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Tune in to Dr. Deri's Online Radio Show. Next show is on Wednesday, May 19, 2010 at 8:00 PM Pacific Time. A Psychiatrist’s Journey: The Human Family
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Posts Tagged ‘Trauma’

Dissociation

Wednesday, April 7, 2010 posted by admin

Picture 6 300x288 DissociationDissociation refers to the splitting off of painful experience from awareness.  Dissociation is the hallmark of trauma.  A child experiences abuse or neglect as an unbearable catastrophe.  Dissociation is the psychic defense of last resort.  Unable to cope or to flee, the child simple “spaces out.”  People sometimes refer to this state as “going out of body.”

In the context of the original traumatic situation, this defense preserves the child’s sanity.  Unfortunately, dissociation tends to persist as the primary mode of psychic functioning throughout the lifetime of the individual.  Such people have great difficulty in knowing or communicating what they are feeling.  These deficits lead to an impoverishment of the person’s emotional life.  Such people tend to experience themselves as ephemeral, or insubstantial.  They usually have great difficulty in achieving or sustaining intimacy in their relationships.

Causes


There has been speculation regarding both biological and psychological causes of dissociation.  From a neurologic standpoint, studies have shown a decreased corpus callosum in traumatized people.  The corpus callosum connects the two hemispheres of the brain.  The right hemisphere processes emotional experience.  The left hemisphere includes the language region of the brain, in most people.  A constricted connection between the two hemispheres could result in a limited capacity for recognizing and articulating emotional states.

From a psychological point of view, Joyce McDougall, a French psychoanalyst, believes that dissociation is the effect of exposure to overwhelming emotion that threatens to attack an individual’s sense of integrity and identity.

Within a developmental context, a child acquires the capacity for emotional experience, regulation and expression, through the parent’s capacity for attunement to the child’s emotional state.  If the adult is incapable of recognizing and distinguishing emotional expressions in the child, it can impair the child’s capacity to experience his own emotional states.

Treatment


Psychotherapy offers a reparative experience for a person suffering from dissociation.  Suffering is actually a misleading term.  Many dissociated people are unaware of their own dissociation.  Often, such a person seeks psychotherapy due to a spouse’s frustration with them.

Working with a profoundly dissociated person in psychotherapy is challenging.  The engine for psyche change is psychic distress.  If the distress itself is dissociated, there may be minimal motivation to engage in psychological work.  Moreover, it is difficult to establish an emotional connection of any depth with a dissociated person.

Often a starting point involves gradually drawing the person’s attention to her state of dissociation.  The therapeutic process is one of symbolically reparenting the child.  The therapist, unlike the actual parent, is able to register and to articulate her patient’s emotional states.  Through repeated interactions in which the therapist is able to service this function accurately, the patient gradually internalizes the process.  As she incrementally acquires the capacity to recognize what she is feeling, the therapy gains traction.

As a person develops increasing awareness of his own emotional states, both present and past experiences come to life.  It becomes possible to narrate, to process and to release the previously frozen residue of early trauma.  As parts of the self that had been dissociated become available for integration, the personality becomes richer, more complex, more textured and more vibrant.

Dissociation makes people feel like ghosts or robots.  Experience has an “as if” quality.  Integration of a full range of feelings gives rise to a robust, embodied passion for life.

As Walt Whitman wrote in “Song of Myself”:

“Urge and urge and urge, 

Always the procreant urge of the world.”

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Blog Talk Radio Show: Dissociation

Sunday, April 4, 2010 posted by admin

Blog Talk Radio logo1 Blog Talk Radio Show: Dissociation

Dr. John Deri’s next Blog Talk Radio Show: Healthy Mind and Body will be on Wednesday, April 7, 2010 from 8-9:00 PM Pacific Time.

The topic will be: Dissociation

Dissociation refers to the splitting off of painful experiences from awareness. Dissociation is the hallmark of trauma.

In this episode, Dr. John Deri will discuss dissociation as a psychic defense of last resort. He will describe the effects of dissociation on the emotional lives of affected people. Finally, Dr. Deri will share his thoughts regarding the treatment of dissociation, including conditions for healing and paths to integration.

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

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Picture 31  Blog Talk Radio Show: How Does Psychotherapy Heal, Part III  – Psyche, Soma and Spirit

Dr. John Deri’s next Blog Talk Radio Show: Healthy Mind and Body will be on Wednesday, March 31, 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 psychotherapy 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

share save 171 16  Blog Talk Radio Show: How Does Psychotherapy Heal, Part III  – Psyche, Soma and Spirit

The Alchemy of Healing

Monday, March 15, 2010 posted by admin

Tai Chi Symbol1 150x150 The Alchemy of Healing“The psychoanalyst listens, the shaman speaks.”

Thus wrote Claude Levi-Strauss, the French anthropologist.  Levi-Strauss, like Carl Jung, was intrigued by pairs of opposites.

I have been reflecting on this particular pair of opposites, listening and speaking, in the context of psychotherapy.  I have come to think of listening and speaking as representing the yin and the yang of the healing process.

The Yin and the Yang of Healing

From a Taoist perspective, yin energy is associated symbolically with the feminine, yang with the masculine.  These energies are not, however, linked with gender.  We all embody the potential for both yin and yang poles of energy.

Yin energy in therapy is manifested through phenomena including listening, empathy and nurturance, as well as through a metaphoric “holding space” for the other.

Yang energy may be expressed through speaking, interpretation, emphatic engagement or confrontation.

Both patient and therapist must develop a full range of these capacities.  The process of healing is catalyzed by a creative dance between these polar energies.  Both therapist and patient need to cultivate their respective abilities to speak freely and to listen fully.  Each must be able to listen to herself as well as to the other.

The Role of Early Life Trauma

The reason why listening and speaking are healing can be understood against the backdrop of early life trauma.  The traumatized child goes unheard.  Neither parent has the wherewithal or the willingness to listen to the child.  As a consequence, the child comes to feel alone, uncared for, disconnected and afraid.  Moreover, such a child is liable to grow up as an adult who is wary of closeness to others.  Such an individual is prone to seek social isolation.

Wilfred Bion, a British psychoanalyst, in his paper “Attacks on Linking,” put forth the premise that such a child is deprived of a primary experience of emotional bonding or “linkage,” with either parent.  This absence breeds in the child an experience of sadness, a sense of futility and ultimately of rage.  The child’s rage has the potential to generalize into an unconscious hatred of all “linkages”: between the child and another human being, between thought and feeling, between the child and himself, and ultimately between the child and reality.  Such broken or unconsummated linkages are the substrate for unspeakable suffering.

The Alchemy of Healing

Through reciprocal speaking and listening within the therapeutic relationship, emotionally meaningful linkages are formed.  The patient’s capacity to achieve emotional connection with the self and with the other is enhanced.  Dissociation between thoughts and feelings, between feelings and images, is transformed into integration.

Through integration of split off parts of the self, healing occurs.  Through relatedness with self and others, the full potential of the patient blossoms and flourishes.

These transformational processes are always reciprocal, between patient and therapist.  Witnessing and participating in this alchemy of healing is deeply moving.  Such participation is the central calling of my life.

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A Buddhist Perspective on Healing: Wisdom and Compassion

Monday, February 22, 2010 posted by admin

Picture 2 300x225 A Buddhist Perspective on Healing: Wisdom and CompassionMy immersion in Tibetan Buddhism has influenced my perspective on the healing process. The central tenets of Tibetan Buddhism are wisdom and compassion.

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.

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Blog Talk Radio logo3 Blog Talk Radio Show:  How Does Psychotherapy Heal, Part III    Psyche, Soma and Spirit

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

share save 171 16 Blog Talk Radio Show:  How Does Psychotherapy Heal, Part III    Psyche, Soma and Spirit

Blog Talk Radio Show: The Shadow Side of Human Nature

Tuesday, February 9, 2010 posted by admin

Blog Talk Radio logo Blog Talk Radio Show: The Shadow Side of Human Nature
Dr. John Deri’s next Blog Talk Radio Show: Healthy Mind and Body will be on Wednesday, February 10, 2010 from 8-9:00 PM PST.

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

.

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Mt Davidson Cross1 225x300 How Does Psychotherapy Heal?  Part III   Psyche, Soma and SpiritPsychological growth and spiritual development are mutually contingent on one another.

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.

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Blog Talk Radio Show: How Does Psychotherapy Heal, Part II

Friday, January 29, 2010 posted by admin

Blog Talk Radio logo6 Blog Talk Radio Show: How Does Psychotherapy Heal, Part II

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

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Blog Talk Radio Show: How Does Psychotherapy Heal, Part II

Monday, January 25, 2010 posted by admin

Blog Talk Radio logo4 Blog Talk Radio Show:  How Does Psychotherapy Heal, Part II

Dr. John Deri’s next Blog Talk Radio Show: Healthy Mind and Body will be on Wednesday, January 27, 2010  from 8-8:30 PM PDT.

The topic of the episode will be:  How Does Psychotherapy Heal, Part II – Psychotherapy and Dependent Origination

The Buddhist theory of dependent origination will be discussed as a perspective on transference and countertransference in psychotherapy. These psychological phenomena will be explored as a medium for the healing of early childhood trauma in psychotherapy.

During the  Blog Talk Radio Show: Healthy Mind and Body, Dr. John Deri will present a clinical case as an example of the work.

To listen to the show 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

share save 171 16 Blog Talk Radio Show:  How Does Psychotherapy Heal, Part II