Blog Archives - Jo Ellen Fletcher, M.A., LMFT

Couples & Hard Conversations

10/31/2015

Many couples come to treatment with
the issues of having hard conversations.
They don't know how to give and receive feedback
in a way that
moves the process forward.

Most of the time the issues are not in having the
'hard conversations'
but in normalizing discomfort
when couples engage in these conversations.

Taking in what the other person is saying,
in the discomfort,
and listening rather than defending
is hard.

Trusting the other person will then in turn listen to you
becomes a challenge as well.
Trust and empathy are the
highest values in commun ication
and shame and blame
postures do not work
for successful communication.

Normalizing discomfort is a critical shame resilient strategy.
What are our common struggles?
The culture of honest construction and engaged feedback
while turning towards our partner with empathy
is the nature of deeper communication.

Vulnerability is at the
heart of the feedback process.
One of the biggest mistakes couples make in
discussing issues involving discomfort
is 'armoring up.'
To protect ourselves from pain we defend.

Honest engagement
around expectations and behavior
is often fraught with uncertainty, risk,
and emotional exposure for everyone involved.

How would it be different if each partner
took some of the following positions?

I know I am ready to hear feedback when:

I am ready to sit next to you rather than across from you.

I am willing to put the problem in front of us rather than between us,
and not slide it towards you.

I am ready to listen, ask questions, and accept
that I may not fully understand the issue.

I can recognize your strengths and how you
can use them to address our challenge.

I can hold you accountable without blaming you.

I am willing to own my part.

I am going to thank you for trying rather
than criticize you for your failings.

I believe by talking about how to resolve our challenges
will lead to our growth as a couple.

I can model vulnerability and openness
that I want to get from you too.

Brene Brown - Daring Greatly

Addition and Treatment Perspectives.

10/27/2015

There is a basic and simple premise about treatment and addiction;
until substance abusers develop the capacity to establish mutually satisfying relationships,
they remain vulnerable to relapse and addiction.

Relationships, therapeutic and social, are shaped by the
projections, assumptions, hopes, wishes and fears
of all it's participants.

The relational perspective in treating addiction
has ushered in more innovative ways
of understanding and treating the disease.

If addicts or alcoholics are to achieve abstinence and sobriety,
they must first detach
from their primary destructive relationship to substances
then develop the capacity for healthy interpersonal attachments.

From this perspective
the 12 step communities
furnish the support and emotional regulation
that newly recovering addicts need
while they make the difficult transition from
the detachment to drugs/alcohol
and the attachment to recovery.

To remember,
the essence of being human is social,
not individual.

Addiction as an Attachment Disorder
Flores

Addictive Vulnerability

10/25/2015

Addiction is a chronic, progressive, relapsing brain disease.
No one culture. class, gender or race is immune. The denial system creates a delusion the denial system. Denial can be broken down to areas of rationalizing, minimizing, justifying and avoiding the consequences of the numbing behaviors. One becomes addicted and alone and very stuck in the numbing compulsions of the disease.

Addition's compulsive behaviors, which are right here right now gratification, relieve one's needs of feeling uncomfortable and/or dealing overwhelming and big feelings. Individuals who have difficulty establishing emotionally regulating attachments are more inclined to substitute drugs and alcohol for their deficiency in intimacy.

Because of a person's difficulty maintaining emotional closeness with others, certain vulnerable individuals are more likely to substitute a vast array of obsessive compulsive behaviors, sex, food, drugs, alcohol, work, gambling, computer games etc. that serve as a distraction from the gnawing emptiness and internal discomfort that threatens to overtake them. When one obsessive compulsive type of behavior is given up, another is likely to be substituted unless the deficiency in self structure is corrected.

Some addicts and alcoholics appear to be very successful and are high achievers in their professional lives, however those who work with these patients on a consistent basis are struck by how fragile their basic sense of self worth has been.

Despite some high functioning addict's exaggerated striving for financial and intellectual success, most addict's need for approval and acceptance leave them consistently vulnerable to injury, rejection, shame, and humiliation.

Of the various ways of recovery from addiction, many addicts and alcoholics have sought healing through 12 step programs. AA and NA are helpful to its members in so many various ways. Some of these healing concepts are mirroring, idealization, and twinship.

Mirroring takes place when members feel they are seen for who they truly are and when they have a positive influence on others. Those suffering from deficits in this area will often have their previously unmet needs for healthy grandiosity and respect gratified by the attention that their continual sobriety brings.

Idealization, whether of a sponsor, the group, or one's higher power, is in evidence when members tell of feeling bolstered by identification with some greater source of power and wisdom. Members with longer periods of abstinence and sobriety serve as important role models that spur others to emulate.

Twinship is operating when members speak of the healing effect of belonging to the group and finding peers with similar experiences. Many of the other positive functions are provided to members doing "twelve step work" which is helping others and sponsorship.

Addiction as an Attachment Disorder - Flores

Origins of Addiction

10/20/2015

The recent work of attachment theory and psychology
has taught addictions specialists
that dysfunctional attachment styles interfere with the ability
to derive satisfaction
from interpersonal relationships
and internal beliefs
that perpetuate this difficulty.

John Bowlby is one researcher who provided a theory
on the functions of early attachment in a child.
If there is not a secure attachment
that occurs during the early childhood years,
there can be long term ramifications
for the child's development
of security and his/her sense of self.

Bowlby states that an insecurely attached child
developed a state to maintain contact
with rejecting or inconsistent caregivers.

Children feel safe when they are closer
to the parent or caregiver,
seek comfort in times of distress,
and have people they can lean on
so they can move forward to discover life.
This is a secure attachment.

If there are early major disturbances in this attachment,
children have difficulties managing emotions,
developing a sense of self and seek comfort
outside of people.

One reason that insecurely attached children
will be vulnerable to addictive behavior
is that they are more likely to cling to things
because they have found
people
too threatening.

Experiences that are related to early developmental failures,
insecure attachments,
leave certain individuals with
vulnerabilities that enhance addictive behaviors.

The craving and seeking for proximity,
sense of well being cannot be met with a person,
so these individuals often seek fulfillment
in another source of well being,
either drug or drink or addictive relationship.

Deprivation of age appropriate developmental needs
(secure attachment)
leaves the substance abuser constantly searching
for something "out there"
that can be substituted for what is missing
"in here."

Addiction as an Attachment Disorder - Flores

Addiction and The Brain

10/14/2015

There is an abundance of research evidence
that inadequate attachment can have
a profound influence on a child's developing brain.

Evidence is also accumulating
that one common adverse consequence
is the brain's increased susceptibility to addictive diseases.

Research on the possible relationship
between certain genetic anomalies and alcoholism had led to the
discovery of a statistically significant incident of a
genetic variable that is related
to a number of behavioral syndromes.

These disorders are linked by a common biological thread
that leads to either an inborn or induced imbalance
in the limbic area of the brain,
(commonly referred to the pleasure center of the brain)
that leaves a person with feelings of
deficits in safety, warmth, and satiety.

If these requirements are not responded to,
the limbic system signals
threat, anxiety, and discomfort.
Craving will be triggered, which motivates the individual
to take action to eliminate negative emotions.

The reward-deficiency syndrome
just described involves a form of
sensory deprivation of brain pleasure mechanisms.

The syndrome is believed to be a consequence of an
individual's biochemical inability
to derive reward from ordinary everyday activities.
It is hypothesized that depletion in dopamine and serotonin levels
contributes to this condition.

The reward deficiency syndrome supports
many of the new research findings
from the emerging neurobiology of addiction.

Prolonged use of substance alter synapses
and the production
of certain neurotransmitters.
At some point,
the addicted brain becomes
quite different from the non-addicted brain.

Addiction as an Attachment Disorder
Flores

Addiction - The Early Stages of Recovery

10/12/2015

During the early stages of recovery from addiction, helping the addict learn how to negotiate the demands of emotional regulation, mutuality becomes important. Relapses are always of primary concern during this first stage of treatment and are often related to difficulties with emotional regulation.

Substance abusers are usually unable to use their feelings as signals and guides in managing or protecting themselves against the instability and chose of their internal world. This disturbance in the regulation of emotions manifests as,

"an inability to identify and verbalize feelings,
an intolerance of incapacity for anxiety and depression,
an inability to modulate feelings..."

If the substance abuser returns to using substances it will only reduce their existing capacity for self regulation even further.

The early stage of recovery is an important time for establishing a safe haven,
and proximity to those who can provide support
and caring for the substance abuse user.

One of the processes in early recovery is to work with a therapist who can provide help with substance abusers to be acquainted with their feelings,
and they are notoriously inadequate in communicating them to others.

The larger lesson the substance abuser has to learn is that emotions are not only vital to self understanding, but also crucial to the understanding of others and the negotiation of all forms of intimacy in interpersonal relationships.

I am Centered

10/10/2015

As a child I was taught
that my emotional needs don't matter.
I grew up without a clear sense
of what made me happy or unhappy.

As I have begun to identify who I am today,
I have begun to heal.
I am learning to protect myself
from the negative emotions of others.
I have chosen to no longer
be the receptacle
for others unhappiness.

As I do this,
I also am learning to tend to
my own inner emotional life.

Regardless of the people or the circumstances around me,
I will keep guard
over the delicate inner
design of my emotions.

When threatened by attacks from without
or critical voices from within,
I will notice them
and restore them to peace
with positive affirmations.

I will create a center
within me today of emotional stability.

"I am doing just fine!"

10/9/2015

Growing up in a dysfunctional family one is probably familiar with confusion
and questions to ourselves like:
What do I really want?
Who am I?
Alongside this struggle of living out
"The Shoulds"
or expectations of others
(especially your parents) in contrast
to your own impulse to explore,
experiment, and take risks
based on your own feelings and desires,
creates confusion.

Which way do I go?
Once realized,
this is a turning point
to begin the life renewing process
of self-discovery.

Grieving the losses of childhood
is the heart of healing work we must do.

When we first begin to feel some of the intense feelings
we have repressed from childhood,
we feel a natural fear
that somehow our pain will be limitless.

Of course the fact is,
that we have such powerful and frightening feelings,
they undermine the denial that says
we are doing just fine.

We are recognizing the presence of something important that needs attention.
Yet each step of the journey
can be the place where we lack courage,
refusing to go on while succumbing to our fears.
At any point, we can choose the path of least resistance,
give our defenses credibility
and ignore our feelings within
that are pushing for acknowledgement.

Fears of our feelings
will cause us to fixate them
in our minds,
believing them to be terminal conditions
or overwhelming monsters,
when they are not.

Intellectually insight can serve as a road map,
and often many revert to this one aspect
only however you gain only a wealth of understanding
without resolving your deeper feelings.

The journey is
ultimately an emotional one.

Working with a therapist
and as healing work progress,
a little at a time,
we can discover a new feeling
and begin to connect it
to a growing awareness of our history.
A little at a time we discover our ability to
identify our feelings
and give them a voice.

The wizard of oz and other narcisists/Payson

Hostage to our Unacknowledged Feelings

10/7/2015

The issues of wounding are critically tied to
our lost opportunities for dealing with our feelings
and, therefore,
to our inability to have empathy
for others and ourselves.

The defenses, which once protected us as children,
are now the barriers preventing us
from finding deeper fulfillment
and intimacy in our lives.

The child who paid the price
of shutting down the feelings of hurt and pain
is the adult who remains hostage
to the blackmail of his defense mechanisms.

The ransom is the damage
that our defenses do to others or ourselves.

For example, we may displace or project our feelings onto others,
or instead internalize our feelings
causing a depletion of confidence and energy for life.

Perhaps our unacknowledged feelings
manifest themselves in the form of
chronic irritability, depression, or a negative outlook.

The healing begins with therapy,
courage, awareness.
Countless clients have said,
"I am afraid if I let myself cry, I will never stop!"
Fear of being overwhelmed is the unavoidable demon
we must wrestle with as
we open the door to the
truth of our unacknowledged feelings.

Each time we express and release some of these painful feelings
we gain confidence in our ability
to regroup after a period of emotional work in therapy.
We can begin to realize how
in getting a glimpse of
greater feelings of aliveness and spontaneity can be,
we begin to feel the reward of
getting in touch with a truer experience of life.

The Wizard of Oz
and Other Narcissists
Payson