Blog

This is my blog page

Psychotherapeutic Boundaries

One of my lifelong priorities has been to demystify the language of psychotherapy. Academic terms and jargon more often make the therapist sound impressive rather than help the patient get better. “Make it simple and down-to-earth for me,” is something I say a lot – to fellow therapists and to my patients, as well. Vague confusion doesn’t do anyone any good.

So today I want to demystify two terms in the psychotherapy profession. These thoughts come straight out of my thesis of 38 years ago. The terms I’m talking about are the external boundary and the internal boundary.

Part of a psychotherapist’s job is to set and control the external boundary for their patients. This means – as simply as I can put it – that it’s my responsibility to create and maintain a safe and beneficial space for my patients. This setting will give them the best chance to understand and resolve their challenging personal issues. Part of the space is my office. Patients must be able to feel physically safe. This includes the promise to complete privacy and confidentiality.

The other “space” that’s part of the external boundary is the structure of the therapy I provide. Working within their budgets as best I can, I determine how many sessions, lasting how long, and happening how often, are needed to give my patients their best chance for success. I also set up scheduling and payment methods to help my patients be more accountable for their progress and success.

The internal boundary of psychotherapy, however, is less directly under my control. It is more like a delicate partnership with my patient. Patients cross the internal boundary to reveal to me their pain, wounds, struggles, and fears. They reveal their traumas from the past and the present and their hopes for the future. These revelations allow me to get to work – helping them address issues, resolve pain, and create a better life and relationships.

But crossing the internal boundary can be complicated by many, many things. Patients can feel shame and have trouble being honest. Patients can want to blame others or events and deny responsibility for themselves. Patients can be in denial, or disconnected, or just plain don’t know how they feel or why they keep making a mess of their lives.

Over my years in practice, I’ve developed ways to help people cross the internal boundary, discovering and revealing their most deeply held pain and secrets so that they can heal. I believe this is where psychotherapy goes beyond having a toolkit. Yes, tools are necessary, but there is an art to using them. In this area, I can always improve.

The Iran Deal is Bad for America

America’s leaders betray our values of freedom and justice.

The Giants of Adversity

The giants of adversity – and the attitude it takes to defeat them.

A Different View of the Rachel Dolezal Debate

Dr. Peter Bernstein shares his perspective on the debate about local NAACP President Rachel Dolezal.

 

 

My Heart for Veterans and Their Families: Part 1

First in a series on our responsibility to help our wounded veterans and their families when they return home.

 

 

Trauma Therapist Podcast

Townsend Article Pictures 001Last week I had the very great pleasure of being interviewed by Dr. Guy MacPherson. Guy is a clinical psychologist and the moving force behind the West Coast Trauma Project, a website dedicated to raising awareness of trauma and helping trauma therapists thrive. “My goal with the West Coast Trauma Project,” Guy explains, “is to help other trauma therapists thrive – through providing actionable information, community building, inspiration and support.”

One of the resources Guy offers on his website is the Trauma Therapist Podcast, a series of recorded interviews with therapists in the field of trauma. My conversation with Guy provided me with an opportunity to share from my heart about my life and work. Follow here, to listen in.

Trauma/Healing 5

Trauma . . .

. . . can happen at any age.

Healing . . .

. . .often proceeds faster in a malleable child than a hardened adult.

Parenting Styles

I’m seeing several families in my practice now with adolescent sons. Adolescence is a challenging time for kids from even the healthiest of families. It’s a time when teens begin to separate from their parents and establish themselves as individuals. To successfully transition into adulthood, teens need to learn how to take on the tasks of adult life, including job skills, relationship skills, and self- discipline.

These can be almost impossible tasks for teens from families with misguided or deficient parenting. Poorly-parented children tend to act out, rebel, isolate, or get self-destructive. The stakes for these kinds of behavior are much higher during the teen years. This is the time families show up in my office because they are in crisis. There’s plenty I can do to help.

I want to talk briefly about parenting styles, which I learned about early in my professional training and included in my typewritten thesis (this was forty years ago). Time may have passed, but these profiles are just as valid today as when I was an intern.

There are three classic parenting styles: authoritarian; permissive; and authoritative. The following definitions come directly from my thesis.

  1. The authoritarian parent attempts to shape and control the behavior and attitudes of the child in accordance with a set, absolute standard of conduct. They value obedience as a virtue and favor punitive, forceful measures to curb a child’s self-will where the child’s actions or beliefs conflict with the parent’s.
  2. The permissive parent attempts to be non-punitive and accepting towards the child’s impulses, desires, and actions. The parent consults with the child about policy decisions and makes few demands for household responsibility or orderly behavior. The parent offers themselves as a resource for the child to use as they wish.
  3. The authoritative parent directs the child’s activities in a rational, issue-oriented manner, encouraging verbal give and take, and sharing with the child the reason behind their policy. The parent values the child’s unique abilities and cultivates a balance of autonomous self-will and disciplined conformity.

The authoritative model of parenting creates healthy families. Most people accept that flawed parenting styles like authoritarian and permissive will lead to problems for children. What many people don’t understand, however, is that kids from both authoritarian and permissive types of families can end up with very similar attitude and behavior problems. The outcomes for authoritarian or permissive parenting can be equally severe and destructive, especially for teens.

That’s what I’m seeing now in the troubled families in my practice. There’s been harshness and neglect, or pandering and overindulgence. The bottom line? Tragic difficulties for all involved.

Trauma/Healing 4

Trauma . . .

. . . can be an isolating experience.

Healing . . .

. . . happens most fully in relationships.

From “A New Normal: Ten Things I’ve Learned About Trauma” by Catherine Woodiwiss

“Ten Things I’ve Learned About Trauma” – by Catherine Woodiwiss

List articles are popular on the internet, some more helpful than others. Catherine Woodiwiss’ “A New Normal: Ten Things I’ve Learned About Trauma” from the Sojouners website is better than most I’ve found on the subject. Catherine has done a good job of translating her experiences with trauma into wisdom and insights worth taking in. Below, you’ll find her first point, “Trauma permanently changes us.” Follow the link at the end of this post to read her entire article.

1. Trauma permanently changes us.

This is the big, scary truth about trauma: there is no such thing as “getting over it.” The five stages of grief model marks universal stages in learning to accept loss, but the reality is in fact much bigger: a major life disruption leaves a new normal in its wake. There is no “back to the old me.” You are different now, full stop.

This is not a wholly negative thing. Healing from trauma can also mean finding new strength and joy. The goal of healing is not a papering-over of changes in an effort to preserve or present things as normal. It is to acknowledge and wear your new life—warts, wisdom, and all—with courage.

Read the full article here.