Tag Archives: Psychology

How does small-time tyranny last?


Tyrants use fear to control subjects. Thus, we understand how North Korean leader Kim Jong Un is elected by 100% of his constituency. To abstain or cast any other vote would be suicide. But since most do not live under such oppression we may wonder how individuals cave to lower-level tyranny here in democracies or locations where we have choice about who we vote for and where we live and work. Why do organizations allow dictatorial leadership? Can’t we all just walk away?

Thanks to one of my students, Dan McCurdy, I pass on this recording from This American Life about a “small-time” tyrant in an upstate New York school district. The story is about the dictatorial dealings of a facilities manager of the school district–not of a principal, teacher, or even a school board member.

How is it possible for one with so little power (so we would normally assume) could wield such power over employees? How could he set off bombs, fire individuals, vandalize homes, threaten others with harm, simulate sex, and more without getting fired?

How? It is simple. He was,

surrounded above and below, by people who looked the other way. (near the end of the above recording)

Why do we look the other way?

We look away for all sorts of reasons. Consider a few of them:

  • Fear that no one will come to our defense if we stand up to abuses (which of course will be true if no one else sees or responds)
  • Need to protect what we have (e.g., position, income, career, reputation, etc.)
  • Cover up own failings (e.g., if he goes down…I will go down)
  • Perceive benefits outweigh consequences (i.e., in this case, school board received lowered energy costs, fewer worker complaints)
  • The people who complain of injustice matter little to us
  • Believe psychological abuse does not really happen

In Anjan Sundaram’s Stringer, he describes the most powerful of dictators are ones who instill fear when present and yet also instill fear of what life might be when that person is gone.

What to do?

When we hear of crazy stories such as the one in the recording, we shake our head and imagine ourselves standing up to power, standing up for the little guy. Too often our imagination never see the light of day. So, how can we keep ourselves sensitized to injustice and ready to act for the good of the weakest community member?

  • Identify our current fears. Who has power over us? What does love and grace look like when responding to this power?
  • Identify places we have chosen safety over truth. Who can help us rectify this problem?
  • Identify those places where we have power over others. Who do we have power over? How do we wield it? Who has God-given us the responsibility to protect? Where do we need to give power back (when taken or used inappropriately)?
  • Fix eyes on how Jesus uses power. How does he wield it with those who have the most power? The least power?
  • Identify habits of cover-up. Where, for reasons of shame, guilt, or comfort do we cover up and present self as someone we are not?

1 Comment

Filed under Abuse, Christianity: Leaders and Leadership, counseling, deception, Justice

When you imagine something does your brain think you see it?


What is the difference between imagination and reality? Sometimes, not that much.

The February 2014 edition of the Monitor on Psychology (v. 45:2, p. 18) lists a brief note about a study published in Psychological Science that looks at eye pupil constriction when imagining light. Here’s the abstract from the link above (emphasis mine):

If a mental image is a rerepresentation of a perception, then properties such as luminance or brightness should also be conjured up in the image. We monitored pupil diameters with an infrared eye tracker while participants first saw and then generated mental images of shapes that varied in luminance or complexity, while looking at an empty gray background. Participants also imagined familiar scenarios (e.g., a “sunny sky” or a “dark room”) while looking at the same neutral screen. In all experiments, participants’ eye pupils dilated or constricted, respectively, in response to dark and bright imagined objects and scenarios. Shape complexity increased mental effort and pupillary sizes independently of shapes’ luminance. Because the participants were unable to voluntarily constrict their eyes’ pupils, the observed pupillary adjustments to imaginary light present a strong case for accounts of mental imagery as a process based on brain states similar to those that arise during perception.

So it seems that thinking about something causes your brain to respond as if it is really seeing. What might this mean about those who are trying to break free of addictions?

  • Would imagining heroin use create observable changes in they body that would make it harder to maintain abstinence
  • Would recalling sexual images create responses that make sexual addictions harder to break?

So, what is the difference between imagining an affair and actually engaging in one? From a brain perspective, maybe not that much. Certainly Jesus’ expansion of the seventh commandment suggests there isn’t a difference between the two from God’s perspective. And yet, we know that actual adultery creates more damage to more people than merely fantasizing about having an affair.

Rumination: the health killer!

I’m currently teaching students a course on psychopathology. Each week we consider a different family of problems. Thus far we have explored anxiety disorders, mood disorders (depression, mania), anger/explosive disorders and addictions. Soon we’ll look at eating disorders, trauma, and psychosis.

There is one symptom that almost every person fitting one of those above categories experiences–repetitive, negative thought patterns.

Rumination.

The content of the repetitive thoughts may change depending on the type of problem (i.e., anxious fears, depressive negative thoughts, illicit urges, fears of weight gain, fears of being hurt, irritability, etc.) but the heart of the problem is the vicious cycle that negative thought patterns produce.

While there are many very good ancillary mental health treatments (Did you know that daily exercise, getting a good 8 hours of sleep each night, and eating a diet rich in protein supports good mental health and may even prevent re-occurrence of  prior problems?) it is essential for those of us who struggle with imagining negative events to find ways to shut down the production of rumination. Mindfulness techniques, thought-stopping, alternate focus may help to interrupt imaging bad feelings, thoughts, events and thereby interrupt the body reacting as if those bad things are indeed happening.

3 Comments

Filed under christian counseling, counseling, counseling science, counseling skills, Psychology, Uncategorized

Free Issue of Journal of Traumatic Stress


As a member of International Society of Traumatic Stress Studies (ISTSS), I am able to offer you a link to a free issue of their journal, Journal of Traumatic Stress.

Click this link for the February issue page with links to download individual articles.  Several essays relate to PTSD treatment for veterans, at least one essay re: child maltreatment in Uganda.

 

3 Comments

Filed under counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd, trauma

Are perpetrators of abuse “other”?


I write, teach, and provide professional care about matters pertaining to child sexual abuse. I sit on a board of a fantastic organization designed to help christian organizations prevent child abuse and respond well when allegations arise. From these experiences I can tell you that victims of abuse struggle the most when they finally get the courage to speak up but then aren’t believed–whether by other family members or those within their community. Since most abuse happens in secret places and since most of us live with happy public facades, it is easy to disbelieve the victim. In fact, the temptation is great since believing the victim means we must alter our perceptions of the perpetrator and the system that supports them. And that alteration disrupts our own lives, threatens our own comfort zone. Since some reports could be, have been false, maybe this one is too…

The first problem in stopping child abuse is the failure to believe victim stories of abuse. Victims know their information will destroy life as it was before the revelation. Believing that they will be singly responsible for damage done by revealing their abuse, they keep silent. Silence always enables further abuse.

But there is another problem, a second problem faced in stopping child abuse: treating abusers as “other,” some sort of monster that is so unlike the rest of us, we can’t imagine being in their presence. Think about these words. Perpetrator. Pedophile. What garish images come to your mind? Or, do you imagine someone with virtue along with their obvious and destructive vices? Do you imagine the image of a victim in that same person?

“Does it make sense to discard an entire oeuvre of work? Or does it simply reflect an inability to live with messiness and ambiguity? To chalk it up as nothing more than the work of a monster, to cast it out of the village, is to senselessly re-affirm the same basic strategy of denial and dehumanization that, ultimately, allows abuse to continue.”

If you are interested in considering the complexities of the person of the perpetrator, I highly recommend this essay where I found the previous quote. It is written by a victim of abuse perpetrated by his father. How do we account for the virtues, the generosities, the humanness, the victim experiences found in individuals who choose to perpetrate against others? Like the author of this essay, I suggest that doing so is absolutely necessary if we are going to make any dent in the incidence of child abuse.

“Most of us would sooner discard all parties who have been tainted by this event than we would look at how tenuous the sanctity of children really is, how commonplace abuse is, or see the capacity for the mostly good to do periodic evil. We live in the same universe as those who abuse kids. We walk among them. If we want to end the sexual abuse of children, it will begin with the recognition that we are simply not that different from them.” (emphasis mine)

Won’t humanizing perpetrators harm victims?

Humanizing perpetrators of abuse does not minimize the need for justice for victims. It does not decrease the place for restitution or incarceration. Naming humanity in perpetrators does not lead to excuse-making (we do that for other reasons!) nor demand explanations for abusive behavior (though sometimes this can be helpful, most would rather have acknowledgement of abuse done). It need not change our triage policy to prioritize victim recovery over all else.

But when we recognize that perpetrators of abuse suffer from the human condition plaguing us all (self-deception, self as the center of the universe, seeing others as objects for self-comfort, choosing fig-leaves rather than truth in response to shame), we have the opportunity to name these conditions wherever they show up in our lives. Naming them early and often hinders the development of the “split-self” where we live publicly one way but privately nurse other shame-inducing habits. And when we are more able to identify these features in ourselves, we may also find that we can identify them in others as well. While we are not responsible for the abuse perpetrated by others, complicity with abusive behavior (failing to respond to evidence of abusive behavior, allowing cover-ups, etc.) does stand as judgment on us.

Let us acknowledge that we are not so different, that “treatment” must start first in our own hearts so that we can help others before abuse takes place.

5 Comments

Filed under Abuse, christian psychology, news, Psychology, self-deception

Treatment of complex trauma: Why mistrust of the counselor is necessary and good!


I am reading Christine Courtois and Julian Ford’s, Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach (Guilford Press, 2013). I won’t be blogging through each chapter but I do recommend it for those working with adult survivors of child sexual abuse, especially those who are new to “complex trauma.”

The first two chapters give an overview of complex trauma reactions and diagnoses. If you want to know more about complex trauma, see this post about another edited book by these two authors. Chapter three, “Preparing for Treatment of Complex Trauma” begins the meat of the book. In this chapter they take up the ever important issue of empathy, safety, and respect as foundation to therapy. They emphasize the need for,

safety within the therapeutic relationship with a therapist who is empathic and respectful yet is emotionally regulated with appropriate and defined boundaries and limitations. (54)

Challenging Counselor Safety Is Common and Good?

This empathy and trust relationship is both foundation and method of treatment (59). But while the therapist is responsible to see that at safe therapeutic relationship has been built, it requires the client to be involved in building such an environment. The truth is that the client’s role in building safety in the counseling office is by passive and active testing of limits. Most counselors tolerate suspicious questions the first or second time. But, it is important for counselors to,

being prepared to patiently and empathically respond to active or passive tests or challenges to trustworthiness as legitimate and meaningful communication that deserves a respectful reply in action as well as in words. (60, emphasis mine)

If the therapist understands and does not take mistrust as a personal affront, the therapeutic relationship can evolve gradually. The client can begin to recognize  that the therapist actually “gets” why he or she is initially skeptical, self-protective, or “realistically paranoid” and does not pressure the client to be a “happy camper” but instead works to earn trust by being honorable, reliable, and consistent. This also implies a view of the client’s initial mistrust as expectable in light of the client’s history–that is, as a strength rather than as a deficiency or pathology. (63)

Sometimes clients can present in an opposite way–to be entirely deferential and affirming the counselor before a track record can be developed. Therapists with these clients need also to be prepared to encourage a healthy level of distrust.

What is not helpful is “artificial neutrality or passive and intellectualized detachment on the part of the therapist…” (64). It is my sense that we usually do this when we are afraid of the client. Not so much afraid of being injured, but afraid of failing or being consumed by the trauma. Or, we get consumed by our own history. A healthy therapist must stay emotionally present yet aware of own internal machinations. A healthy therapist must be able to predict some of the angst that arises in treatment of complex trauma and able to prepare self and client for this inevitable distress.

2 Comments

Filed under Abuse, counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd

Of dogs and addictions


Our six-year-old cocker spaniel has learned a new trick. After having lived with us for over 1.5 years, she has figured out that she can open the pull-out cabinet drawer that contains our trash. This only happens when we leave her penned in the kitchen. I suspect we left some wonderful smelling meat scraps in it one night and the desire enabled some higher level problem-solving skills (she’s not the brightest dog in the world). Now that she has learned how to do this, we’ve taken to bungy cording the drawer. A few nights ago, we forgot and came home to a mess of coffee grounds and torn up trash all over the floor.

Interestingly, our dog responds in quite a predictable manner. Normally, when we come home, she is at the door to greet us by dancing around and putting her front paws on our legs. But each time we have come home to a mess she has made, we see her cowering and ready to bolt. The last time we came home to this mess, she squeezed out the door before we could get into the house so she could run away. No, we don’t beat her. She knows she has done wrong.

I’ve wondered what goes on in her head during the time she is into the trash. Does she know it is wrong? When does she start feeling bad. The moment we arrive? Has she been cowering and feeling guilty as soon as she spreads trash around? One more funny behavior: when we send her to her crate (in the basement) for a time out, she goes right away. But then, after a bit, we see her outside of her crate but sitting patiently. Then, she’s at the bottom of the stairs looking to see if we will let her up. Then, her front paws on the first step, waiting in anticipation that we’ll say all’s forgiven.

And this relates to addictions how?

Most individuals who struggle with an addiction have the strong feeling of guilt even as they partake. Guilt rarely is enough to stop us from acting out. Even knowing that we may well be caught does not stop us as much as you might think it would. The desire to have what is right at our fingertips can easily overwhelm all sensibilities and logic–that will race back to us as soon as we finish partaking or as soon as someone finds out. Our initial response may include running away. Guilt and shame prevail for a time and then we creep back into life hoping that the troubles we have caused will blow over and life will return to normal.

Of course, we are not dogs and so we must use the gifts God has given us (a brain capable of higher order planning, the Spirit) to learn from our mistakes and misdeeds. We can

  • remove ourselves from proximity to the addictive agent
  • plan for accountability, especially during vulnerable times
  • examine the roots, shoots, and fruits of our addictions with a trusted friend/counselor
  • remind ourselves of the power to say no and the foolish, false promises of addiction

For more of what I have written about addictions and interventions search the word in the seach box at the top of this page.

Leave a comment

Filed under addiction, christian counseling, christian psychology, counseling, Psychology, sexual addiction

Getting the Right Treatment for Sexual Abuse? 7 Questions to Consider


You will find the theme of sexual abuse all over the news these days, from clergy sexual abuse to teacher-student improprieties. This level of public discussion allows some victims to feel empowered to speak about past abuse. Hopefully these same individuals find the courage to seek out a counselor to address ongoing struggles with memories, shame, and self-doubt.

But will just any counselor do?

How can you know if the counselor you’ve picked is the right one? Are there questions you can ask to determine whether you are getting good care? Check out the following questions.

How does my counselor handle my disclosure of sexual abuse?

It takes great courage to tell another person about violations of body and soul. Victims fear not being believed, blamed, or worse, having their secret told to others. Thus, when a person sets aside those fears and speaks of what has been hidden, it is a great honor to be blessed with that story. Consider these questions to see how your counselor rates:

  • Does my counselor show evidence of great care for my story? Do they treat it as precious? Once you have told the story, what do they do next? While we counselors hear many tales of woe, it can be tempting to ignore sexual trauma, especially if it happened many years ago or is especially horrific. Some counselors think that past experiences should remain there. They choose to focus only on present problems. Or, counselors can dive into the story and unintentionally force the client to talk too much about the abuse before trust has been fully established.
  • Does my counselor seem in a rush to “get beyond” my abuse to forgiveness, confrontation or reconciliation? There is a place and time to talk about these matters. However, if you have just started telling your story and these topics are their prime focus, then you know that they are most interested in getting to the end of the story, the happily ever after part. The impulse to get to the end will inevitably make you feel like your abuse was a mere trifle.
  • Does my counselor seem to have an unhealthy interest in all the details of my abuse? Counselors who ignore your abuse story are not the only danger. Counselors who dive into your story with great relish may cause you to feel re-victimized. There is a time and place for telling the story in greater detail (so as to process what you have come to believe about yourself and others). Those who rush in to the gory details seem to think that all story-telling is beneficial (see this link for the difference between bad and good trauma storytelling). By the way, a counselor who offers you private access (texting, emailing, late-night phone calls, house visits) without limits and boundaries may be offering you something that is for them and NOT you.
  • Does my counselor let me set the pace of counseling? The heart of abuse is oppression and stealing voice and power (I’ve written more about that in my chapter in this book). A good therapist may unintentionally re-enact abuse when they use their position to coerce clients to meet their own agenda. A benign dictator is still an oppressor! A common question I have received from beginning counselors goes something like this, “How can I make [name] tell me about her abuse?” My answer? You should not try to force her. What happened to her was coercion. You can provide a small modicum of healing by allowing her to decide when and if she will tell you anything. “But, won’t that mean that [name] will not get better?” Yes, it means her recovery will take longer. But consider this: you are undoing her abuse experience by giving her power to decide what she does with her body, including her mouth. It is true that there will be some pushing and prodding, but it should be gentle with the client feeling that he or she has the power to say no or to slow down the process.
  • Does my counselor educate me about trauma symptoms and typical treatments? Trauma symptoms (intrusive memories, hypervigilance, attempts to avoid triggers, numbing, etc.) are not just a psychological phenomenon. The whole body has been traumatized. Your counselor should be able to talk about the effect of trauma on the brain at a lay person level. Further, your counselor should be able to tell you what we *think* we know about the biology of trauma and what we still do not know. (By the way, if they are too enamored with one particular theory or cure-all treatment…RUN).

 A quality counselor will also talk to you about the typical 3 phase model of trauma recovery. They will educate you why it is important to develop good self-care strategies and to eliminate harmful behaviors (addictions, cutting, risky behaviors) before entering into the work of processing memories. They will tell you that safety and stabilization phase (first and ongoing) is about finding ways to stay in the present and to reduce dissociation. When you do tell your story in greater detail, the effective counselor always leaves room in each session to help you leave the office well.

  • When my memories are fuzzy, does my counselor urge me to try to remember? The very nature of talking about past events (whether happy or horrific) brings old memories to the surface. Inevitably, a client will recall some feature of their abuse they had not remembered for some period of time. Or, they will recall something in a very different light and as a result it will feel like a brand new memory. However, your counselor should not be intent on finding lost memories. There are two reasons for this. First, memories can be constructed. When details are vague, our minds may have ways of filling in the blanks with false ideas (However, the likelihood of constructing an entire memory of abuse ex nihilo is rather rare. In my 24 years of counseling, no abuse victims in my office ever reported having NO lasting memory of abuse. All recalled many details even if some details were not). Second, God may have a reason for keeping certain memories from you. Not everything needs to be remembered to get well.
  • What goal does my counselor seek? Counseling works best when counselee and counselor agree on goals and the means to get to those goals. Do the goals your counselor seeks make sense to you? Some goals are unrealistic and even dangerous. “Completely healed” or “as if it never happened” are unlikely and could even be dangerous in that they would make you vulnerable to re-victimization. Goals to confront, cut-off, or reconcile may be legitimate but expectations and safety plans must be reviewed ahead of time. Consider also that reconciliation may not be a good idea.

Your Questions?

I have just touched the surface on a few questions. You might have many other questions you’d like answered. Feel free to suggest questions here and I will attempt to answer some over the next few days.

7 Comments

Filed under Abuse, Christianity, counseling science, counseling skills

Could surprise divorce cause PTSD?


A former student (HT Armando!) sent me this link today about a woman who experienced PTSD like symptoms after receiving an out-of-the-blue text from her husband telling her he was leaving and divorcing her.

She experienced flashbacks, nightmares, became hyper-alert to dangers, unable to sleep and other such symptoms that are common to PTSD. She did not have an actual or perceived threat on her life–a necessary requirement for the current diagnosis of PTSD. However, she did seem to respond to the surprising evidence that her husband had deceived her for some time as having been “sleeping with the enemy.”

This question for you is whether you think it harms those who suffer classic PTSD (i.e., those who do experience a threat on their life) to lump them together with those who have similar symptoms from non-life threatening trauma. Yes? No?

I have observed pastors in significant conflict with church leaders exhibit PTSD like symptoms. I have observed individuals who learn in late adolescence or adulthood that their parents were actually adoptive parents. It appears that some of the same symptoms exhibited by those who experienced rapes, car crashes, or war trauma show up in some individuals whose world is turned upside down by another’s deception and duplicity.

So I ask the question again: What is gained or lost by expanding PTSD diagnosis to include those with similar symptoms but without the threat of physical injury or death?

Here’s one gain and loss for someone having this kind of divorce reaction. Those who have the symptoms without the physical threats may find some comfort in knowing their reactions are had by many others. However, I would imagine that most of these same people may find their symptoms abate more quickly than that of those who see actual death and destruction. Thus, a diagnosis of PTSD may end up hurting them due to an over-estimation of recovery time needed.

3 Comments

Filed under counseling science, Post-Traumatic Stress Disorder, Psychology

“Schizophrenic and Successful”? What are the factors in success?


This recent New York Times Opinion Page essay is written by Law Professor, Elyn Saks. She tells a bit about her diagnosis of Schizophrenia years ago and her fight against those who thought that she would not amount to much. While we shouldn’t assume that everyone who struggles with delusions and hallucinations will rise to Dr. Saks level of accomplishments, we should take note where we give in to hopelessness when someone we love receives such a similar diagnosis. Such hopelessness will surely hamper our loved one’s prognosis for recovery.

There are two important factors that predict both recovery from mental illness and future recurrence of symptoms.

  1. Acceptance of diagnosis and treatment compliance
  2. Absence of family and social stressors

These factors are found in nearly all forms of mental illness, but especially pertinent for depression, mania, and psychotic disorders. When a person accepts the existence of a problem and commits to a treatment strategy, they are likely to be more cognizant of the signs and symptoms re-appearing and therefore willing to seek additional help. When medications create irritating side effects, the committed person will either find ways to tolerate these irritations or work with their doctor to find alternative treatments.

The absence or minimization of family stress requires the family or community to not behave in ways that exacerbate the problem. The family must also accept the limitations and not act in ways that place unrealistic expectations on the patient. This of course requires a great deal of sacrifice–on top of existing grief and loss over relationships that will not be what they could be (e.g., caretaking a spouse with mania, supporting an adult child who needs a sheltered environment). This means releasing the demand for the patient to reciprocate empathy or have insight about their impact on the family. Still further, when we loved ones maintain a hopeful perspective–identifying a patient’s value, capacity, and possibility for a future–we offer that person the greatest chance for success.

For some, success may mean being able to hold down a steady cashier job. For others, success may mean staying out of the hospital. Still others may rise to Dr. Saks level of success in academia. If you have a family member who suffers with mental illness, work hard to see them beyond their illness and evaluate their current capacities (rather than by their best or worst day). Oh, and be sure to find someone to talk to. Your family member isn’t the only one who needs help coping with a difficult world!

1 Comment

Filed under counseling, counseling science, Psychology

What happens after a trauma may be the key in the formation of PTSD


Thanks to a friend I read this essay today about a possible way to model PTSD formation–by considering what does or does not happen in the trauma victim’s social environment after the trauma experience. The article discusses 2 different studies, one animal and the other human.

The animal study concludes that kidnapping a mother rat from her pups for more than 15 minutes will result in anxious activity upon reunification in the same cage where the trauma happened. Mother and pups will continue to be over-reactive well beyond the event. However, if mother and pups are reunited in a new environment, the trauma reactions (racing around, stepping on each other, aggressive behaviors) seem not to be present. Might it be that they have a shared job of exploring the new environment?

The human study points to the importance of having reunification symbols or rites of re-entry when bringing child soldiers back into the community. This appears to have value over just quietly pretending that nothing happened.

2 Comments

Filed under Abuse, counseling, counseling science, Post-Traumatic Stress Disorder, Psychology, trauma, Uncategorized