shame

David Earl Johnson, LICSW

4 minute read

I’ve been a skeptic about self-help books as have many of my colleagues. Self-help concepts often represent the home grown philosophy of the author. Seldom is there comprehensive research documentation of the foundations of the concepts shared. And so you can never be sure you are reading something that applies real science to every day needs. Cover via Amazon This book is an exception. Buddha’s Brain – The Practical Neuroscience of Happiness, Love, and Wisdom.

David Earl Johnson, LICSW

8 minute read

This is the third in a series of articles on emotional intelligence for personal growth. Self-awareness is one of the most important benefits we get from spending time in a mindful state. The longer we are able to stay mindful, the more we learn about our selves. We come to recognize the ebb and flow of our thoughts, moods, emotions and impulses. We begin to see relationships between our thoughts and feelings and external events.

David Earl Johnson, LICSW

5 minute read

Very sad and difficult times for people in this economy. Those who are still working are waiting for the next lay-off notice. Small businesses are struggling to make ends meet. Worse yet the unemployed are at their wits end. Virtually everyone I see in my practice these days are seeking treatment directly or indirectly because of the economy. Another hidden part of the drama is that the unemployment rate no longer includes those whose unemployment insurance has lapsed and they no longer register at the unemployment office as looking for work.

David Earl Johnson, LICSW

17 minute read

I really enjoy reading the blog Kellevision.com. She says it like it is and seldom misses the point of what she’s writing about. She identifies a problem in programming for homelessness and proposes a set of concepts to help clarify the situation. Image via Wikipedia “Many of the “barriers” faced by the chronically homeless are not external. They are self-inflicted. Repeatedly failing to pay one’s utility bills is not a barrier.

David Earl Johnson, LICSW

12 minute read

Since I heard of all the excitement in the therapy literature about forgiveness therapy, I’ve been a skeptic. I’ve worked with a lot of people who have experienced unforgivable abuse. Often they are tortured by their feelings of anger, resentment, helplessness, violation, and shame for allowing themselves to be a victim. They also feel guilt about their anger with the perpetrator so much so they feel morally obligated to forgive the perpetrator.

David Earl Johnson, LICSW

6 minute read

Image via Wikipedia We have become a medicating culture. If we don’t like how we feel, we can take a pill to feel better. Kellen Von Houser, MA, LPC, in her blog [Kellevision][1] says it boldly. “My concern is for people who are actually experiencing the normal emotions of life, labeling them “mood swings” and trying to medicate their discomfort away. My concern is for doctors who participate in this and validate it.

David Earl Johnson, LICSW

27 minute read

ResearchBlogging.org Aaron Beck, considered the Father of Cognitive Therapy, is an American psychiatrist and a professor emeritus at the Department of Psychiatry at the University of Pennsylvania. He is President of the Beck Institute for Cognitive Therapy and Research that is directed by his daughter, Judith S. Beck, Ph.D.. He is noted for his research in psychotherapy, psychopathology, suicide, and psychometrics, and the Beck Depression Inventory (BDI), one of the most widely used instruments for measuring depression severity. At age 87, the man is still publishing, building on his pioneering work on the cognitive model of depression. In his latest article published in the American Journal of Psychiatry, he recalls his early work:

Caught up with the contagion of the times, I was prompted to start something on my own. I was particularly intrigued by the paradox of depression. This disorder appeared to violate the time-honored canons of human nature: the self-preservation instinct, the maternal instinct, the sexual instinct, and the pleasure principle. All of these normal human yearnings were dulled or reversed. Even vital biological functions like eating or sleeping were attenuated. The leading causal theory of depression at the time was the notion of inverted hostility. This seemed a reasonable, logical explanation if translated into a need to suffer. The need to punish one’s self could account for the loss of pleasure, loss of libido, self-criticism, and suicidal wishes and would be triggered by guilt. I was drawn to conducting clinical research in depression because the field was wide open–and besides, I had a testable hypothesis. I decided at first to make a foray into the “deepest” level: the dreams of depressed patients. I expected to find signs of more hostility in the dream content of depressed patients than nondepressed patients, but they actually showed less hostility. I did observe, however, that the dreams of depressed patients contained the themes of loss, defeat, rejection, and abandonment, and the dreamer was represented as defective or diseased. At first I assumed the idea that the negative themes in the dream content expressed the need to punish one’s self (or “masochism”), but I was soon disabused of this notion. When encouraged to express hostility, my patients became more, not less, depressed. Further, in experiments, they reacted positively to success experiences and positive reinforcement when the “masochism” hypothesis predicted the opposite (summarized in Beck). Some revealing observations helped to provide the basis for the subsequent cognitive model of depression. I noted that the dream content contained the same themes as the patients’ conscious cognitions–their negative self-evaluations, expectancies, and memories–but in an exaggerated, more dramatic form. The depressive cognitions contained errors or distortions in the interpretations (or misinterpretations) of experience. What finally clinched the new model (for me) was our research finding that when the patients reappraised and corrected their misinterpretations, their depression started to lift and–in 10 or 12 sessions–would remit.” We owe a lot to Dr. Beck. His cognitive model of depression still dominates how I and most of my colleagues write treatment plans for persons suffering with depression. Our goal is to inspire and teach our clients to change their negative self-evaluations, correct distorted memories, and create an expectation of success. The only problem is depression is not that simple. Try as they might, many clients are able to recognize what they need to do, understand how their thoughts about themselves and their world need to change, are able to state those changes, and diligently practice them. But when they really need to be able to master their fate, when ruminative thoughts spiral downward into the depths of depression, their efforts quickly collapse and they succumb. So is the Cognitive Model of Depression wrong? No, I think it’s incomplete. There is the biomedical model of depression involving errant neurotransmitter levels treated by various anti-depressants. That discussion is beyond this article’s purpose. I’m more interested in what we as therapists can do differently in the counseling office. Of course we need to be sure a severely depressed client is referred for a medication review. But I want to know how we might better facilitate our clients attempts to master their mood. To this end, I will review my recent reading on the subject of emotion and argue to include emotion in a new Cognitive Theory.

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David Earl Johnson, LICSW

6 minute read

Recently, the []1NYTimes.com had an article about a malicious sort of on-line anti-social behavior called Trolling. One of the people the author interviewed was Jason Fortuny, a thirty-two year old web programmer, who’s passion is trolling. “Today the Internet is much more than esoteric discussion forums. It is a mass medium for defining who we are to ourselves and to others. Teenagers groom their MySpace profiles as intensely as their hair; escapists clock 50-hour weeks in virtual worlds, accumulating gold for their online avatars.

David Earl Johnson, LICSW

5 minute read

It’s been apparent to me for a number of years that there appeared to be problems with the concept of schizophrenia. Sub-types of the disorder have very different symptoms. Some include paranoia, some do not. Some include prominent disorganization, some do not. Today, I tripped over an article with information on another part of the disorder that fits only into some sub-types. Symptoms are roughly divided into three groups, positive (i.

David Earl Johnson, LICSW

4 minute read

Shame has been a particular interest for me. It has appeared repeatedly as a major barrier in therapy, especially in those for whom therapy has failed in the past. It takes a lot of courage to re-enter therapy after feeling it was previously insufficient. Fortunately, a person returning to therapy after a less than satisfactory experience is significant motivated to try new ideas. Agreeing to therapy is a humbling experience in and of itself.