Archive for the ‘Pennsylvania’ Category

Ministry Assessment Program (MAP)

Friday, June 15th, 2012

In addition to my work as a therapist in my own practice, I coordinate the Ministry Assessment Program (MAP) at the Samaritan Counseling Center where I have worked for sixteen years. MAP assists leaders in various religious denominations to discern which candidates seeking ordination have an authentic vocation in ministry and are psychologically and emotionally sound enough to proceed. Our evaluations are just one part of a rigorous vetting and formation process.  It can go on for several years with personal, academic, and theological reviews and tests at different stages along the way.

You can imagine, then, what it feels like to be a candidate coming to a psychologist for an interview about very personal things and to undergo extensive psychological testing—intimidating to say the least.  It is important then, that the evaluator approaches this process with respect and consideration for the feelings and privacy of the candidate.  The fact is that the vast majority of those who come before us are sound psychologically and many are talented and experienced to boot.  We hope, then, to give them something for their trouble— to create  an experience for  them that will help them to better understand themselves and to help them grow while at the same time encouraging  them.

Sometimes candidates have an experience during the process that is not all that different than what clients experience in therapy.  Though the expressed purpose of the process is evaluative not therapeutic, in my experience some of the best assessments turn out to be therapeutic as well. If I listen to the candidate attentively and appreciatively, candidates often find the words to say who they really are and why they are on their particular spiritual journey.

I am reminded of a young man who was surprised to find his eyes filling up with tears when he told me about how deeply affected he was by the hymns in his childhood church. “I had a lot of energy “, he recalled, “was nervous and insecure.  The songs told me that I and other people were important.” I wanted to get across, in the report, the depth of the emotional connection with God and others that he conveyed to me. I wrote, “Music seems tap in to his emotional and spiritual core—the part of his experience that he finds hard to articulate.”  It wasn’t that he felt called to music ministry. He is an energetic advocate for social justice who sees evangelism as creating a sense of community outside the church walls in the inner-city neighborhood of his church.  His high energy, though, could at times be a liability—sometimes leaving him tense and restless. Music was a potentially quieting experience for him and a pathway of his spiritual life.  One of the recommendations I gave was, then, for him to “foster this part of himself, perhaps through using music as a regular practice of prayer.”

I hope that I am getting across that a good assessment captures the “person” not just data—that in the right environment candidates sense it is safe to talk about what’s most important to them.  And as one would expect in this work what is most important is often a meaningful  relationship with God and others, or the sense of being a part of “something larger than oneself”.  As I wrote in a previous post on therapy and spirituality,  I hope to grasp  “something in the client’s voice, cadence or metaphors that suggest something of faith. And with patience and gentleness the therapist, without being intrusive, may welcome the subtle spirit into the session”.  It is not the role of a psychological evaluation to judge a person’s theology or beliefs, but I would fail to know them if I did not come to understand what these things mean to them.

I have learned to take the stance that  James and Melissa Griffith wrote about in their book  Encountering the Sacred in Psychotherapy: How to talk with people about their spiritual lives. They try to “stay in the position of an anthropologist meeting another person in an unknown culture….The skills most helpful for opening therapy to the spiritual and religious domains have been those for preparing our own selves to meet someone not yet known- the fostering within ourselves of curiosity, wonder and openness to the being of the other.”

As the  candidates receive feedback several weeks later and eventually a copy of the final report, we hope to mirror back to them their hopes, fears, gifts as well as the places they may be in  need of healing or growth. When we are successful,  we have done it in a way to preserves their dignity and they feel like we “got them”.

 

 

 

 

“Nice Jacket!”

Sunday, January 8th, 2012

I ran into a friend at the open air Eastern Market yesterday.  Because it was a Spring like day in early January we stood outside awhile and had a meandering conversation.  Somehow we got talking about cognitive/behavioral psychology and how, though it is a fruitful theory for creating effective therapy, it is somehow lacking in capturing the beauty of irrational thinking which is part of why we are so lovable and able to love.  In other words, the same irrational thinking that can cause us so much suffering (for example, painful self-consciousness that leads one to automatically assume that others are being critical) can also create the kind of quirkiness that engenders affection.

I must say, first of all, that I realize the trouble that faulty thinking can cause.  A benign example of the kind of thinking that can lead to trouble happened today when my daughter, Hannah, and I were walking our dog, Oliver, downtown.  A guy stepped out of House of Pizza, smiled at us and asked us how we were.  As we walked on Hannah heard him say, “I like your jacket”, followed by a laugh.  She looked at me and asked if I thought he was laughing about my jacket or hers.  You see she was wearing her  pilly and oversized granny-sweater. I, for my part, was, wearing my wife’s jacket since mine was in the laundry.  Hannah boasted that she didn’t care since she loved the sweater and it wasn’t first time someone insulted it.   I figured he was laughing at me, since it’s the kind of thing a guy might laugh at, (though I must admit Hannah’s sweater was pretty ratty).

Hannah did admit surprise, however, since he had seemed so authentically friendly at first.  I pointed out that since I left middle school it’s been pretty rare that some one randomly makes fun of me.  With that we went on our way.

When we arrived at my office Hannah happened to look down at Oliver and suddenly realized the man had been talking to him.  Oliver was, as we knew, wearing a jaunty red jacket.  Some how, though,  we each managed to leave that little piece of information out of our analysis.  In addition, the fact that the man had been friendly and that we were not in middle school did not sufficiently sway us from the  distorted perception of what he was saying. Our pre-conceived ideas about how someone might judge our jackets led to our mistakes.  In this  case the preconception was a negative self-reference.  Not much harm done here, but imagine if such things  won the day—if, for example, one’s low self-esteem multiplied itself by seeing negative comments everywhere.   This is where  cognitive therapy is extremely helpful—to help people learn to recognize, and to scrutinize negative thoughts as opposed to swallowing them whole.

It is humbling to find, as Hannah and I did, that even a reasonable analysis leads to the wrong conclusion when important information is ignored.  But back to the idea I introduced at the beginning,  that this faulty thinking is often what endears us to one another.

To illustrate this point ,I have created a link to a story I heard this week on the public radio program This American Life.  It is about a woman who comes up with an ill-advised scheme out of love for her adult son who has Asperger’s Syndrome and out of a simplistic belief in the goodness of people.  She advertises to find people to volunteer to companion her son for the long haul. The scheme fails after the woman devoted a huge amount of time and energy to it.  It is easy to see the misconceptions on which her plan was based, but it is even easier to see the love for her son, and the seriousness with which she accepted the responsibility that comes with  that love.  It is this sort of crazy love that defines us, in the end, more than our cognitive functioning or, as in the case of Hannah and I,  the lack thereof.

To listen to the story  click:  http://www.thisamericanlife.org/radio-archives/episode/420/neighborhood-watch and then choose Act 1: Wary Home Companion.

 

 

The Chaos Within

Monday, September 5th, 2011

Most of us know the feeling—and it’s a terrible one. We are in the grip of a powerful and painful emotion. It seems to have a life of its own—Instead of us having the feeling, the feeling seems to have us. The feeling is automatic. We don’t “will it” it “takes us” and often at the worst times. If the feeling is shame, it’s paralyzes us, if it is fear it brings a sense of doom, if it is anger, it may destroy something beyond repair.

Taking a step back we can see that feelings at their strongest and most irrational come from the most primitive parts of us. The primitive part is always there even in our maturity. Our mature Selves are like a city built on the ruins of ancient civilizations which themselves were built one the ruins of primitive tribal regions.

There are periods when all is stable, when the past is the past. Then there is seismic activity, and when there is trauma or mental illness in our history it is like a Fault Line where all the pressure from life’s Teutonic plates create a vulnerability. When certain factors shift, the earth quakes, and the mists from the primitive parts of ourselves rise.

The Ancients conceived of the primeval period as Chaos—the infinite space and formless void which existed prior to the creation of the world.  Out of Chaos the gods, men, women, all life and all things arose. Poets have envisioned Chaos as darkness and things of the lower realms.

There is a parallel to this mythological view in neuroscience—the lower realm is the lower and mid-brain, the part of us that acts and feels. The lower realms of the brain  existed hundreds of  thousands of years before the higher (thinking) brain evolved. The low and mid-brain are quicker than higher brain.  They  are great when fight-or-flight is called for, but not so good in the complex world of civilization. The psychoanalyst, Heinz Hartmann pointed out that we have evolved to be more independent of the natural environment where the basic instincts of the lower brain are most needed. Modern life calls for much repression of the anger and fear necessary for fight-and-flight. Psychoanalysis, which is the forerunner of psychotherapy, is based on the premise that most mental illness is related to the conflict between instinct (with all the primitive emotions that come with it) and the expectations of society. Troublesome emotions that are completely repressed, have never been processed and refined from the higher thinking brain. So they inhabit the lower realms and can be released in their unrefined form during a seismic shift.

In the religions of the ancient Near East, there is a recurring motif of struggle against Chaos where the Hero battles a monster depicted sometimes as a dragon. Isn’t the dragon a great image for that powerful emotion that “rears its ugly head” within us?

Psychologists who explore the emotions, which in their most basic form are called the “primary affects”, emphasize the role and value of the emotions.  Even the negative emotions are positive in their proper place. When, however,  our emotions come with such force that they are way out of proportion to the event that stimulated them we know that something is wrong.

It is an important journey to become aware of our emotions and resources such as therapy can be invaluable in helping us to address them instead of repress them. But understanding can take a long time. What do we do, in the mean time to manage emotions so that they do not cause us too much pain or wreak too much havoc?

This is what my colleague, Carol Emerson, and I hope to address in our Fall Series From Chaos to Freedom . Through a viewing videos followed by discussion  we hope to offer opportunities for learning strategies to handle what often feels like emotional chaos.

The video series is on Marsha Linehan’s “Dialectical Behavior Therapy”(DBT) which offers a way of approaching problems of emotions. One strategy, Mindfulness, for example, develops the presence of mind to be in the moment. Once one can stay present to a crisis, Tolerating Distress without escalating the emotion is the next task. Having some strategies available to weather the crisis is a way to turn it into an opportunity for change.

This video series is open to anyone who is interested in learning the strategies of mindfulness, distress tolerance, radical acceptance and opposite action. The group will view 30 minutes of Marsha Linehan demonstrating one of her strategies. Following the viewing, there will be open discussion about the strategy and how to apply it to one’s situation.

 

To Register: Please email me at phazeltine@gmail.com

 

Fee:                $20 per session

 

9/20/11          7:30 to 9:00   Mindfulness Part I

9/27/11          7:30 to 9:00   Mindfulness Part II

10/4/11          7:30 to 9:00   Distress Tolerance: Distracting

10/11/11        7:30 to 9:00   Distress Tolerance:  Self Soothing

10/18/11        7:30 to 9:00   Distress Tolerance: Improve the Moment

10/25/11        7:30 to 9:00   Distress Tolerance: Pros and Cons

11/1/11          7:30 to 9:00   Practicing Reality Acceptance: Part I

11/8/11          7:30 to 9:00   Practicing Reality Acceptance: Part II

11/15/11        7:30 to 9:00   Opposite Action

 

Location:       227 North Duke Street, Lancaster, Pa 17602

 

To find out about a parent education and support group using DBT strategies click here  a delicate balance

 

How does religion come up in a therapy session?

Monday, May 11th, 2009

 

Sometimes religion enters psychotherapy the moment the client enters the room. This was the case with Nancy. Her bright face and warm smile changed to an urgency as she sat down. Leaning forward on the edge of the couch she clasped her hands and told me that she no longer knew how to pray. Her son had been an ex patriot in Mexico and his life had been threatened by a corrupt official. She had been in daily contact with him and the embassy arranging for immediate departure. She prayed for his safety as fervently as she pursued embassy officials and knew, from all her past experience with prayer, that he would arrive safely. When she was told of his murder, she sunk into grief and a crisis of faith: her prayer had not been answered despite her belief that it would be. The very faith that had sustained her in past losses was threatened. This left her bereft.

Other times it enters in surprising ways by those who had never discussed experiences in anything but secular ways. Ann, an anthropologist, during an intense moment in telling her story in group therapy one night reached beneath her collar to pull a chain to reveal a medallion of the Virgin of Guadalupe. Ann had long since left her nominal Catholic faith and was drawn more to Buddhism , yet, she explained, the virgin had become her mother long after the death of her own manic depressive mother.

Or the therapist may hear something in the client’s voice, cadence or metaphors that suggest something of faith. And with patience and gentleness the therapist without being intrusive may welcome the subtle spirit into the session.

A reasonable question remains. “How can a therapist open therapy to spiritual concerns a person might bring if the therapist shares no common tradition with the person? This is the core question addressed by James and Melissa Griffith in Encountering the Sacred in Psychotherapy. They have found that they can best do this when they “stay in the position of an anthropologist meeting another person in an unknown culture….The skills most helpful for opening therapy to the spiritual and religious domains have been those for preparing our own selves to meet someone not yet known- the fostering within ourselves of curiosity, wonder and openness to the being of the other.”

Henri Nouwen speaks of creating a “friendly emptiness”. In his book Reaching Out, Nouwen uses various phrases to try to capture the essence of hospitality. The therapist with different beliefs from the client may offer hospitality in the way of “friendship without binding the guest and freedom without leaving him alone. Hospitality”, Nouwen explains, “is not to change people, but to offer them space where change can take place.” “It is not a method of making our God and our way into the criteria of happiness,” he writes, “ but the opening of an opportunity to others to find their God and their way.”

Hospitality and patient listening can provide the necessary sanctuary within which one’s faith will most likely be expressed.

Click on the image of Jesus and the Samaritan Woman to see more work by the artist

East and West: Buddhism and Psychology

Sunday, May 3rd, 2009

 

Below is a link to an article from the Vancouver Sun on Buddhism and psychology. It describes and gives some historical background on the interest of Western psychotherapists in Eastern religion. Douglas Todd, the article’s author, sees the potential richness in this fusion but also writes of those who caution against superficial treatment of these disciplines.

The risk of any interdisciplinary endeavor, such as the blending of religion and psychotherapy is of diluting both and thus diminishing them. Each is a discipline and practice in it’s own right; and as any serious disciple and practitioner can tell you each is a life long endeavor. Yet, not to seek to draw upon religion because of being committed to psychotherapy would be to ignore a vital source for exploring the interior world. It is best to proceed, but to do so with humility.

Ancient Buddhism and modern psychology