I am always searching for new resources to guide clients to. Many people are in need of information and help but can't afford therapy, live in areas where there is not good access to therapy, don't feel ready to start therapy at this time or don't have the time to take off work/kids/etc. to attend therapy. Obviously as a psychotherapist I think therapy is HUGELY helpful. I also acknowledge that good information, whether as an adjunct to actual therapy or in lieu of therapy, can be transformative for some people.
In that light I am very pleased to point you towards a great on-line resource for information about healthy sexuality. Whether or not you are a survivor of sexual trauma who is trying to figure out how to get comfortable with sex again, or someone who is struggling with a pornography addiction, or a couple looking to improve your sexual connection this youtube channel has something for you. The youtube channel is owned by the Center For Healthy Sexuality in Los Angeles, California. The director, Alex Katehakis, has also written a great book called Sex Addiction as Affect Dysregulation which is due out very soon.
I strongly recommend taking a minute to browse the videos available on this amazing channel. Some of the ones that caught my eye were:
But there are MANY more videos on this website and new ones being added regularly. So take a look! Whether you are partnered or single, young or old, gay or straight (or anywhere in between) sex is part of the human experience. We all need healing and many of us need healing in some of our sexual selves. I encourage you to be curious about how some of these resources might help you.
As always I also encourage you to consider therapy if you feel that you are stuck and in pain.
Best wishes for your sexual, emotional, physical and relational health,
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This is, by far, the most accurate account of marriage I have ever read. Alain de Botton's most recent novel is not for those who want to maintain a fairy-tale version of marriage. It is certainly not for anyone who wants to cling to the idea of a soul mate, someone born to understand your every wish without you even uttering it. It is for those of us who seek to understand why so many marriages fail. Who seek to understand what marriage is really, truly about. (I say here marriage but really I am talking about any kind of long-term coupling). It is not a sad story by any means. It is a realistic story of two flawed people who build a life together. That life includes romance, but also children, mess, affairs, work and heartache. But in the end they continue to "choose each other" as Bruce Feiler would say in his recent book.
The book follows two characters as they meet and fall in love and continues on through their lives for the first few decades of their union. During this time they struggle, sometimes together and sometimes privately, with just what to expect of marriage. In the end they come to understand that with all its flaws marriage offers us something unique and valuable-- the opportunity to truly put another's needs first, over and over, which can only be done by growing as a person.
Of course like the rest of us the characters in de Botton's book had no idea what marriage was at first. The soon to be husband reflects on his desire to propose and concludes that "He hopes through the act of marring to make an ecstatic sensation [falling in love] perpetual." (p. 40) Not to be cynical here, I have been happily married for nearly two decades, but to think that by marrying as an act itself you can seal in that feeling of falling in love would be quite misguided. One has to work at continuing to fall in love like one has to work at staying in shape. Sadly if not properly guided many of us will eat too much cake, go to the gym too infrequently and then not recognize that person in the pictures from our 20 year high school reunion. Marriage is much the same. Many of us come to the institution poorly trained and somehow expect that following our instincts will lead us to the habits that build and sustain this marvelous partnership. Years or decades later when the union is on its last breath we wonder what happened.
The main characters also find that being coupled sheds light into areas of our lives that previously we had happily been spared. As de Botton puts it "The single state has a habit of promoting a mistaken self-image of normalcy...[our] tendency to tidy obsessively when ...feel[ing] chaotic inside, [the] habit of using work to ward off...anxieties, the difficulty...in articulating what's on [our] mind when...worried, [the] flurry when [we] can't find a favorite T-shirt---these eccentricities are all neatly obscured so long as there is no one else around to see [them]." (p. 42) How beautifully this captures our own self-serving bias-- that how we are, what we think, what we feel, what we prefer, how we operate, is normal. Forgetting all the while that we are just as weird, conflicted, inconsistent, hypocritical, defensive or even downright crazy as the next person. This self-serving bias leads us to the problem that "Without witnesses, [we] can operate under the benign illusion that [we] may just, with the right person, prove no particular challenge to be around." (p. 42) Ah, the illusion that we are right and our partner SO wrong! That if only they would come to their senses and agree with us! Be like us!
De Botton also touches on the potentially tragic tendency of humans to move towards familiarity. We think we are searching for that perfect person who will complete us, who will overlook our bad habit of leaving the milk out or staying up until 3am on Facebook only to be obscenely grumpy the next day. But alas what we are actually searching for is a relationship "that it will be reassuringly familiar in its pattern of frustration." (p. 44) He muses that when we do, accidentally, run into a person who is healthy and not inclined to replicate our painful childhood wounds we find ourselves "rejecting [them] not because they are wrong but because they are a little too right-- in the sense of seeming somehow excessively balanced, mature, understanding and reliable-- given that, in our hearts, such rightness feels foreign and unearnt." (p. 44)
This is where in working with couples I think it is important to point out the opportunities of what might seem like an unfortunate union. For when we partner with this person who is inclined to hurt us in ways that are similar to our original caregivers we also open up the possibility that these new attachment figures (our partners) can HEAL those old wounds. This is the type of work promoted by Dr. Stan Tatkin in PACT. Dr. Tatkin explains why relationships are so "hard" in his brief Ted Talk and helps us to understand how the things we bring to our relationships-- our childhood wounds, our attachment styles, our nervous systems, can undermine our hopes for a perfect union. In working with couples using the PACT style I try to help partners heal each other's wounds from childhood, which has the nifty benefit of not only freeing up more resources in the now-healed-person but also creates immense gratitude, love and appreciation for the partner-who-healed. It's a beautiful gift that pays forward.
The characters of de Botton's book also experience the sad phenomenon pithily described as "if it's hysterical it's historical". Meaning, when you partner reacts hysterically (i.e. going WAY overboard) they are probably "triggered" into some childhood feeling being brought up by the present situation. This has the misfortune of causing a person to react like a lunatic given the current circumstances. When triggered by our spouse, de Botton says "we lose the ability to give people and things the benefit of the doubt; we swiftly and anxiously move towards the worst conclusions that the past once mandated." (p. 84) The spouse that is 20 minutes late is confused with the father who abandoned us; the wife who circles the room chatting with everyone while her husband is left at the punch bowl becomes the mother who never had time for him. And on and on. These are the circumstances that, if misunderstood, can tank a marriage. But often it takes a professional to help the two lost souls embroiled in these patterns to see what is really going on.
And much to my surprise in reading de Botton's book, his couple actually finds themselves in the office of an attachment-based couples therapist! I swear de Botton did not consult with me on this. Although if he had it's certainly what I would have recommended. And as has been my experience for the past decade of using PACT, de Botton's couple is able to heal what had previously been fodder for battles enumerable. They learn to see the wounded child inside of each other and minister to it. And their love grows immeasurably. It would sound like a fairy tale if I did not see this exact narrative play out so many times in my own practice. His couple learns that "Everyone is always impossible. We are a demented species." (p. 182) De Botton goes on to show us how "The Romantic vision of marriage stresses the importance of finding the 'right' person, which is taken to mean someone in sympathy with the raft of our interests and values. There is no such person over the long term. We are too varied and peculiar. There cannot be lasting congruence. The partner truly best suited to us is not the one who miraculously happens to share every taste but the one who can negotiate differences in taste with intelligence and good grace. Rather than some notional idea of perfect complementarity, it is the capacity to tolerate dissimilarity that is the true marker of the 'right' person. Compatibility is an achievement of love; it shouldn't be its pre-condition. " (p. 216).
It's a beautiful book with a real and honest look at marriage, warts and all. Some people ask me how you know if you are ready for marriage. My usual response is that no one can be ready for marriage because it calls you to be someone you are not yet ready to be. Your fullest, highest, most evolved self. But perhaps from now on I will recommend as an alternate answer that you are ready for marriage if you can read this book and still believe in love. If you can see it not as a tragedy but as a testament to the power of two people's desire to overcome who they were and become better people within the bonds of a partnership that will push their every button. If you can see that as love, then maybe you are ready.
Wishing you health and happiness in all of your connections,
Have you ever wondered how a text stands up to a phone call? Or a phone call to an in-person meeting? What about emails? How have all of these modern developments affected our human relationships?
There is new research coming out now that these forms of electronic communication are NOT equivalent to the old-fashioned face-to-face talking/interacting. Which makes sense when you consider that the human brain would have a lot of trouble evolving at a pace to keep up with the latest iPhone app or emoticon. Our brains were wired for in-person interactions in which we can use data from the visual stream, and vocal tone, volume and pitch. We intuitively know what a frown means even when no words accompany it, and we also know that even if said with a smile certain words uttered in a snarly tone mean a fight is brewing. These kinds of nuances cannot be parsed out by the human brain when the message is communicated via text or email and may only be partially correctly decoded in a phone-call or audio message. Furthermore not only is it likely that the message can be mis-interpreted but our poor brains also can't derive the type of support that they need from these relationship proxies.
In one study done with girls who were put into a stressful situation it was shown that being able to either talk to a comforting person (their moms) over the phone or meeting up with this person after the stressor reduced physical signs of stress (levels of cortisol) compared to texting, which did nothing for stress. Additionally being able to talk on the phone or in person with the support-person caused a release of oxytocin, a hormone that helps us bond and mitigates the effects of stress. Again this effect was not seen with texting.
In another study done on adults over 50 researchers found that the probability of having depression increased as the frequency of in-person contact with other people decreased. Meaning that the less real-live contact that these people had with other humans increased the likelihood that they would suffer depression. Humans need other humans and we need to be with each other in ways that are not purely viritual.
So keep those you love close-- close enough to see, touch and hear without the interloping of wires and circuitry. And reach out to them frequently for contact and connection. Save the less personal forms of communication for business and less significant relationships if you want to be happy and healthy. At least until Mother Nature comes out with thehumanbrain2.0. But I'm not holding my breath.
Yours in health,
6/21/2015 0 Comments
Secrets and Lies
Shame, embarrassment and self-interest are powerful motivators. They can keep us from letting others truly know us. We tell ourselves that "what they don't know won't hurt them" or "it's not relevant" or "they wouldn't understand". But if you truly examine why you don't tell those close to you these difficult truths it usually comes down to the trifecta of secrecy: shame, embarrassment and self-interest.
Why share? How harmful are these undisclosed bits of ourself? Isn't everyone entitled to their own private lives?
In a recent post on the blog "Mirror of Intimacy", Alexandra Katehakis and Tom Bliss wrote of disclosure that "Keeping secrets from, or telling lies to, your partner can be an enormous burden that will ultimately get in the way of your sexual intimacy. A guilty conscience is not sexy, but making yourself vulnerable is". They went on to say that "Exposing your true self means facing your shortcomings and any accompanying shame you feel about your actions. Speaking the truth about things that make you feel bad about yourself can be scary or painful, but is essential if you want to build your relationship on honesty. Living a life of secrets and lies doesn't allow love and sexuality to flourish but, instead, suffocates them."
Katehakis and Bliss recommend that we "Take time today to think about what an act of courage it would be for you to disclose any secrets and lies you're holding that separate you from your partner. Are you ready to face yourself and stand up as an adult? Keep current with your partner by banishing secrets and lies from your relationship, and experience what it's like to live in honesty every day."
That's a tall order for many of us. Especially if you grew up in a dysfunctional family where secrets and lies were the norm. Many of us were taught that being vulnerable would be met with blame, punishment, shaming, teasing or attack. Certainly this would train us to keep anything difficult or potentially self-incriminating to ourselves. And to those of us who grew up in dysfunctional homes not only does this secrecy seem normal, it seem smart! Why make ourselves open to the slings and arrows of those around us? Haven't we suffered enough?
If only that strategy worked. I often tell those who work with me that I am a huge pragmatist. I really am. I aspire to do what works because in the end I just want the desired result. If lying or keeping secrets or sequestering parts of ourselves away from our loved ones worked I would have no issue with it. If it did not ultimately cost us, if it did not ultimately lead to loneliness and damaged relationships, I would encourage it. Whatever road leads to health and happiness I am fully prepared to not only walk myself but lead others on.
Unfortunately keeping secrets, lying (by omission or otherwise) and partitioning off parts of ourself so that no one knows the true us really doesn't work. It may serve to keep us safe in the moment, but ultimately it keeps us apart from those we yearn to be close to. It leaves us feeling that existential angst of "born alone, live alone, die alone". Which I firmly believe is NOT true! In fact, of all living organisms, humans are born to need others MORE, not less. We are inherently pack animals, desperately in need of connection to maintain our own mental and physical health.
When I work with people on trying to deepen connection to others I am fond of explaining the concept of "laddering intimacy". Relationships deepen when each person reveals something to the other that represents an emotional risk. This prompts the other person to respond with their own escalating level of emotional risk. The process builds on itself, giving each person the feeling that they are being trusted with important information. This bonds people together. When we fail to disclose risky material to our partners or loved ones our relationships wither and become flat. We drift apart. We no longer have that feeling of being tightly bound together. What we do to protect ourselves ultimately cuts us off from the very relationships that we need to survive emotionally.
I encourage you to take stock of your intimate relationships. How vulnerable have you made yourself? Are there parts of yourself that you keep hidden? Do you lie by omission? Keep secrets? Revise the truth? If so, what toll do you think it has taken on your relationships? Are you truly close? And what are you really afraid of?
Many years ago while still in training a wise supervisor (Dr. Marc Rathbun) told me "marriage isn't about having fun, it's about growing up". I think those words are true for any deep relationship, not only marriage. I think that being close to someone is about growing up and realizing that we cannot continue to protect ourselves while expecting others to be vulnerable. We cannot be halfway invested and yet reap the full benefit of intimacy. Part of being an adult is moving past one's fear, past one's selfish desire to protect oneself at the expense of another. Withholding, lying and secrecy leaves the relationship inequitable. We hold cards the other doesn't. This is the currency of childhood, of a time when self-centerdness is the natural phase of our development. But it holds no place in adulthood and cannot lead to truly deep bonds with others. And circling back to my pragmatism, the good news is, if you practice disclosure and put all of your cards on the table, you will be rewarded with the same. In this way you create the intimacy we all need. The price, I would argue, is worth the benefit.
Wishing you health, happiness and closeness with those you love,
2/17/2015 0 Comments
The Importance of Touch
We all know on an intuitive level the power of touch. When we hear an infant cry our instinct is the pick the baby up and hold it, chest to chest, right over our heart. Mother nature has embedded in each of us the intrinsic knowledge that touch soothes. Touch is the earliest sense to develope in the human fetus. Surely that relates to it's importance in the survival of the organism. And yet our modern life, especially in this country (the USA) has diminished the amount of touch that each of us engages in every day. Studies done by Harper, Wiens and Matarazzo (1978) looked at touch in various contexts, including one study done in coffee houses. They found that during a one hour sitting 180 touchings were observed for Puerto Ricans, 110 for French, none for English and 2 for Americans. That's quite a difference! What exactly are we, as American's, missing out on?
One study done on pre-term infants (Field, International Journal of Behavioral Development, 22(4),1998) found that the stimulation of pressure receptors under the skin caused an increase in vagal nerve activity and slowing physiology that then caused the babies to be more relaxed in their behaviors. This also led to a decrease in stress hormones, most particularly cortisol, and an increase in immune function, particularly natural killer cells. The take home point again is that TOUCH MATTERS. Babies do better when they are touched, as do we all.
Another interesting study in the Journal of Behav Med. 2003 Fall;29(3) by Grewen, Anderson, Girdler and Ligth showed that loving partner contact is related to lower cardiovascular reactivity. This was measured by blood pressure reactivity to stress in healthy adults. The stress was induced by asking people to do a public speech (one of the most common fears!). Half of the participants had been able to hold their partners hand for 10 minutes prior to the speech and also asked to hug their partner for 20 seconds. The other half were just asked to sit by themselves for 10 minutes. People who had the loving contact of their partner prior to the stress had less increases in BP. The authors concluded that "These findings suggest that affectionate relationships with a supportive partner may contribute to lower reactivity to stressful life events and may partially mediate the benefit of marital support on better cardiovascular health."
Another study done by Grewen, Girdler, Amico and Light (Psychosomatic Medicine, 67, 2005) found that people's opinions about how supportive their partners are can be measured by looking at oxytocin, norepinephrine, cortisol in the blood as well as actual blood pressure before and after loving contact with their partner. Couples were assigned to 10 minutes of loving contact and then their blood was analyzed. Those who rated their relationship as more supportive had higher levels of oxytocin and in women higher partner support was correlated with lower BP. For women higher levels of oxytocin were also related to lower BP and lower levels of norepinephrine. The authors conclude that "Greater partner support is linked to higher [oxytocin] for both men and women; however, the importance of [oxytocin] and its potentially cardio-protective effects on sympathetic activity and BP may be greater for women." Again it is important to note that this study essentially measures the effects of physical contact with a loving partner, showing that loving touch in a supportive relationship literally affects our body chemistry in beneficial ways.
This link between loving touch and oxytocin lead to Dr. Zak prescribes at least 8 hugs per day in his TED talk in order to feel happier and more connected, as well as to nurture relationships. Zak's talk discusses the findings of the research above on hugging one's partner and how it can benefit one's health, especially the cardiovascular system.
In the wake of Valentines's Day it seems appropriate to celebrate the importance of loving touch. Perhaps science has finally given us reasons to stop feeling guilty about our inherent interdependence. It's time to support our need for connection and quite literally embrace our need for others. My advice is to love well and touch often. Your heart, immune system, stress level and state of mind will thank you.
With warm wishes,
7/11/2014 0 Comments
What I'm Reading Now- Love 2.0
I've decided to keep a reading list in case anyone is interested in the same kind of uber-nerdy psychologically oriented stuff as me. So here goes!
I just finished a book entitled Love 2.0 by Barbara L. Frederickson, Ph.D.. Good stuff. Basically the book is about the positive impact that love has on us as human beings. As I tell all of my patients, humans are "hard-wired" for connection (just ask poor Harlow's monkeys). So it's no surprise that when researchers such as Dr. Frederickson study the impact of love on things like health they find that love matters. For example, people who reported more loving contacts with others during the day had significantly better "vagal tone". Vagal tone is the relative health of the vagus nerve, the largest nerve in the body. The vagus nerve is responsible for your ability to recover from the fight or flight response. So after being scared or threatened (when your heart rate naturally accelerates) your vagus nerve helps the heart rate to slow back down to its normal pace. The better your vagal tone, the faster your heart rate recovers. People who report a higher number of loving connections during the day (this can be a warm hug from a friend, a sweet text from your significant other, etc.) have better vagal tone. They are literally healthier than people who have less positive social connections. Vagal tone is associated with heart disease also, and since heart disease is still the #1 killer in America, vagal tone should be important to us all. Vagal tone is also related to the strength of one's immune system, especially regarding inflammatory responses. Inflammation is implicated in things such as arthritis, strokes, diabetes and some gastrointestinal disorders. So again vagal tone is something we should be thinking about.
Dr. Frederickson gives lots of encouraging information about how we can improve the amount of "love" we get in our lives. For example she has found that just thinking about a loving exchange with someone we care about can cause the same health improvements as having that exchange. So sitting at your desk and remembering the big hug you got yesterday from your close friend can actually re-create the positive effect of that hug right then and there at your desk. There are precious few things we can do sitting at our desk that are going to improve our health, so I think this finding is very encouraging!
Another recommendation that Dr. Frederickson. makes is to practice LKM. This is Loving Kindness Meditation, a buddhist tradition. She gives explicit instructions on how to do LKM (it's quite easy) and explains-- you guessed it-- the numerous mental and physical health benefits of it. I especially appreciate that she explains how to do LMK if you have problems loving yourself (as many people do). Part of LKM can be directing loving feelings towards oneself, and that is not always easy if you come from a dysfunctional family where you were lead to believe that there were major things wrong with you. She gives some "work arounds" for this problem which I found very helpful.
If you are interested in research on the impact of positive social connections (aka "love") I think you will find this book very readable and informative. It doesn't focus on romantic love (so the title may seem a bit misleading) but does a great job of expanding our ideas about what love means and how it can influence our emotional and physical health.
First I need to give credit to the originator of this metaphor, a friend and mentor Dr. Stephen Finn. Dr. Finn is a psychologist in practice here in Austin, Texas and is on faculty at UT Austin. He has mentored many psychologists over the years and is a world-renown expert on psychological assessment. If you are interested in psychological assessment you may find his website, www.therapeuticassessment.com, of interest. Now that I have given credit, let me explain what "saucering" is.
Krista Jordan, Ph.D., ABPP
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