling. Their personality is not really any different from anyone else’s. Psychological geek talk though, personality is defined by the pattern of thinking, feeling, reacting or behaving. If we all lived alone in caves, this would not be an issue, but we are a social creature, a personality disorder is more in regard to social experiences. How we interpret the information we receive in this social experience can be maladapted. Misperceived. This can apply to how we look at ourself as well, or how we react to others in a social setting. This is refereed to as our “environment”, more psychological geekologie.

Wondering why you get migraines?

I haven’t touched on this subject in a while.

Sensitivity

Empathy

We all have varying degrees of this.

There are some of us, actually it may be one in four or one in five, that have more sensitivity, more empathy. With this gift can follow other gifts, that are not as nice.

Migraines are one.

Someone that has migraines will know, that stimuli seems to be more powerful when you have one. Light, noises, smells, hot cold, being near people… many things are more felt, more unwanted when suffering with one. We, yes we, are more sensitive to stimuli, hypersensitive even.

This sensitivity is often felt when not with the migraine as well. We are more aware of smells, light our surroundings than others. There are many reasons why someone may suffer with a migraine, or have them much more often. Tests are run, you are connected to machines, poked and probed. Tis good to do this, to be sure there is not an underlying medical reason for having them.

Often the tests all come back negative, this is good right? So then we wonder why we keep having them, for this too, there are many reasons.

Sometimes it is because about 20% of the population is more sensitive, more tuned in. The term is highly sensitive person or HSP. You are born with this, it is not something that happened to you. A person that is a HSP has more receptors, takes in more information. This can apply to sense of smell, empathy, many things. It is like feeling a fine piece of silk using eight fingers and both thumbs rather than one.

This abundance of information can sometimes be overwhelming, most are not aware that they are taking in more information, what do they have to gauge it with? Is everyone not this way? This over abundance of information can often cause migraines, there seems to be a very strong connection. Powerful emotions can be felt, but where others know when someone is upset, someone with HSP may feel the same feelings, become upset in the same way, in crowds this can be overpowering. In settings where emotions are higher, this can be overpowering. 

Migraines can be triggered.

When someone discovers that they perhaps feel some things differently, more powerfully, than others do, they have that aaaha moment. All the loose marbles are suddenly gathered up into a neat package, they stop rolling around making all that noise in our heads.

Well not quite, but it does help. When you learn why you feel someone’s emotions before they are aware of them, why it seems you can almost read minds at times, why light may hurt, why sounds become too much, why crowds are overwhelming and so much more, you can learn to adjust. Or to know, you won’t be in the crowd too long, so when you are out, this feeling will pass.

This power to receive more data, yes power, can lead to more creativity, many artists are found to be HSP.  I have heard the term that an HSP watches the world in high definition. 

This heightened awareness can trigger the flight or fight response faster for some, it can cause an increase of anxiety. Not for all though, as we are all different. Introverted is also often the case, but again, not always.

 The feeling with a migraine is often that your head is going to explode, this is often the feeling a Highly Sensitive Person  will feel with all the information being processed, there is a connection.

Does a repetitive sound, like someone absently drumming their fingernails make you want to scream? That dripping faucet that others don’t seem to hear, the smell that is barely there for others, you are finding very annoying. 

A very quiet acoustic guitar verses a concert with a loud band is often something that makes you smile inside.

Pausing to watch the ripples on a lake and finding such deep peace in this, in fact water of many types, even a shower, can have a strong pull for you. A healing power too. A restoration.

Someone that is a Highly Sensitive Person has many traits. They will vary for each, you can google this if you are curious. 

Perhaps there is a reason for your migraines after all, maybe your bag of marbles is sorted out now.

 

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Q & A with a therapist

This is a post that has been under construction for a while in my notes, I may do more in the future. 

Students ask questions of me, often when they discover I am in practice as not all of their professors are.

Some of the questions asked are the same as what friends or family will ask, when their curiosity grows.

Do you get angry with patients, do you cry, are you afraid of any of your patients, do you call them patients…

Maladaptive personality shaping from the parent.

Narcissism, this is a difficult disorder. The person is very self absorbed. Self obsessed. Selfish. A strong sense of superiority. Uniqueness, requiring praise, entitlement. Will feel no regret taking advantage of others for their own gain. Arrogant. When criticized will rebel. Empathy is not one of their tools, lying perhaps will be. Self esteem is actually quite low. Someone with NPD (Narcissistic Personality Disorder) is very unlikely to seek help as they do not feel there is anything amiss with them.

Why bring this up?

What about the child of a Narcissistic Parent? Or Parents as they often attract one another.

it isn’t rocket science, that is easy.

A Porsche technician was removing a computer chip from one of the many components on the engine of a Spyder when he spotted a well-known Psychologist in his shop. The Psychologist was there waiting for the service manager to come and take a look at her car when the mechanic shouted across the garage, “Hey Doc, want to take a look at this?”

The Psychologist, a bit surprised, walked over to where the mechanic was working. The mechanic straightened up, wiped his hands on a rag and asked, “So Doc, look at this engine. I opened its brain, tinkered with the memory, adjusted the wiring, reprogrammed its pathways and when I finished, it worked just like new. So how is it our wages are not equal when you and I are doing basically the same work?”

The Psychologist paused, leaned over and whispered to the technician , “Try doing it with the engine running.”

 

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