Shrink Rap (Psychology Books) discussion
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Termination of therapy is a loss, but if it's done under circumstances like you're describing, it's also an indication of success for both the client and the clinician. It's like they say, if we're good we are always working ourselves out of a job, at least with the people we have on our caseloads at the time. As for how we can get along without continued interaction with someone who's helped us as much as this guy has you, by the time we've worked with someone through a lot of stuff, we've probably internalized their approach enough that we can stop and ask ourselves, "What would (name) say about this?" and come up with a useful response.
Regarding EMDR, my first impression when I heard about it in grad school was that it sounded really goofy. However, after an internship supervisor and one of our professors both said they used it and found it effective, I decided to give it a shot. I went to the training in 1996 and 1997 (it's a two-stage process, with each stage taking place over a weekend workshop; you can get info on scheduled trainings around the country at the website of the EMDR International Association or EMDRIA at www.emdria.org. In part 1, you learn the basic theory and techniques, then go back to work and practice on relatively straightforward issues with clients and/or interested colleagues. After about 20-25 sessions that way, you go back and do part 2, which goes into more depth and involves picking among various populations or issues to learn adapted EMDR tools for - in my case, I chose addictions.) As part of the first half of the training is experiencing the therapy yourself. I had been in counseling off and on for about eight years at that point with some therapists who I think were good ones, but I found that my first EMDR session felt as if it had enabled me to make more progress with my PTSD than the preceding eight years had. I'd had recurring nightmares for as long as I could remember, and if I encountered reminders of the most intense traumas I'd experienced (two in particular) I'd get shaky, anxious, choked up, and depressed afterward. That first EMDR session was very rough, almost like reliving those two worst events somehow mixed together, but when it was done (about half an hour or 45 minutes) I had a couple of insights about them that I'd never connected before, and although I'm still uncomfortable with reminders the distress is a light shadow of what it was.
I've used it with a number of clients, and for about half of them it was a waste of time, but for the rest it helped quite a bit. One exception, which in the EMDR training as it is now they'd have advised me not to try it - that client was suffering from schizophrenia and had some fairly active delusions, and he never came back but I am afraid it made things worse for him.
I worked on my own therapy for several sessions with another person who used EMDR with me, and it was very effective - each time I had experiences that I can only describe as being like waking dreams or visions that left me with understandings of some self-destructive patterns to which I'd been oblivious, usually via dreamlike metaphors.
I have also used it for meditation and found it helpful. One example: I was about to take a licensing exam, and I was nervous and keyed up. I went to the school where the test was to be held an hour or so early and sat down in the test room with my trusty #2 pencils. I picked out a couple of points on the wall in front of me to use as focal points, and did the eye movements while thinking to myself that I had prepared thoroughly, which was true, and visualizing myself breezing through the exam with no trouble. In about five minutes I was feeling completely calm - all the chatter in my head had gone silent - alert, and focused. When the other folks taking the exam filtered in I could see how jittery they were, but that calm stayed with me. I was the first one to finish the exam, and I passed with a high score.
I'd describe it as a combination of cognitive-behavioral, psychodynamic, and neurological interventions. I don't know whether the theory of how it works is accurate, but I know it works for a lot of people.

You're right--therapists work hard to get their clients to a point of not needing them anymore. I could live without him, I would still be able to have a good life--and that is a major accomplishment! And yes, I have internalized his voice, sometimes I hear him telling me stuff in my head that he's told me in person, so it's not like I will lose him entirely. And I am happy that I have come so far that the subject is even under discussion, but the feeling of loss out weighs that so much. He's the first person I ever told the truth to. All the truth that I could possibly dredge out of me. The people in my life I was used to being with didn't want to hear it. I didn't even know I needed to say it. And I was in such destructive situations, my marriage, my church. I had no profession, no way to support myself. All that has changed.
I know it will happen and it will be really hard. I'm proud and sad all at the same time. For now we are going on a monthly basis, once a week, and checking in every month, should we stay at once a week, or go to every other. So....see what happens.


I once read something that struck a chord, written by a woman whose child was born with some significant disabilities that meant her child's life, and those of her husband and herself, could never be the way they'd expected. She compared it to getting on a plane you thought was going to France and finding, when you get off, that you're in Holland instead. At first one tends to feel cheated, angry, scared, confused, probably with some understandable self-pity. And Holland will never be France, so you'll never get to take the trip you planned. But Holland has its own unique benefits, and over time you can come to a place of acceptance and appreciation for the good parts.
I would never urge anyone to go out and get themselves traumatized, or trivialize it if it's happened. But it is, or can be, a doorway to knowing some things that can't be learned any other way, and some of those things can become priceless resources for someone in a helping profession.
And if I had to boil the change EMDR gave me down to a phrase, I'd say it turned some still-open wounds into scars - still a bit tender, but no longer as if they'd happened yesterday.

I know I've had experiences a lot of other people haven't had and I often wonder what the purpose of that is. Some of the really weird stuff my ex used to do isn't even most books, like sleep deprivation, off the wall stuff like that. He never left a mark on me, that would have been too easy and run of the mill, I guess. Plus, it would have been evidence, and he was really good at not leaving evidence.
I like the analogy of Holland and France. I know I never thought my life would turn out the way it did. I joined a cult and married an unstable, abusive man all before I turned 20 and planned on living happily ever after! Didn't happen that way. Wonder what country I landed in?
According to the quote, I stopped being a chld when I was five. I like that quote, it's sad, but really true.

out the other side without having your spirit broken.
There's at least one place where sleep deprivation is documented pretty well - in the literature on torture. A lot of other practices often found in cults qualify as torture and brainwashing, too.
There have been times when, as with the scar on your finger, it can be a comfort in a bad time to think about others in the past and reflect that although they hurt at the time the pain is only a memory, and that the day will come when the present pain is only a memory too.
They can be useful reminders in another way. Before a lot of my work in therapy and recovery programs, I had a scary temper, and once I lost it at work and went across the top of my desk at someone and burst a blood vessel in my left eye in the process. Now any time I get really tired or stressed out that part of my eye goes red again, which is impossible to miss in a mirror even if I'm distracted and out of touch with how I'm doing; it's like a message saying, "Lighten up, slow down and ease off!"

After telling my therapist about my marriage, especially the early days of it, which were the worst, he said that some of the stuff my husband did were torture techniques that they use in interrogation and brainwashing. It's strange to think about now. Living that way.
That's interesting about your eye, it's like a signal or flag. My stomach is my flag, I guess, it gets upset very easily. I also cry much more easily than I used to. I think that is part of my healing--I used to be so numb, I didn't cry at all sometimes for months, and then that would make me feel so bad inside I would cut myself--it was like if the tears couldn't come out, I had to relieve the pressure by letting some blood out. Now I cry at movies, all kinds of places and situations and every time I do, I know it's a victory, I know it means I'm alive--physically and emotionally.

I believe that in the same way the body has to heal at its own pace, the mind does too. I think one of the functions of that numbing is to protect us from things we don't have the strength to deal with, or that we don't have the time or energy, or are still too vulnerable and need to maintain vigilance and self-protection, to work on. When we have more strength or sophistication, or are in a situation where we can let our guard down, our minds let issues and emotions come up as we become capable of coping. It's not a good idea to push ourselves - or our clients - to dig too hard, lest it end up causing retraumatization instead of healing. Even with EMDR, which brings experiences back up so intensely it's like a flashback, it seems that this self-protective "governor" mechanism still operates.

I think I came close to retraumatizing myself because I pushed myself real hard during some of the most intense times of the therapy, I don't think I ever actually did though. For a while, I saw my therapist on thursday, was depressed at least through Monday, felt a little better Tues and Wed, then saw him again on Thursday and the whole cycle began again. We spent time talking about it, it's hard to know how much to push and how much not to. It sems like we're in a different phase now, and a visit to him doesn't affect for me days. Maybe that evening, maybe not even that much now.
How did you make that decision with your clients? It seems like a very fine line.

With clients, I let them prioritize the issues, and I am careful about hitting them with observations or interpretations that I get the sense would blindside them; a lot of the time I paraphrase what they're telling me as a check to make sure I've understood, and I'll put some reframing into that, so it's still the same information but with an added layer of meaning, if possible more positive than what they started with. For example, with their PTSD symptoms, I will explore how those symptoms made perfect sense as successful adaptations to their circumstances, and instead of seeing themselves as damaged goods, I'll invite them to consider how they came out as victorious over things that might have destroyed them if they'd been less adaptable. Part of that realization will typically be a softening of denial and minimization, and the beginning of letting themselves see how bad it really was.
If people aren't ready and still can't see some of this, I don't push, I just try to shift to practical ways they can make their day-to-day lives more the way they want them to be - symptom relief, getting people off their backs, or whatever else they want to see happen.

My therapist, too, has worked hard to let me know that these things I was doing, things that are no longer helping me and need to be changed aren't bad in anyway--they actually saved my life. They just are not adaptive techniques for the life I have now. But they were for back then. I'm here, aren't I?

Re-adapting is often difficult and can be terrifying. However, for someone who adapted the first time - maybe with the body and mind of a child, often without much support from anyone else, in a position of near-total dependence on and vulnerability to the people who may have been that same person's worst enemies - that person, now with the body and mind of an adult, with more autonomy and less vulnerability, with the support and help of others including a therapist - that person can adapt again, and even if it's hard, it won't be as hard as that earlier adaptation was.

That's the great thing about being an adult! Sometimes I feel so happy that I'm 47 instead of 7!! Now I have the resouces and help and what I need to adapt to life now. It's hard--but I'm doing it! I'm not a little kid anymore.
I have a hard time feeling like an adult sometimes, I have to remind myself that I am an adult and have the resouces of an adult. I'm not a child at everyone's mercy.

I am Sarah, and I hope to be a Psychiatrist one day. I'm particularly interested in mood disorders, especially manic depression, but generally anything related to psychology astounds me.
I'm currently reading An Unquiet Mind by Kay Redfield Jamison for personal reasons, but other than that I can't say I have read too many psychology related books. So recommendations would be greatly appreciated, and I look forward to conversing with all of you!

For great books by a great psychiatrist, you can't go wrong with Irvin Yalom. It's not too early to start figuring out what kind of practice you anticipate seeing patients for, such as choosing the issues that interest you most, then getting familiar with the writers who share yours.
Are there particular problems and disorders you want to read on? We might be able to make lots of recommendations.

Well, what I really would like to focus on at the moment is Psychotic Disorder NOS, Borderline Personality Disorder, and Narcissistic Personality Disorder. I also would like to read more memoirs, preferably ones of mood disorders.

I have a lot of memoirs of people with various mood disorders and other psychological problems, such as being traumatized, on my book shelves. If you would like to, we could be on each other's friend's lists and you could check them out. I also have a bunch on my to-read shelf.
I love Irvin Yalom--he's one of the best!

My great interest is in the enneagram (personality types), which probably still has to be seen as somewhat esoteric and not officially accepted. However, I consider the enneagram very useful as a model, it simply works for me, to reduce stress. My hobby is to try to understand how very unhealthy people behave, such as reading true crime stories about serial killers on the internet. And on the other hand, I study very healthy individuals like mystics, and try to understand what happens in their heads.

Re the Enneagram, a sort of related system that's been studied a bit more systematically is the Myers-Briggs Type Indicator (MBTI). I took a course in using the MBTI at San Diego State and some clients have found it very useful in figuring out things like how to communicate with family members, which careers were most likely to suit them, etc. There are a husband-and-wife couple of therapists named Tieger and Barron-Tieger who've written a book on using it for career choices titled Do What You Are and one on parenting titled Nurture by Nature. There are some other good ones like Work Types by Kummerow, Barger, and Kirby and What Type Am I by Barron. Barron (aka Barron-Tieger) has also written on the Enneagram.
Sarebare, on people with borderline patterns, the most important thing in practical terms seems to be that much of time is really untreated complex PTSD. If the PTSD is addressed, often the "personality disorder" diminishes greatly or goes away. In that area it's also useful to study the work people have done on self-injury - the best book I've read on that is A Bright Red Scream by Strong.

And James, that is definitely a common theme I've come across while looking up examples of borderline personality disorder. Would it be safe to assume that PTSD plays a decent role is most personality disorders?



Sometimes I wish there was an alternate universe where I hadn't been traumatized and I could have telescope and see myself there and know who I would have been if all this stuff hadn't happened. But then other times, I'm glad none of that exists. It might feel really crummy to look through that telescope.


Re MBTI. I know MBTI, and there are correlation tables for MBTI-type versus enneatype. But these tables are all slightly different. Personally I don't think a strong correlation exists; MBTI and enneagram are basically different systems. Enneagram is more about underlying strategies, our motives, less observable.
Hello Sarebare. The enneagram system includes personality disorders. A table exists with DSM-IV correlations. Just as an example, the Narcissistic Personality Disorder is listed as an enneatype 4.
Hi Leslie. I hope to communicate with you all more.


Sarebare--sometimes it is the pain of our lives that makes us more willing and able to help others, I believe that with all my heart. I think part of my life purpose is to work against sexual abuse and that wouldn't be true if it hadn't happened to me. It reminds me of the title Touched by Fire--it's like first you have to get burned, and that hurts. I wish I had never been sexually abused, but I was, I was touched by fire, you could say. Now what? Help others who have been burned too.




If you sift through the entries in this string from the top - it takes some time - there are a lot of recommendations for books, and also for areas of specialization in the field. It's an endlessly fascinating field and never stops growing and evolving. I believe that a couple of areas that are going to see more expansion and study than most in the near and midterm future are gerontology, as the population keeps aging, and trauma work, as we try to help the millions of veterans who have come home from Iraq and Afghanistan, many with subtle traumatic brain injuries from IEDs as well as psychological aftereffects.
Brandon, you might find some good stuff happening on brain functioning in that area in particular, especially as people develop more sensitive and sophisticated ways to detect injuries. You might also be particularly interested in the book Children in a Violent Society, which talks about differences in the maturation of brain structure due to childhood trauma.
Lisa, you may find transpersonal psychology of special interest to you, along with Jung's work looking at the intersection of psychology and spirituality.

Thanks for your recommendation of Jung and transpersonal psychology. I do have interest in these. I have also enjoyed attachment theory, emotion focused couples therapy, practices of mindfulness & the brain research application by Dan Siegel.

I'm a student of psychology at North Seattle Community College. I'm looking forward to asking questions.

Hello to all. I'm an RN and am currently pursuing an MA in psychology, being always fascinated in everything that deals with behavior/minds/brains. My interests are more into psychobiology, psychosociology, sexuality, deviance, prejudice, ostracism, animal behavior, cultural-anthro... lots really -- but not so much into projectives, psychodynamics, psychoanalysis. I have no idea where my studies will ultimately lead to. Psychologist or not, I think I'll continue to read psyc-related stuff for the rest of my life due to sheer fixation.

This is a good forum, various folks focused on all sorts of niches and areas of interest within the field. For the areas you mentioned, there's a lot of exciting research on the brain going on - seems like the amount of useful knowledge about brain functioning has been doubling about every four or five years.
One area where the need will be big for the next several decades is in treatment for people coping with the combo of PTSD and traumatic brain injury - the wars in Iraq and Afghanistan are putting tens of thousands of people in that situation. I'm thinking about going back to school, and being a disabled vet, if I do I'd like to get involved in research in that area.

We may have interacted before thanks to Grand Rounds and Encephalon blog carnivals - I am happy to discover this group now that we have published The SharpBrains Guide to Brain Fitness, by neuropsychologist Elkhonon Goldberg and me.
In short, Elkhonon and I have done our best to present and summarize much recent research and tools on how to develop/ maintain/ protect a variety of cognitive and emotional self-regulation functions important for "brain fitness" across the lifespan. We placed special emphasis on lifestyle/ behavioral interventions such as aerobic exercise, meditation, cognitive therapy, cognitive training software...I believe psychology students and practitioners will enjoy it a lot.
Happy to engage in a conversation here at Goodreads with anyone interested. A full Table Of Contents and more info on the book here:
http://www.sharpbrains.com/book/
The Sharp Brains Guide to Brain Fitness 18 Interviews with Scientists, Practical Advice, and Product Reviews, to Keep Your Brain Sharp

Online Marriage and Phone Counseling
I am looking for new friends on Good Reads.

Just joined the group. My main interest is in autism and Asperger syndrome.
Oh, and cats, of course ;o)

There are a couple of good books on autism by Lynn Kern Koegel and Claire LaZebnik that you might be interested in if you haven't seen them yet: 'Overcoming Autism: Finding the Answers, Strategies, and Hope That Can Transform a Child's Life', and 'Growing Up on the Spectrum: A Guide to Life, Love, and Learning for Teens and Young Adults with Autism and Asperger's'. Of the two authors, the first is a clinician and the second is the parent of a son with autism as well as a novelist. Very well organized and written.




A lot of the inmates I worked with in my last job (it was in the state prison system's psychiatric hospital) had been clients in one of those same programs as adolescents, but I hadn't worked with them, although one other therapist there had a man on his caseload he'd worked with in his early teens.


If you are in a situation where you can use a video as a tool, there's a better-than-average documentary on gang life called 'Lives In Hazard' that Edward James Olmos did while he was shooting 'American Me' - we also used it with staff when I was teaching at the state corrections academy.
Another thing that seemed to have some impact with at least some of the kids when I was working a day treatment program with gang kids was a psychoed presentation on the difference between respect and fear - if you'd like, I can send you the lesson plan; it's basically a guided discussion drawing on examples from the participants. In my case, we had a great youth activities supervisor named Mike that the kids thought the world of - he was gentle and respectful but firm. I'd get them to think of people that they dreaded - their typical concept of respect - and think about whether they'd rather have other people think of them the way they thought of those people, or the way they thought of Mike (I couldn't do that if Mike was actually present because he got too embarrassed.) The lesson plan is in Word - let me know if you want it.
A final video resource - too harsh for kids, probably, though - is the film 'Once Were Warriors' - it was filmed in New Zealand and is a portrait of the impacts of poverty, gangs, alcohol, and domestic violence on a Maori family. I also used a clip from it to open a presentation on domestic violence at the state corrections association's annual conference.
Hello, What a great idea. I love to read about others in the field.
My name is Julie A. Fast. I write books on the comprehensive treatment of bipolar disorder and depression. These days I really focus on family members and partners of people with bipolar disorder. We talk a lot about psychosis. It's so misunderstood. I just read and did a review for the new edition of Stop Walking on Eggshells. What a great book. My books are.... Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder and Get it Done When You're Depressed. I was diagnosed with bipolar in 1995 - these books talk about how I manage the illness. I can write full time now and I'm thankful.
Thanks for this group! Julie
My name is Julie A. Fast. I write books on the comprehensive treatment of bipolar disorder and depression. These days I really focus on family members and partners of people with bipolar disorder. We talk a lot about psychosis. It's so misunderstood. I just read and did a review for the new edition of Stop Walking on Eggshells. What a great book. My books are.... Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder and Get it Done When You're Depressed. I was diagnosed with bipolar in 1995 - these books talk about how I manage the illness. I can write full time now and I'm thankful.
Thanks for this group! Julie




In addition to your own books, what titles have been most useful to you in working with folks with bipolar DO and depression? I like Here Comes the Sun by Rosselini and Worden, but don't have as many books on the shelf on these issues as on PTSD and addictions.
Good to have another person who sees the disorder from the inside as well as from the clinician perspective. I was diagnosed with bipolar disorder in 2002 myself, after a depressive episode led to a prescription for an antidepressant which in turn kicked off a memorable manic spell. I have also had to adapt to alcoholism (sober 19 years) and PTSD from childhood and the military, so those three areas have been my strongest interests. I too am writing full time now, in my case due to some physical disabilities.
Books mentioned in this topic
Honeycake: A Circle Of Trust (other topics)School's Out Forever: I've Done My Time (other topics)
MiXED NUTS or What I've Learned Practicing Psychotherapy (other topics)
Defying Mental Illness: Finding Recovery With Community Resources and Family Support (other topics)
A Life Lived Ridiculously (other topics)
More...
He brought up seeing him every other week and gradually less and less, til it's not at all, and it turns out it's because we got in the habit of me coming in and talking about whatever I was upset about that day or week and he said he was spending at least half the appointment time giving me emotional support, which I should be getting more from other people in my life, but instead I depend on him too much for, and not getting therapy, which is the thing I can get from him and not from the other people in my life. Which, I realized was true. So now, we are getting back to being real therapeutic-for lack of a better way of saying it--instead of a lot of emotional support.
But I don't want to end my connection with him. But like he said, even if he just kept seeing me, he's older than I am and he's going to retire eventually. This is a huge issue for me. How do I give up the person who helped me get out of an abusive marriage, a church that is a cult, helped me find out I have ptsd and that's why I am how I am, in a lot of ways, and has helped learn how to have a good life for the first time since I was about 3?