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Trying to Fix It

First rule of therapy: Don’t give advice.

Therapy is about facilitating a person finding their own answers. It’s about helping them remove obstacles to happiness and contentment. It’s about offering options relevant to the situation without making it about right and wrong.

That being said, the reality is that we therapists often offer advice just like everyone else, and it’s often misplaced.

For instance, I was recently feeling quite low due to being in pain from a tooth infection and surgery recovery. I was miserable and my dear friend, also a therapist, told me to look at a TikTok video she had just posted on how to feel better. I did look at it and I did NOT feel better. She’s my friend, though, so I texted her that what I really needed was a hug and the virtual hug she sent me did make me feel better.

Pain and emotion are in our limbic systems. Thinking and rationality are in the prefrontal cortex. When someone is conveying verbal information, it does not make it to the limbic system. In fact, when the limbic system is activated by emotion, it shuts down the prefrontal cortex’s ability to think. A hug goes directly to the limbic system to help calm us and allow thinking to come back online (see My Pocket Therapist: 12 Tools for Living in Connection for more information about the brain and how it affects our behavior).

So, what makes it so hard to not give advice? Well, when we care about someone, we feel Connected to them (with a capital C from Addict America: The Lost Connection). When we are Connected, we feel their pain, so wanting them to feel better is also about wanting to feel better ourselves. But feeling better is not easy nor even possible sometimes. What we need to offer is empathy – sharing their pain but not getting lost in it. Be with them without needing to fix it.

Carl Rogers’ Person-Centered Therapy, which is the foundation for almost all therapists, promotes genuineness, acceptance, and unconditional positive regard. These qualities are incredibly healing without any other interventions. Without them, other interventions are less effective.

So the next time someone you care about is hurting, offer them a hug, hold their hand, and just be with them. Listen without giving advice, be available to give them what they say they need, and don’t try to fix it!

Be Connected
Be in Light,
Carol

Sins of the Father

I’ve always been intrigued by this part of a verse from the Bible. Several verses, actually. Sometimes it refers to the sins of the father being visited on the children and sometimes that the children can escape that fate by embracing God.

When I take on a new client, I begin with their history, which includes the events and messages from childhood that continue to impact their emotions and behavior. In that way, the punishments, traumas, criticisms, and generally careless parenting are the sins that are visited on the children. Kids internalize messages like “I’m not good enough,” “I’m worthless,” or “I’m unlovable” and these stay with them and become the filter through which all other life events are processed.

A few Bible verses say that the children will be punished for the sins of the father to the third and fourth generation. We are finding more and more evidence that people have generational and genetic memories that impact them in the present. During a breathwork session, I experienced the traumatic events my mother lived through while I was in her womb and I realized that it explained a lot about my self-concept and my relationships with others.

When we look at the narcissists in politics or who run companies that plunder our environment or harm employees, we can often find that their fathers were cold and demanding and their mothers failed to protect them, leading to a constant striving for love and approval. Of course, they never get it, which often leads to addiction.

Addicts, no matter the drug of choice, are seeking relief from the emptiness and pain of not having had a loving and affirming family environment and will often behave narcissistically, although most are not true narcissists. Addicts in recovery are empathetic, loving, and caring people for whom I have the utmost respect and admiration, because they are doing the hardest work a person can – making daily choices to be congruent with the person they are choosing to be – free of the past and taking responsibility for themselves. A true narcissist will never be able to recover the intimacy and Connection that are in every person’s innate being, and for that I will have compassion but no unrealistic expectations.

So, the sins of the father, or parents, are the failure to provide love and safety to the children and that will follow those children and their children’s children until the cycle is broken through awakening, awareness, motivation for Connection, and the healing that comes from the willingness to be in recovery one day at a time.

Be In Light,
Carol

Pathology

Merriam-Webster defines as follows:

pathology
noun
pa·​thol·​o·​gy pə-ˈthä-lə-jē
pluralpathologies
1
the study of the essential nature of diseases and especially of the structural and functional changes produced by them
studied plant pathology
2something abnormal:

athe structural and functional deviations from the normal that constitute disease or characterize a particular disease
the pathology of pneumonia
bdeviation from propriety or from an assumed normal state of something nonliving or nonmaterial
the pathology of wine
cdeviation giving rise to social ills
connections between these pathologies … and crime Wendy Kaminer
social pathology

“Pathology,” “pathological,” and especially “pathologize” have become politically incorrect and emotionally charged when therapists are trying to discuss what’s going on with our clients, which makes it very difficult to actually define and describe their problems. Therapists will try to avoid “pathologizing” a client and their concerns in the attempt to avoid shaming or blaming them for whatever is happening.

For example, the word “codependence” has fallen out of favor because it is seen as pathologizing the pain and trauma the partner of an addict is experiencing as a result of the addict’s behavior. (see April 2021 newsletter)

Recently, I was following a discussion about the term “sexual anorexia” and one or two therapists were saying that this term “pathologizes” a person’s avoidance of sex as a result of their own or a partner’s sexual behavior.

So, what do we call it when someone comes to us in distress, for whatever reason, and we try to diagnose the problem and then treat it? Is trauma not pathological when it is expected and normal? Should we then just accept it and leave the person suffering? Of course not. Trauma that is an expected, or “normal,” response to an event can still be pathological in that we want our “normal” mental state to be one of emotional balance and absence of pain or distress.

It becomes a bit paradoxical that on the one hand, we therapists want to remove the stigma that surrounds mental health therapy, but on the other hand, we want to refrain from pathologizing clients’ mental health issues so we don’t stigmatize them.

I’m going into the hospital for hip replacement surgery in a few weeks. I have pain and loss of mobility resulting from hip dysplasia that led to arthritis. The arthritis is a normal result of years of dysplasia and it is all pathological in that it causes distress and deviates from optimal physiology. I feel no shame or blame around this. Why can’t we bring that same attitude into our sessions?

At the end of the day, it becomes exhausting trying to keep up with non-offensive or non-triggering language and I find it best when I just define whatever terms I’m using, like “sexual anorexia” and “codependence.” They are useful for conceptualizing what is happening and directing the appropriate interventions. If someone is having a reaction to a particular word or term, then just ask “What is the meaning of this for you?” and go with that. Focus on the words distracts from what is really going on with the person in front of us.

Perhaps the simplest way of looking at this is how I look at everything – disconnection and Connection. Pathology in any presentation is disconnecting and Connection is our natural state.

 

Pathology                                            Healing                                                Connection

Be In Light

Codependence By Any Other Name

“A rose by any other name would smell as sweet” Shakespeare, Romeo and Juliet

A lot of us are used to the controversy about the term “sex addiction,” but there is also a growing discussion about the term “codependence.”

I’d like to break it down and then I am happy to hear anyone’s thoughts about it.

Let’s start with “dependence.” Merriam-Webster defines it as “the quality or state of being influenced or determined by or subject to another.” They also define it as “drug addiction.” So, the words “another” and “drug” are used interchangeably. In other words, a person can be dependent, or an addict, if they are being controlled – willingly or by virtue of the power of their limbic system – by something or someone external to themselves.

In this way, I define addiction as well – seeking something external to control one’s internal state, whether it is physical or emotional pain or distress. The external “something” can be a drug, such as heroin or cocaine, or a behavior, such as seeking sexual gratification or using technology. Since the drug or behavior can only temporarily relieve the symptoms of pain but don’t address the underlying cause, there will never be enough and hence, addiction.

So, what is codependence? It is similar but with a twist. A codependent person pairs up with a dependent person and engages in trying to control that external person’s behavior or feelings in order to control their own internal distress.

For example, if my sense of well-being is based on my partner’s mood, then I will constantly be trying to control his mood so I feel ok. I will be focused on not making him mad or trying to make him happy. The problem is, if he is an addict, then “mad” and “sad” are emotional states that allow him to reach for his drug or behavior of choice, so my efforts will be in vain and I will continue in a state of anxiety and stress. If this has been going on for some time, then it will feel normal to me.

Why does this happen? The answer to any “why” is “because we are addicts” (See My Pocket Therapist: 12 Tools for Living in Connection). The answer to why we are addicts is because we experienced some attachment disruption in childhood that led to a fear of intimacy and connection. We are both engaged in an unconscious controlling of intimacy so we maintain a comfortable distance from each other (see Intimacy by the Numbers). This is not a conscious choice. Consciously, we want to be more Connected, but our limbic systems do not feel safe when we get too close (See Addict America: The Lost Connection). The resulting distress from this push-pull between thinking brain and emotional brain is only relieved by reaching for those external drugs or behaviors or trying to control those external people’s emotions and behaviors. Is this making sense?

The reason “codependence” has taken on an unsavory feel is because historically, therapists and authors and others have pathologized people, mostly women, who are in relationships with addicts by giving them diagnoses such as Borderline Personality Disorder, Dependent Personality Disorder, Histrionic Personality Disorder, Bi-Polar Disorder, etc. Do you see a theme here? Especially in the last 20-30 years since sex addiction was identified as a thing, partners of sex addicts who were blind-sided by the sudden discovery of the addicts’ behavior were labeled as “codependent” and their subsequent traumatic responses were seen as falling into some of the above categories of pathology, rather than the expected reactions of a betrayed partner whose world was just turned upside down. This dynamic can really differ from the partner of a drug addict or alcoholic who has long been aware of the addiction and has tried, through various means ranging from loving to punishing, to stop the person from using. The underlying codependence as I’ve described is still a thing, but may present differently. However it shows up, the partner is not behaving pathologically, but is responding to the current situation from the place of their inner child who learned that attachment needs to be controlled and love is not safe.

What I’m seeing now is a rejection of a term that has been laden with misinformation, various subjective interpretations, and an energetic search for a more palatable term. I’ve been looking for that term myself, without success, because as I defined codependence in the beginning of this article, it fits.

What I’ve observed in my lifetime of personal experience and 30 years of professional experience is that controlling intimacy is what people do and they do it very unconsciously. The woman, if you will, who is living her life in what she believes is a secure marriage with her children and husband and job all seeming to provide stability is really comfortable only because there is a level of disconnect of which she is unaware, because it is what she has been accustomed to since childhood. She has been unknowingly engaged in maintaining the distance that her cheating partner has created with his secrets. She is not crazy or pathological, she is actually quite normal, since very few of us had the upbringing to allow us to be fully Connected with another person. Her trauma is real and horrible and painful beyond imagining when those secrets come out and that still does not negate that she has probably spent a lot of energy trying to make her husband happy, trying to keep him from getting angry, trying to get him more involved with the family, and on and on. If she feels successful in this, then she feels safe and her anxiety is seldom present. In her own busy life, she is probably not aware of her underlying tension. Only in moments of stillness might she question the reality of her life and then she will reach externally for something to distract her, something she can control. When the secrets come out, she realizes she has no control and never had any control, and that devastation is earth-shattering.

Just like people try to come up with alternative terms for sex addiction, but miss the mark, so is trying to rename codependence. We can call it an intimacy or attachment problem and that is true, as far as those go, but that definition of dependence really nails it. What’s more, it doesn’t have the term “disorder” attached to it, so it is actually less pathologizing than some other terms.

One more note. It makes more sense and is less problematic when we can say “codependent behavior” rather than “you are a codependent.” I am a person who is of Celtic descent, has green eyes, holds a doctoral degree in Human Sexuality, and sometimes behaves codependently. I can sometimes behave from an addictive state and more often try to behave from a recovering state and be in Connection.

I’m open to suggestions. What do you think?

Be In Light,

Carol

I don’t want to work with $*x Offenders!

(warning: this article may be disturbing to some readers. Take care of yourself and call the Sex Abuse Hotline at: 800-656-4673 or chat online at: online.rainn.org)

Ask therapists who they definitely don’t want to work with and the majority will say, emphatically, “sex offenders!”

Why? Well, they often have some preconceived about who and what sex offenders are. They think about the guys in the mugshots on the sex offender registry. They think about the celebrities who have been arrested after years of predatory behavior. They think about men and women doing unspeakable acts on children. And they are often victims of sex offenders themselves.

So, when I teach classes on Risk Assessment and Treatment of Sex Offenders and know that I have quite a few sexology/sex therapy students wondering why they need to take these classes, I tell them what I’m going to tell you now.

First, sex offending is an umbrella under which are child molesters, pedophiles, rapists, sex traffickers, sex harassers, voyeurs, and exhibitionists. The predatory, violent child rapist is the one who gets the most media attention and on whom our fears and anger is placed, but that person represents just a small fraction of sex offenders. Making laws and basing our behavior on these few, although extremely devastating, psychopaths does the opposite of what we really want, which is to protect victims, especially children.

As experts in the field of sexology, we want to understand the nature of sex offending so that we can best protect the public. Helping the offender is with that primary goal in mind, so it’s a win/win. We want to know what motivates each type of offending, so we can tailor our treatment to that. For instance, a rapist is motivated primarily by power and control while a voyeur is motivated by sexual excitement.

Here's something a lot of people don’t know: Not all child molesters are pedophiles and not all pedophiles are child molesters!

Treating them both the same will not be the most effective way of helping them to not offend again.

There is a segment of the population referred to as MAPS – Minor-attracted persons, or non-offending pedophiles. People, almost all men, who fall into this category of recognizing their urges but resisting acting on them have, until recently, been completely invisible. They have been scared to death, rightly so, to seek professional help because most therapists wouldn’t want to treat them, would judge them and be repulsed by them, and would be thinking that they have to report them (they don’t if the person has not acted out). Fortunately, there are now websites dedicated to supporting MAPS (https://www.b4uact.org/ and https://www.virped.org/) and therapists who are specializing with MAPS to help them live healthy lives and never touch a child.

Next, even if a therapist doesn’t work with sex offenders, they will undoubtedly work with victims of sex offenders, whether children, parents, partners, or others whose lives have been affected. Not everyone who has been a victim is willing or able to just cut all ties with the offender and knowing the nature of the offenses can help us treat all of our clients. If I am working with a person who was the victim of a parent and is still trying to have a relationship with that parent, it will be critical to know if that offender is a pedophile or a child molester who is not a pedophile.

Finally, certified sexologists/sex therapists are experts in this field and need to be voices of reason. Sex pushes people’s buttons in many ways, as evidenced by restrictions on sex education, censorship, and shaming coming from religious and other groups. This intensifies when people talk about sex offenders. Fear and anger replace rational thinking, with the result that not only are people harmed directly, but we fail to effectively protect children. We need to speak up and speak out as knowledgeable experts whenever and wherever we can.

So go ahead and sign up for a Free Class and gain more insight and understanding into this misunderstood area. Maybe, like a few of my students, you will even decide to specialize with MAPS or sex offenders.

Until then

Be In Light,
Carol

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