It’s a diagnosis that ravages two percent of the general population and twenty percent of patients in psychiatric inpatient facilities. Characterized by frantic efforts to avoid abandonment, intense patterns of idealization and devaluation of interpersonal relationships, high levels of impulsivity in spending, sexuality, or eating– all with deleterious effects—and this is only the beginning.
Welcome to the world of Borderline Personality Disorder (BPD).
The fragile realm of BPD is rapidly changing in treatment and diagnosis. Changes to the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are heralding the most prominent adjustments to psychiatric diagnosis in some thirty years. Personality disorders are taking the biggest hit – half of personality disorders in the current manual getting the “boot.” All these changes and more are preliminary and awaiting field trial.
While diagnosis is an important part of the mix of modern medical and mental healthcare, it does little to directly help treatment and recovery. For those effected by BPD – it’s ravaging. For those that treat it – taxing.
But advances in treatment have occurred: you just won’t find them in the DSM. Research-based humanistic person centered treatment methods provide a beacon of hope for those with BPD.
Research published in the Journal of Humanistic Psychology provides hope and help. Adam Quinn, a social worker and clinician whose work covers the gamut of trauma survivors, veterans, and seriously mentally ill clients tackles the treatment of Borderline Personality Disorder with the Person Centered Treatment Model (PCT).
Quinn tackles the diagnosis and treatment of BPD with rigor, practicality and eloquence. Examining the array of conventional approaches, Quinn highlights the empirical evidence for person centered treatment for individuals diagnosed with or possessing characteristics of Borderline Personality Disorder.
It’s Carl Rogers’ technique, twenty first century style.
The following six process mechanisms, resulting from Person Centered facilitative mechanisms demonstrate the effectiveness of such therapy:
Increased Accurate Awareness: Through the therapist’s facilitative embodiment of congruence, unconditional positive regard, and empathic understanding, a BPD client moves from a state of idealized interpretations of their environment to reality based interpretations; thus a lessening of interpersonal abandonment issues.
Internal Locus of Control: As the therapeutic alliance continues to authenticate and express congruence, a BPD client gradually moves from the external locus of control that causes many issues, to an internal locus of control.
Assimilate Previously Threatening Experience: In the process of gaining an internal locus of control, the interpretation of external experiences changes and assimilates into the realistic realm of expectations. As an increase in accurate awareness of inner and external realities occurs, the positive regard of the therapist becomes part of the “selfhood” of the client; thus promoting inherent elf-actualizing and self-growth tendencies.
Defensiveness to Acceptance: Based on the facilitative qualities present in the therapeutic relationship, the client gradually moves from their classic defensive state to a state of self-acceptance. The borderline tendencies of the client begin to substantially lessen as the internal locus of control recognizes its value as a person through the experience of the therapist’s genuinely expressed non-possessive unconditional positive regard. Issues of suicidality are common in this phase for the client as they test their “worthiness” in the face of the clinicians continued positive regard.
Increased Acceptance of Others: Through the testing and subsequent internalization of the therapeutic acceptance, the client begins to more fully accept themselves and in turn begins to accept others; without the previous fear of abandonment, and the elements of devaluation and idealization. Self-harm behaviors lessen as interpersonal unstable relationships decrease. The self-actualizing tendency further promotes congruency between self and experience; thus the client begins choosing healthier relationships.
Reliance on Self Evaluation: In this phase, internal evaluation of experience becomes paramount as increased reliance is placed on the client’s internal locus of control. Through the genuine person centered therapeutic relationship, the client moves toward an inner locus of control; where reactivity and affective instability cease to exist and self-evaluation predominates.
With Quinn’s research as a foundation, great work and hope remains to recognize the endless possibilities with treating borderline personality disorder with the person centered therapy model. As Carl Rogers once said, “This is the person-centered scenario of the future. We may choose it, but whether we choose it or not, it appears that to some degree it is inexorably moving to change our culture…”
— Liz Schreiber
Unbound Posts
Studies suggest it is possible to rehabilitate sex offenders – by acknowledging their humanity
It’s been a big week for sex abuse scandals: the Archdiocese of Philadelphia has suspended 21 priests – the largest mass suspension in church history – as a result of accusations involving inappropriate contact with minors.
Meanwhile victims groups have begun to say publicly that the Catholic Church should monitor accused priests the way the police track convicted sex offenders … and create special housing for them.
Sexual violence is never permissible, yet lost in the discussion of these horrifying crimes is the question of rehabilitation. For the most part, the public assumption is that once a sex offender always a sex offender: rehabilitation is not possible.
It’s an understandable assumption – rehabilitation requires taking an offender seriously as a person: how can we do this with sex offenders, especially child abusers? How can we reach out to them to address their humanity, and human needs?
But there are horrifying consequences if this assumption is wrong. If sex offenders can be rehabilitated, then failure to do so not only is cruel to the offender, it puts more people at risk precisely because sex offenders remain untreated.
In fact, it is humanistic and existential therapy that has proven most effective in rehabilitating adult sex offenders – and it achieves this success precisely by relating to offenders as human beings.
In preliminary research (PDF) humanistic and existential psychology, utilized in the group therapy context, has proven successful in rehabilitating sex offenders.
Adult sex offenders were studied in the context of an atmosphere focused on safety, empathy, relation. Facilitators and clinicians of the groups utilized existential psychologist, Irvin Yalom’s group therapy process, and principles of Rogerian therapy; while concomitantly condemning the criminal acts of sexual abuse perpetrated by the group members. Group therapy with the offenders consistently focused on genuineness, empathy, and unconditional positive regard for all group participants; not the abhorrent sexual conduct itself.
“Many approaches to sex offender group treatment stress confrontation as a primary therapeutic tool and focus on breaking through denial,” say researchers Sheri Bauman & T. Gregory Kopp. “We believe that such approaches result in pseudocompliance by clients. However, clients are more likely to explore underlying dynamics that contributed to their offense, such as low-self-esteem and shame, when they feel safe. They are more likely to improve social skills and decrease isolation when they feel understood, accepted, and supported.”
Bauman and Kopp’s study is timely; as it comes in the furry over a raging debate regarding sexual and identity disorders in the American Psychiatric Association’s upcoming publication, DSM-5. In the DSM-5, the Paraphilias Subworkgroup has proposed including a diagnosis known as Paraphilic Coercive Disorder. The inclusion of such a disorder would allow many states to justify indefinite civil commitment for sexual crimes.
Accordingly, to qualify for Paraphilic Coercive Disorder, a person would need to meet the following criteria:
- Over a period of at least six months, recurrent, and intense sexual arousal from sexual coercion, as manifested by fantasies, urges, or behaviors. [23]
- The person has clinically significant distress or impairment in important areas of functioning, or has sought sexual stimulation from forcing sex on three or more nonconsenting persons on separate occasions. [24]
- The diagnosis of Paraphilic Coercive Disorder is not made if the patient meets criteria for a diagnosis of Sexual Sadism Disorder.[25]
Including such a disorder into the upcoming DSM-5—is senseless. If the most effective rehabilitation programs involve acknowledging the people behind these awful crimes, slapping another label on them will further alienate them from humanity; and in turn we will increase recidivism rates. Offenders need rehabilitation not another diagnosis: “sex offender” is already as big a label as we have.
Sexual violence cannot be tolerated – and neither can the lack of rehabilitation efforts. While the acts of sexual offenders are unquestionably repugnant, therapy must focus on bringing human-like qualities back into the offender’s life to prevent recidivism.
In the long run, it’s the best way to keep everyone safe.
— Liz Schreiber
The American Psychological Association’s new guidelines are a step forward for gay rights
Last month, the American Psychological Association (APA) approved the release of the publication, Guidelines for Psychological Practice with Lesbian, Gay, and Bisexual Clients. It’s an essential publication, for psychologists and laymen a like, in order to empathically relate and ethically care for all people with equality—and according to their needs.
The guidelines were written with an emphasis on what was declared by the APA’s 1975 resolution stating, “Homosexuality per se implies no impairment in judgment, stability, reliability, or general social or vocational capabilities.” Since that time, the APA has been a staunch supporter of the “mentally healthy” aspects of same-sex attraction. In sum, the guidelines speak to the rationale and application of twenty one specific guiding principles for psychological practice with lesbian, gay, and bisexual clients.
Chances are you or someone in your family is in a committed same-sex relationship. And–likely, they want equality and proper care. The recent census reports 1.2 million gay couples living together in the United States; roughly between 3-5 percent of the total population reporting an LGBTQQI orientation. (Lesbian, Gay, Bisexual, Transsexual, Queer, Questioning and Intersex)
It recent years, academia, professional organizations and social service agencies have caught on. Rightfully so: Discrimination based on ethnicity or gender is a no-no — sexual orientation is no different. Psychology, specifically psychotherapeutic practice, has made huge growth. These new guidelines are part of that progress.
Highlights include:
Guideline 1: Psychologists strive to understand the effects of stigma (i.e., prejudice, discrimination, and violence) and its various contextual manifestations in the lives of lesbian, gay, and bisexual people
- Because of the mainly heterosexual society in the United States, great stigma exists; research has proven this can lead to mental health issues for homosexual persons.
- Therapists are encouraged to provide a safe therapeutic environment and have an in-depth understanding of societal stigmatization; otherwise refer the patient.
Guideline 3: Psychologists understand that same-sex attractions, feelings, and behavior are normal variants of human sexuality and that efforts to change sexual orientation have not been shown to be effective or safe.
- In the Journal of Consulting and Clinical Psychology, through empirical data and analysis, author Douglas Haldeman states, “Psychologists are obliged to use methods that have some empirically demonstrable efficacy, and there is a paucity of such evidence relative to [sexual] conversion therapy. Moreover, there is a need to understand fully the potentially damaging effects of a failed conversion treatment.
- Through Haldeman’s research and writing and that of other distinguished clinicians, sexual conversion therapy has proven ineffective, unethical, and psychological damaging.
Guideline 4: Psychologists are encouraged to recognize how their attitudes and knowledge about lesbian, gay, and bisexual issues may be relevant to assessment and treatment and seek consultation or make appropriate referrals when indicated.
- As in any therapeutic agreement, if the clinician is not skilled in a particular area or has a personal bias which interferes, they are ethically, legally, and professionally obliged to refer to a competent practitioner.
Guideline 4: Psychologists are encouraged to recognize how their attitudes and knowledge about lesbian, gay, and bisexual issues may be relevant to assessment and treatment and seek consultation or make appropriate referrals when indicated.
- As in any therapeutic agreement, if the clinician is not skilled in a particular area or has a personal bias which interferes, they are ethically, legally, and professionally obliged to refer to a competent practitioner.
Guideline 12: Psychologists are encouraged to consider the influences of religion and spirituality in the lives of lesbian, gay, and bisexual persons.
- A comprehensive resource for advocacy in religion and spirituality for the LGBT population can be found here under Appendix B: http://www.apa.org/pi/lgbt/resources/guidelines
Guideline 16: Psychologists strive to understand the impact of HIV/AIDS on the lives of lesbian, gay, and bisexual individuals and communities.
- An in-depth medical and psychological understanding of these diseases is implicated for work with this population. Helpful resources include: https://www.aids.org/ and www.thebody.com
Writer Winifred Gallagher stated, “It’s hard to imagine anything more difficult to study than human sexuality, on every level from the technical to the political.” This is absolutely true, but the APA’s understanding of ethical and effective care is a step towards to furthering psychological care for all people—regardless of sexual orientation.
Managing Regrets for Healthy Living
Maybe an unexamined life is a little more worth living than we thought: recent research has shown that wallowing in regret can lead to feeling stressed, anxious, and unhappy about life … and even impact physical health.
A study in the recent issue of the Personality and Social Psychology Bulletin shows that about 90 percent of adults have deep or existential regrets about their lives and that the more they dwell on it the worse their quality of life tends to get. If we all have big regrets – and it looks like we virtually all do – then managing regret is a crucial life skill.
How do we do that?
Managing Regrets for Healthy Living
Current research in psychology and sociology has begun to focus on self-regulation processes – a person’s ability to come up with ways to manage how they feel at any given moment. For example, someone may self-regulate, and ease their pain, about losing a job by thinking about the homeless person on the street.
Previous research has shown that this works for feelings of regret, too: in general, people feel better about lost chances or regrets when they think about others who are worse off than they are. Say, for instance, someone is mulling over losing an opportunity to travel around the world when they were in college. Thinking about others who never had the opportunity to go to college tends to be an effective way to ease the pain of regretting that missed trip.
Bauer and Wrosch tested two hypotheses about self-regulation and regrets:
- We feel better about lost opportunities when we see that others have lost similar opportunities and that getting access to these opportunities was not easy
- That feelings of regret are not related to age. We are as likely to feel the loss of opportunities at any age.
Their research indicates that both of these hypotheses are true. What this suggests is that regret isn’t a phase we go through or a feeling we “deal with,” but a fundamental question of the way we find meaning in our lives.
Existential Regrets
In existential-humanistic psychology, regrets are associated with finding meaning in our existence through our experiences. Without meaning, there is regret. An article published in the January 2004 issue of the Journal of Humanistic Psychology, “Existential Regrets: A Crossroads of Existential Anxiety and Existential Guilt” defines existential regret: as a “profound desire to go back and change an experience in which one has failed to choose consciously or has made a choice that did not follow one’s beliefs, values, or growth needs.”
Existential regret may seem far more profound than the type of regret that Bauer and Wrosch were looking at in their research but it’s not. Regret is regret. It’s about making choices that are ultimately in line with our values and the kind of person we want to be. A trip around the world could have been incredibly transformative. There may be good reasons that someone wouldn’t go … perhaps the young college student felt they needed to stay home and work part-time to support their family. But even in cases when both the choice to go and to not go is in line with their values, one can regret … profoundly and existentially … making a choice that cuts off an avenue for meaningful personal growth. That’s why the feelings of regret don’t necessarily go away with age.
Living with Regrets
At the same time looking at the lives of others reminds us that we are not just self-created … we are products of the world around us as well, inevitably “living for others” (in Satre’s phrase) and making the choices we have to make as well as the choices we want to. Seeing this struggle in others can make us remember that we can not expect perfect results in our struggles. Being proud of the victories we have attained is a source of meaning and one that we are reminded of when we see those who have not been able to attain it. Someone who feels regret for not taking a trip because he needed to take care of his family can feel pride in what he has accomplished when he hears about another family falling apart.
Dealing with Regrets
If that seems to accentuate the negative a bit much, there’s good news: Another, more positive, strategy for dealing with regret is available. According to Bauer’s and Wrosch’s research, people also self-regulated to ease the pain of regret by re-engaging with lost opportunities.
How did they do that? By looking at others in their lives that managed to accomplish their goals.
Recall those little success stories we hear on Oprah or read in the magazines by the checkout stand about the grandmother who decided to go back to college to complete her degree or the returning veteran who is an amputee post-war who completes the marathon they always wanted to compete in. These types of stories can be just as helpful in self-regulating our feelings of regret as comparing ourselves to others who are a little bit worse off in life. This type of self-regulation, the researchers found, seems to be far more healthy and provides a great opportunity for personal growth.
Study Humanistic Psychology at Saybrook University to learn more about the process of managing regrets to aid yourself and others in leading a healthier life.
— Makenna Berry
Psychology still needs to take Dr. Martin Luther King Jr.’s advice
In 1967, as black communities in Detroit and Newark were still picking up the pieces after rage had exploded onto the streets during the “Long, Hot Summer,” Dr. Martin Luther King Jr. addressed the American Psychological Association in Washington, D.C.
From the podium, Dr. King offered his vision for how psychology and sociology could help pull us all toward humanity’s highest potential.
“You who are in the field of psychology,” he said, “have given us a great word. It is the word ‘maladjusted.’ This word is probably used more than any other word in psychology. It is a good word; certainly it is good that in dealing with what the word implies you are declaring that destructive maladjustment should be destroyed. You are saying that all must seek the well-adjusted life in order to avoid neurotic and schizophrenic personalities.”
Recommended Read: “Justifiably Maladjusted”
Today psychology is still very focused on the maladjusted individual. But King’s vision went beyond neurosis or what we think of as “mental illness.” What, he wondered aloud, does psychology have to say to the average person who supports the status quo, who remains blind, or who chooses to ignore the ills that plague our society?
“I am sure that we will recognize that there are some things in our society, some things in our world, to which we should never be adjusted,” King said. “There are some things concerning which we must always be maladjusted if we are to be people of good will. We must never adjust ourselves to racial discrimination and racial segregation. We must never adjust ourselves to religious bigotry. We must never adjust ourselves to economic conditions that take necessities from the many to give luxuries to the few. We must never adjust ourselves to the madness of militarism, and the self-defeating effects of physical violence.”
The summer of ’67 was obviously not just about love but about the upheaval of the American psyche. Young and old were pushing past their ideas of what it meant to be American as well as what it meant to be human. The desire to be human—or more accurately a better person—was emerging in the field of psychology as well as popular culture. The literal meaning of psychology is the study of the “psyche”: the soul, spirit, or breath. In the western study of the soul, it seems imperative that we study to understand how that soul is impacted by the choices of the individual and by the choices of society. King saw the connection between the well-being of a person and the condition of the community. A damaged soul can be tied to a damaged community and vice versa.
A recent article published in the Journal of Humanistic Psychology speaks about Liberation Psychology. Much like King’s vision, liberation psychology focuses on the relationship between the individual, community, and the spiritual self in fulfilling our basic needs.
Alsup suggests that advocacy like King’s fulfills a basic need of individuals as laid out in Maslow’s Hierarchy of Needs. King knew all too well the detrimental effects that racism had not only on the black community but the nation as a whole. He said at one point in his speech:
“If the Negro needs social sciences for direction and for self-understanding, the white society is in even more urgent need. White America needs to understand that it is poisoned to its soul by racism and the understanding needs to be carefully documented and consequently more difficult to reject. The present crisis arises because although it is historically imperative that our society take the next step to equality, we find ourselves psychologically and socially imprisoned.”
The narrative of the ‘60s is still present today: With the ever-increasing numbers of new immigrants, racism is no longer just black and white. Psychologists who work with any individual, no matter their socio-economic status, must understand that whatever is happening in society at large will ultimately show up in the therapist’s room. In 1967, psychologists were not interested in the link between social justice and psychological well-being. King challenged them to consider how generations of social, economic, and psychological oppression had impacted the hearts and minds of black Americans. Today psychologists are still being challenged to understand that the client who is present in the room with them brings in not only their family system but the community that they live among, along with all of the ills that pervade it.
King’s APA speech was prophetic, forecasting the revelation we still grapple with today. The work of the psychologist is not just with the individual but with the community as a whole. Perhaps the work can be even more transformative if we understand that helping one person move toward self-actualization can help a whole community move towards a true freedom and justice.
Pretending to be happy makes other people miserable
When you’re having a lousy day and someone asks “How are you?” … what do you do?
If you’re like most people, you lie. You decide that the truth won’t go over well and push down your negative emotions.
But just because it’s common doesn’t mean there aren’t consequences. What does publicly denying our unhappiness do to our well being, and what effect does it have on others?
Researchers from the University of California Berkeley, Stanford University, and Syracuse University recently answered those questions in a study called “Misery Has More Company Than People Think: Underestimating the Prevalence of Others’ Negative Emotions”
Their conclusion: People think that others are happy even when they may not be. Believing that others are happier than them can lead to rumination, loneliness and feeling less satisfied with life.
In other words, we’ve got to stop doing this. Sure, sometimes it’s not appropriate to say “I’m miserable, actually” – but when we put on a happy face, people believe us, and it causes problems.
We all know people compare material stuff and try to “keep up with the Joneses”; the researchers here propose that we also compare emotional experiences. Is our attitude keeping up with the Joneses?
Hanging out with friends and hearing that everyone is doing just fine may make people believe that others are doing better than they are. After all, isn’t that what it’s supposed to do? Believing it is referred to as “emotional pluralistic ignorance” – the tendency to believe that people are as happy as they appear in public.
This has an effect on our own well being. Believing that others are happier than they really are sets up an unrealistic standard (imagine if the Joneses won the lottery), and that standard makes us feel lonely, ruminative, depressed and less satisfied. Add to this the fact that hiding how we really feel often makes us feel even worse, and we’re bringing about a whole new level of personal pain.
This has an effect on our own well being. Believing that others are happier than they really are sets up an unrealistic standard (imagine if the Joneses won the lottery), and that standard makes us feel lonely, ruminative, depressed and less satisfied. Add to this the fact that hiding how we really feel often makes us feel even worse, and we’re bringing about a whole new level of personal pain.
Existential-Humanistic psychology has a concept called a part of/a part from. This speaks to a person’s ability to be separate from others while still being connected. Believing that no one else feels sad or struggles with day to day life pulls us apart from those who surround us. But underneath all of that we are all actually connected. Even if people feel that they are alone in our “misery” they are not. They’re all experiencing its affects together.
Ever think about the song “Put on a Happy Face”? It seems that we as society have taken that to heart. There’s one lyric that sticks out for me,
And if you’re feeling cross and bitterish
Don’t sit and whine
Think of banana split and licorice
And you’ll feel fine
Optimism is one thing but burying personal pain and loss can have detrimental effects on not only us but others as well. It’s obvious that people don’t feel safe enough to be open in society, and that’s too bad. It’s worse when there’s a price that many people pay in order to fit in with the crowd.
There’s another quote by Bugental that captures this, “Each of us is like a person who pays blackmail to keep a feared reality from becoming manifest. So paying, we maintain a semblance of peace at increasingly heavy costs to our resources.”
Putting on happy face may cost not only our own well being but the well being of those we care for. It can be a relief to know that your best friend has spent nights crying, or your co-worker is just as stressed out at work. This can create a link between people that doesn’t necessarily create more sadness and grief but does create an important connection that can serve to help us be more content with who we are at any given moment in our lives – through sadness and happiness.
— Makenna Berry
Are antidepressants accomplices to school shootings?
Do you know that the perpetrators of some of the most notorious school shootings in the world were on antidepressants?
No? I didn’t think so. Most people don’t. It doesn’t get talked about very often.
But in fact Cho Seung Hui, the shooter in the Virginia Tech massacre in Blacksburg, Virginia was on antidepressant medications. He killed thirty three people and wounded countless others, before taking his own life.
Eric Harris, one of the shooters at Columbine High School, in Littleton, Colorado was on antidepressant medications at the time of his shooting rampage with fellow classmate, Dylan Klebold.
Matti Juhani Saari, the shooter of ten at a Finnish College in Europe was on antidepressant medications at the time of his shooting spree when he later took his own life.
Kip Kinkel, the fifteen year old shooter at Thurston High School in Springfield, Oregon, had been on anti-depressants in the weeks before his shooting spree that killed and injured nearly two dozen people.
So, what is the connection between anti-depressants and shooting sprees? Could antidepressantmedications be “accomplices” in some of the worlds most senseless and horrifying school shoot sprees. What are the implications and what is being done?
In Britain, researchers from Cardiff University have looked into the link between hostile and aggressive acts and antidepressant selective serotonin reuptake inhibitor (SSRI) medications. The research found that individuals on Paxil, and its generic paroxetine, have twice the risk for violent behavior, aggression and hostility than those not on SSRI antidepressant medications.
Depression is bad – but is aggression any better?
As part of the study Mike Adams, a health advocate and outspoken critic of the over-medicalization of children states, “We also know that SSRIs cause children to disconnect from reality. When you combine that with a propensity for violence, you create a dangerous recipe for school shootings and other adolescent violence,”
Currently, 1.5 million children are on antidepressant medications. In 2008, consumer advocates and parent’s right organizations called on Congress to explore the link between psychiatric medications, school shootings, and the harmful aggressive side effects of psychotropic medications. Advocates for reform are calling on Congress to mandate “black box” warnings to include mania, psychosis, hostility, hallucinations and homicidal behavior—to the current warnings regarding suicide.
Above and beyond the link between psychiatric medications, primarily antidepressant medications and hostile and aggressive acts, is the ethical and medical question of the efficacy of antidepressant medications. Clearly, the side effects are devastating—horrendous. But, are the antidepressant medications effective?
Survey says no. Two meta-analyses from the mother hens at the Food and Drug Administration and American Medical Association show that antidepressant medications for mild to moderate depression are little better than a placebo effect, and show questionable “clinical significance.” For individuals with severe depression, antidepressants are said to be slightly more effective. Studies show decreased responsiveness to the placebo effect among individual’s diagnosed with severe depression, rather than to increased responsiveness to SSRI antidepressant medication.
Sounds like a big Pharma hoax 101; and the abhorrent part–the lives being lost at the hands of adolescents on antidepressants who involve themselves in killing sprees in schools. Indeed, we have an ethical dilemma on our hands—millions of people on lethal antidepressant medications—and its effects are tragically widespread.
— Liz Schreiber
Carl Rogers’ legacy of human dignity
Recently, Time Magazine compiled a list of the twenty-five most powerful and influenential women of the century. And, to no surprise, Mother Teresa ranks in at the top.
A Roman Catholic nun, known for her symbolic simple white garb with blue stripes, Mother Teresa brought the values of human dignity and intrinsic worth to one of the most impoverished places on earth, working with the sick and the dying. Teresa, named at birth Agnes Gonxha Bojaxhiu, undoubtedly revolutionized a world by her humble example and unselfish love to the dying, the sick, and abandoned in Calcutta, India.
As I read about Mother Teresa, I was reminded of another Nobel Peace Prize nominee, one who brought the values of human dignity and intrinsic worth to the psyche, bringing the idea of self-determination and presence into the both the therapists office and everyday life.
We are nearing what would have been the 108th birthday of Carl Rogers, and he deserves to be celebrated as much as Mother Teresa – and for many of the same reasons.
Rogers, a true revolutionary and pioneer, looked at human nature through the lens of hope, promise, and positivism. Rogers was nominated for the Nobel Peace Prize (an award Mother Teresa won) in 1987 for his work in South Africa and Ireland in conflict resolution. His scholarly work, nearly as influential as that of Sigmund Freud, introduced the concept of research to the world of psychotherapy and brought the revolutionary person-centered approach to psychology, education, organizations and communities.
Roger’s believed in affirming a person’s basic worth; without judgment, doing so in the form of unconditional positive regard. Perhaps nothing describes Roger’s and his theoretical work more than his renowned book, Client-centered Therapy: Its Current Practice, Implications and Theory. In this piece, Rogers describes the nineteen core tenets of his theory regarding the human person, their worth and the therapeutic environment.
Some of the nineteen tenets include:
1) The understanding that behavior is basically the goal directed attempt of the organism or person attempting to satisfy its needs as experienced, in the field of its perceptions.
2) The organism or person reacts to the field as it is experienced and perceived. This perceptual field is, for the individual, “reality.”
3) The organism reacts as an organized whole to this phenomenal field.
4) The organism has one basic tendency and striving – to actualize, maintain and enhance the experiencing organism. Rather than viewing the individual (organism) as controlled by ‘a mass of drives’ like his predecessors, Rogers considered all strivings to be different facets of the one tendency
5) The best vantage point for understanding behavior is from the internal frame of reference of the individual himself.
6) As a result of interaction with the environment, the structure of the self is formed – an organized and consistent conceptual pattern of perceptions and relationships of the “I” or the “me,” inclusive of the attached values.
Rogers is credited with writing sixteen books and many articles, all with a humanistic and phenomenological orientation. His work was and continues to be revolutionary long after his death.
Rogers, much like Mother Teresa, valued the human being in a non-judgmental way. Rogers’ work went beyond the surface, to a place where the individual, or organism as he often wrote, was much greater than a psychological pathology or personality deficit. Both Mother Teresa and Carl Rogers were true leaders and pioneers of humanistic service to people of all races, creeds, and socioeconomic statuses.
Carl Rogers and Mother Teresa saw the innate human potential and worth in each person. Through Rogers’ writings his legacy lives on encouraging clinicians and educators to look beyond the surface to a place where freedom and positive regard can unleash the human potential and actualizing tendency in a student or client. And, through the shelters, hospitals, and homes for the dying, Mother Teresa’s humanistic example of love continues to thrive.
Both humanists – both revolutionaries.
– Liz Schreiber
The psychological impact of suburban poverty could be big
When we think of suburban areas of the United States, we think of white picket fences, generous green lawns and kids playing hopscotch. The suburbs aren’t always the richest areas of the country, but they’re the most elite: inhabited by the people who rose above traditional neighborhoods and landed in communities of choice.
It’s an outdated notion, if it was ever true. During the Great Recession things are quite different for many suburban families. “Suburban Poverty” is now a phenomenon commented upon in newspapers and magazines. Food and clothing shelters have come to suburbs that never had them before, and existing ones serving suburban areas have seen exponential growth in places like the suburbs of Cleveland, Baltimore, Chicago, Detroit, and Atlanta.
In some ways, Suburban poverty is very different from what we still think of as “regular” poverty: most suburbs aren’t walkable and don’t have effective public transportation, meaning the suburban poor must still have cars. The schools are often more genteel. But in other ways “suburban poverty” is just “poverty” with an adjective.
The question no one has the answer to: will suburban poverty have the same psychological impact on children and adults that urban poverty does?
Erik Erikson, well known for his developmental stage theorem, spoke to the eight stages of life. In his renowned book, Childhood and Society, Erikson emphasized the encounter a person has with the social world cross culturally in the context of development. Either we go mature from one stage to the next, or we get stuck along the way – unable to resolve the stage we’re in and access the stage that comes after it.
Erickson’s Stage Theorem
1) Basic Trust versus Mistrust: represents the encounter between a child’s developing ego and their external environment.
2) Autonomy versus Shame and Doubt: represents the biological maturation of the internal autonomy in a child by fostering the child’s ability to do things without their parent. Conversely, shame and doubt come about by way of the social expectations, pressures and realities of the external world.
3) Initiative versus Guilt: represents the forward movement of development, especially as it applies to planning and goal making; thus the development of the superego.
4) Industry versus Inferiority: the most decisive stage of ego development where a child is said to develop cognitive and social skills.
5) Identity versus Role Confusion: involves the confusing development of new social conflicts and demands; including innate instinctual drives.
6) Intimacy versus Isolation: involves the development of intimacy, self-knowledge, and mutuality in the context of a romantic relationship. Failure of these things results in the feeling of isolation.
7) Generativity versus Isolation: descriptive of the developmental milestones that occur in a intimate relationship inclusive of child-bearing and the production of things and ideals through work. Failure in these realms results in isolation.
8) Integrity versus Despair: representative of an elder’s inner difficulties regarding utility and existential meaning in one’s past life experiences.”
Erickson emphasizes that identity is mostly an unconscious process. Because of this, it’s easy to get “stuck” without knowing it, which makes it difficult to make lasting commitments; many times this results in a “psychological moratorium”—where decisions regarding careers, intimate relationships, and school are often delayed.
That’s a common phenomenon among both the urban and suburban poor – poverty creates uncertainty, which causes major decisions to be postponed, which in turn creates more uncertainty. A recent Time Magazine cover story showed that statistically, the poor are least likely to get married for just this reason: they lack financial certainty. That’s as much a psychological affect as it is an economic one.
Possibly, instead of looking at poverty through the lens of economics, we need to look at it through the lens of lifespan development. Likely, if we did this, we would see that children and adults who experience poverty go through many “psychological moratoriums” as a result of unfinished developmental business. This would mean their ability actualize as persons is greatly hindered.
We just don’t know what kind of impact that will have, but it’s something we can take steps to minimize. To do that, however, the traditional suburban self-image will have to change.
— Liz Schreiber
The benefits of adversity are very, very real
Score one for Nietzsche: studies show that what does not kill you actually does make you stronger. At least in moderation.
A recent report, “Whatever Does Not Kill Us: Cumulative Lifetime Adversity, Vulnerability, and Resilience” in the Journal of Personality and Social Psychology, found that yes, when bad experiences happen we do suffer from mental, physical, and spiritual pain – but in that suffering many of us develop a greater understanding of hardship and are more prepared for it when (not if) it comes again. In other words, adverse experiences offer opportunities to gain strength to tackle our future challenges.
While the concept has been around ever since Nietzsche first put it into words (if not longer), this is a relatively new area for serious psychological research. Past research tended to focus on how we reacted when things fall apart – but not how we recovered. There are a number of studies, stories, and blogs that tell us that when hit by adversity we just crumble. Our health collapses, we eat terrible food, don’t exercise, fall into despair and hang on to the pain for far too long. End of story. But although people sometimes crumble in extreme situations, we often come out the other end stronger. We collect new skills, ideas, and perspectives that can guide us in the future.
Humanistic thinkers and spiritual practitioners have long known there is another chapter.
In addition to Nietzsche, I’m reminded of a wonderful book written by Pema Chödrön called When Things Fall Apart: Heart Advice For Difficult Times that deals with how to overcome adversity. She stated in her book that she had a sign on her wall that read
“Only to the extent that we expose ourselves over and over to annihilation can that which is indestructible be found in us”
Now researchers have caught up, showing that there are benefits to experiencing adversity in life. After a difficult challenge or moment, we are less likely to feel pained or challenged next time around.
This is often referred to as resiliency. Resiliency involves having the mental and physical resources that help us deal with challenges in life. What is adversity and how is it relevant? Adversity forces us to reach out for help, to create social networks, and to realize that we cannot and should not overcome our struggles on our own. Resiliency can make us feel we have a little more mastery in life. When we face adversity with resilience, we become stronger than we were before the challenge.
This is not to say that we can’t reach a breaking point in life. There are times when life is just too hard. Too much hardship can deplete our toolbox of coping skills and put immense pressure on our families, friends and communities. It may get so bleak that we fall into a sense of hopelessness and losing control. The researchers don’t go into what can be done in these times but others have emphasized a number of “ways through” that include accessing all three of our vital resources: mind, body and spirit. Some ways could include seeking guidance from a therapist, or spiritual advisors; recognizing our physical limitations; mediation; resting; support groups and most importantly honoring one’s own self worth.
This research also shows that all of our attempts at avoiding pain and suffering may be to our detriment. Avoiding difficult times is not often possible, but many people try their best to escape by not taking risks or doing something to numb the pain. Avoiding difficult situations can mean missing out on opportunities to grow from adversity. Pema Chödrön speaks to this rather well,
“Most of us do not take these situations as teachings. We automatically hate them. We run like crazy. We use all kinds of ways to escape — all addictions stem from this moment when we meet our edge and we just can’t stand it. We feel we have to soften it, pad it with something, and we become addicted to whatever it is that seems to ease the pain.”
Trying to avoid acknowledging or being present with adversity causes us to miss out on some of the greatest lessons in our life. In these times, we often learn about true friendship, and that we are strong, empowered, smart and resourceful. The researchers Seery, Holman and Silver are not endorsing that we set ourselves up for suffering in life. What they have established through research is as much as hardships hurt, they can also bring out the best in us.
I wonder what else Nietzsche was moderately right about.
– Makenna Berry