Due to popular demand, we have decided to rerun last week’s Blog Talk Radio Show – Panic Disorder: The Absent Self.  Our show Healthy Mind and Body will be on Wednesday, March 10, 2010 from 8-9:00 PM PDT.

The topic will be -  Panic Disorder: The Absent Self

Panic disorder is a terrifying, potentially disabling condition. It can be viewed as a specific form of separation anxiety: separation from the self.

In this episode, Dr. Deri will discuss psychological and pharmacological approaches to the treatment of panic disorder. The role of early life trauma as well as the potential co-occurrence of substance abuse will be highlighted.

Dr. Deri will discuss a clinical case, by way of illustrating and elaborating on these themes.

To listen to the show you can:

1.    Dial the phone in telephone number at (347) 989-0560

OR

2.    Tune in to our online channel at http://www.blogtalkradio.com/Healthy-Mind-Body

Dr. John Deri’s next Blog Talk Radio Show: Healthy Mind and Body will be on Wednesday, March 3, 2010 from 8-9:00 PM PDT.

The topic will be -  Panic Disorder: The Absent Self

Panic disorder is a terrifying, potentially disabling condition. It can be viewed as a specific form of separation anxiety: separation from the self.

In this episode, Dr. Deri will discuss psychological and pharmacological approaches to the treatment of panic disorder. The role of early life trauma as well as the potential co-occurrence of substance abuse will be highlighted.

Dr. Deri will discuss a clinical case, by way of illustrating and elaborating on these themes.

To listen to the show you can:

1.    Dial the phone in telephone number at (347) 989-0560

OR

2.    Tune in to our online channel at http://www.blogtalkradio.com/Healthy-Mind-Body

Wisdom in Healing

From a conventional point of view, phenomena are incontrovertibly how they appear. At this level, healing in psychotherapy includes the kinds of work that I have described in previous blogs and radio shows.  It is essential to bring dissociated feelings and memories into conscious awareness.  Doing so in the context of a caring psychotherapy relationship allows the “working through,” the integration and the release of these emotions.  Mourning is central to this process: mourning for both what was wounding and for what was lacking in the patient’s early life.

Another key component of the healing process is working on the patient’s “shadow” side.  Trauma propagates through identification with the aggressor.  It is a painful, but vital, step to recognize one’s own propensity to hurt others.

From an ultimate point of view, all phenomena are inherently “empty.”  I am not qualified to discuss the Buddha’s teachings.  So, for our purposes, let me just say that healing is facilitated by the cultivation of the awareness that all of our perceptions, all of our experiences, are like a mirage, like an illusion.  We all construct our own “psychic reality.” 

This realization is very powerful.  It gives us the freedom to construe the past from multiple vantage points.  We can achieve release from an identity as a perennial victim of circumstances.  We can develop the capacity for what Carolyn Myss has called “symbolic sight.”  We can learn to “learn from our experience” (Wilfred Bion).  We can develop the potential to do things differently, to experience transformation. 

Viewing life as an open field, rather than as a constellation of solid figures, liberates us from fixity, from the unconscious compulsion to repeat the past.

Compassion In Healing

Compassion for others is the antidote for narcissism.  Narcissism is the root of all suffering.  When we fixate on an “I,” we experience ourselves as fundamentally disconnected, constricted, anxious and depressed.  When we cultivate our compassion for others, we feel alive, related and infused with life energy.

Wisdom and compassion are inseparable, like the two wings of a bird.  In conjunction with one another, they liberate us from suffering, allowing our spirits to take flight.  The darkness of our delusions is dispelled.  The radiance of our innate nature shines forth unimpeded.  We are free.

Dr. John Deri’s next Blog Talk Radio Show: Healthy Mind and Body will be on Wednesday, February 24, 2010 from 8-9:00 PM PDT.

The topic will be:  How to Stay Calm in an Age of Anxiety. It will be a rerun of a recorded episode.

We are currently living in the midst of an age of anxiety. Economic uncertainty is high. Change and dislocation are rampant. Anxiety is a natural human response to these conditions.

During the show Dr. Deri will share:

• Why “healthy anxiety” can help you to move forward in your life
• How to identify when anxiety overwhelms and paralyzes us
• The long term mental and physical consequences of anxiety and stress
• Five steps to implement that will help you to reduce anxiety and reach peace and calmness. Spiritual dimensions of overcoming anxiety will be highlighted.

To listen to the show you can:

1.    Dial the phone in telephone number at (347) 989-0560

OR

2.    Tune in to our online channel at http://www.blogtalkradio.com/Healthy-Mind-Body

Richard was a 39 year old married man living with his wife and their two young children.  He was a self employed businessman.  He presented with an acute onset of panic attacks.  These episodes had been occurring with increasing frequency, during the weeks prior to our first session.

Richard and I worked together in twice a week psychotherapy for a period of four years.  His symptoms of panic disorder were relieved by high doses of antidepressant medication, during most of this time.

Early Life

Richard’s early life experience was powerfully influenced by his distant, critical, cynical father.  The father, a successful professional, was rarely at home.  Richard’s mother was comparatively more available to him.  However, she was primarily focused on her husband.  Moreover, she was largely preoccupied with her own painful feelings of isolation.  As a result, Richard was on his own emotionally.

Polysubstance Abuse

Like Sophia in my previous blog posting, Richard turned to alcohol as a young man.  He used alcohol as a way of deadening and escaping from his psychic pain.  Some years later, he began regularly using cocaine.

When I met Richard, he was drinking 6-9 drinks per day, as well as the occasional bottle of wine.  Despite this clearcut pattern of alcohol abuse and dependence, Richard was in complete denial about his alcoholism.

Themes in Therapy

The primary theme in Richard’s therapy was to draw his attention to his repetition compulsion.  He abandoned his family and himself much as he had been abandoned.  A recurring memory wove like a thread throughout the therapeutic work.  Richard had been put out in the back yard whenever he had cried as an infant.

A key dream, to which we often returned, consisted of a brief exchange between Richard and his mother.  In the dream, Richard told his mother, “I’m in pain.”  To which she replied, “I’m in pain, too.” In other words, Richard was entirely excluded from his parents’ minds.

As a young unemployed adult, Richard literally went hungry.  His wealthy parents withheld financial support.

As a mature adult, Richard abandoned his own family, through alcoholism and workaholism.  He was absent to himself as well.  He would often work for long stretches, without eating or sleeping.  He was entirely out of touch with his emotional states.  Alcohol and work were his psychic refuges of unconsciousness.

The Therapeutic Work

The initial therapeutic task was building Richard’s capacity for mindfulness regarding his own self states.  This work began with developing his attention and appropriate responsiveness to basic bodily sensations, e.g. eating when hungry.  This process of growing self awareness then extended to his emotional states.  During the early phases of our work, Richard would compulsively play video games, when he was neither drunk nor working.  Gradually, he learned to make space for his own psychic experience.  He developed an increasing repertoire of healthy activities in synch with his emotional states.

The next major hurdle in therapy was overcoming Richard’s denial of his addictions.  To put it briefly, this achievement was won as a result of a two year long intrapsychic and interpersonal tug-of-war.  Once Richard joined AA and CA, our therapeutic work truly blossomed.  The step work and the psychotherapy were mutually synergistic.

Within the context of the fourth step (“performing a searching and fearless moral inventory”), it became possible to draw Richard’s attention to his abandonment of his family.  This was an extraordinarily painful phase of the work.

Another key component in Richard’s healing process involved helping him to recognize and to neutralize his own inner critic.  This voice was a direct internalization of his critical father.

Finally, through a combination of the psychotherapy and the twelve step programs, Richard overcame his narcissism.  He developed a genuine, growing capacity for concern for others.  This transformation in his character was deeply moving for both of us.  Our own relationship with each other was immeasurably enriched accordingly.

Outcome

Richard became clean and sober.  His panic attacks resolved, off all medication.

His marriage dissolved.  His business went bankrupt.  His life, as he had known it, came crashing down around him.

Yet, paradoxically, Richard was happier and more grounded  than he had ever been in his life.  He had a greatly enhanced capacity for intimacy.

Once again, we encounter the archetype of death and rebirth: the phoenix rising from the ashes.

When I called Richard to request his permission to tell his story, he readily assented.  “I tell my story all the time in the [12 step] meetings,” he said.  “And, guess what?  I’ve just celebrated my fifth year of sobriety.”

When I ponder the question of the meaning of life, I no longer have to search for an answer.

Dr. John Deri’s next Blog Talk Radio Show: Healthy Mind and Body will be on Wednesday, February 17, 2010 from 8-9:00 PM PDT.

The topic will be: How Does Psychotherapy Heal, Part III  – Psyche, Soma and Spirit

Psychological growth and spiritual development are mutually contingent on one another.

This week, Dr. Deri would like to share with you a case that illustrates the interdependence of psyche, soma and spirit in the healing process.  Sophia is a 70 year old member of a religious order.  She and Dr. Deri have been meeting in twice a week psychotherapy for the past four years. Sophia decided to authorize the dissemination of her life story.  She prays that doing so might illuminate the path of healing for others.

During the show Dr. Deri will discuss:

Psyche: Healing Early Trauma
How Sophia reached an experience of genuine compassion.

Psyche and Soma
How our therapy helped Sophia to maintain her physical and emotional homeostasis.

Psyche and Spirit
Sophia felt abandoned by God, the Father.  She underwent a protracted “dark night of the soul” (St. John of the cross). As she healed her psychological wounds, Sophia’s spiritual life, has blossomed.

To listen to the show you can:

1.    Dial the phone in telephone number at (347) 989-0560

OR

2.    Tune in to our online channel at http://www.blogtalkradio.com/Healthy-Mind-Body

The topic will be:  The Shadow Side of Human Nature. It will be a rerun of a recorded episode.

“Everyone carries a shadow, and the less it is embodied in the individual’s conscious life, the blacker and denser it is.” (Carl Jung, Psychology and Religion, p.131). All too often, we turn a blind eye to the shadow side of human nature. It is only with an enormous effort that we can acknowledge this side of ourselves. In the context of trauma, we invariably have to deal with a considerably intensified shadow. If such a person wants to be cured, it is necessary to find a way in which his conscious personality and his shadow can live together.

During the show Dr. John Deri will share with us:

➢    Why we turn a blind eye to our shadow side

➢    How we become aware of our shadow side

➢    How to integrate our shadow side.

To listen to the show you can:

1.    Dial the phone in telephone number at (347) 989-0560

OR

2.    Tune in to our online channel at http://www.blogtalkradio.com/Healthy-Mind-Body

.

“Nothing can be created or destroyed”

I remember having this thought, with great conviction, at the age of three. I was gazing intently at a large rock covered with green moss.

Not the thought of a three year old ….

Valentinus, a second century Gnostic, wrote:

“What liberates us is the knowledge of who we were, what we became, where we were, whereinto we have been thrown, whereto we speed, wherefrom we are redeemed, what is birth and what rebirth.”

From the age of five, I have been inexplicably drawn to and mesmerized by Tibetan mandalas.

Throughout my life, I have experienced external reality as a projective field. What we apprehend through our five senses, and our sixth sense, is a highly idiosyncratic construction.

This perspective motivated me to study anthropology and psychology in college. I wanted to learn how culture, language, memory and desire shape perception.

During graduate work in psychology, I investigated the physiology of perception. Concurrently I did research at Rockefeller University, on the localization of opiate receptors in the brain.

My interest in higher integrative functioning remained a passion throughout medical school. Inspired by Wilder Penfield’s “Mystery of The Mind,” I decided to become a neurosurgeon.

Three thousand miles (New York to San Francisco) and two years later, I had an epiphany: I truly wanted to be a psychiatrist. As the British psychoanalyst, D.W. Winnicott, wrote:

“Home is where we start from.”

The manifest context for my felt urgent need to choose psychiatry included an impassioned reading of Goethe’s Faust, a spontaneous total immersion in philosophical Taoism and a resurgent compelling interest in the life and work of Carl Jung. Jung’s autobiography, “Memories, Dreams, Reflections,” had made a searing impression on me as a fifteen year old.

The reading of a book, “The Tao of Psychology: Synchronicity and the Self,” by the Jungian analyst Jean Shinoda Bolen, crystallized my decision.

Some years later, my connection with Tibetan Buddhism resurfaced. I was drawn to seek out teachings from a few Tibetan lamas, notably the Dalai Lama and Khenpo Tsultrim Gyamtso Rinpoche.

The twin principles of Tibetan Buddhism are compassion and wisdom, “like the two wings of a bird.” I have come to experience compassion as the life force, Henri Bergson’s “Elan Vital.” This force sustains me. It infuses my work.

As Santideva, an 8th century Buddhist, wrote in “The Way of the Bodhisattva:”

“For as long as space endures, and for as long as living beings remain, until then may I too abide, to dispel the misery of the world.”

This week, I would like to share with you a case that illustrates the interdependence of psyche, soma and spirit in the healing process.

Sophia is a 70 year old member of a religious order.  She and I have been meeting in twice a week psychotherapy for the past four years.

Sophia’s father sexually abused her from her early childhood until puberty.  Sophia’s mother was hypercritical, perhaps envious, of her.  At age 20, following one abortive relationship with a man, Sophia decided to enter a convent.

During her early adult life, Sophia turned to alcohol to drown her sorrow.  Some years later, she developed a bipolar affective disorder.  More recently, she was diagnosed with insulin dependent diabetes, as well as with Parkinson’s Disease.

1.    Psyche: Healing Early Trauma
Donald Kalsched, a Jungian analyst, has written a trenchant book called “The Inner World of Trauma.”  In describing the work of recovery from trauma, he suggests “where there is an affect, look for an image.  Where there is an image, look for an affect.”

With this advice in mind, I encouraged Sophia, a talented artist, to create artwork that would give expression to her childhood memories and feelings.  She took to this process readily, with great creativity.  There ensued an extended period during which Sophia would bring drawings, watercolors, paintings or poetry to each session.  Through giving form to her experiences, Sophia was able to access and to express her feelings at a deep level.

These feelings included shame, rage, terror and sadness.  She ultimately reached an experience of genuine compassion, for herself as a little girl, and finally even towards her parents.  Her repertoire of emotions expanded dramatically.  She came to revel in her own sensuality and sexuality.  She came fully alive, before my eyes.

2.    Psyche and Soma
Diabetes and Parkinson’s Disease have profound emotional effects.  Reciprocally, emotional states have a major impact on the manifestations of these physical conditions.  Much work in the therapy has had the goal of helping Sophia to maintain her physical and emotional homeostasis.

At times, I coordinate her care with other treating physicians.  Doing so is both good medical practice as well as an opportunity to model appropriate symbolic parenting.

Psychotropic medications are utilized to stabilize Sophia’s mood.

3.    Psyche and Spirit
Sophia’s sexual abuse, and more specifically her father’s perversion, led her to question her faith.  She felt abandoned by God, the Father.  She underwent a protracted “dark night of the soul” (St. John of the Cross).

As she healed her psychological wounds, Sophia’s spiritual life, has blossomed.  She has developed a vivid, direct personal relationship with Jesus and Mary (the Divine masculine and feminine principles).

Sophia has internally reaffirmed her vows.  She has rededicated herself to minister to those in need, within her community.  She has found and is maintaining an appropriate balance between nurturing herself and caring for others.  She experiences the indestructibility of her own spirit.

Last week, Sophia said to me, “Thomas Aquinas wrote that contemplation yields illumination only when one gives to the world.”

It was in this context that Sophia decided to authorize the dissemination of her life story.  She prays that doing so might illuminate the path of healing for others.

Thank you to all my loyal Blog Talk Radio listeners for your ongoing support.  Our show “How Does Psychotherapy Heal, Part II – Psychotherapy and Dependent Origination,” that was scheduled for January 27, 2010, will now be aired on Wednesday, February 3, 2010 at 8:00 PM PDT.

Due to technical problems on the Blog Talk Radio Show website this week, we had an unanticipated rerun of a recorded episode: How To Identify And To Deal With Emotional Trauma, in place of the live show that had been scheduled.

During my show on February 3, 2010 I will present and discuss a clinical case.  I would like to express my deep gratitude to my patient for graciously permitting me to make use of our work in the context of this radio show. It is her intention to help to relieve the suffering of others through the sharing of her story.

To listen to the episode you can:

Dial the phone in telephone number at (347) 989-0560

OR

Tune in to our online channel at http://www.blogtalkradio.com/Healthy-Mind-Body