tag:blogger.com,1999:blog-63651043652918088762024-03-08T09:04:07.647-08:00Dr Raphael GunnerThoughts on psychotherapy, business, and yoga.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.comBlogger21125tag:blogger.com,1999:blog-6365104365291808876.post-27085154619238784292008-06-01T17:18:00.000-07:002008-06-04T11:29:19.036-07:00Friendship<span style="font-family:lucida grande;">Every Sunday morning I have breakfast with a friend. I first met this friend when I was 19. We generally talk about the challenges of being human. We implicitly look to each other for help. </span><br /><br /><span style="font-family:lucida grande;">Sometimes help comes in the form of an insight. Sometimes it comes as a personal anecdote. And sometimes it arrives as a question from the dark, a flash of lightening for an instant illumining the sky. Whatever the form, the help has been valuable. At least in my case, it has shed needed light. </span><br /><span style="font-family:lucida grande;"><br />One day, however, I had a new experience. I had been feeling alone, and I described this to my friend. Rather than attempt to make me feel better, my friend replied that this seemed about right. He didn't try to take my experience away. He acknowledged it. He normalized it. He stood by me while I had it.<br /><br />Just after this exchange we got up to leave and walked a half block in the direction of my car. I found myself filled with gratitude and love. A powerful image seized hold of my mind. I felt like I was standing at the edge of an abyss, looking at a red sky that signified death, and right next to me, simply present, was my friend. I told him the image, and he immediately grasped it. Then we quickly parted for yet another week.<br /><br />Soon after this experience I came to understand that I now had a new definition of a friend -- someone who stands by you whatever you feel. The paradox in my case was that I'd been feeling alone. And while I was feeling alone my friend was with me. He was a witness to my aloneness and yet not an antidote. Like a loved one at one's deathbed. Present but distinct.<br /><br />Eventually I recognized that what my friend did for me is very much what I try to do for my patients. To be with them while they share their most painful feelings. To do nothing to try to take these feelings away. To acknowledge them. To normalize them. To stand by them while they have them. In this way, I realized, I try to approach them as a friend.<br /><br />To my surprise, this led to the unorthodox conclusion that friendship forms the cornerstone of good psychotherapy. Not the friendship of broken boundaries and needless self-disclosure in which therapists use the treatment for their own gratification. That is exploitation masquerading as friendship. But the friendship of emotional courage and unbroken presence in which therapists stand by their patients whatever they feel.<br /><br />Of course, this is easier to say than to do. And no one is always so skillful a therapist. But knowing what it feels like to experience such friendship certainly makes it less difficult to achieve. And for this I am deeply grateful to my friends.</span>Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com2tag:blogger.com,1999:blog-6365104365291808876.post-15521415973173054832008-05-10T16:29:00.000-07:002008-05-12T15:13:55.020-07:00A Good Relationship RedefinedI recently came to an unsettling conclusion. That my definition of a good relationship has been out of whack. I used to think that in a good relationship:<br /><ol><li>You have the same values -- you fundamentally agree on what's right and wrong.</li><li>You have the same goals -- you are equally interested in wealth, family, education, health, and leisure.</li><li>You have the same vices -- you both do or do not drink alcohol, do drugs, look at pornography, overeat, under eat, overwork, under work, overexercise, or under exercise (to name but a few). </li><li>You have the same sexual fantasies -- or at least ones that are complementary and mutually exciting. </li><li>You have the same body rhythm -- you like to get up, go to sleep, and relax at similar hours. </li><li>You are equally neat -- or equally messy, as the case may be. </li><li>You have the same thermostat -- you like the window open or closed.</li><li>You have the same politics -- you vote for the same candidate or at least the same party.</li><li>You have the same aesthetic -- you like the same art, the same music, the same furniture, and the same clothing. </li><li>And you have the same past times -- you both do or don't like going to the movies, reading books, listening to music, visiting museums, and traveling to exotic places on your free time.</li></ol><p>In essence, I used to think that in a good relationship you're both the same. It certainly made finding a good relationship very difficult. There was only one person who fit my requirements: me. This narrowed my chances of finding a partner considerably.</p><p>My recognition that a good relationship doesn't mean you're the same gradually took shape over a number of years. Though it was painfully slow in coming, three insights pushed it forward. Insights from friends who shared their wisdom with me.</p><p>The first insight was that the challenge in finding a partner is not to find someone who won't disappoint you. It's to find someone who'll disappoint you in ways you can handle. </p><p>The second insight was that you'll be disappointed in ways you can't handle. When this occurs you won't dream of leaving the relationship. You'll decide to leave the relationship and will start to plan your exit. This will go on until you remember why you're there. Why it is you chose the relationship with this person to begin with. At this point you'll unpack the valise in your mind. Nonetheless, the same thing will happen repeatedly as long as you continue to stay in the relationship. </p><p>The third insight was that you must accept your partner as they are. You cannot accept only those qualities you adore. You must also accept fully those qualities you despise. You don't have to like these qualities. Nor do you have to share them. Nor do you have to collude in their enactment. But you can't make your love contingent on change. You must be prepared to take the good with the bad.</p><p>This was a long way from where I began. I had always assumed that I'd find my other half. Someone with whom I would form a perfect whole. Then it turned out that this was a myth. That disappointment is part of the DNA of relationship, written into the double helix of human attachment. Not only would I not find the mirror image of myself. I'd find someone who was different in all the wrong ways and would have to accept them without qualification.</p><p>Yet to my surprise this came as a relief. Because it freed me from the pursuit of an imaginary relationship. A relationship that exists only in movies and ads. I finally understood that it's okay to love someone even if they failed to live up to your dreams. I finally understood that it's okay to stay with them even if they never attempted to change. The goal isn't to find a perfect relationship. The goal is to find one that's just good enough. And there's lots of room there for disappointment of all kinds.</p><p> </p>Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com4tag:blogger.com,1999:blog-6365104365291808876.post-76962742691005377852008-04-21T11:50:00.000-07:002008-04-21T12:59:54.148-07:00The Psychology of Yoga and the Yoga of Psychology[The following essay first appeared as an article in the March/April 2008 issue of <em>The Los Angeles Psychologist</em>, the bimonthly publication of The Los Angeles County Psychological Association. This publication is geared to mental health practitioners, and this particular issue focused on creative approaches to psychotherapy. As editor Meghan Moody states in her introductory comments, "This issue . . . offers a look at a few creative practices that go beyond traditional talk therapy, inviting you to color outside the lines" (5). As a psychologist and yoga teacher, I was asked to contribute.]<br /><br />The challenge for me is how to be present. To my sensations, my feelings, my thoughts, and my actions. It's an awful lot to ask and very hard to achieve. But yoga has helped by providing a method. Its has given me a safe space in which to practice showing up.<br /><br />One reason I love yoga is because it's concrete. I attempt to work my body without getting distracted. Without trying to escape the intensity of the moment. Bending forward, bending backward, twisting sideways, and lifting skyward. All without losing a smooth, balanced breath. All without losing a smooth, balanced mind.<br /><br />But we invariably do yoga the way we do life, and the same unwholesome habits inevitably plague us. For some, it's overworking. For others, it's being distracted. For still others, it's not managing to get onto the mat. As Jon Kabat-Zinn says in the title to his book, "Wherever you go, there you are."<br /><br />And that's how yoga works. We start with a posture and end up with ourselves. Increasingly aware of our distractions and habits. It's hard to see our weaknesses in all their florid glory, which is why practicing yoga takes so much courage. But the practice also encourages us to be kind, to practice <em>ahimsa </em>or non-violence on every level, to discern with compassion instead of judging with harshness. This makes it possible to tolerate others. This makes it possible to tolerate ourselves.<br /><br />The great thing about yoga is that we get to keep practicing. And the longer we practice the more we can grow. Of course, it's always tempting to avoid growth at any cost. All we need to do is reinforce our old habits. But if we really want to change, yoga's a good bet. It gives us a chance to see what we're up to.<br /><br />By revealing in living color our unconscious habits, yoga helps us cultivate non-attachment and presence. Over time, we can learn to optimize our practice. We seek sensation and avoid pain while maintaining our breath. We get stronger and more flexible and assume harder postures. We notice with greater speed when we're becoming disregulated. We think about why we are getting overwhelmed. And we change what we do so that it feels better.<br /><br />Gradually, we're more able to observe our experience, to reflect on our observations, and to act on our reflections, all of which enables us to become much more present -- to maintain our homeostasis under stressful conditions. In essence, the practice helps us achieve quiet mind, which, more or less, is the definition of yoga.<br /><br />And then there's psychotherapy. Being a patient is hard enough. But being a psychologist is infinitely harder. Especially when it comes to encountering yourself.<br /><br />A thousand times a day, I'm challenged with feelings. Frustration with this patient for coming late again. Anguish for that patient who's binging and purging. Fear for this patient who's feeling suicidal. Sadness for that patient who's just lost his father.<br /><br />Every session is another chance to be overwhelmed by the torrent of feelings that threatens to flood me. Every session is another chance to push the feelings away - by getting sleepy, becoming directive, or spinning cogent theories. These are some of the ways I unknowingly create distance, from the patient, from myself, and from the relationship between us.<br /><br />This is where the yoga comes into play (not to mention the years of therapy, supervision, and classes). Because is a glacial sort of way yoga has changed me. It has helped me to notice when I'm not showing up, and it has helped me to figure out how to come back. It has also helped me notice when my patients are absent. They may appear to be there, but it's really an illusion. They're a million miles away -- angry, silent, or distracted. It's thrilling to bring them back. To guide them toward their core. To help them stay present to the pain they uncover.<br /><br />How astonishing it is to be able to be present. If only for an evanescent moment now and then. Though the presence comes and goes, it's amazingly deep. It brings with it an indescribable feeling of intimacy. I can see it in my patients. I can see it in myself. It is thrilling. It is transformative. It is scary. It is sublime.<br /><br />This is the hope that keeps me alive. To go deeper. To get closer. To stay longer. To be more present. To move nearer and nearer to a state of quiet mind. To move nearer and nearer to the essence of yoga.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com9tag:blogger.com,1999:blog-6365104365291808876.post-24362641164941475242008-03-28T09:59:00.000-07:002008-03-31T10:50:18.633-07:00Choice and Necessity in Life Truly LivedMy senior year in college I spent a semester studying the novels of James, Ford, and Conrad. I was dismayed to discover that this coterie of writers believed that the definition of a well designed character is one whose actions are finally inevitable. It seemed untrue to life that one's destiny is sealed. That one is locked into a fate with no chance of change. As far as I could tell, one always has options. One just needs the courage to deal with the consequences.<br /><br />Six years later I found myself grading blue books in grad school. It was a beautiful day, and the window was open. I hated grading exams. It filled me with dread. I was never sure who was right, the student or me. And calculating points was a tortuous process. Suddenly, as if an angel had landed on my shoulder, I heard a voice say, "You don't have to do this." I got up, walked out, and never looked back. From that moment on I knew I'd never be a professor. I made the choice to change the story line of my life.<br /><br />This was a transformative moment for me. I recognized that I had a choice in my career. I didn't have to follow the plot I was given. Or even the one I wrote for myself. I got to change the narrative whenever I wanted. As long as I was ready to handle the fallout.<br /><br />The fallout was massive but utterly vitalizing. I finished my doctorate, took accounting and finance, temped to support myself, and moved to California -- in hopes of pursuing a career in entertainment. I had little savings, no job, few friends, and a rusted car. I was starting a career from scratch at age 30. But I was chasing what I wanted and leaving behind what I didn't. That alone was worth the losses incurred.<br /><br />It took a decade from my moment of epiphany in the library to settle on a career that made sense for me. In the interim I was a Kelly Girl, a would-be producer, and a developer. I learned what it felt like to work in an office, to option a script and pitch a movie, and to buy land and build apartments. I discovered the exhilaration and anxiety of doing deals. I got a huge dose of the reality I longed to experience. Then I was ready to explore something new.<br /><br />When I realized that I didn't have to be a professor, I discovered that what seemed necessary was actually optional. This freed me to ask myself what truly felt good and on the basis of this feeling to change my career. Though I didn't realize it at the time, my paradigm had shifted. I stopped following my head and started following my heart. Not only in what I did but also in how I did it. And not only professionally but personally as well. It was only an illusion that my destiny was sealed. Once I saw the illusion it ceased to exist.<br /><br />Over the years I have come to the shocking conclusion that very little in life is actually necessary. We don't choose to be born, and we don't choose to die. But much in between, within absolute limits, is in many ways within our control to negotiate. The challenge is to be mindful in the choices we make -- while recognizing that at best they're no more than good guesses. As long as we can accept the consequences of change, we can continue to exercise our option to choose. To choose lives that feel right despite our thoughts and fears. To choose lives of courage, and freedom, and change. To choose lives that continuously surprise and confound us with the unfolding mystery of who we really are.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com1tag:blogger.com,1999:blog-6365104365291808876.post-27799594077112966642008-03-07T12:21:00.001-08:002008-03-12T22:52:57.475-07:00From Loving Perfection to Perfecting Love: A Matter of AcceptanceMany years ago, out of the blue, my girlfriend asked me if I liked her . . . body part. This created an immediate dilemma. I had never really thought about whether I liked it. As far as I was concerned she was a beautiful woman. But once she posed the question, I didn't know what to say. I looked for some standard by which to measure its quality. On a scale of 1 to 10, how did it rate? Should I compare it to a model's? To an athlete's? To an actor's? Needless to say, I made a mess of the moment. Only now do I understand what she was asking.<br /><br />I recently took a course in Mindfulness-Based Stress Reduction (<span class="blsp-spelling-error" id="SPELLING_ERROR_0">MBSR</span>), a secular approach to Buddhist meditation based on the work of Jon <span class="blsp-spelling-error" id="SPELLING_ERROR_1">Kabat</span>-<span class="blsp-spelling-error" id="SPELLING_ERROR_2">Zinn</span>. <span class="blsp-spelling-error" id="SPELLING_ERROR_3">MBSR</span> claims that we are perfect the way we are, but at the same time it encourages long lasting change. Initially this appeared to be a hopeless contradiction. Eventually the contradiction resolved into a paradox when I realized that <span class="blsp-spelling-error" id="SPELLING_ERROR_4">MBSR</span> redefines the term <em>perfect</em>.<br /><br />The conventional meaning of perfect is "without flaw or blemish." It derives from the Latin <em><span class="blsp-spelling-error" id="SPELLING_ERROR_5">perfectus</span>, </em>the past participle of "to finish," and in this sense means "finished," "lacking nothing," "complete." This definition of perfection is based on performance. Anything or anyone who is conventionally perfect has met the highest standards of possible achievement. They've reached a level of excellence that's as good as it gets. They lack nothing in their capacity to realize their goals.<br /><br />The unconventional meaning of perfect is "worthy of love." This has nothing to do with the etymology of the term and doesn't appear in the <em>Oxford English Dictionary</em>. But the claim that we are perfect just the way we are means that we are worthy of unconditional love. No matter how flawed or incomplete we may be, we each deserve love because it's a birthright. To be loved, in other words according to this claim, is a right to which we are inherently entitled. We needn't do anything at all to deserve it.<br /><br />What's stunning about this unconventional definition of <em>perfect </em>is that it quietly undermines an entire way of thinking. It takes a term that describes the performance of the few and revises it to describe the birthright of the many. It takes a term that entails rigorous comparison between contenders and revises it exclude all reference to others. It takes a term that evokes social stratification and revises it to make everyone equally worthy. By redefining the term <em>perfect</em> as "worthy of love," <span class="blsp-spelling-error" id="SPELLING_ERROR_6">MBSR</span> dismantles the foundation of the paradigm by which value and love are based on achievement.<br /><br />What it means to be perfect just the way we are is to be worthy of love regardless of achievement. To be worthy, this is to say, of unconditional acceptance, of empathy for our pain, and of compassion for our suffering simply because we are part of humanity. This kind of love is radically inclusive. It holds all people together regardless of difference in a universal embrace of mutual acceptance. This does not however mean that other people must like us, nor does it mean that we must like them. But it does mean that if we could learn to love others we might be able to achieve a depth of understanding that would allow us to live together in relative harmony.<br /><br />What's true between people is also true for oneself. To accept oneself as perfect just the way one is is to manage to love oneself regardless of achievement. To accept oneself unconditionally, to empathize with one's pain, and to have compassion for one's suffering keeps one together regardless of conflict in a self-sustaining embrace of internal acceptance. This does not mean that one must also<em> like</em> oneself. But it does mean that if one could learn to love oneself one might be able to achieve a depth of understanding that would allow one to live in relative harmony with oneself.<br /><br />To accept others and ourselves just the way we are is also the best hope for the depth of understanding that makes possible both collective and individual transformation. Only by understanding our differences with others and only by understanding our differences with ourselves is it possible to find practical solutions to conflict. Moreover, when we attend to the differences at play we already put in motion the process of change. This is because attending is a <span class="blsp-spelling-error" id="SPELLING_ERROR_7">transformative</span> act. By shifting the emphasis from opposition to acceptance, replacing critical judgment with compassionate discernment, the simple act of attending invites new information that generates insight and lays the groundwork for change.<br /><br />The change that is made possible through total acceptance can lead to greater health, smoother functioning, and more contentment. It can end wars between people and end wars within ourselves. And it can lead to a more vital experience of life. It cannot, however, make us any more or less perfect, at least not in the unconventional sense of the term. Because no matter how much we do or don't change, we are always just as equally entitled to love. This is what it means to be perfect<em> as is</em>. Worthy of love no matter what.<br /><br />When I look back at that terrible moment years ago when my girlfriend asked suddenly if I liked her body part, I now understand what she really was asking. She was asking if I accepted her just the way she was. Without condition. Without comparison. Without requiring any change. She wasn't asking if I liked her body but rather if I loved her self. I only wish I could have answered, "You're perfect just the way you are." But it has taken me a lifetime to understand what this means.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com2tag:blogger.com,1999:blog-6365104365291808876.post-48664327024960962932008-02-07T11:55:00.000-08:002008-02-10T14:46:27.491-08:00The Hard Work of LoveIn my first semester of grad school in English literature at Harvard I enrolled in a seminar in Renaissance poetry. My professor was an elegant man in his 60s known for his vocabulary, intelligence, and wit. The class had two requirements, a book report and a paper. He delivered his evaluations of each student before the class.<br /><br />My book report on Christian imagery went very well. He called it "exemplary," and I felt like a star. My paper on Ben Jonson went very badly. The details have faded, but the pain lingers on. I remember him suggesting it was more of a draft.<br /><br />I was devastated and went to see my professor in his office. I asked him why he humiliated his students in public-- I wasn't the only one in the class he had shamed. He told me he saw Harvard as a cloistered environment. He said it was his duty to prepare his students for the profession by helping them to build up their scar tissue in advance. My internal response was, "Don't do me any favors."<br /><br />About 10 years ago I heard he had died. Unfortunately, my response wasn't especially yogic. I was delighted and imagined doing a dance on his grave. I hated him then, and I hate him now.<br /><br />And yet, the only hope for me is to to love my professor. It's hard to believe that anyone so sadistic hasn't been the victim of sadism himself. I take his cruelty to his students as a gauge of the cruelty done to him. The profession -- or life -- left its scars on his heart.<br /><br />Loving my professor means accepting him completely, empathizing with his pain, and feeling compassion for his suffering. To the extent that I hate him I begin to resemble him. And to the extent that I resemble him I lose my humanity. The choice is very clear: to cultivate hatred and perpetuate trauma or to cultivate love and generate healing.<br /><br />This is not in any way to deny his brutality. Nor is it a roundabout way to excuse it. It is, nevertheless, a plea to explain it. And in order to explain it I must understand it. I cannot do this effectively if I push him away, if I resist his perspective, or if I prematurely judge him. I cannot do this effectively without acceptance, empathy, and compassion. I cannot do this effectively without the openness of love.<br /><br />It is also not to suggest that I must tolerate abuse -- regardless of how much pain my abuser has suffered. On the contrary, it's essential to do what I can to protect myself. But protecting myself from abuse does not entail hatred. To love those who hate me <em>and also </em>to protect myself. This is the way to retain my humanity.<br /><br />And so the work before me is to cultivate love -- while doing whatever is necessary for protection. To accept, to empathize with, and to extend compassion to all beings no matter how great their capacity for hatred. This goes beyond my grad school professor to include every person who is capable of this feeling.<br /><br />As far as I can tell, this includes everyone. It includes Hussein, Milosovich, Pol Pot, and Hitler. It includes my employers, therapists, teachers, and colleagues. It includes my parents, sister, partners, and friends. And, most importantly, it includes myself. To accept, to empathize with, and to extend compassion to us all. That is truly the hard work of love.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com2tag:blogger.com,1999:blog-6365104365291808876.post-42899572363041402512008-01-21T15:28:00.000-08:002008-02-03T17:56:12.717-08:00The Meaning of Love: Acceptance, Empathy, and Compassion<p>In the movie <em>Dead Man Walking, </em>Sean Penn plays Matthew Poncelet, a white supremacist who's been sentenced to death. Susan Sarandon plays Sister Helen Prejean, a Catholic nun who petitions the court on his behalf. Though she initially believes that Poncelet is innocent, by the end she recognizes that he's guilty of murder. And yet, she continues to love him completely. He's a murderer, and she loves him. How can this be?</p><p>Something changed in me when I saw <em>Dead Man Walking</em>. I saw that it's possible to love another person even if you don't like the terrible things they do. Before I saw the movie I thought you earned love. Afterwards, I realized that love is a birthright.</p><p>It took becoming a therapist for me to apply this. I learned to accept my patients completely as they are. I learned to try to see the world through their eyes. And I learned to have compassion for their suffering and pain. In other words, I learned to love them as fellow humans doing the best they can with the resources they have.</p><p>This doesn't mean that I don't worry about their actions. I often feel concerned about the choices they make, the harm they sometimes do both to others and to themselves. Undereating, overeating, purging, abusing drugs, obsessing, checking compulsively, driving recklessly, and being promiscuous. But these destructive actions don't make me dislike them. They demonstrate how much my patients are suffering and the lengths to which they'll go in order to survive. </p><p>When I think about why I love my patients this way, I realize it's because this is how my therapist loved me. She accepted me, she empathized with me, and she radiated compassion. No matter what I did to keep things together. </p><p>My experience in therapy taught me how to love. To love my patients. To love my students. To love my family. To love my friends. It even layed the groundwork for me to love myself. To accept, to empathize with, and to extend compassion to everyone. A task that it certainly easier said than done.</p><p>As with Sister Prejean, it doesn't mean we deny the truth. Nor does it mean we don't condemn, convict, and punish. But it does mean that we separate the doer from the deed and remember that we all deserve to be loved. No matter how terrible the crimes we commit. No matter what we're willing to do to survive. </p>Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0tag:blogger.com,1999:blog-6365104365291808876.post-72410963925683720232007-12-29T12:46:00.000-08:002007-12-30T12:40:48.555-08:00The Challenge of Love<em>I picked up a man from the street, and he was eaten up alive with worms, and nobody could stand near him he was smelling so badly. I went to him to clean him, and he said, "Why you do this?" And I said, "Because I love you."</em> -- Mother Teresa (<em>Mother Teresa</em>, 1986 Documentary)<br /><br />I've been thinking a lot about love in recent weeks. What it means to love. What it means to be loved. You'd think it would be obvious. But it's strangely elusive. Only now can I recognize it. Only now can I attempt it.<br /><br />Unfortunately, I've always confused liking with loving. I've mistakenly assumed that they were points on a line. That loving was a matter of liking times ten. But I'm finally realizing that this isn't the case. That liking and loving aren't related at all.<br /><br />A survey of any date site tells us all about liking. It's amazing to see what people like in their mates. Intellectual, biker, atheist, religious, conservative, liberal, hippy, clean cut. These qualities all have one thing in common. They are based on idiosyncratic, individual taste.<br /><br />But love has nothing to do with our taste. Where taste locates difference, love finds identity. Where taste pulls apart, love brings together. And where taste creates strata, love evens out. To like is to discriminate between qualities based on taste. To love, on the other hand, is completely to accept.<br /><br />But what are we completely accepting with love? On one level, it is the qualities we dislike in other people. The fear, helplessness, and panic that seize our partner is a clutch. The greed, envy, and brutality that emerge when they fail. But on a deeper level we are accepting those same qualities in ourselves. Our capacity as human beings to have feelings we despise. Our capacity as human beings to commit acts we cannot speak.<br /><br />In fact, one might say that it's our discomfort with ourselves, with our capacity for unconscionable feelings and acts, that lies at the root of our discomfort with others. We invariably hate in others what we hate in ourselves. And we can only love others when we completely accept ourselves.<br /><br />To accept ourselves completely is to accept our humanity. That all people, as people, have the capacity for evil. That all people, as people, have the capacity for good. That we can all commit murder. And we can all save a life. That we can all be oppressors. And we can all be oppressed. Recognizing this identity makes it possible to bring together. Makes it possible to even out. Makes it possible to accept. Recognizing this identity makes it possible to love -- even when we don't like some of the qualities we embrace.<br /><br />This is what Mother Teresa so deeply understood. That she was the worm eaten man on the street. That she was the savior who gave him to eat.<br /><br />And the benefit of cultivating the capacity to love? An acceptance of self and an acceptance of other that creates the conditions in which compassion can arise. It is only through compassion that we are able to explore. Only through exploration that we are able to discover. Only through discovery that we are able to understand. And only through understanding that we are able to resolve.<br /><br />Love, it turns out, makes it possible to find peace. Peace with our enemies. And peace with ourselves. This is my hope for the new year.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0tag:blogger.com,1999:blog-6365104365291808876.post-33605304471139677882007-11-24T13:37:00.001-08:002008-01-07T09:38:48.974-08:00You Are Not Your Yoga PostureYears ago I was living with a jewelry designer who noticed the intensity that I brought to my yoga practice. In particular I was struggling with a posture called <em>pasana</em>. You crouch down with your knees together, keep your heels on the floor, twist your torso to the left, loop your right arm around your knees, reach the left arm behind your back, and (if you're lucky) clasp your left wrist with your right hand. Then, for fun, you do the other side. The literal translation of <em>pasana </em>is noose pose. There's no more to say. You get the idea.<br /><br />In any case, my girlfriend watched me struggle with the posture. Though she didn't say anything about what she saw, one day she gave me a talisman for my practice. It spelled out in beaded letters: "You are not your <em>pasana</em>."<br /><br />It has taken me a long time to understand what she meant. I grew up in a world, as so many of us do, where we learn to value ourselves on the basis of our achievements. For me, it was academics. Going to an elite school. For others, it is money, beauty, or sports. But whatever you're measuring, the bottom line is the same. Your are only as valuable as your achievements.<br /><br />And achievement in this system is always comparative. Being the smartest, the wealthiest, the most beautiful, or the most athletic. Enough to join the ranks of the chosen few. Enough to prove definitively that you are truly special.<br /><br />Because what's at stake is your lovability. Feeling special enough for others to love. When value is about achievement, and achievement is about winning, the only way to feel special is truly to stand out. If you win, you feel special and therefore worth loving. If you lose, you feel worthless and completely unlovable.<br /><br />Moreover, we tend to treat ourselves with the same conditional judgment. If we go to Harvard, earn tons of money, become a model, or make the pros, we secretly believe we are God's gift to man. But if we're rejected, squeak by, get turned down, or don't get drafted, we attack ourselves harshly with hatred and loathing.<br /><br />To make things worse we almost always equate possessions with achievement. We treat our houses, our cars, our clothes, and our offices as indications of success and thus as proof of lovability. And invariably we include everything else in our orbit. Our wives, our kids, our friends, and our acquaintances. They all become gauges of our success, and we need them to achieve for us to feel lovable. If they don't, we feel disgusted and push them away, afraid that their failure will somehow infect us.<br /><br />Needless to say, this is a challenging way to exist. Always feeling judged, judging ourselves, and judging others. Afraid we'll be left if we don't constantly win. On the verge of leaving others because they fall short. More or less living life on a tightrope with no net.<br /><br />For many people this is the only life that they know. And they're confounded when I suggest that there may be another way. It's as if I'm describing an unthinkable universe. They can't imagine a world where love isn't based on achievement.<br /><br />Or to put it in terms of my girlfriend's talisman, they can't imagine a universe in which you are not your <em>pasana. </em>In which your value isn't determined by what you do, what you own, what you look like, or whom you know. In which your value isn't determined by achievement at all.<br /><br />This was my experience when she gave me the talisman. Which is why I didn't understand what she was trying to tell me. She was saying that she didn't love me for my <em>pasana --</em><em> </em>or for any of the other achievements I had spent my life amassing. But if she didn't love me for them, what else was there to love? I couldn't find anything else of value to point to.<br /><br />Then I realized that it wasn't about me. It wasn't so much that my girlfriend loved <em>me</em>, it was more that she loved how she felt in <em>my presence</em>. God knows what it was about my presence that worked for her. I'd like to think it was my integrity, my honesty, and my compassion. But it was at least as much my confusion, my self-deception, and my guilt. And all of this filtered through the lens of her subjectivity. None of it in any way an impartial measure of my value.<br /><br />In other words, I realized that she loved the way we fit. And the fit had nothing to do with being the best and the brightest and had everything to do with the quality of our connection. She liked how she felt, and that was enough. My proficiency at yoga was completely irrelevant.<br /><br />Which is not to say that she didn't enjoy watching me practice. Appreciate my professional and personal achievements. Or take pleasure in my appearance and how we looked together. It's just that they had no bearing on the nature of her love. They didn't affect our connection or change how she felt. They colored the landscape but didn't alter the ground. For her the ground was solid enough on which to build a life.<br /><br />Unfortunately, for me, the same wasn't true. I was as hard on my girlfriend as I was on myself and unable to forgive her for her humanity. Only now, many years after I ended the relationship, do I understand how my girlfriend was able to accept me despite the many ways I was neither best nor bright: she cared about fit, about the connection between us, about how good she felt when she was around me and not about what I had managed to achieve.<br /><br />Realizing this, even late in the game, allows me to shift what I look for in relation. Rather than scanning for objective achievement, I focus instead on subjective attachment. How do I feel in relation to the other? How do they feel in relation to me? What is the nature of the connection between us? And the same goes for the relationship I cultivate with myself. How does it feel? Is it wholesome or parasitic?<br /><br />Understanding the distinction between achievement and attachment also enables me to empathize with any patient or student who has come to believe that love is based on performance. It helps me to understand why the stakes are so high. It helps me to recognize why the pressure's so great. And it helps me to invoke the unthinkable hope of striving to achieve because it feels good.<br /><br />And this in itself is a wonderful gift. For without the risk of rejection to push us ahead, we can finally stop and ask ourselves what gives us pleasure. And even if we continue to do the same things, why we choose to do them can fundamentally change -- a change that can transform our experience at the root. <em>Pasana</em> for pleasure, who would have thought? That is an unthinkable universe, indeed!Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com1tag:blogger.com,1999:blog-6365104365291808876.post-14791437058195557792007-10-28T19:03:00.000-07:002007-10-29T11:17:10.703-07:00Further Reflections on the Question of Power vs Preference: Or How to Deal with Bartleby's SyndromeHerman Melville's story "Bartleby the Scrivener: A Story of Wall-Street" is about a clerk in the period before Xerox machines and typewriters whose job it is to copy legal documents by hand. Though Bartleby is initially a diligent copyist, he is unwilling to run errands or work in groups to check for errors. This does not win him any good will. "Imagine my surprise," his employer says incredulously, recounting Bartleby's response to his request for assistance, "nay, my consternation, when . . . Bartleby in a singularly mild, firm voice, replied, “I would prefer not to.”<br /><br />"I would prefer not to" may also be the response, though more likely delivered as passive resistance, when one member of a couple moves from power to preference. It's rare to find a couple that starts so mismatched, since we are usually drawn to partners at a similar level of consciousness. But sometimes, through therapy, one person can change, and then then as they say, "Let the games begin."<br /><br />If it's the other way round, and you play the power game, there's really nothing new of any substance to discuss. As always, you'll be trying to get your partner to agree. You'll assume that only one of you can be right in any conflict. That the one who is right will be the only one who is normal. And that that person will have a corner on the sanity market. The other one will be wrong, abnormal, and crazy. Same book. New cover. Disturbing and familiar.<br /><br />However, if you're the one who prefers to prefer, and if you love your partner enough to want to stick around, how do you handle the pressure to duke it out? The answer essentially is to refuse to engage. You can't fight a war if no one shows up. Or so they said during the Vietnam conflict.<br /><br />But refusing to engage is only the shorthand. The longhand is that it's necessary to hold onto your experience in the face of tremendous pressure from your partner to have theirs. That to hold onto your experience you must have strong and clear boundaries. That to have strong and clear boundaries you must accept difference from your partner. That to accept difference from your partner you must tolerate being separate. And that to tolerate being separate you must handle loneliness, doubt, and fear -- the terrifying feelings that come with having a distinct body, the state of existential aloneness from which no one escapes.<br /><br />Few of us, if any, manage all this consistently. But even understanding this disengagement conceptually can help you circumvent the habitual clashes that destroy the integrity of so many relationships. It can help you determine when your partner is scared and is trying to merge to find emotional shelter. It can help you determine when you're overwhelmed and are tempted to merge to find any shred of safety. And it can help you begin to do the invaluable work of developing the capacity to sit with your feelings -- which is the real hope for internal and interpersonal change.<br /><br />If you're lucky, your partner will benefit from your efforts and will discover that they also can survive on their own without demanding that the two of you pretend to be one. Hopefully, they'll find their way to a compassionate therapist who can help them start to build a more robust sense of self. And if possible, the two of you will begin couples counseling and have a chance to view your relationship through the eyes of a professional. Being able to deal with separateness can make it possible to come together as two distinct people in search of common ground. And there's no telling how close two such people can be.<br /><br />If you're unlucky, however, your partner will feel abandoned and will be unable to sustain the connection between you. They'll refuse to seek help individually or as a couple, not because they're immoral but because they're afraid. In this instance you may find that no choice is appealing. To leave can be gut wrenching, but to stay can be deadening. Either way, it may be time to start asking tough questions. Because as challenging as it is to deal with existential aloneness it's even more challenging to deal with the loneliness of a relationship in which there's no one with whom to share the utter terror of being separate.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com2tag:blogger.com,1999:blog-6365104365291808876.post-84694465552394111142007-10-23T14:37:00.000-07:002007-10-28T19:03:25.116-07:00Power vs Preference: A Matter of ChoiceI once had a relationship in which the big conflict was the window. My girlfriend liked it open because she ran hot. I liked it closed because I ran cold.<br /><br />What was challenging about this conflict was how personal it became. My girlfriend was convinced that there was something wrong with me. I didn't have enough body fat and I didn't have enough hair. Her solution was that I should bundle up and wear a hat to bed. This made me feel like a character out of Dickens. I was convinced that there was something wrong with her. She had too much body fat, and her thermostat was off. My solution was that she should lose weight and see a doctor.<br /><br />Both of us, in other words, accused the other of being wrong. One of us had to be normal and the other abnormal. There was no room in our relationship for both of us to be normal. There was no room in our relationship for us both to be right.<br /><br />As a result, we entered into a sustained power struggle. I fought to keep the window closed because I wanted to feel normal. My girlfriend fought to keep it open because she wanted to feel normal. If I allowed the window to be open I tacitly acknowledged that I was defective. If my girlfriend allowed the window to be closed she tacitly acknowledged that she was defective.<br /><br />In this way, the conflict over the window became a fight for self-esteem. I fought to keep the window closed because I needed to protect my sense of self. Secretly I was afraid that there was something wrong with me. My girlfriend fought to keep the window open because she needed to protect her sense of self. Secretly she was afraid that there was something wrong with her.<br /><br />On an even deeper level, this was a conflict over sanity. If she was right, I couldn't trust my experience of the world. Maybe I didn't have a right to feel cold. Maybe I didn't feel cold, I just thought I was cold. If I was right, my girlfriend couldn't trust her experience of the world. Maybe she didn't have a right to feel hot. Maybe she didn't feel hot, she just thought she was hot.<br /><br />Without knowing it we had become players in a zero sum game. One of us had to be right, to be normal, to be sane. The other had to be wrong, to be abnormal, to be crazy. With our sanity on the line, it's no wonder we fought so hard. The consequence of capitulating meant admitting you were mad.<br /><br />Needless to say, that relationship eventually failed. It's amazing how many windows you can find if you need to. Every choice can be turned into a referendum on your sanity. Every difference can be twisted into a matter of right and wrong.<br /><br />Years later I had a chance to revisit this issue. I was dating a smoker who yearned for fresh air. I was all for fresh air, but I didn't like the cold. And so the old battle lines reappeared.<br /><br />This girlfriend, however, refused to engage. She had been there and wasn't interested in playing the power game. For her, the window question was a matter of preference. She preferred it to be open. I preferred it to be closed. Why we had these preferences was not on the table. It was enough to acknowledge that we were different in certain ways. The challenge was to figure out a workable compromise, not to demonstrate that the other person was wrong.<br /><br />As simple as this may sound, it was a revelation for me. By thinking in terms of <em>preference</em> rather than in terms of <em>power</em> I was freed from having to justify what I liked and who I was. It was as if my girlfriend were saying, I accept you as you are with all your particular tastes and desires. I may not share each of them or even understand why they're there. But there's room for both of us to be different <em>and</em> normal. We just have to figure out some workable solutions.<br /><br />I can't stress enough what a relief this was for me. For the first time in my life I didn't have to be right, my sanity wasn't on the line, and winning wasn't an issue. I could have my own preferences, and she could have hers. I could be curious about her experience, and she could be curious about mine. I could imagine accommodating her preferences without losing my sense of self. And she could imagine accommodating my preferences without losing her sense of self. It became a practical matter of compromise instead of a personal matter of victory. Instead of thinking about winning I could think about co-existing.<br /><br />It also freed me up to think about broader differences in new terms. Differences between individuals, communities, religions, and nations. I could conceive that in some way and within certain constraints most of the world is both different and normal. Allowing this to be possible at least temporarily shifts the focus. It enables us to stop asking who's right, normal, and sane, and it encourages us to start asking how we can manage to live together -- without having to destroy those whom we don't understand.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0tag:blogger.com,1999:blog-6365104365291808876.post-13840121642686802702007-09-23T14:39:00.000-07:002007-09-24T13:53:35.788-07:00Corporate Culture and the Rules of the GameIt has always struck me as extremely perverse that the UHaul motto is "An Adventure in Moving." Having rented my share of UHauls through the years, including a 24 foot truck equipped with a hydraulic lift and a steering wheel that could have doubled as a Catherine's wheel (the medieval torture device used to discourage apostasy), the last thing I would hope for is an adventure in moving. I would definitely prefer something much more predictable. A brief stroll perhaps. Or even a nap.<br /><br />Unfortunately, I have also had adventures in working. Some in "real" jobs in education, entertainment, and real estate and some in temp jobs in law, medicine, energy, and film. Some of these jobs were more adventurous than others, but none was exactly the same as any other.<br /><br />All of which is to say that every firm has its culture, its own set of rules that govern behavior. Some of these rules may find their way to a manual. When you show up and when you go home. But most of these rules are never written down. If you can contradict your boss. Whether it's okay to joke around. Even where you are supposed to purchase your clothes. Many of these rules you only discover when you break them. Others, you may never have the luck to find out.<br /><br />So, how do you figure out what the rules are? Knowing that there are rules gives you a boost. It prepares you to look closely from the minute you start (or better yet, from the minute you go for the interview) at how the employees behave on the job. When they come, when they go, if they take lunch, if they take breaks, if they take vacations, if they work weekends, how they treat authority, what their mood is, how they dress, what their posture is, how they walk, how they address clients, whether they take personal calls, and if they are punctual to meetings. Not that every employee will act the same way. You will invariably observe a wide variety of styles. But look for clear trends among the stars of the firm. And from their behavior, extrapolate the rules.<br /><br />Once you know the rules it's easier to play the game. Or better yet to decide if it's a game you want to play. If not, you can look for a better fit somewhere else -- which is generally a safer bet than trying to bring change, depending on the size of the firm and your position. If so, you know what's expected and can try to deliver. Either way, it's crucial to identify the rules. Not to do so is like driving a UHaul without lights. More of an adventure than you signed on for when you started.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0tag:blogger.com,1999:blog-6365104365291808876.post-20533017135834757192007-09-15T12:07:00.000-07:002007-09-17T12:44:24.532-07:00Rage in the Workplace: A Matter of HelplessnessThough it would appear that the world of business is populated by adults this is at best only partially true. Unfortunately, I have witnessed the most infantile behavior from people who otherwise would seem to be of age. In one company I had a boss who routinely yelled at me and was reputed to have thrown a typewriter out the window. In another I heard my employer say of someone he didn't like that he was going to remove his genitals and force them down his throat -- though admittedly in somewhat less delicate terms. And in a third I saw a member attack the chairman of the board in an attempt to humiliate and remove him from office. Each case was not only an act of <em>a</em>gression. Each case was also an act of <em>re</em>gression in which a would-be adult turned into a child.<br /><br />To understand more clearly what happened in these moments, it's helpful to remember what it's like to be two. Imagine that you are no more than 18 inches tall. You come up to your parents' thighs, chairs and tables look like mountains, and the family boxer outweighs you by 25 pounds. You know what you want but barely know how to say it. The world feels often dangerous and beyond your control.<br /><br />Now, imagine that you're sitting in a cart at the market. Your mother is pushing you, and you see a balloon. You like the balloon. You want the balloon. You point to the balloon and shout, "Balloon!" Your mother says, "That's right! That's a balloon!" but keeps pushing her cart without stopping to get it. Again you say, "Balloon!" This time even louder. But your mother keeps going despite your insistence. Frantic, you shout "Balloon!!!" and burst into tears. You gesture wildly and start screaming at the top of your lungs. All to no avail. Your mother doesn't stop.<br /><br />Two things happen to you in this moment. First, you encounter the limits of your power. The fact that you are unable to change the situation. Second, you experience a feeling of helplessness. A response to the fact that your power is limited. This combination proves to be overwhelming. It's scary to discover that you don't have control. And it's painful to feel helpless in the face of this discovery.<br /><br />Anything is better than this state of affairs. Immediately, your fear and helplessness give way to anger. Adrenaline fills your veins as your fury starts to mount, and you feel increasingly powerful and even invincible. Big and strong enough to take on the world. Superman, the Hulk, and Spiderman in one. You talk louder, gesture wildly, cry, and then scream. Now for sure you will get what you want. No helplessness here. Just Herculean force. At least until your mother walks past the balloons and replaces your fantasy of omnipotence with impotence.<br /><br />My boss, my employer, and the member of the board all regressed before me to childlike states of mind. They encountered situations they thought they couldn't change. And as a result they experienced feelings of helplessness. These feelings were immediately displaced by waves of anger which swelled to fantasies of deadly omnipotence. Their acts of aggression were acts of regression designed to reverse overwhelming realities and the intolerable feelings to which they gave rise.<br /><br />Understanding this sequence can be enormously useful in sorting out the behavior of those with anger issues. To be able to recognize in the face of someone's rage that they are probably drowning in feelings of helplessness can keep you from launching a counterattack. Such an attack only tends to make bad conditions worse. You become the casualty of their anger and thus evidence of their omnipotence or the agent of their defeat and thus evidence of their impotence. Either way, one of you gets hurt in the process, and the underlying situation isn't addressed.<br /><br />A better choice is for you to disengage from the conflict until the groundswell of anger has had a chance to subside. Only then will it be possible to look at the situation and figure out if there are really no options to pursue. Sometimes, of course, this is the case. And difficult decisions need to be made. But often there are choices, if not always ideal, that lose visibility in the fog of helplessness. In a calmer state of mind, these choices appear and make an impossible situation feel much more acceptable.<br /><br />Of course, none of us is exempt from moments of rage that arise in the face of feelings of helplessness brought on by circumstances that seem beyond our control. But just as we want to understand this state in others, so we want to understand this state in ourselves -- and to do what we can to find solid land. First, by stepping back and acknowledging that we're angry. Second, by observing that we probably feel helpless. Third, by asking ourselves if we are as helpless as we feel. And fourth, by figuring out if there are tenable options. If there are we will discover that we have more power than we thought. And if there aren't we will have to deal with the disappointment and loss that invariably accompany the experience of failure. But this in its own way is a mark of success. The success of emerging from child to adult with the capacity to think about our most painful feelings and mindfully to act on the basis of these reflections.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0tag:blogger.com,1999:blog-6365104365291808876.post-11786004835604502032007-09-05T16:31:00.000-07:002007-09-08T15:53:10.421-07:00The Importance of Healthy Relationships in BusinessBefore I saw the light and became a psychologist, I spent several years developing real estate in Los Angeles. This was during the early to mid-1990s after the market took a dive from the heights of the 1980s. Home owners were suddenly "upside down" in their mortgages. A house that in 1989 had appraised for $500,000 in 1992 was worth $350,000. This made a mortgage of $400,000 more than the adjusted value of the property. As a result, many borrowers handed their keys to the lenders. The lenders ended up with lists of "Real Estate Owned," which they then tried to slash by further lowering prices. The net effect was a cataclysmic depression in value which didn't turn around till the end of the decade.<br /><br />One of the few areas of the market to stay firm was tax credit based affordable housing. In exchange for restricting rents, developers were allocated credits which they then sold for cash to syndicators, corporations, and individuals. Revenue from these sales, along with a variety of grants, provided the equity for a typical project. The debt often came from conventional lenders happy to finance below market rate housing.<br /><br />Developing a successful project entailed certain givens. The numbers had to pencil. The demand had to exist. And each member of the team had to be competent. If any one of these pieces wasn't in place, it jeopardized the overall success of the project. You could put up a great building in a firm rental market, but if it cost too much to build, it would go belly up. You could come in on budget in a firm rental market, but if the construction were shoddy, it would go belly up. And you could build a great building and deliver it within budget, but if the market were soft, it would go belly up. Numbers, demand, and competence were all necessary for success.<br /><br />And yet they were not sufficient for success. Healthy relationships were also essential. This is because you can't deliver a project if the members of the team don't interact effectively. To purchase the land the developer must have healthy relationships with his broker, the title company, his attorney, the appraiser, and frequently with a private group of investors. To construct the building he must have healthy relationships with the architect, the construction lender, the general contractor, and the accountant. If he's building affordable housing, he must have healthy relationships with the neighborhood, the council person, the city development office, the state tax credit agency, and the syndicators, corporations, or tax credit broker/dealers. Finally, to lease it up, he must have healthy relationships with the permanent lender and the management company. Moreover, any of these entities that has more than one person must also have healthy internal relationships. In every aspect of every stage relationships matter. If the relationships aren't healthy, the project will suffer.<br /><br />Though I saw this firsthand in my experience as a developer, I see it secondhand as an executive coach and psychologist. Again and again the challenge of relationships presents itself. Supervisees try to figure out how to satisfy supervisors. Supervisors try to figure out how to motivate supervisees. Founders try to figure out how to satisfy boards. Boards try to figure out how to motivate founders. CEOs try to figure out how to satisfy VCs. And VCs try to figure out how to motivate CEOs. Every relationship has its own challenge. If one isn't working the whole system suffers.<br /><br />The difficult question is how to manage these relationships. One must have the sensitivity to read other people, the strength to maintain solid but flexible boundaries, the intelligence to understand the flow of power in hierarchies, and the resilience to withstand the inevitable conflicts. Fortunately, these abilities can be cultivated through insight, and insight can be nurtured through coaching, therapy, and training. But the key is to recognize the importance of relationships to begin with -- that along with good numbers, strong demand, and a team competence, healthy relationships are essential for success.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0tag:blogger.com,1999:blog-6365104365291808876.post-61458398618530803872007-08-28T16:38:00.000-07:002007-09-02T21:13:56.743-07:00What Are You Supposed to Talk About in Therapy?One of the questions I'm most frequently asked is, "What are you supposed to talk about in therapy?" It's not surprising that this question comes up with such frequency. After all, most doctors take the lead with their patients. They ask where it hurts, how it happened, when they noticed. They make a diagnosis and write a prescription.<br /><br />With therapy, in contrast, the doctor follows the patient. The patient tells the doctor what he is feeling, and the doctor listens closely and tries to grasp his experience. He may make a diagnosis, but he won't write a prescription (unless he is a psychiatrist and wants to add medication). He tries to help the patient come to terms with his feelings. To name them. To think about them. And to act on his reflections.<br /><br />So, what are you really supposed to talk about it therapy? Talk about anything you feel strongly about. Your boss, your boyfriend, your wife, your mother. The election, the war, health insurance, your taxes. A book, a poem, a movie, a painting. Especially about something that's gotten under your skin.<br /><br />The key is to talk in a personal way. Discussing the nuances of military strategy can take you away from your troubling feelings. Discussing your sadness at the death of a friend, your anger at the poor treatment of the wounded vets, or your frustration with the politicization of the military conflict can bring deeply held feelings out into the open. The payoff in therapy comes from talking about your feelings. Talking about your ideas can be a defense.<br /><br />At the end of the day, it doesn't matter what you talk about as long as you talk about how it makes you feel. Like the leaves of a tree, the things we talk about are connected. Follow them deep enough and you'll get to the root.<br /><br />Your anger at the poor treatment of the wounded vets, for example, may remind you of your fury toward those who hurt animals. This may call to mind a painful memory from childhood in which you saw a pack of angry boys kill a cat. That may remind you of bitter fights between your parents in which you saw your mother being struck by your father. Suddenly, your feelings about the wounded vets have more meaning. You see why you feel as upset as you do.<br /><br />Which is not to say that every feeling should be traced to its origin. Or that each feeling is rooted in some agonizing trauma. But it is to say that if something is really bothering you, there may be more at stake than you might think from the surface. Tracing the feeling inside can reveal these connections, make the feeling less confusing, and help you think about its significance. It won't take it away, but it will help you to deal with it. A good way to create the emotional space within which to feel a great deal more free.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com2tag:blogger.com,1999:blog-6365104365291808876.post-325254112777966002007-08-05T12:14:00.000-07:002007-08-05T16:43:08.813-07:00Pain vs. Suffering: A World of DifferenceThere's a comment in an essay by Sylvia Boorstein that has proven extremely suggestive for me. Boorstein is a therapist, a meditation teacher, and a yoga instructor. Her essay appears in a book edited by Stephen Cope entitled <em>Will Yoga & Meditation Really Change My Life?</em> "I was consoled by the idea of the end of suffering," she writes playfully,<br /><blockquote><p>long before I had any ability to calm or focus my attention. I remember the chagrin I felt when, after some significant period of practice, I realized that I had confused the promise of the end of suffering with the end of pain, which was what I <em>really </em>had hoped would happen. I was embarrassed not to have figured out something so obvious -- really, what <em>could </em>I have been thinking? (17)</p></blockquote>Boorstein doesn't explain the difference between suffering and pain, but it's clear that the distinction is powerful for her. This difference seems to come from the The Four Noble Truths, but I leave it to those who know Buddhism to say for sure.<br /><br />Whatever its origin, I find this distinction very useful. It suggests that there are feelings that cannot be avoided that arise as the result of the most human experience. The death of a child. The collapse of a marriage. Violation of one's body. Rejection by a parent. These are a few of the commonplace traumas that define what it means to live in this world, to be subject to change, to be a victim of chance. These are a few of the traumas that cause pain.<br /><br />The difference Boorstein points to implicitly suggests that how we manage our pain determines whether we suffer. If we sit with our pain and don't try to block it, we have a chance to experience it, understand it, and act on it. We may not be happy about it, but we learn to accept it. And with this acceptance comes insight and wisdom.<br /><br />If, on the other hand, we try to avoid pain, this invariably leads us to suffer. Drinking, doing drugs, abusing sex, binging and purging. Or any of the myriad other ways we numb ourselves. All these attempts to avoid pain make things worse. First by bringing harm to ourselves and often others. Second by leaving our pain unattended. Rather than gaining wisdom by dealing with our pain, we add suffering to the mix by trying to avoid it.<br /><br />This is the state that most of us are in when we finally decide that we're ready for therapy. We know we are suffering. And we know we're in pain. Even if we don't know the difference between them.<br /><br />The work of psychotherapy is to bring an end to suffering by helping us to deal with our underlying pain so we no longer have to anesthetize ourselves. This work requires us to turn our gaze inside, to notice how we feel, and to reflect on our feelings. Though challenging, it allows us to get to know ourselves so we don't live in constant fear of who we are. It doesn't eliminate the pain that comes with life but it does eliminate the suffering we add to it.<br /><br />Maybe it's not the happiness we hoped for, but it's light years away from the place where we started. And there's nothing like distance to give us perspective.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com2tag:blogger.com,1999:blog-6365104365291808876.post-4196348990320892672007-08-03T15:55:00.000-07:002007-08-04T13:02:43.691-07:00The Pain of Life and the Life of PainEvery once in a while I have the following discussion:<br /><br />Patient: All I'm asking is that you take the pain away.<br />Me: I wish I could do that.<br />Patient: What does that mean?<br />Me: As far as I can tell, pain is part of life.<br />Patient: So what am I doing here?<br />Me: Learning to manage it. . . .<br />Patient: I hoped you'd get rid of it.<br />Me: You wanted a cure.<br />Patient: That's what doctors do -- they make it go away!<br /><br />At these moments I find I'm the bearer of bad news. Pain is part of life, and there's no way around it. The best we can do is learn how to manage it. That's the only way to stay healthy despite it.<br /><br /><p>All the same, it's second nature to try to avoid it. And it's amazing how clever we can be when it comes to it. We abuse drugs, we abuse alcohol, we abuse sex, we overwork, we under eat, we overeat, we overexercise, we oversleep, we pull our hair, we pick our skin, we obsess, we check the locks, we count words, we get into fights, we cut ourselves, we kill ourselves -- just to find a way around feeling the pain.</p><p>Unfortunately, these strategies tend not to work. Or at least not to work on a permanent basis. Otherwise, why would we ever give them up? </p>Often our strategies fall apart in a crisis. We get sick. We get fired. Our relationship crumbles. That's when we're forced to take a look at ourselves. It's when they're overloaded that our defenses tend to crack.<br /><br />And that's when those old, painful feelings leak out. And what a toxic stream that looks to be! Rage toward a father who had an affair. Fury toward a mother who demanded perfection. Helplessness before an uncle who sexually abused us. Humiliation at the hand of a sadistic older brother. They are old. They are raw. They are untouched by time. Unlike a good wine, they don't mellow with age.<br /><br />Which is why it's important to let these feelings see light. To sit with them. To get to know them. To think about why they're there. To bring the wisdom of experience to bear on their meaning. To make sure they don't secretly distort our perception.<br /><br />That's what it means to deal skillfully with our pain. Therapy can't get rid of it but it can help us to manage it. So we finally have a chance to move out of the past. So we finally have a chance to move into the present.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com8tag:blogger.com,1999:blog-6365104365291808876.post-63462082428985097662007-07-25T09:37:00.000-07:002007-08-10T11:05:41.226-07:00No Pain, No Gain? No Gain With Pain!Every athlete knows the aphorism, "No pain, no gain." And anyone who watches television knows the Nike motto, "Just do it." Both of these expressions share a disrespect for the body. Specifically, for its capacity to identify pain as a means of protecting it from possible injury. The unspoken message is don't trust your body. Your body will steer you wrong. Trust only your mind.<br /><br />We Americans are very good at distrusting our bodies. The Puritans treated the body as an instrument of temptation. Trust your body and you risk burning for Gluttony, Lust, and Sloth. Deny your body and you find salvation through Abstinence, Chastity, and Diligence.<br /><br />It's not hard to see the modern fruit of these roots. Skinny is good, fat is bad. Sex is dirty, refusal clean. Leisure suspect, work productive. From the beginning, we've associated pleasure with guilt. And, more to the point, pain with success. "No pain, no gain" crystallizes these American values. "Just do it" transmutes them into an actionable plan.<br /><p>Yoga offers an alternative approach to the body by teaching us <em>ahimsa</em> -- the principle of nonviolence. We can always hurt ourselves by doing too much. We can never hurt ourselves by doing too little.</p><p>Yoga helps us avoid committing violence against ourselves by teaching us to distinguish between pain and sensation. This distinction is crucial for physical development. In order to grow, we must challenge our limits. This generally means cultivating powerful sensation: we burn, we cramp, we strain, we stretch. Yet if we push our limits too far we end up in pain. The body's way of telling us we're about to get hurt: we tear, we pop, we break, we crack.</p><p>In teaching us to distinguish between pain and sensation, yoga enables us to optimize physical growth. We work as hard as we can without injuring ourselves. Instead of "No pain, no gain" we pursue "No gain with pain." A radical departure from the Nike approach.</p><p>Even so, especially when we first start to practice, it's tempting to apply Nike's directive to yoga. We willingly kill ourselves to be the best in the room. To be the strongest, the most flexible, the one with the greatest stamina. The most admired by the teacher. The one to stand out. </p><p>If we're lucky, yoga helps us to see what we're up to, to understand why we're doing it, and to find a better way. It teaches us to observe, to reflect, and to act. A systematic approach to achieve lasting change. A methodical way to optimize growth.</p><p>Ultimately, this is the great gift of yoga. And if we can do it on the mat, we can do it in life. We can optimize not only our physical growth, but our emotional, intellectual, and spiritual growth as well. After all, the definition of yoga is not perfect abs. The definition of yoga is essentially quiet mind. A state that no amount of pain let's us gain. </p>Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0tag:blogger.com,1999:blog-6365104365291808876.post-86467629874911605562007-07-21T14:40:00.002-07:002007-07-23T15:39:16.385-07:00Starting and Stopping TherapyOne of the guiding principles of conventional therapy is that it’s always the patient who makes the first call. It's hard to imagine the reverse being true:<br /><br />"Hello. I'm Dr. Gunner. I understand you need therapy."<br />"I do?"<br />"You're depressed."<br />"I am?"<br />"So, you're anxious."<br />"Not really."<br />"Maybe mood swings?"<br />"Don't think so."<br />"Perhaps seeing things?"<br />"Where?"<br />"I know you're hearing things."<br />"What's that?"<br />"You're overeating."<br />"I'm on a diet."<br />"You're <span class="blsp-spelling-corrected" id="SPELLING_ERROR_0">under eating</span>."<br />"I weigh the same."<br />"We'd better meet."<br />"Hold on a moment, I'll just grab my keys."<br /><br />It's hard to imagine this conversation taking place because therapy only works if the patient initiates. When the patient makes the call, it means he wants help. It means he is looking for some kind of change. It means he is unhappy about the status <span class="blsp-spelling-error" id="SPELLING_ERROR_1">quo</span>.<br /><br />Sometimes other people want the patient to change. Husbands want their wives to change. Wives want their husbands. Parents want their kids to change. Kids want their parents. No matter what the reason, this never works. Change only comes if the patient really wants it.<br /><br />Take Ben Kingsley, for example, in the movie <em>You Kill Me</em> (2007). He's a hit man who can't shoot because of his drinking. In a moment of uncharacteristically therapeutic thinking, the mob sends him to rehab to deal with his alcoholism. At first he resists, but eventually he relents. He realizes that his drinking is getting in the way of the one thing he loves to do most in his life. He goes on the wagon to become a better killer. At the end of the movie he's a happy hit man once more.<br /><br />If this character were my patient, I could help him stop drinking, but I <span class="blsp-spelling-error" id="SPELLING_ERROR_2">wouldn</span>’t be able to help him stop killing for a living (other than by reporting him as “a danger to others"). He enjoys his profession and likes doing it well. He has absolutely no conflict about pulling the trigger.<br /><br />Fortunately, most people intuitively understand that therapy is only possible if the patient wants help. This is the starting point for everything that follows.<br /><br />When therapy is working the patient and therapist join forces to think about the <span class="blsp-spelling-error" id="SPELLING_ERROR_3">patient's</span> experience. The patient tells the therapist what he is feeling, and the therapist listens closely and tries to figure out why. They may agree or disagree about what the experience means, but only the patient knows for sure how it actually feels. Even the most empathic of therapists is guessing. It's up to the patient to confirm or correct.<br /><br />Sometimes the challenge of dealing with one's feelings makes coming to therapy less than appealing. At these times, it's common for patients to conclude that the therapist isn't helping, that there's no hope for change, or that he's suddenly recovered and is feeling very happy. It's important for the patient and therapist to remember how scary and painful certain feelings can be. It's easy to be tricked into despair or delight if one doesn't respect the great difficulty of growth. Real growth takes hard work, resilience, and patience. It's tough to change the patterns that have governed our lives.<br /><br />As long as the patient is feeling unhappy, is hoping for change, and is looking for help, there's a very good chance that the therapy will succeed. Over time, if the treatment works, the <span class="blsp-spelling-error" id="SPELLING_ERROR_4">patient's</span> life will improve. He will be more able to deal skillfully with the difficulties of being human and will be less dependent on the therapist to process his experience. When the patient can manage well enough his own, the progress of therapy has come to a close. This is a true victory for both the patient and therapist. A confirmation that change is really possible, after all. And a source of great hope about the quality of life to come.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com2tag:blogger.com,1999:blog-6365104365291808876.post-26130063006955082052007-07-15T16:12:00.000-07:002007-07-21T14:38:44.822-07:00Addictions and ProtectionsI've never liked the term "addiction" because it implies moral weakness. At the same time as we pity "addicts" we dismiss them as inferior. We treat them like sinners on the brink of damnation. We keep a healthy distance so they don't take us with them.<br /><br />None of this makes any sense to me, other than as an expression of a fear of ourselves. A fear of our weakness. A fear of our inadequacy. A fear of our capacity to commit heinous sins. We stay away from addicts to stay away from ourselves. To disavow the destructive parts of ourselves.<br /><br />Rather than thinking in terms of addiction, I prefer to think in terms of protection. I see addictive behavior as a tool for survival. And I wonder what dangers it's designed to protect.<br /><br />No one I know hasn't been wounded by childhood. If we're lucky, we find tools to deal with the pain. This makes us more aware of it and helps us to live with it. And it offers our wounds an opportunity to heal. If we're unlucky, we find tools to push the pain away. This makes us less aware of it and doesn't help us to live with it. And it keeps the wounds open so that they don't heal.<br /><br />"Addictive" behavior is a tool to escape pain. I have seen many versions of this tool in my practice. They include drinking, drug taking, binging, purging, restricting, sex seeking, hair pulling, skin picking, and obsessional thinking. It doesn't really matter what version you use, though some versions are more harmful to your body than others. At the end of the day, the goal is the same: to push away the pain so that you can survive.<br /><br />My working assumption when it comes to emotions is that we generally do the best we know how. If we drink, take drugs, binge, purge, or restrict, we do so because it seems like the best option. If another tool seemed better, we would choose it instead. But no other tool seems likely to compete.<br /><br />This makes sense if you stop to consider. It's hard to believe that feeling your pain is the fastest and most effective way to reduce it. It's easier to believe that avoiding it is better. Hence, the logic of pushing it away.<br /><br />In addition, we often choose our tool when we're wounded. Often, there is nobody there to consult. No one with whom we can talk about our feelings. No one to help us process the pain --of divorce, domestic violence, sexual abuse, academic failure, romantic betrayal, sexual confusion, loneliness, parental pressure, rape, and physical illness to name just a few.<br /><br />However, many people eventually start to wonder whether there might be a more effective tool within reach. The tool they have used to avoid one kind of pain often ends up causing another kind of pain. They may have avoided the pain of abuse, but now they have to deal with the pain of cirrhosis. Moreover, there's the impact of all those buried feelings. Like the roots of a tree, they determine the blossom. Invariably they affect how we feel and what we do.<br /><br />The good news is that there are lots of better tools. The only question is which is the right one for you. In my own life I've found two especially useful ones. The first is individual therapy. The second is astanga yoga. Group therapy, art therapy, dance therapy, yoga therapy, meditation, and the many 12 step programs are also good. Whatever brings you together with like-minded people in a supportive, compassionate, and therapeutic environment. If this is too much, start writing your feelings. This will help deepen your relationship with yourself. These are the most effective tools I've discovered. They are the best way to deal with the pain that can keep you from blossoming into the best version of yourself.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com4tag:blogger.com,1999:blog-6365104365291808876.post-77952798008718885512007-07-06T13:53:00.000-07:002007-07-06T14:22:20.096-07:00The Goal of TherapyI used to think the goal of therapy was to eliminate pain. Then I realized that pain is an inevitable part of life. We can't keep the ones we love from injury, sickness, or death. And we can't keep ourselves from suffering the same. What we can do is develop the skill to deal with the pain. This entails learning how to identify our feelings, developing the capacity to reflect on these feelings, and cultivating the discipline to act on our reflections. If we feel, think, then act, we learn to live with our pain. If we rush straight to action, the pain stays acute. Like an untreated wound, it never fully heals. This is why therapy is so challenging and promising. It challenges us to acknowledge our most painful feelings. But promises that if we do so our life can improve, we can finally move on, and find new sources of joy.Dr Raphael Gunnerhttp://www.blogger.com/profile/14717283679734254317noreply@blogger.com0