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Twisted Self-Deception

I Have a Desire to Empathize….

I’m reading a book titled “Staying Sober” by Goreski & Miller (2013).

It’s for an upcoming internship at a homeless shelter next quarter.  Since I decided to take a quarter off, my three goals have been as follows:

*Improve my overall level of self-care. (This will require me to re-institute my weight loss regimen, find a spiritual community, & solidify friendships).
*Prepare for the NCE exam. (This will involve listening to a bunch of CD’s, reading through “The Encyclopedia of Counseling”, & creating a series of blog posts for review)
*Prepare for my upcoming internship. (This will involve reading information pertaining to a therapy group I co-facilitate while I also consider my own therapeutic approach, for my first meeting with the supervisor)

img_3184I just finished the first few chapters of “Staying Sober” & was struck by the following comment: “addiction is distinguished from drug use by a lack of freedom of choice (page, 39).”  While the physical effects of addiction explain this lack of freedom to some extent, there’s more to it than that.  Addiction affects every area of one’s life and in time becomes their primary coping tool. It is a disease which includes delusional thinking and self-deception. This inability to see things as they are that can eliminate any motivation to change.  Immersed in a distorted reality, they are unable to overcome the endless cycle of obsession and compulsion.

Since my addiction history is limited, this information was very thought provoking.  I recalled the last three months at my last internship site.  The perspective this resource provided was a useful counterpoint to the confrontational style I witnessed there.   In order to help, I must first understand my clients and appreciate what it is to walk in their shoes.  The following quote from Gorek & Miller, (2013) intrigued me for this reason.

“The middle stage of addiction, is marked by a progressive loss of control…unable to function normally without the dru, family and friends begin to notice problems with the person’s job, health, marriage and legal matters. They are apt to believe, however, that the person is just behaving irresponsibly. They are not aware that the addicted person is not choosing the behavior (Gorski & Miller, 2013, p. 47).”

This quote seems to describe 2 perspectives of addiction…

*On one hand, there are the addict’s loved one’s who want them to simply “Get their Shit Together”.  From an outsider’s perspective the answer is quite simple: “Just Quit”….
*On the hand, there is the addict’s first-hand experience: “…The person cannot, through willpower, choose to drink or use responsibly” (Gorski & Miller, 2013, p. 47).  The answer isn’t that simple.  

Developing Empathy (Connecting the Dots)

How Does This insight Relate to My Own Experiences

These divergent perspectives describe two sides of a bigger picture.  Both perspectives are critical to understanding addiction as a biopsychosocial issue.  Without this, everyone is left perplexed, while the addict is left feeling shamed and misunderstood.  In fact this situational overview of addiction is reminiscent of my own experiences in an abusive relationship over 20+ years ago.  For this reason, I think its worth describing these diverge perspectives.  In one post, titled “Collateral Damage” I include excerpts of a letter written by my father after I dropped out of school and moved to New York.  The second, is an excerpt from a post titled “Stages of Change”, in which I describe my own growth process during this relationship.

An Outsider’s Perspective
A First-Hand Account

Getting the Big Picture – A Dialectical Perspective….

The above quote comes from another blog post in which I provide an overview of the theoretical perspective underlying Lineman’s Dialectical Behavioral Therapy.  This therapeutic strategy provides a combination of change, validation, and dialectical strategies.  I find this perspective useful, since it represents my very first introduction with therapy as a client, when I first started seeing my current therapist and joint a DBT Skills Group.  To this day, my therapist asks the question “What is the AND?” as a dialectical exercise, that requires me to address the side of the matter that I might resist acknowledging.  How can this question pertain to my own story?

So What is the AND? – UNDERSTANDING MY DAD

Its been about 20+ years since I left that abusive relationship.  Today, I can clearly understand my Dad’s logic.  Put simply, nobody was forcing me to stay in the situation.  The solution to my misery is to leave him and move on with my life.  However, as you might expect, there’s a “BUT” coming.  It’s not as easy or simple as that…

From a First-Hand Perspective – “LEAVING IT” 

img_2877So where’s the “BUT”?  Without getting too far “off track”, I’d like to note the importance of “CONTEXT”.  The idea of walking in someone’s shoes is vital.  You can’t truly understand the problem and it’s solution until you know an individual’s lived experience.  While, my parents were puzzled: “We didn’t raise you this way?”…I was angry by their complete ignorance of the inner world of fucked-up-ness.  t was a suicidal, bullied, and ostracized as a kid .  From the time my best friend Ruby left, my life was worse than death, as an unseen pain that knew no end.  I had no friends and supporters.  Nobody was in my corner.  My parents were too busy with their careers.  My sister was self-righteous.  My extended family made me feel like the perpetual outsider as the biracial oddball.  My classmates labeled me the fruit-nut.  The teachers ignored me since I was was so compliant & obedient.  This is the backdrop that enabled me to develop such a shitty self-esteem that made “THE IT YEARS” so very attractive.  I was desperate to numb the unresolved hurts of my childhood with the most convenient band-aid that fell in my lap.  This bandaid: any promise of affection, love and belonging I could find.  Like attracts like…

Twisted Self-Deception…

So with this perspective in my mind, I can begin to construct, in a general way those things that stand in the way of progress.  Unresolved issues from an individual’s life-history exist as monkey-wrenches forestalling forward movement.  However, something still puzzles me.  The fact is I was deceiving myself much as a recovering addict was: I knew the problem and could write a novel detailing it from every possible angle.  I knew the solution, plain and simple.

What is it in the psyche that allows one to ignore facts?

In his book Vital Lies & Simple Truths, Goleman (1996) notes: “there are…vital parts of our lives which are, in a sense, missing – blanks in experiences hidden by holes in the vocabulary.  That we do not experience them is a fact which we know only vaguely, if at all” (p. 15).   Sharpio (1996) notes the perplexing nature of self-deception when he asks: “How can the knowing deceiver also be the unknowing deceived?  How can one intentionally, knowingly, not know?” (p. 786).  Definitely food for thought….

Defining Self-Deception….

The Stanford Encyclopedia of Philosophy defines self-deception as: “the acquisition and maintenance of a belief (or, at least, the avowal of that belief) in the face of strong evidence to the contrary motivated by desires or emotions favoring the acquisition and retention of that belief, (Self-Deception, 2006).”  This process of willful denial reflects a desire to uphold a preferred version of reality by editing out evidence to the contrary.  Jean-Paul Sarte characterizes this as a matter of bad faith wherein we intentionally lie to ourselves & choose pretty lies over bitter truths.  Whether we do this intentionally or not is a matter of debate.  However, based on this description, it appears self-deception functions as  complex psychological mechanism that allows us to avoid responsibility of anything that causes us anxiety.  Belief systems and personal attitudes can exist as a filtering systems allowing reality to bend according to our preconceived notions, like byproducts of self-fulfilling prophecies.

Our Relationship with Reality…

img_2878In my college literature class, many years ago the “suspension-of-disbelief” concept was discussed.  It refers to a decision on the part of the readers, to suspend any disbelief in the “un-reality” of a story so we can immerse ourselves in it.  In my opinion, self-deception works in very much the same way.  Self-deception allows us to understand our reality in a way that dispels fears and anxieties.   It allows us to develop a sensible version of external reality based on our life experiences and temperament-based attitudes.   For example, the MBTI test makes it clear that we process information & utilize it in ways that are comfortable to us.  Our past experiences are a template for making sense of life events.  In my own case, unresolved traumas from my childhood created a minefield of anxiety.

When Self-Deception is “twisted”

As stated earlier, attitudes & beliefs function as reality filters, allowing us to create an experience that reflects it.  Essentially, self-deception is a process in which our belief systems acts as self-fulfilling prophecies.  We edit out all aspects of our experience that contradict these beliefs.  In light of this, how do you explain self-deception in situations where you prefer to hold onto undesirable beliefs?  Mele, (1999), calls this twisted self-deception, “instances [in which]…people deceive themselves into believing things they do not want to be true” (p. 117).  For example, why is it that I preferred to hold onto what my childhood bullies said about me?  Why did I then subsequently choose to adopt the unwanted belief in that abusive relationship that I was unworthy of love and belonging?

What follows are some thoughts to better understand  twisted self-deception & why we would prefer to believe in negative falsehoods over positive realities

1st: unwelcome false beliefs are desired as true even if they are unwanted (Mele, 1999).

img_2895For example, we might not want to believe the burner is on after we leave the house.  However, the idea that the house burns down scares us.  Therefore, for the sake of vigilance we choose to believe we left it on.  This allows us to avoid losing our home.   When, applying this insight to that abusive relationship, an f’d up logic begins to unfold:

(((FYI – it is worth noting that the example below, constitutes my mindset 20+ years ago after I graduated high school & not how I feel today….))
*RELATIONSHIP GOALS “THEN”: to gain acceptance, love, and belong from others.
*RELATIONSHIP FEARS “THEN: To re-experience rejection, shame, & invalidation.
*THE UNWELCOME BELIEF:  I believe I won’t measure up to others expectations and that somehow all my bullies and tormentors “were right about me”.
*MOTIVATION TO BELIEVE:  Unresolved anxiety & trauma d/t undiagnosed-PTSD and a desire to avoid any “triggers”…
*”PERCEIVED” FUNCTION OF UNWELCOME BELIEF:  Worrying about others’ opinions is a byproduct of unresolved hurt, and reflects a state of perpetual hyper-vigilance, in which I actively avoid anything that might trigger old traumas.
*THE REALITY:  The reality is, we perpetuate what we deny.  My life situation was  a reflection of my mindset at the time…like a walking shit-magnet.

2nd: Unwanted false beliefs are associated with a misinterpretation of evidence….

The interesting thing about belief-systems is that we experience them as logical conclusions from life experience.  “What [we]…end up believing is determined by…the strength of the evidence for and against [a] proposition (Mele, 1999, p. 125).”  When conceiving beliefs as byproducts of experiences, we fail to see that they also define our life experiences, as well.  Failing to get this fact causes life experiences to be misinterpreted as “FACTS”:

We believe something…

We act on belief…

Life reflects these beliefs

We forget that beliefs define experiences…

We use experiences as evidences of beliefs.

Most – if not all – therapeutic approaches include insight pertaining to the notion that beliefs also exist as cause.   They are not just logical conclusion of life experience.  They also define our experience, by acting as self-fulfilling prophecies when unexamined.

3rd: Twisted self-deception reflects a desire to avoid psychological discomfort (Mele, 1999).

It is only logical that those things which occupy the greatest share of our mental energy have the biggest effect on how we perceive things.  In my own case, a blind fear of rejection overwhelmed my thinking at this point in life.  I conducted myself in all relationships according to one implicit goal: avoid rejection.  I still had not resolved the traumas of childhood.  My perpetual hypervigilance, wouldn’t allow me to.  In my own twisted mind, any evidence of rejection or disapproval was a source of great worry and stress.  I would respond by ruminating endlessly over the matter.  By attempting to avoid psychological discomfort of these triggers, I allowed my insecurities to direct the course of my life throughout my 20’s.

4th: The selectivity paradox associated with twisted self-deception reflects underlying motivational biases (Mele, 1999).

I selected unwanted false beliefs over truth due to a blinding motivation to avoid trauma triggers.  I was well-aware of the problem and its solution.  However,  overwhelming panic would result from the mere suggestion that I accept rejection willingly.  This was simply an unthinkable price to trigger pay.   Likewise, Goriski &. Miller, (2013), note that a knowledge of the problem and its solution isn’t enough to “cure addiction”.  Many addicts are brutally aware of this fact, yet feel powerless to stop given addictions powerful biopsychosocial nature.

“Addiction is a condition in which a person develops a biopsychosocial dependence…[it] is accompanied by obsession, compulsion, and loss of control. When not using the person…things about, plans and looks forward to using again…despite long-term painful consequences (Gorski & Miller, 2013, p. 39).”

Twisted Self-Deception & Coercion.

Some parallels can clearly be seen in the twisted self-deception that is prevalent in abusive relationships and addiction.  However, there are also some key differences that are worth noting.  Firstly, addiction has a biological component that explains the self-deceptive nature of one’s thinking.  Secondly, abusive relationships include an interpersonal component tha makes the self-deception much more complex.   In an article titled “On The Psychology of Self-Deception” David Shaprio defines coercion as follows:

“a type of self-deception that is enforced by external threat. This occurs not as a matter of internal submission [or internal anxiety] but as a matter of suspended critical judgment or inability to engage in rational thinking (Shaprio, 1996, p. 794).”

This is especially critical knowledge, when counseling individuals who are in various stages of extricating themselves from an abusive relationship.  What follows are a few key points worth noting on the coercive nature of abusive relationships:

“The objective relation to external reality is suspended (Shaprio, 1996, p 794).”

Abusive relationships impair your ability to thinking logically.  Knowing the nature of past insecurities, my “ex” utilized them as a coercive tool.  He dangled promises of love in front of me like carrot on a stick, (while never fully delivering).  He utilized fear of rejection as a powerful motivator that would allow me to put up with whatever he dished out.

“…the bullied and intimidated wife does not dare even to look at her angry husband. Much less can she consider what she is saying and, perhaps more to the point, what he is doing clearly. From her standpoint, merely to consider him, to look at him objectively is an act of brazen defiance (Shaprio, 1996, p. 795).”

Diminished Personal Autonomy (Sharpio, 1996)

The above quote comes from a recent post titled “Stages of Change”, in which I describe my own experiences leaving an abusive relationship.   In this particular instance, every single action I took throughout the day was coercively controlled by my ex.  I was constantly on edge and lived in fear of disappointing him.  A loss of objective interest in reality occurred through his verbal dominance, requirements of secrecy and a gradual process of isolation & imprisonment (Shaprio, 1996).  My ability to engage in a healthy discernment of the situation was inhibited, by a constant state of hyperarousal.  This perpetual state of fear-based complicance existed due to his adept knowledge of my trauma triggers.    Over time, he was able to associate “his leaving” with the realization of my “worst fears”.   My only available response in this situation was a dissociative compliance.

  1. I couldn’t see beyond my desire to avoid rejection.

  2. Rejection was a powerful trauma trigger.

  3. I was well-aware of the problem: He treated me like crap.

  4. I also knew the solution: I should leave.

  5. Knowledge alone wasn’t enough.

  6. My moment-to-moment awareness was focused only on emotional survival.

Self-Deceptions are shared constructs in an Abusive Situation.

“the objective relation to external reality, the normal attitude of judgment, is suspended or disabled, at least within the relevant area, in some cases consciously so…the subject of coercion never does come to believe in the ordinary sense that he did what he did not do. But he can be brought to the point where he is unable to sustain disbelief. To be more exact, he cannot sustain the capacity to consider the matter, to believe or disbelief…a passive, uncritical state of mind is a familiar anxiety-forestalling defense reaction (Shapiro, 1996, p. 797).”

What this quote convey’s is simply the idea that twisted self-deception is a shared by both the abuser and abused.  Both individuals are partaking in a relationship that requires them to create a reality based on self-deceptive untruths.  Additionally, the abuse victim is in an emotional state that makes rational judgment difficult – if not impossible at times.  This brings me to a final point worth noting about the twisted self-deception which occurs in an abusive relationship.

….An UnWritten Relationship Contract

Goleman (1996) suggests even health relationships are based on some degree of agreed-upon self-deception.  In his book, Goleman (1996) refers to the work of family therapists Lilly Pincus & Christopher Dare who note that an unwritten marriage agreement often exists between married partners:

“This agreement…is between the unconscious of each, and has to do with the partners’ mutual obligations to fulfill certain unspoken longings and soothe unmentioned fears. In its most general form it goes something like this: ‘I will attempt to be some of the many important things you want of me, even though they are some of them impossible, contradictory and crazy, if you will be for me some of the important, impossible, contradictory, and crazy things I want of you. We won’t have to let each other know what these things are, but we will be cross, sulk become depressed or difficulty, if we do not keep to the bargain” (Goleman, 1996, p. 157).
  1. I entered into this sort of unspoken agreement slowly.

  2. In the beginning there were promises of love and acceptance.

  3. He became the solution to all my worst fears and insecurities.

  4. Then a “boot camp” period occurred where I was transformed into his willing participant

  5. He assessed my insecurities, and feelings of low self-worth.

  6. He utilized them against me, turning insecurity into certainty.

  7. In this way, he presented me with the embodiment of your worst fears:  “I am worthless & unlovable”.

  8. In a state of constant hyper-vigilance I developed learned helplessness.

  9. Only then, was I able to fully agree to this unwritten contract that “He puts up with me & I comply fully”.

  10. Unable to see beyond my own feelings of hopelessness, I felt stuck, with no solution but to survive moment-to-moment.

CONCLUSIONS…

In this academic & personal exercise, I’m “thinking out loud”.  I’m attempting to utilize personal experience as a basis for understanding the twisted self-deception that exists as an element of an addictive mindset.  I think I’m several steps closer towards empathy, for my future clients in the recovery classes for the upcoming internship.  However, more study and experiential reflection is required to fully connect the dots.  As time progresses and new insights pop up, I will take up this train of thought up again as it pertains to issue of addiction…

THANKS FOR READING…

Image: 1

References

Goleman, D. (1996). Vital lies, simple truths: The psychology of self deception. Simon and Schuster.
Gorski, T. T., & Miller, M. (2013). Staying sober : a guide for relapse prevention. Spring Hill, Florida: Herald Publishing.
Lynch, T.R., Chapman, A.L, Rosenthal, M.Z., Kuo, J.R., & Linehan, M.M. (2006). Mechanism of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology. 62(4), 459-480
Mele, A. R. (1999). Twisted self-deception. Philosophical Psychology, 12(2), 117-137.
Self-Deception (2006, October, 17).  Retrieved from:  http://plato.stanford.edu/entries/self-deception/
Shapiro, D. (1996). On the Psychology of Self-Deception.  Social Research, 63(3). Retrieved from:  http://www.communicationcache.com/uploads/1/0/8/8/10887248/on_the_psychology_of_self-deception.pdf

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Freud’s Ego Defense Mechanisms (Psychoanalysis)

In his article titled “On The Psychology of Self-Deception”,  Shapiro, (1996) asks: “Self-deception can easily seem paradoxical. How can the knowing deceiver also be the unknowing deceived? How can one intentionally, knowingly, not know?”   While many of Freud’s concepts have long been dismissed, several aspects of his work have made a lasting impact on the field of psychology.  One of these concepts pertains to the notion of repression within the mind’s subconscious.  So why is it we lie to ourselves and hold outside our awareness a critical component of reality from our understanding??  Baumeister, et al, (1998) state the following:

“Nearly all adults hold preferred views of themselves. In most cases, these are favorable views of self—indeed, somewhat more favorable than the objective facts would entirely warrant, as nearly all writers on the self have observed. A recurrent problem of human functioning, therefore, is how to sustain these favorable views of self. Patterns of self-deception can help create these inflated self-perceptions (p. 110).”

According to Freud, upholding a preferred view of ourselves and the world we live requires some mental gymnastics of sorts.  “Defense Mechanisms are, in essence, attentional tricks we play on ourselves to avoid pain….the ostrich policy” (Goleman, 1996, p. 118).  Rosenthal, (2005) describes defense mechanisms as the mind’s ability to conceal from our awareness anything that causes us pain or anxiety. What follows is a list of common defense mechanisms.

Repression

Repression is a simple defense mechanism that involves “keeping a thought, impulse or memory from awareness” (Goleman, 1996, p. 119).  Shameful and dreadful memories or impulses that run counter to our values or idealized self-perception are “forgotten” and blocked from memory.  Freud notes that ordinary individual efforts are generally unsuccessful in recalling this information. Psychoanalysis is required (Rosenthal, 2005).  It occurs unconsciously.

Sublimation

Sublimation occurs when we channel an unacceptable and unconscious urge into something socially acceptable.  For example, a person with violence and aggressive urges can take up a job as a professional boxer (Rosenthal, 2005).   Goleman, (1996) notes that this defense mechanisms “satisfies the unacceptable impulse indirectly by taking on an approved object…[it] is the great civilizer, the force which keeps mankind manageable” (p. 121).

Reaction Formation

“Denial is a refusal to accept things as they are…[a] common first reaction to devastating loss” (Goleman, 1996, p. 120).  On other occasions, denial can pertain to an unwanted or shame-inducing impulse and/or desire.  With reaction formation we start by denying this fact or impulse and then transforming it denied into its polar opposite.   Reaction formation replaces  anxiety by producing impulses and unconsciously rejects them by producing an instinct to do the exact opposite in our mind (Rosenthal, 2005).  In doing so, it seems that we are able to prove ourselves we aren’t we what we loathe.  I’m definitely guilty of doing this as an INFP with OCDish tendencies who loathes her own absentmindedness.

Suppression

Suppression is a deliberate choice to not think about something (Rosenthal, 2005).  In other words, this defense mechanism involves a willful denial of reality.  In contrast, repression is an unconscious process that occurs out of our arenas.  It generates traumatic anxiety and pertains to those things that are way too painful to directly address.  A convenient example of this can be found here and here on my blog.

Regression

“Occurs when a person revers to a behavior that he/she has outgrown” (Rosenthal, 2005).  In this instance, individuals hope to refer to a time when they feel happy and secure.  The most convenient example I know if, includes my teenage boy’s behaviors shorty after his last heart surgery.  Normally your typically independent teenage male, in a hurry to grow up, the pain after his surgery was overwhelming.  Suddenly he had reverted to that kid who always needed me around.  Click on this link to read more about my experiences as a parent raising an ill child.  

Rationalization

Rationalization involves attempting to defend behavior and/or life outcome by utilizing a socially acceptable explanation (Rosenthal, 2005). “Rationalization allows the denial of one’s true motives by covering over unpleasant impulses with a cloak of reasonableness” (p. 121).  In other words, these are slick lies we tell others and ourselves in order to avoid revealing our true motives.  The best example I have of this comes from my youngest son, during dinner.  He looks at me with his best innocent smile and states: “I want to save some of this for you”, and then grabs dessert.

Projection

Projection involves attributing a character trait to other people that you despise in yourself (Rosenthal, 2005).  Goleman (1996) describes this as a distancing of one’s own emotions.  This occurs in a two-step process.  First, we deny a certain aspect of ourselves that we dislike.  Then, once blocked out of consciousness, we “displace those feelings outward onto someone else…Once cast out onto someone else, the projected part of the self is encountered as though it were a complete stranger” (Goleman, 1996, p. 121).  For a convenient example of projection, click here.

Displacement

Displacement is a defense mechanism that refers to how we handle pent up negative feelings.  It involves expressing hidden and unconscious feelings or instincts onto a convenient target.  The first step in this process involves a denial of some hidden emotion or instinct.  The second step involves a purging of negative emotions associated with this denied aspect of ourselves.  For example, lets say you’re mad at your husband and frustrated at work.  So you go home and scream at your wife and kick the dog.  This is displacement.

References

Baumeister, R. F., Dale, K., & Sommer, K. L. (1998). Freudian defense mechanisms and empirical findings in modern social psychology: Reaction formation, projection, displacement, undoing, isolation, sublimation, and denial. Journal of Personality66(6), 1081-1124.
Goleman, D. (1996). Vital lies, simple truths: The psychology of self deception. Simon and Schuster.
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Shapiro, D. (1996). On the Psychology of Self-Deception.  Social Research, 63(3). Retrieved from:  http://www.communicationcache.com/uploads/1/0/8/8/10887248/on_the_psychology_of_self-deception.pdf

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Feeling the Gratitude….(& A Few Oprah Favorites)

6230854973_52df93805d_zThis week a beloved member of our family died. His name was “WARFY”.  He was a 19-year-old cat my husband got from a farmer while looking at a camper shell from a local craigslist ad. This elderly man had about 20 animals on his farm and was having difficulty “keeping up with them”. As a big Star Trek fan he decided to name his pets after various characters from the show. My husband fell instantly in love with two tiny kittens who were born from the same litter. “WARFY” was the large, dominant and friendly one. “DATA” was a much more shy and reserved feline….

….At any rate, I remember getting ready for my Sunday night shift and passing Warfy as he was attempting to climb up the stairs. He stopped part way and looked up at me as if to say, “Can you carry me the rest of the way?” I called my son and had him grab our old friend. I told my boys, that the time is near and they need to say good-bye. At 16 and 10, they did understand, but it was nonetheless difficult for them. He passed in his sleep some time that night while snuggling next to my oldest son….

image….Fast-fowarding a couple days, I’m was confronted with more sad news today. My son came home today and told me his friend’s mother just died at the age of 31, due to complications from drug and alcohol use. This was like the cherry on top of a sundae. Throughout the week as a therapy student and healthcare worker, I’m already inundated with sad news.  this sort of ring-side seat tragedies and turmoil definitely leaves is impact upon me…

…Today, while scrolling through the OWN Network Youtube Videos, I found myself watching on a few random clips and reflection upon the happenings of my week.  Here are a few favorites …

The Power of Gratitude….

imageThis video discusses the power of gratitude:  a feeling of appreciation and thankfulness.  I am a big believer in the idea that what you focus on expands.   In other words, like attracts like.  If all you do is complain, what you get back in life is more to complain about.  Focusing instead on what you have to be grateful for is a powerful force for change.   My job is helpful in putting things into perspective, I’m profoundly aware that life itself is a gift.  Tomorrow isn’t a guarantee.  Every day, is all there is…..

imageI’m grateful for my two boys & the opportunity I have to watch them grow into two young up.  I almost lost my oldest son & endured a miscarriage before having my youngest.  I love these two boys with every ounce of my being…

imageI’m grateful for my “partner in crime”.  He has brought into my life the experience of knowing what it is to be truly loved.  I am grateful for this in ways words don’t describe after surviving a “dysfunctional” relationship in my youth…

Finally, I’m grateful for 40+ years of perfect health.  I’m grateful for all the life experiences that brought me to the present moment.  They have allowed me to grow into the person I am today.  I spent my youth working through unresolved traumas.  I now have opportunities to work on myself, uncover my true potential & life purpose.

History or Destiny?  Which one are you choosing today???

“When you hold onto your history, you do it at the expense of your destiny….” – T.D. Jakes

I love this tidbit, definitely an “AHA MOMENT”.  As this video notes, you only have so much energy in life to give.  The question which then naturally comes to mind is: where are you focusing your energy?   It has taken me many years to let go of old traumas, and begin forgiving unresolved transgressions within my family.  As T. D. Jakes also notes: “Forgiveness is a gift you give yourself”

Taking Responsibility…

“When you know better you do better” – Maya Angelou

Here, Oprah describes feeling alone after being moved away from her grandmother.  She states she came to understand then that “If anything is going to move forward in my life, I have to be responsible for making it happen.”  This means seeing yourself as a solution the the problem, and living by the serenity prayer.  What can you change?  Focus on this.  What is beyond your control, (i.e. other people and/or circumstances)?  Let it go, forgive, and move forward…..
*The power to change things is in the present.  Put all your focus here….
*Be willing to see things for what they are.  This requires a bit of Radical Acceptance…
*Take constant & consistent action in the direction of your goal.  

Believing in Yourself

You become what you believe you are and you get what you believe is possible.”– My Mother …

imageBeliefs when unexamined exist as self-fulfilling prophecies.   Oprah calls these “Shadow Beliefs”.  Examining these belief systems and understanding them is critical to “Getting Unstuck”.  Failing to do so, means acting on all your unresolved bullshit.  You perpetuate what you deny endlessly like a hamster on a wheel.  Understanding this, has allowed me to dig deeper, into the true nature of my motivations.  What drives me forward?  As Oprah notes, until you understand this, all you can do is mindless acting on your shadow belies. In the end, you’re running away from what you don’t want, according to a predefined and skewed belief system.

The Secrete to Surrender…

“God can dream a bigger dream for you than you could dream for yourself – Oprah”.

I still struggle with this life lesson.  Surrendering control and allowing things to happen is difficult for me.  However, I’ve noticed that when I hold too tightly to something it escapes my grasp.  For much of my life I’ve felt “perpetually stuck”.  Creating forward motion has required me to learn to let go.

*I’ve set goals for myself.

*I strive to achieve them.

*I’ve hope for a successful outcome.

*I’m doing all I can, one step at a time.

*I surrender & hold onto my faith.

*Things will fall into place as they are meant to….

*This is what is meant by “letting go”

Love Liberates

“I’m grateful to have been loved and to be loved now & to be able to love because…love liberates it doesn’t hold – that’s ego.  Love liberates.  – Maya Angelou”

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NCE STUDY – Understanding LGBT Clients…

(((I am currently studying for a licensure exam & completing an internship.  This blog post is intended as a study exercise.)))

PART ONE: A Literature Review Paper…

According to research, higher rates of mental health diagnosis, substance abuse and suicidal ideation exist within the LGB by community (Biescheke, et al, 2007, Hays & Iwasama 2006; Herek & Greene, 1998).   With mental health diagnoses concentrated in the areas of anxiety, depression, and suicidal ideation, it is important to note these issues are commonly correlated with “minority stress” in research, (Biescheke, et al, 2007, Hays & Iwasama 2006; Herek & Greene, 1998). Defined as a form of social stress related to stigmatized minority status, it will be essential to start off with a discussion of this concept. (Meyer, 2003, p675).

In this paper, I begin by discussing the concept of “minority stress”. I then discuss key issues common within the LGB community: identity development, coming out, and internalized homophobia. I conclude by providing a summary of how these key issues affect LGB youth and how to develop a treatment plan with these factors in mind.

Minority Stress.

In attempting to understand the concept of minority stress, it is vital to understand how discrimination exists as its cause. With social discrimination bringing about a stigmatized status amongst LGB minorities, the result is the minority stress they are forced to contend with (Herek & Greene, 1998; Meyer, 2003)

Discrimination as Cause.

Firstly in contextualizing the nature of minority stress, it is important to understand the nature of the discrimination they encounter. In a book titled “Stigma and Sexual Orientation” there is a brief review of research that examines the underlying motivations of assaultive acts against LGB victims. The conclusions made from this research are that assaults on LGB individuals can be seen as resulting from motives best defined as “a learned form of social control of deviance”, (Herek & Grene, 1998, p7). In this respect the motives aren’t entirely personal in nature, but simply an extreme form of gender norm reinforcement, (Herek & Greene, 1998).

“To reconcile the apparent contradiction between the socially normative attitudes held by assailants and the visciousness and brutality of their behavior….during the course of my research I came to conceptualize the violence not in terms of individual hatred but as an extreme expression of American cultural stereotypes and expectations regarding male and female behavior…From this perspective, assaults on homosexuals and other individuals who deviate from sex role norms are viewed as a learned form of social control of deviance rather than a defensive response to personal threat.” (Herek & Greene, 1998, p7)

Stigma as Cause of Minority Stress.

With this perspective in mind it is important to note that the definition of stigma is simply a “characteristic of persons that is contrary to a norm of social unity”, (Herek & Greene, 1998, p108). Key aspects of the underlying causes of stigma exist external to the individual. Additionally, when you note that such a stigma is associated with an elemental component of one’s overall identity, the result is minority stress. Understanding the nature of this minority stress as comprising an array of interrelated individual and social factors is essential, and will be discussed next.

The Nature of Minority Stress.

It is clear, when taking time to understand the nature of minority stress, it exists as an interrelated set of social, group, and individual components, (Meyer, 2003). For example, society is comprised of social structures that appear to stand against an LGB minority lifestyle. Additionally, the social environments in which an LGB individual lives often create a meaning system that completely negates their experience (Meyer, 2003).   Against these social factors, are other variables such as family dynamics, social environment, and individual factors that also play a part. For example, individual factors such as methods of handling stress and forms of cognitive appraisal influence the nature these social factors have on a person:

“The more an individual identifies with, is committed to, or has highly developed self-schemas in a particular life domain, the greater will be the emotional impact of stressors that occur in that domain.” (Meyer, 2003, p678)

Distal / Proximal View of Minority Stress

In attempting to bring some clarity to the interrelated factors that comprise minority stress, a research article I found (Meyer, 2003), describes an interesting perspective of stress worth mentioning. Firstly, this research proposed that stress is comprised of three components as discussed in the following quote:

“I have previously suggested three processes of minority stress relevant to LGB individuals. From the distal to the proximal they are (a) external, objective stressful events and conditions (chronic and acute), (b) expectations of such events and the vigilance this expectation requires, and (c) the internalization of negative societal attitudes. (Meyer, 2003 p676)”

While well beyond the scope of this paper, the article then goes on to provide some discussion of how such factors are interrelated.   The crux of this theory’s proposed stance is that such abstract social concepts become relevant psychological through the manner in which we decide to cognitively appraise them (Meyer, 2003, p676).

Common LGB Issues

In attempting to further put into perspective key issues common within the LGB community, a few key observations can be made that help put them into context.   In this section I discuss three key issues in the LGB community: (1) identity formation, (2) coming out, and (3) cognitive appraisal.

Identity Formation.

“In social identity theory and identity theory, the self is reflexive in that it can take itself as itself as an object and can categorize, classify, or name itself in particular ways in relation to other social categories or classifications.” (Stets & Burke, 2000, p224).

As the above quote indicates a person’s identity is essentially an internalized subjective construct of “you”. (Stets & Burke, 2000). In this respect, it can be thought of as a byproduct of our interpretations. For individuals with a sexual minority status, developing a positive identity is problematic as a result. (Bieske, et al, 2007, p19).

Before going further it must be noted briefly, that much in-group diversity exists within the LGB community. For example, contextual factors such as cultural background, sexual preference, and gender orientation influence individual LGB identities. Adding to these factors is the historical context within which a person lives.   Finally, adding to the confusion is the fact that the three components of sexual orientation (same sex identity, same sex behavior, same sex attractions) don’t exist in equal degrees with all LGB identifying persons, (Hays & Iwasama, 2006). Finally, while stage theories help to conceptualize the identity formation process, it must be noted, that identity development isn’t necessarily experienced like that first-hand. Instead often described as a fluid and abstract notion, it is more accurately understood as a lifelong process.

Coming Out.

It is important to note, that unlike many minority groups, LGB individuals have the option of concealing this stigmatized status (Hays & Iwasama, 2006). Early on in the process of LGB identity development, this concealment is often an essential coping mechanism. Having said this it should also be noted that coming out “is associated with lower psychological stress” (Hays & Iwasama, 2006, p224).

Internalized Homophobia.

Another key factor to note, that makes the LGB community unique amongst all minority groups, is their status is often not shared within the family (Hays & Iwasama, 2006). As a result, LGB individuals are often raised within a cisgendered, heteronormative environment to varying degrees (LGBTQA, 2014). The consequence of this is a learned belief system defined as “internalized homophobia” (Hays & Iwasama, 2006). Overcoming this is key in the coming out and identity formation process for LGB individuals.

Counseling LGB Youth.

In taking time to consider what the concept of minority stress means in the daily lives of LGB youth during key developmental years, concepts such as Marsha Linehan’s “invalidation” and Brene Brown’s “shame” come to my mind.

LGB youth, in the early developmental stages of form an adult identity, often deal with the issues above as an internal struggle without little outside guidance.   In doing research for this paper, I found two great resources that were helpful in allowing me to develop a rudimentary understanding of how to begin to formulate a treatment plan for this community of individuals. In providing counseling for any LGB youth, the eclectic counseling perspective mentioned in our Hays textbook, (2006), would be my starting point. Key insights, such as what I discuss from these resources, will be helpful in the ongoing case conceptualization and treatment formulation process.

Early LGB Identity Development.

The first key insights I found beneficial were within the video link provided in the assignment description for this week. Titled, “Working with Gay/Lesbian Youth Clients”, this video provides samples of counseling scenarios with LGB youth clients. What I found most interesting were the varied stages of development displayed within each counseling session.   With each stage of development there exists a unique set of characteristics, and counseling considerations with each stage. I discuss each of these stages briefly below.

Identity Confusion Phase.

During this early phase of LGB identity development, the client is experiencing a growing internal awareness that is not well defined.   As noted earlier, the majority of LGB individuals often hold this minority status alone in the family. Without any family or friends to provide guidance, the growing internal awareness can be experienced at first as just “being different somehow” (Sage Productions, 2014). Often understood within a heteronormative family environment, the growing awareness of homosexuality exists against within an array of denial strategies.   Often not ready to admit such feelings outwardly, or put labels to things, ongoing self-rejection is an early core issue. Key goals during this stage include: (1) empathetic listening, (2) building trust, (3) validating confusion, (4) assessing suicide risk potential, and finally (6) probe for greater specifics regarding situations and associated feelings, (Sage Productions, 2014).

Early Identity Acceptance.

During the early identity acceptance stage there exists a clear awareness of the nature of one’s attraction. With a greater degree of awareness, there still exists much internal confusion and heightened degrees of anxiety in moving forward.   Key goals during this stage include: assessing the use of support systems and providing tools with which to address anxiety in a healthy manner (Sage Productions, 2014).

It is useful to note, in concluding my remarks on this stage with a brief quote from another resource that sheds light on the importance of a support system for LGB youths:

“Through reappraisal, the in-group validates deviant experiences and feelings of minority persons….It is important to distinguish between group-level and personal resources because when group-level resources are absent, even otherwise-resourceful individuals have deficient coping. Group-level resources may therefore define the boundaries of individual coping efforts.” (Meyer, 2003, p677)

Late Identity Acceptance.

With greater internal clarity and awareness of oneself, the process of coming out to oneself and others becomes the overarching goal during this stage. Continuing to assess the degree of clarity, helping clients to forge a new positive identity will be important focuses during this stage of the counseling process.

In concluding this brief discussion on LGB Identity formation, it must be noted that much in-group variation exists. An in depth discussion of this matter is well beyond the scope of this assignment. Therefore, this discussion is just a brief cursory overview that is helpful for me as a useful as a form of rudimentary case conceptualization.

Addressing Key Stressors For LGB Youth.

“Four stressors are of particular importance to lesbian, bisexual and gay youth, (a) overt acts of abuse, harassment, and violence, (2) development of one’s identity as a sexual minority person and related internalized homophobia, (3) disclosure of sexual orientation to others and related lack of adult social support, and (4) development of platonic and romantic relationships with other lesbian, gay male, and bisexual peers.” (Safran, et al, 2001, p217)

Understanding key issues associated with a stigmatized sexual minority status as an LGB youth is one critical matter that cannot go without mention. When you consider the overt expressions of hatred, heteronormative environments along with a scarcity of social support, the heightened risks to an individual’s well being become clear. An article titled “Cognitive Behavioral Therapy with Lesbian, Gay and Bisexual Youth”, lists stress reduction, anxiety, and depression as three key issues for individuals in this community, (Safran, et al, 2001).  I discuss each of these in turn briefly below:

Depression & CBT.

As per the cognitive behavioral perspective, stigmatizing experiences alongside negative environment factors and a “dysfunctional attribution style” are what lead to feelings of hopelessness in LGB a youth (Safren, et al, 2001). Utilizing CBT techniques such as cognitive restructuring are useful in addressing negative preconceptions of any same-sex attraction, (Safren, et al, 2001, p221).   Alleviating thinking errors such as “catastrophizing” (Safrem, et sl, 2001), and self-blame, can help with depressive systems. The importance of this consideration becomes clear in light of the higher rates of substance abuse and suicide associated with the greater prevalence of depression,

Anxiety & CBT.

It’s not surprising that LGB youth experience higher rates of social anxiety when you consider the lack of social support they often receive. In fact, preconceived “what if’s”, (often in the form of worst case scenario conceptions), frequently underlie this anxiety, and can produce an avoidance-based coping style. Ultimately, this fear of self-disclosure and social situations can only limit normal adolescent development.   Assisting LGB youth through cognitive restructuring and varied forms of social support can give these individuals a new frame of reference with which to move forward (Safran, 2001).

Stress Reduction & CBT.

“It is not the stressors themselves that cause depression but that one’s cognitive interpretation plays a mediating role. From a cognitive-behavioral perspective, external acts of homophobia, if occurring chronically, uncontrollably, or unpredictably, can lead to internalized homophobia, as well as helpless or hopeless attributions.” (Safram, 2001, p222).

Addressing one’s ability to cope with daily stressors is yet a final key priority that cannot go without mention. In fact, I find this notion of internalized homophobia as a root cause especially troubling. It will be useful to conclude this paper by discussing internalized homophobia (and the stress that comes with it), from within the framework of the earlier discussion.

Firstly, it is important to note that LGB discrimination is best understood as “a learned form of social control of deviance”, (Herek & Greene, 1998, p7). Stigma resulting from this is simply due to holding a characteristic which “is contrary to a norm of social unity”, (Herek & Greene, 1998, p108). Based on these definitions, internalized homophobia can be thought of as a stigmatized self-concept based on discriminatory experiences. This internalized homophobia, influencing ones identity and belief systems, produces minority stress as a result, (Herek & Greene, 1998; Meyer, 2003).

Having said all this, I conclude with the thought that it seems once belief systems of ourselves become internalized they exist as self fulfilling prophecies. We become what we believe we are and get what we are told is possible. CBT a can become a much-need coping tool in this by helping LGB youth understand they always have the ability to choose otherwise.

PART TWO: Exploratory Exercise Paper….

((ABSTRACT – In this paper I provide a summary of my experiences in joining in with an LGBTQI University Organization Meeting.  I start with a review of relevant literature and end with a discussion of insights gained.  From this experience I have concluded that continued service within this community is essential in order to serve it effectively as an LGBTQI ally.))

Initial Thoughts

Approximately, 33% of females and 37% of males have had a climax with somebody of the same sex after 18 (Rosenthal, 2005).  Additionally about 10% of the U.S. Population identifies as gay & lesbian (Rosenthal, 2005).  A quick literature review shows a higher rate of mental health diagnosis, substance use, and suicide within the LGBT community as a whole (Biescheke, et al, 2007; Herek & Green, 1998).    Additionally, mental health diagnoses heightened in the areas of depression and substance use (Biescheke, et al, 2007; Herek & Green, 1998).  Additionally, a book titled “Stigma & Sexual Orientation (Herek & Green, 1998), makes it clear that discrimination (and the stigma that exists as result) are predominant causes of these high rates of mental health and substance abuse problems.

To understand this discrimination as cause, it is important to step back and understand the concept of identity a bit.  As the above quote alludes to, identity is an internalized construct of the self, based on an interaction with others and the environment.  When you consider how discriminatory acts against one’s very identity, I can only imagine how stigmatizing and shame-inducing and invalidating this might be. Defined as “a characteristic of person’s that is contrary to a norm of social unity” (Herek & Green, 1998, p. 108), stigma can produce a highly problematic identity formation process.  When taken alongside ostracizing reactions of family and friends LGBT individual’s internalized homophobia, transphobia and minority stress are often the norm (Herek & Green, 1998).

Summary of my Experience…

(((Here I provide just brief excerpts from my paper, in order to show, that there is much left to learn.  As I have discovered, intention means little if there is no action to back it up.  Understanding the privilege that comes with being a cisgendered heterosexual is critical.  Ignorance is never an excuse for any shortcomings in my desire to act as an LGBTQI ally as a future counselor)))

The Importance of Community….

“An element included in virtually all sexual-orientation models is finding and developing some sort of connection to the LGBT community. Community is important in helping break the sense of isolation and despair that can occur from being different, which is an early piece of identity development, (Biescheke, et al, 2007, p. 213).”

The first thing that struck me was how welcoming and friendly everyone was.  While I am a cisgendered heterosexual, I felt an immediate belonging and camaraderie within the group.  As a bullied child with few friends, I also struggled in my teens and 20’s.  It is for this reason, that I immediately appreciated the efforts of this organization to provide members a chance to interact with others who implicitly understood them.  The interaction was light-hearted and fun.  We decorated cookies while watching a movie and engaged in casual conversation.

In-Group Trust.

Implicit social norms existed that presumed an understanding of relevant social norms.  These implied social norms appeared to allow a heightened level of trust to exist amongst participants regarding things such as proper rules of preferred pronoun usage for example.   As somebody mentioned to me at one point: “It is simply nice to just hang out and have fun”.  This comment really struck me as I came to appreciate in that moment the privilege of cisgendered heterosexual.   I was able to just be me unselfconsciously.  For example, the idea of being “clocked” as a trans person, puts you constantly on edge.  I came to realize how luck I was to not know what this is like.  The idea of in-group trust stands out as a essential from this perspective.  Community organizations such as this provide participants a chance to be themselves “unselfconsciously” as I live my life 100% of the time.

I left the experience wondering if my own ignorance regarding the LGBTQI community reflected what I’ve witnessed within the extended family as a biracial child.  While I cringed at the thought of this, I reminded myself that all I can do by denying this fact is perpetuate it.  Self-awareness, on the other hand, is ultimately empowering if it leads to change and growth.

“privilege also tends to isolate people, cutting them off from information and experiences related to specific minority groups that could be helpful and enrich their lives…privileged areas are often in those areas in which people hold the least awareness.” (Hays, 2008, p. 42).
 

Identity as a Foundation of Self

During this meeting I became aware elemental sexual preference and gender identity are as fundamental aspects of daily living.  While conceived of in black and white terms for the cisgendered heterosexuals,  these concepts in reality are much more fluid. This fact helped me understand better why LGBT community in Omaha was so protective.   I left this experience with a profound realization of how being LGBTQI can potentially affect  all aspects of your life.

In-Group Diversity

The LGBTQI community is very diverse and is an umbrella term that comprises many sub-groups.  For example, sexual orientations vary greatly from lesbian, gay, bisexual, and even asexual.  Additionally within the trans community you have concepts such as FTM, MTF, bigender, gender, trans, and genderqueer.

**Here’s a link to a list of terms that I could useful.
**Here are some tips to being a better LGBTQI ally.

In conclusion, it appears there is much left for me to learn.  Developing multicultural competency will be a life-long commitment & personal journey as I increase my understanding of those communities I hope to serve within.  

References

Bieschke, K.J., Perez, R.M., & DeBord, K.A. (2007). Handbook of Counseling and Psychotherapy with Lesbian, Gay, Bisexual and Transgender Clients. Washington D.C.: American Psychological Association.
Bilodeau, B.L. & Renn, K.A. (2005).  Analysis of LGBT Identity Development Models and Implications for Practice. Gender Identity and Sexual Orientation: Research, Policy and Personality. 111, pp. 25-39.  
Hays, P. (2008). Addressing cultural complexities in practice. (2nd ed.) Washington, D.C.: American Psychological Association.
Hays, P., & Iwasama, G.Y. (2006). Culturally Responsive Cognitive-Behavioral Therapy: Assessment, Practice, & Supervision. Washington, D.C.: American PsychologicalAssociation.
Herek, G.M. & Green, B. (Eds.) (1998). Stigma and Sexual Orientation. (Vol. 4). Thousand Oaks, CA: Sage Publications.
Johnson, R. (2013) Forensic and Culturally Responsive Approach for the DSM-5: Just the Facts. Journal of Theory Construction & testing. 17(1), 18-22.
LGBTQI (2014). About LGBTQI+ In Lincoln, Nebraska. Lincoln, NE: University of Nebraska Lincoln.
Mays, V.M., Cochran, S.D. (2001). Mental health correlates of perceived discrimination among lesbian, gay and bisexual adults in the United States. American Journal of Public Health. 91(11). 1869-1976.
Meyer, I.H. (2003). Prejudice, social stress and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin. 129(5). 684-697.
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Safren, S.A., Hollander, G., Hart, T.A., & Heimberg, R.G. (2001). Cognitive-behavioral therapy with lesbian, gay and bisexual youth. Cognitive and Behavioral Practice. 8. 215-223.
Sage Productions. (2014) Working with Gay/Lesbian and Youth Clients. Retrieved from:https://ssoblackboard.bellevue.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2Fwebapps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_328162_1%26url%3D
Stets, J. E., & Burke, P. J. (2000). Identity theory and social identity theory. Social Psychology Quarterly, 63(3), 224-237. Retrieved from http://ezproxy.bellevue.edu:80/login?url=http://search.proquest.com/docview/212780126?accountid=28125

 

 

 

 

 

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NCE STUDY – Asian American Families

(((I am currently studying for a licensure exam & completing an internship.  This blog post is intended as a study exercise.)))

Understanding Acculturation…

“Asian Americans represent a wide range of diversity to the extent to which they have adopted the norms of the dominant US culture and retained the norms of the traditional Asian culture” (Trihn, et al, 2009, p. 25).  While enculturation is the process of acquiring the norms and values of a particular culture, acculturation is a process of socialization that occurs when an individual is influenced by two cultures.  With acculturation, immigrants struggle to maintain values from their country of origin, while learning to adapt to the norms of the dominant culture they live in.   The process of acculturation differe greatly from family to family as well as amongst individual members.  Triton, et al, (2009) notes that a “problematic distancing occurs between immigrant parents and children” (p. 27), when varied rates of acculturation occur within each generation.  This is commonly known as a “cultural gap”, wherein “parents tend to cling to values from their culture of origin….[while] children might increasingly adopt the norms of the dominant society (Trihn, et al, 2009, p. 29).  As I have experienced personally within my own diverse extended family, children are often raised hearing mixed message and are left to “figure things out” on their own.  LaFramboise, et al, (1993) define acculturative stress as a “worsened mental health status…anxiety, depression, feelings of marginality, alienation, and identity confusion (p. 29).”  Lee, et al, (1996), describe five types of Asian Families based on the dynamics of this acculturative transition

  • TRADITIONAL FAMILIES: “consist entirely of individuals born and raised in Asia, with little exposure to Western Culture (Lee, et al, 1996, p. 275)
  • FAMILIES IN CONFLICT:  Families in conflict often immigrate to the United States with young children.  As a result, children are acculturated into American society while parents and grandparents tend to uphold traditional values.
  • BICULTURAL FAMILIES:  La Framboise, et al, (1993) defines biculturalism as an ability to operate effectively within two cultures.  As a result, well acculturated parents, who hope to instill in their children a pride and appreciation for their own ethnic identity.
  • AMERICANIZED FAMILIES: All family members adopt mainstream cultural values.  My mother has preferred to adopt this acculturative style, and as a result I know little about her home country
  • NEW MILLENNIUM FAMILIES:  These families go “beyond prior cultural expectations and are forging new identities…’integrate multiple cultures… (Lee, et al, 1996, 275)”  ‘

Values & Belief Systems…

Asian Americans comprise about 3% of the U.S. population, (4,000,000 people), (Rosenthal, 2005).  By 2050 it is estimated that this population will grow to about 8%.  Relatively little is known in literature about Asian Americans.  Rosenthal, (2005) states that “one theory for this is that very few Asian Americans have very few problems and are very successful and thus researchers are not giving this group attention that they deserve.”  What follows is a “quick and dirty” overview of key insights that should be kept in mind when counseling Asian clients..

  1. COLLECTIVIST IDENTITY:  As an American it is important to understand a collectivist identity.  Doing so requires one to set aside, (for the time being) the idea of individualism.  Seeing yourself as part of something greater than yourself is essential.  Identity is constructed based on a different point of reference.  For example, in my mother’s culture life centers around family and plays a central role in daily life.
  2. PATRIARCHAL FAMILY LIFE: The vast majority of Asian cultures have a very patriarchal structure, where the dad has a wealth of authority (Rosenthal, 2005).  However, the degree of patriarchalism that is presented in an Asian family, depends on the degree of acculturation.  Additionally, Asian countries with a greater westernized sociocultural influences tend to be more egalitarian in nature.  This is especially true in the Philippines, where my mother was raised.
  3. GUILT & SHAME:  My mother comes from a collectivist culture in which family life is central to daily living.  For example, she is still called “Nene” which means baby.   Additionally, she discusses the notion of “DUTY” as a responsibility to her family.  This notion of “duty”, while foreign to me is very important to her.  It is by fulfilling this “duty” to family members that she expresses her love as a wife, mother, sister, and daughter.  Integral in this belief system is a form of social control that parents utilize on children to encourage compliance.  Failure to respect your elders and live up to your “duty” can produce feelings of shame and guilt.
  4. COLLECTIVE TRAUMA:  Asian families often have complex migration histories that involve political upheaval and wartime experiences (Lee, et al, 1996).  For example, my mother’s family survived WW2 and eventually immigrated to the United States for a better life.  A complex history of trauma exists within their family history with lasting, profound effects.
  5. ACADEMIC PRESSURE – There is a greater pressure to succeed within Asian families.  For example, Rosenthal (2005) notes that while 41% Asian mothers say academic is critical, only 11% of white mothers hold this belief.
  6. BODILY COMPLAINTS EQUATED WITH EMOTIONAL ILLS (Rosenthal, 2005).  Rosenthal notes that oftentimes Asian cultures equate emotional problems with physical ailments.  As a result, it will be important to investigate all physical complaints thoroughly to develop an understanding of the underlying cause.
  7. LESS LIKELY TO SEEK THERAPY –  Rosenthal, (2008) also notes that Asian Americans are less likely than other demographics to seek therapy.  As a result, when thy do seek therapy, they are often extremely disturbed.  Additionally, Rosenthal (2008) states Asian Americans have a higher incidents of depression than any other minority group.
  8. STOICIM = MATURITY:  In many Asian cultures, a “lack of emotional expression represents maturity…[and] silence is seen as an act of respect.” (Rosenthal, 2008).  As a result, it will be important for therapist to “carry ball more” (Rosenthal, 2008) during therapy and lead the conversation with well-thought out questions.

ADDENDUM:  Exploratory Interview Paper.

In this paper I share the insights gained from an interview with my mother. In addition to learning about my mother’s background, I got to know more of our relationship with one another from her perspective.   I will begin by utilizing the addressing model and move on with a summary of the interview. In addition to sharing insights about my mother’s culture, I will add a bit of personal reflective commentary. At the end of this paper I have provide a transcription of the recorded interview.

Utilizing the Addressing Model

In this section, I utilize the Addressing model, as discussed in our textbook. This model acts as a framework around which to explore the influence of my mother’s culture on her own belief systems. As I have come to understand it, these cultural belief systems, affect many elements of a person’s life. In addition to defining a life perspective it also influences your identity, feelings, thoughts, and interactions with others, (Fortune, 2012; Hays, 2008). The cultural gap has between us has been an ongoing struggle.  The importance of multicultural sensitivity is vividly apparent to me. For the sake of brevity, I discuss the key areas of greatest relevance for my mother, having the biggest impact on her identity. I provide only a brief overview of details relevant to my mother’s life history within each relevant area. In a later section I share these specific arenas of life were relevant to her development in her own words.

Age and Generational Influences.

The Silent Generation. My mother was born in the Philippines in 1938, moved to the states in 1965, and has lived here since.   A member of the silent generation that preceded the baby boomers, my mother’s earliest years were in the midst of a war. While she has little memory of her earliest years of life, according to records she’s uncovered, her dad signed up for the “USAFE” (United States Army of the Far East), just one day after the bombing of Pearl Harbor. The date this occurred was December 8th, of 1941.   With her father away, her mother was left alone with a three year old and five year old.   While completely ignorant of the realities of war in my own life, I have an appreciation of the effects it had on my mother’s family.   They had to develop a toughness that served them well as the war came to a close in their survival.

Extended Family Influences. The Philippines is much more collectivist in its orientation in comparison to the United States which is clearly individualistic (Fortune, 2012; Root, 1997). The extended family is central to one’s life and identity. For example, in the United States the focus is on our own goals their achievement. In the Philippines, on the other hand, the well being of the extended family is a primary consideration (Fortune 2012; Root 1997). This can be seen in the way members of the family, will sacrifice of themselves, for the sake of the family. It can also be realized in the way family harmony and psychological-well being of the extended group takes precedence over individual insecurities and any need to vent pent up emotions (Fortune 2012).

Extended family influences go well beyond one’s degree of personal orientation toward a collective unit. According to my mother, the Philippines is very much a melting pot. While the majority of the country is Catholic, they also display influences from other religions such as Confucianism. As a result of this, it is a well-known but unspoken rule within the family that children display absolute obedience to elders. Any elders, whether strangers, older brothers, parents, uncles are to be shown respect. Finally, one interesting fact seems to illustrate to me how much membership to the family defines your identity. Within the family, siblings do not call each other by name, but by birth order.   My mother was “Nene”, as the youngest in the family, this word in Tagalog means “baby”. My aunt on the other hand was the older sister and was called “Ate”, for big sister.

Developmental Disabilities.

While my mother has no disabilities to speak of, she is a retired Clinical Cytogeneticist and worked in the Center for Developmental Disabilities at the University of South Dakota. One of her tasks was counseling parents of children with developmental disabilities. Her support was very critical when my oldest son was born with a congenital heart defect.   Very ill, needing several heart surgeries, these medical issues affected his childhood development for quite some time. Through her support and educated background, I feel I was able to handle the situation well as a parent of a sick child.

National Origin & Racial Identity.

Racial Identity. As a Filipino who immigrated to the United States in the 60’s my mother is definitely a minority in this culture. Having said this, she does make a point to note that she was raised in the Philippines, and was part of the “majority” there.   Everyone, like her was Filipino, and so race was an inconsequential issue she gave little thought to. Therefore, issues such as “Insidious Trauma”, (defined by Maria Root as “trauma associated by a devalued identity in a dominant culture,” (Hays, 2008, p115)), don’t apply to her.

This isn’t to say she didn’t experience racism, as she will note in her interview summary below. Nonetheless, she has noted a set of coping skills that many who had lived their entire lives as a minority didn’t have.   Part of the problem for many who were raised here, she notes, is the racism experienced, was throughout critical years of childhood development. Nonetheless, she also says there is more to the issue that. While the Philippines and American are both melting pots, she has stated there was a different preconceived reaction to the idea of different groups blending together. Growing up, it was know the Philippines was a melting pot was a non-issue and that everyone there was the byproduct of many blended cultures.   In fact, there are Spanish, and Chinese ancestors in her family. In contrast to this, she felt this culture seemed to hold the idea of differences between various groups as being significant in a way she didn’t understand. For example, the idea of marrying a white man and having mixed kids to her wasn’t a big deal. Despite this, in the late 60’s and early 70’s she felt people reacted sometimes to this in a manner she didn’t quite understand.

National Origin. As an immigrant, my mother’s biggest issues have been associated with attempting to honor her own values while having to learn about a whole new culture. Finding a balance between these two competing value systems is best described as “bicultural competence” (LaFramboise, et al, 1993). The greatest ambivalence she experienced was in raising her two daughters. Living in a small town in the Midwest with few minorities and foreigners, she had little support. Adding to this was the fact that she was separated from her extended family, another critical support system, unavailable to her.

Socioeconomic Status.

My mother’s socioeconomic status and background are quite intriguing to me. Currently, my mother and father are both retired doctors and upper middle class in their background. Additionally, growing up, her extended family was also considered solidly upper middle class.   For example, she notes her parents were able to afford to put two girls through medical school. Without any loan programs, advanced education, was available only to those who could afford it. She was very lucky.

On the other hand, despite this fact, there are a few unique details that differentiate the meaning of social class for my mother.   Firstly, she said, the overall standard of living was different from the United States.   This made her experiences of blending into my dad’s upper middle class background still quite difficult. She didn’t quite understand the materialistic perspective whereby your possessions defined your worth.   Her perspective is really of the need for essentials in life: food, clothing, and shelter. While she does enjoy having things, it was simply for how they reminded her of “back home”. She didn’t feel it reflected on her worth as a person.

Still, having said all this, the critical cultural differences she dealt with go much deeper. In the aftermath of the Second World War, her family lost everything, but “the clothes on their backs”.   Having to work hard and rebuild their lives, she simply states the overall life perspective on things is entirely different, and “hard to put words to”.

Religious Practices.

Spain came to the Philippines in 1400 and ruled there until the late 1800’s. As a result of Spain’s influences: (1) many words in Tagalog are of Spanish origin, (2) many last names are of Spanish origin, and (3) the primary religion practiced by 95% of the population is Catholicism.

Adherence to Catholicism as a member of the church community was vital to my mother’s family. For example, she said they all said the rosary every night. On Sundays all 24 of her cousins went to mass every Sunday, sitting in the same two pews every week with Grandma behind them to ensure they behaved. She warned them of their misbehavior with a flick on the ear.

Gender Roles.

Due to America’s influences, the Philippines has a very egalitarian view of the genders. For example, within the extended family system, the oldest child in the extended family is considered head of family, whether male or female. In fact, my mother said her family was very matriarchal in nature with the last two family heads being female.

After the Second World War, her maternal grandmother was a widow, and left as matriarch of the family until her passing. After her death, my moms own mother became family head as “Ate” of her four younger brothers and sisters. Everybody respected them both as head of the family and did as they said.

Also notable of the matriarchal vibe in the family was the fact that all family resources were devoted to equally toward both men and women pursuing advanced degrees. When you consider the fact that this occurred in the 30’s for my grandmother’s generation, its really quite remarkable.   In conclusion, its also interesting to note that the women surpassed the men in performance, with all finishing their education and even earning advanced degrees.

Cultural Assessment Interview Summary

While the previous section provides a perspective of my mother from within the Addressing Model, this section provides an overview of her life in her own words. At the end of each section I will include a few of my own personal thoughts.

Early Traumas

“I don’t remember much of my early years. I was born in 1938 and the war started in 1941 by the time the war started I was three years old…. I don’t remember much about growing up in a normal sense, such as reading books and going to bed at night since were refugees of the second world war and were living in caves alongside mountains, growing our own food…” (Johnson, 2014)

When the war came to a conclusion, my mother was about six years old.  Life for her in the aftermath of war was very different from life in America.  Nobody had anything and all people were left to rebuild their lives from search.  her parents were educated and were fortunate to find jobs.  Her mother was a schoolteacher.  Her father took advantage of the GI Bill as a former soldier of the USAFE and became an engineer.  While I have been able to talk with my mother about these experiences, I’ve come to understand that some caution needs to be taken when discussing these issues.  There is often an unspoken rule amongst my mom’s family that you aren’t to bring that stuff up, because it is too painful.  Having said that, I am grateful my mother has shared these experiences with me.  It has helped me understand how these early experiences influenced her.

Limiting Emotional Expression.

There are two key characteristics within my mom’s culture that influence how emotions are expressed:

  • RESPECT YOUR ELDERS:  As stated earlier, in my mom’s culture an authoritarian parenting style was the norm.  In the case of war, this was clearly essential for survival.  Absolute respect was essential and meant listing to mom for the sake of survival.
  • FAMILY WELL-BEING IS FIRST:  Thinking of the family collective unit first is essential during wartime.  Within my mother’s family the idea of harmonious family relations was important.  Making this a priority over personal feelings meant suppressing our own private needs for the sake of harmony and to avoid strife.

Material Loss & Gain.

In a recent conversation since our interview, my mother complained about something my sister said recently.  She allowed me to record this portion of our conversation on Skype since it was relevant to the topic at hand:

“You know what Dorene said to me? ‘Kevin and I decided we are not going to have all this stuff’, who a swish of her hand.  She waved her hand out from her chest while holding Audrey…”Stuff” as in all the things in our house.  I thought to myself: ‘Dorene I like them, I collected them.  I crocheted the afghans, I made the quilts, and sanded the refurbished furniture.  It has my guts and soul in it’  I had to say to myself ‘cool it Virginia’… Yet when you think about it, she was absolutely right in her viewpoint.  To her they are meaningless.  Nonetheless for me, understand I wanted frilly homey things.  My take on this, is that I want memories from back home, since I took none of this with me when I moved to the states.  Like my mother’s Queen Anne dining table and chairs.  I couldn’t take it with me.  I left home with two suitcases and only my memories.” (Virginia, 2014)

As I heard of the misunderstanding between my mother and sister, I couldn’t help but think of the things from within the perspective of this assignment.  My mother’s early childhood was filled with tremendous loss.  After the war, at the age of 7 she had to work with her family to rebuild their lives from nothing.  She learned to work hard, remain tough, and as a result is appreciative of what she has.  Additionally, she put much time creating things as her form of “art”.  What’s interesting is that since everybody after the war was in the same situation, nobody was better than anybody else.  The American notion that our material possessions can define our social class wasn’t relevant then.

As a result of all this, today she sees her material possessions as reflective of memories of “back home”  They also reflect all the hard work she’s endured to get to where she is.  They hold value that isn’t quite understood from an American materialistic perspective.

Social Expectations & Generational Influences.

“When you were born what were the social expectations of a person of your identity?…What generational roles make up your core identity? (Ajuoga, 2014).”

The differences between parenting styles and family structure stand at the forefront as key insights that make the Philippines different from the states.  I discuss these below alongside my mother’s struggles to raise two daughters in a foreign culture.

Parenting Styles.  Parenting styles in the United States are very different form where my mother grew up.  While she says we are more friendly, empathetic and familiar, parents are more authoritarian in the Philippines.

As a child in the Philippines you are to be seen but not heard. Crying and whining are not allowed, whether or not you are at home or in public. We are supposed to behave and remain compliant. So parents there were more authoritative and less empathetic….American parents are so much more permissive. In a way it is great at times, but you see American kids whine and whine, until they get their way. Over here kids are so much more familiar…The other thing in America because of all this permissiveness, the spinoff is kids are left disrespecting authority, and are less compliant as a result. In the Philippines kids are compliant, we comply with what our elders tell us, that’s the biggest difference. (Johnson, 2014).

Extended Family Structure.  

…I think it’s also easier in the Philippines growing up because of the extended family system. I had 24 cousins we all lived on Grandma’s piece of land, building five houses on it. It was a communal area we spilled out of the houses, and played together….The family structure in the Philippines, I think this is because we are Southeast Asian. you know of Confucianism? Philippines is a melting pot, Spain came to the Philippines in 1400, so we are Christian, but we do have a lot of Chinese, Japanese, and Indian emigrating to the Philippines. So there is also Confucianism, and it you revere your ancestors. As a matter of fact, there are names for the first-born son. My mother is firstborn, she is called “Ate”, they call her this and not Maria.   The second born is called “Eche”, that is my aunt who is a Physician. You call siblings by birth order. I was “Nene” which means baby for the youngest child. I am the youngest. You are supposed to respect your elders….” (Johnson, 2014)

The above quote points out a critical difference between American and Filipino family structures.  Family order is a critical component of one’s identity.  My mother was called “Nene”.  She was always called this whenever we visited, even as an adult.  In this respect, generational influences carry a greater weight as a component of one’s identity.

Education in Biculturalism.

I was never conflicted in my identity, I just was clueless about much regarding raising kids here. I should have kept up on what went on with your education. I should have been more on top of enforcing you to do well. You guys didn’t tell me anything. I remember a lady in church say jokingly, “I hear Dorene has a boyfriend”.   I just smiled and nodded. I only found out your sister was dating this way.   There are so many different kinds of kids and different kinds of parents.   No one child is the same. Every child has different needs, every parent has a unique set of life experiences. I think in your case you wanted to spare my feelings because I was a foreigner. You didn’t tell me what was going on.

As the quote above indicates, my mother’s greatest difficulty was in trying to figure out how to raise us in a different culture.  With a set of normative values drastically different than what she was familiar with she struggled with an ongoing internal conflict.  She wanted to remain true to her own values while helping us adjust in American Culture.  It’s interesting to note that my mother’s own acknowledgement of my struggles at the end of the quote here.  Very protective of her, I kept many of my struggles in fitting in to myself.

Norms & Values.

“When you were a teenager, what were the norms, values & gender roles supported within your family, peers, culture and in the dominant culture (Ajuoga, 2014)”

Key differences in norms between my mother’s culture and my own appear to be the greatest in the areas of dating, money and parental control.  I provide my mother’s thoughts on these areas below.

Adolescence & Dating.

“The other reality of my upbringing in the Philippines was you didn’t date until College. By the time you are in college you have some degree of maturity and did it then. We didn’t drink in high school, we did not date, we had no car, and there were no extracurricular activities in our public schools. Our society couldn’t afford them as you can here. When you go home you walk or take the bus and your mother was there. The norm was that you maintained your virginity as a girl. I was a virgin for a long time, because I was never propositioned. The boys don’t propositioned the girls.   I don’t think teenage boys that young, are knowledgeable of how to do such things…..There is a strong need in adolescence to be popular and fit in. There is a ladder, like a pecking scale. Teenagers are so insecure it seems like so much to handle at that age….As a girl, we didn’t wear makeup. In college you wear lipstick. This is when you start dating college….. There was really no bullying, because in school, if you are picked on at recess, you have many cousins and relatives to stand up for you. There is always a bigger and older cousin or sibling looking out for you. On the same note, if you are misbehaving, they will also inform adults, and you will be punished. This is because the reputation of the family is important, and protected in this respect. My mother’s family, the Gonzales family, has a good reputation in town. Among all 24 cousins, nobody got in trouble, and we were all upstanding citizens. I all these respects it’s a much safer environment. (Johnson, 2014).”

In my home my mother made the rules, my father was busy with his job much of the time and preferred to leave such issues to her.  As a result, I did suffer quite a bit of difficulty with fitting in.  I felt there existed a notion of ‘normal’ as in how I am supposed to be around my peers but yet I wasn’t taught how to be that.  I stood out.  I didn’t wear makeup, or dress like the other girls.  I was clueless in the realm of dating and didn’t experience my first kiss until my second year of college.  I was entirely on my own in figuring things out in this culture.  With American High Schools centered around fitting it, I was definitely an oddball, and bullied endlessly.

Adolescence and Money.

“there were no extracurricular activities in our public schools. Our society couldn’t afford them as you can here. When you go home you walk or take the bus and your mother was there. The norm was that you maintained your virginity as a girl….We had no money as teenagers.  We didn’t work at McDonalds. Boys and girls have no money. Many families can’t afford a car. We didn’t own a car until High School. We didn’t have a television until High School. We had crushes like everyone. It was never actualized. In the Philippines you did what your elders said and accept their wisdom. We don’t have the high school wisdom, they ‘don’t understand'” (Johnson, 2014).”

With fewer resources available, and entirely reliant of parents, adolescent life in the Philippines was very different. She would struggle with the idea of allowing us to have what we wanted.  For example, she says also makes the following comment in our interview:

“You wanted moon boots or Gloria Vanderbilt jeans, do I relent, yes or no? Just because that’s what everybody else in this culture is doing, does that mean you must as well?” (Johnson, 2014).

Her measuring stick was very different.  With the life of the average middle class family very different in the Philippines, she didn’t understand our desire for “things”.  She always had a problem with the idea that fitting in for girls meant dating and having certain clothes.

Adolescence & Rebellion.  

In the Philippines you did what your elders said and accept their wisdom. We don’t have the high school wisdom, they “don’t understand”, sums up a complaint of American kids. Even if you don’t take the advice, by asking it, they might make you their favorite. They appreciate this…On the same note, if you are misbehaving, they will also inform adults, and you will be punished. This is because the reputation of the family is important, and protected in this respect. My mother’s family, the Gonzales family, has a good reputation in town. Among all 24 cousins, nobody got in trouble, and we were all upstanding citizens. In all these respects it’s a much safer environment.” (Johnson, 2014).

When I was growing up, I remember my mother absolutely hated the Golden Girls and Rosanne.  These two television shows bothered her.  She felt everybody was so disrespectful.  There was a clear standard within our family that you are to be respectful and not allow your emotions to get away with you.  As two intellectual individuals, my parents were very stoic.  I felt they weren’t too interested int he open expression of emotion.

Social Movements in Teens.

“How was your view of the world shaped by the social movements of your teenage years (Ajouga, 2014).”

If there were any social movements which stand out for my mother it was the influence of Hollywood and the influx of American influence into her culture during the Post World-War 2 era:

“We are very westernized as a country and were very much influenced by America. I grew up with Elvis Presley, Patsy Cline, and The Everly Brothers. We saw movies and T.V. too, such as Mission Impossible, Bonanza, and I Love Lucy. American Music influenced me, because you heard it on the radio. We did have magazines, but I didn’t have television until high school. As a matter of fact, Rebecca would write celebrities and receive a signed letter from them. We didn’t have any social movements resulting from teenage angst, or youth rebellion, (Johnson, 2014).”

Educational & Occupational Opportunity.

“When you were a young adult, what educational and occupational opportunities were available to you?” (Ajuoga, 2014).  

“The reason we are compliant with our elders is because you rely on them for education as well as food, clothing, and shelter. In the Philippines it is somewhat a given that the parents pay for the child’s education, if able to at all. If you have the drive and ability, you are encouraged to go to College. Your ability to go to college is ability of your parents to pay. This is because there are no Federally Guaranteed Student Loans.   This is what’s different about America. Anybody here can get an education. Back home, if parents are well off, you stand on their shoulders as they pay your education. If not, you can have the ability, but not the resources to get a degree. It really is also an unspoken fact that when you do finish your education, you better have a marketable skill, career, and you support your elders in their old age because basically they gave up their retirement for your education.   Usually in the Philippines, the parents live in the kids’ house. Grandma then does the babysitting and usually does it for free. That also makes it difficult to get away from things, because Grandma is there to watch over everyone.   The education of your child is your form of retirement, (Johnson, 2014)”

The one thing I remember my mother always complained about growing up, is the issue of popularity in the United States.  It always distressed her how much it seemed peer group interactions influenced our identity as a person.  In her culture, education is available to those who can afford it.  As a result, in a respect, it enforces social class structures there.  Those who can afford, continue sending kids to college, so they have greater work opportunities.  Those who work can’t afford it don’t, and so consequently climbing out of poverty is quite difficult.

As a result of this, in adolescence, academic achievement is higher in importance for kids.  Children are divided into groupings in her school by academic achievement.  The ones in class number one were the high achievers and everybody looked up to them.   She also said the school displayed everyone’s grades in the town center on an announcement board for everyone to see.

Life in the States.

The entire quote below consists of my mother’s concluding remarks regarding how she transitioned to life in the states.  I have nothing to say about what is written below, other than I have a lot of respect for her.  She was quite young and yet very secure in who she was.

“When I moved here back as a resident, I had a good command of the language. the Filipino t.v. Anchors speak American Midwest English. I have trouble understanding other accents, but Midwest accents make sense to me. The thing I had trouble with were idioms such as “the cat’s meow”. I do feel my fellow residence at Baylor treated me fairly, although I was the only female, foreigner, minority in the program.   Although I do believe I imposed this upon myself, I felt I had to be twice as good to be good enough. I felt determined to prove myself. I was over prepared with a goal to do twice as good as anyone else. What did help is my older sister was already a resident at Baylor going to school. We were there together. I do remember people sometimes were surprised I was the housekeeping staff and not the physician in scrubs, so I learned to dress well and look the part. You know if I received discrimination from patients at times who didn’t want me to care for them because of my color. Oftentimes they were minorities like me, which surprised me. Nonetheless, I had to work hard to prove myself over time.   There was a time when I had trouble on the bus system. I took myself at face value, yet there were people who felt I shouldn’t sit here at a certain location on the bus. Since it wasn’t illegal to do so, I would stay there. They were the ignoramuses. I found it hurts only you if you put value upon the opinions of those people. I know who I am and stick to that identity of myself. To tell you the truth today, I don’t think of myself in terms of race, but as a person. The same goes for you, your sister or your father.   We are just a family; people.   I didn’t have the effects of being a minority growing up. While the Philippines is a melting pot country, but it was less “in your face” as an issue. In this country, it is more an issue in an “in your face manner”.   Back home, we are so diverse as people it wasn’t an issue. I, for example, have Spanish and Chinese in my family background, as do you through me….I’m being fair to each child. You give your child what they need, as they need it. Make your own way. Let go of any old gripes they aren’t worth the familial disharmony. Your successes are your own, as are your failures. I see myself as me; I am Virginia first and foremost. Race in a respect is a social construct, not genetic fact.   My identity is a choice of my own that I make it for myself irrespective of what comes at me from the race perspective, (Johnson, 2014).”

References

Ajouga, P. (2014). Re: MCC 638 Week Four Overview. Retrieved from: https://ssoblackboard.bellevue.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2Fwebapps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_328162_1%26url%3D
Fortune, B.A. (2012). Acculturation, intergenerational conflict, psychological distress and  stress in Filipino-American families. Regent University, Virginia.
Hays, P., & Iwasama, G.Y. (2006). Culturally Responsive Cognitive-Behavioral Therapy: Assessment, Practice, & Supervision. Washington, D.C.: American Psychological Association.
Hays, P. (2008). Addressing cultural complexities in practice. (2nd Ed.) Washington, D.C.: American Psychological Association.
LaFromboise, Coleman, H.L.K. & Gerton, J. (1993). Psychological impact of biculturalism: Evidence and theory. Psychological Bulletin. 114(3) 395-412.
Lee, E, McGoldrick, Monica, Giordano, J, Pearce, J.K., (1996) Ethnicity and Family Therapy (2nd Ed.), (pp. 227-248) NY, NY: Guilford Press.
N. H. Trinh et al. (eds.), (2009).  Handbook of Mental Health and Acculturation in Asian American Families, Current Clinical Psychiatry, DOI 10.1007/978-1-60327-437-1z
Root, M. P. (1997). Filipino Americans : Transformation and Identity. Thousand Oaks: SAGE Publications.

 

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NCE STUDY – A Cultural Self-Assessment….

(((I am currently studying for a licensure exam & completing an internship.  This blog post is intended as a study exercise.)))

PART ONE – A Cultural Self-Assessment….

According to our textbook, a bias is simply a “tendency to think, act, or feel in a particular way.” (Hays, 2008, p24). Personal biases emerge as a result of our upbringing and sociocultural background, (Hays, 2008). Our life history provides us a worldview, value system, identity and cultural background that produce the very biases we carry into therapeutic relationships, (Hays, 2008). In light of this fact, a cultural self-assessment is the first step toward developing greater multicultural competency as a counselor. I start this self-assessment by utilizing the Addressing Model to provide a rough overview of my sociocultural history.  I then move on to a series of interview questions, which can help to shed light on areas of privilege, as well as value systems, and identities.

Utilizing the Addressing Model

Age and Generational Influences

My Parent’s Generation.

My mother was born in 1938 and my father was born in 1941. They are members of the “silent generation”, born just prior to the baby boom (Martin, 2004). Their earliest years of life occurred while the world was at war. My mother, from the Philippines, grew up in the middle of war. My dad, an American, was ignorant of war altogether. They were both raised to work hard, get an education, and pursue the American Dream. For my mother’s family this meant gathering resources to put both of their two daughters through medical school and then help them to immigrate to the states. For my father’s family, this meant raising their sons in a strict household, expecting them to work hard, and then put themselves to school. In the end, they all did so, earning advanced degrees.

My Generation.

I was born in 1969, and grew up in a small college town in South Dakota. Unlike many of my generation, I was spared from having to experience divorce first-hand, with divorce rates soaring to 50% in my childhood (Amato & Cheadle, 2005). With everyone in my extended family enjoying long and happy marriages, I have come to value the commitment of marriage and family.

Typical of many women in generation, I am fairly skeptical of the idea of “having it all”; a popular notion existing in westernized cultures in the aftermath feminist movement (Genz, 2010). While very appreciative of the strides made, I’ve witnessed many women struggle to keep up with home and work life in frustration. With many women in my generation have chosen to put off family, or opt out all together, I’ve chosen to put off career pursuits in favor of focusing on my family life, while my kids were young (Genz, 2010).

Developmental Disabilities

            Fortunately, I have no physical disabilities or health issues whatsoever. I’ve had the privilege of ignorance that comes with living in a healthy body, and never having to think about living with disability. (Hays, 2008). Nonetheless, I’ve found plenty of opportunity in my life to learn about living with disability. As a Hospital Tech I have had a great deal of opportunity to work with disabled individuals. As the mother to a son with a congenital defect, I’ve gained insight into experience of raising a child with special needs. I’ve developed an awareness of what it is to deal with physical disability on a daily basis. In fact, I’ve felt a great deal of satisfaction from these experiences, and wish to explore this area as a potential career path.

Religion and Spiritual Orientation

            My religious background is complicated, by the fact that my family isn’t unified in its religious beliefs. My father is an atheist, my mother is devoutly catholic, and my sister considers herself a “born-again” evangelical Christian. As an agnostic, I can see everyone’s point of view and respect each one, as right for that person. I don’t feel it is right for anyone to impose their religious beliefs on others. Nonetheless, I do find the other members of my family disagreeing on matters quite often. My sister and mother disagree with the others beliefs on the grounds that it goes against their own. My father refuses to talk about it altogether and this annoys my mother and sister.

Ethnic & Racial Identity

“The ecological model of racial identity development acknowledges that there are many different ways people of mixed racial heritage may identify themselves….These identities do not necessarily coincide with how other persons identify them. Thus the private identity may be different from the public identity assumed or validated by others.” (Root, 1998, p240).

I am a biracial individual, born to a Filipino mother and White father. A book written about my hometown, by author May-Lee Chai, titled “Hapa Girl” (2007), provides a good depiction of my childhood environment overall.   Also biracial, she was a senior in high school when I was a freshman and endured much of what I did growing up.

My racial identity can be best described as a personal knowledge I hold within.   It isn’t reflected in my phenotypic appearance and consequently is rarely acknowledged in my interaction with others. (Root, 1998). As a result, my identity as biracial is held with pride despite often being refuted and criticized by others. Additionally, because I’ve never been to the Philippines, it isn’t based on any cultural heritage. (Root, 1998) While purely American, from a cultural perspective, I claim both my Asian and American heritage from an identity viewpoint.

Socioeconomic Status

The socioeconomic status of my family of origin is solidly upper middle class. In contrast, my family of procreation would most likely be somewhere in the lower middle class. My husband comes a working class background, and had a rough home life. Adding to this, until recently, I’ve put off career pursuits in favor of family. As a result, I have experienced some downwardly mobile, in a matter of speaking. By marrying someone of a different socioeconomic class, I’m aware of the huge cultural divide between my husband’s family and my own. I feel comfortable in both worlds, yet my husband doesn’t enjoy being around my extended family, (despite getting along with my parents). A quote from a book titled “Reading Classes” by Barbara Jensen (2012) that sums up my husband’s experiences well:

“I knew I wasn’t middle class like some others in the movement, and I believed I wasn’t as smart as they were. I knew my brain worked okay, but they knew more, lots more, and I wanted what they had. They often referred to authors I had never read or even heard of. They used words I didn’t understand, and they often talked about their college experiences, worldly travel, orchestral music, and other things with which I had little opportunity and experience. They appeared to all understand one another, but sometimes I just pretended I understood, and then I felt ashamed of both not knowing and pretending.” (Jensen, 2012, p18)

Sexual Orientation & Gender

Sexual Orientation & Cisgender Status.

Regarding the issue of sexual orientation and gender identity, I happen to be a cisgendered heterosexual.  Being cisgender, I moved through life with a body that matches my gender of identification, (Levy, 2013). Being a heterosexual, I have a sexual preference that is deemed acceptable by all facets of our society (Levy, 2013). I have never felt the need to think about my sexual orientation or gender identity to the extent I have my racial identity. Any thought I do give to such matters has been purely political in nature, since I’ve always been very supportive of LGBT rights. Having said this, I do feel simply believing in equal rights isn’t enough With ignorance, can come a lack of awareness of things such as subtleties of interaction and the imposition of our biases that can indeed be felt as discriminatory, regardless of their intention, (Hays, 2008)

Being Female.

While being a female certainly implies a second-class status, it must be noted that the degree to which this is experience varies by culture. Fortunately, my sociocultural background has been one which values and empowers women.   Having said this, it would be fruitful to learn about the implications of being female in cultures other than my own, as a matter of perspective.

Indigenous Heritage & National Origin.

On the one hand, I’m an American living in the United States and have no experience living in another country. I am neither an immigrant nor of indigenous heritage. On the other hand, with a mother who emigrated from the Philippines, I’ve witnessed a bit of what it is like to balance the influences of two competing cultures. Described best as a biculturalism, or dual identity status, (Framboise, 1993), raising a family in a foreign culture was certainly problematic for my mom. From my perspective, the cultural gap that resulted did require time to work through. Having not occurred until well into my own adulthood, I have a relationship with my mother today, which is very different from that of my childhood.

Cultural Self-Assessment Interview

In this portion of the paper, I move on to a series of self-assessment interview questions. It is my intention to answer each within the Addressing Model framework. I will consider how each question applies to my sociocultural history as described within this model.

“When I was born what were the social expectations for a person of my identity?” (Ajuoga, 2014).

My biggest struggles with social expectations associated with identity, are in the areas of: (1) gender roles, (2) race identity, (3) socioeconomic class, and (4) religious affiliation. Other addressing components such as disability, sexual orientation, and indigenous heritage, have been of little concern. I will address these areas of struggle in turn, leaving female gender roles issues, for later.

Racial & Ethnic Identity. As mentioned already, I have experienced a great deal of confusion regarding my ethnic identity. My own biracial identity has been largely met with messages of disapproval, with others needing to inform me what they believe is the correct one (Root, 1998). It has taken some time, to sort through this issue as I’ve learned to let go of the idea that validation from others is ever a realistic expectation.

Religious Identity. While my mother’s family is devoutly catholic, my father’s family is predominantly agnostic and atheistic. The competing perspectives from this interfaith family background yielded an array of contradictory expectations (McCarthy, 2007). As my sister and I matured, our chosen routes diverged greatly. I came to identify myself as agnostic, while my sister has joined an evangelical church and embraced those ideals. The biggest issues in our family have come as we’ve tried to maintain a sense of integrity while also respecting others’ beliefs (McCarthy, 2007).

Socioeconomic Identity. Maria Root discusses in her work on mixed race identity, that individuals from such backgrounds can often develop negative biases against one side of their family as result of negative treatment, (Root, 1998). Within my father’s extended family I have experienced just this growing up. The ignorance and ethnocentrism they display, alongside the pride, and unwillingness to see any other perspective has been the source of much pain. As a byproduct of this experience, I’ve developed a negative bias against their upper middle class socioeconomic ideals (Root, 1998). It’s only in my adulthood, that I’ve been aware of how much I rejected this component of my identity, while embracing husband’s working class background instead, (Root, 1998). Coming to terms with this will be essential in my growth as a counselor (Hays, 2008).

 “When I was a teenager, what were the norms, values, and gender roles supported within my family, by my peers, in my culture and in the dominant culture” (Ajouga, 2014)

Overall, a great deal of conflict exists regarding norms, values, and gender role expectations within my extended family. In her article an article on biculturalism, Teresa LaFrombroise, discuss the impact of living between cultures (LaFrombroise, et al, 1993). This article mentions feelings of psychological discomfort as the initial result of a dual identity-based conscious that can have potential benefits in the long run, (LaFrombroise, et al, 1993). Having many conflicting identities, as mentioned previously, I’ve experienced much of this discomfort and have likewise developed many fruitful life lessons as a result.

Gender roles.

Within my family, gender roles brought about much confusion as a child.   Conflicting messages existed as a result of complex familial generational and cultural gaps. My dad’s family came from a traditional background, with the belief that women were supposed to stay at home. In contrast, my mother’s family was very forward thinking. Since my maternal grandparents were both teachers, it was very important their daughters go to school. Having two daughters finish medical school was a source of great pride.

These competing perspectives left me with a conflicting and contradictory array of familial gender-based role expectations. Against this backdrop, was the generational influence of being born in the aftermath of the feminist movement, (Genz, 2010). Not feeling the need to having it all, I have instead discovered a path that has worked for me.

Norms and Values.   While there were many conflicting norms and values within my extended family, this wasn’t really the biggest issue in the context of day-to-day life as a child. The greatest source of conflict existed between the values and norms my parents held me to in contrast to what was expected in my hometown. Norms and values regarding: (1) relationships and dating, (2) parental roles, (3) rules of emotional expression, as well as (4) appearance and demeanor stand at the forefront as most problematic.

In keeping with her cultural background, my mother assumed the role of matriarch, and was largely responsible for setting parental limits. My dad, busy at work most of the time, didn’t want to interfere. As a result, my mothers cultural belief systems were the standard we complied with at home. Naturally unbeknownst to them, this key factor resulted in an array of problems throughout my childhood, when it came to fitting in (Chai, 2004; Fortune, 2012).

For example, regarding the issue of appearance, my mother didn’t allow me to shave my legs or wear makeup, and I was bullied endlessly for it (Chai, 2004). In the arena of dating, I was absolutely forbidden from even considering it until we finished college, because that’s how it was for her growing up, (Fortune, 2012). Added difficulties resulted from differences in parenting role expectations between my mom’s culture and my hometown environment, (Root, 1998). Cultural differences such as these, caused many parents and teachers to misunderstand my mother. They often thought poorly of her parenting style, because it was so different from what they knew. This added to my difficulties in trying fitting in at school.

How was my view of the world shaped by the social movements of my teen years?” (Ajouga, 2014)

With a population that was mostly white, middle class, and well educated, my hometown had a very ethnocentric feel to it (Chai, 2004). At school, a large portion of my classmates came from families that called this town home for several generations. This gave many of my classmates the benefit of a large social and familial network, as well as consistent socialization, on how to follow the values and norms of the local culture (Chai, 2004).   Without this knowledge base or support system, fitting in was difficult, and I was bullied throughout much of my childhood, (Chai, 2004). As per Brene’s Brown work on shame, my personal view of the world was based on an underlying identity based on shame as she defines it:

“The definition of shame that emerged from the research is, ‘ an intensely painful or experience of believing we are flawed and therefore unworthy of acceptance, and belonging.” (Brown, 2006, p45)

“When I was a young adult, what educational opportunities were available to me? And now?” (Ajouga, 2014)

While I did enter college with many opportunities for learning, my ability to make the most of them limited by my problematic childhood history.   Nonetheless, having been born into an upper-middle class environment to two highly educated parents, provided me with many privileges I failed to appreciate at the time, (Hays, 2008). Today, after having come to terms with my past through counseling, I’m grateful for the opportunity to make the most of these privileges and pursue this degree.

“What generational rules make up my core identity (eg., auntie, father, adult child, grandparent)?” (Ajouga, 2014)

Key generational roles which are strongly associated with my identity, include my roles as a daughter and mother. In fact, I hold my role as parent before any others in my life. Having nearly lost my oldest after several open heart surgeries and then suffering a miscarriage before giving birth to my youngest, I value my time with my kids greatly. It’s been my goal in life to learn the lessons from my parents, and be there in ways they were not able to. Making sacrifices for my kids, showering them with affection and cherishing our time together are key priorities in my daily life.

Regarding my role as daughter, while I’m not as close to them as I’d wish, I do strongly identify with my duties to them. As the oldest child with a background in health care, its expected that I be there to care for them when they age.   I plan on trying my best to live up to this expectation as a show if respect and love, knowing action and not words work best a communicating such things with them.

PART ONE: Conclusion

In completing this assignment, I’m actually surprised at how much I learned about myself. Rereading my personal history has been quite enlightening, as a much-needed perspective within to contextualize the outcome of my life.   It’s cleared while my complex sociocultural history yielded much stress as a child, its also provided me with wonderful opportunities for personal growth. Inspired by this fact, I am committed to a lifelong process of learning as a counselor and plan to use these insights as I worked completing my degree.

PART TWO:  Becoming a Culturally Competent Counselor

“Every man is in certain respects; (a) like all other men, (b) like some other men, and (c) like no other men” (Leong, F.T.L., 2011, p. 150).  We are inextricably connected to culture, defining it while simultaneously existing as a byproduct of it.  (Leong, F.T.L., 2011).  It is clear that counseling can’t occur in isolation of society at large (Sue & McDavis, 1992), and that counseling interventions are never culturally neutral (Framboise, et al., 1993).  Consequently multicultural competence must be an integral component of  ethical therapeutic practice .   A multimodal approach will be needed to consider varied factors from multiple viewpoints.

Towards a Solution

A quick review of literature reflects the complexity of the issue, with a complexity of approaches encompassing an array of factors to consider from multiple perspectives.   For example, the AMCD Multicultural Counseling Competencies, includes an awareness of one’s own cultural perspective, the clients, as well as knowledge of appropriate interventions based on these factors. (Arredondo, et al., 1996).  Assessing one’s beliefs, knowledge base, and skill set, within these three areas is essential for multicultural competence (Arredondo, et al., 1996).  Adding to this perspective, is insight from an article which says our personal development can be understood from a universal, group oriented and finally individual one (Leong, F.T.L, 2011).   In keeping with the idea that the individual and society at large are mutually definitive and interrelated in a complexity of ways, this perspective can be useful from a variety of theoretical perspectives.  Additionally, it could provide useful insight when utilized alongside the ADDRESSING Model discussed in our textbook (Hays, P, 2008).

A Tentative Plan

With multicultural competence such a complex issue, a plan is essential as a general guide to the development of this skill.  In this section, I provide a tentative outline of how I plan to develop multicultural competence.  In doing so, I will utilize the Bellevue University MCC Graduate Student Disposition Rubric to organize my thoughts (Bellevue University, 2014).  Additionally, in the spirit of this assignment, I believe a more informal and honestly self-reflective discussion is essential to make the most of this exercise.

Professionalism: Maturity & Responsibility.  

“Seeks solutions independently and/or identifies faculty who can assist…uses discretion by discussing the problem with only the appropriate person(s); focuses on solutions rather than blame….is respective to constructive comments….maintains confidentiality….always displays a thorough preparation…always demonstrates behaviors that exemplify honesty, and integrity…” (Bellevue University, 2014).

Strengths.

When reflecting upon the above, I feel my work as a C.N.A./Psych Tech has prepared me fairly well overall.  Confidentiality and discretion are very familiar concepts, (Catholic Health Initiative, 2014).   Additionally, maintaining a sense of integrity is what keeps me going during even the most difficult shifts.  This concept of integrity has meant thinking of the well being of clients first, and doing right by them first and foremost.  In doing so, this has meant letting go of any ego-based need to blame someone else.  Regardless of who is to blame, I have had to learn to understand the perspective of those whom I provide care for.  Adding to this, work-oriented skill development are my personal experiences as a biracial individual.  I’ve developed an understanding of the concept of cultural relativity and feel a heightened self-awareness has been an adaptive response to this experience.  The result is a greater willingness and open-mindedness to idea of understand cultural perspectives other than my own.

Area of Growth.

Being thoroughly prepared from the standpoint of multicultural competency, will have to be an ongoing commitment.   On the one hand, I’m a very self-aware individual, in terms of my own cultural values and biases (Arredondo, et al, 1996)  Additionally, I am very willing to learn about other cultures (Arredondo, et al, 1996).  At the same time, I do need to gain greater knowledge and skills when through interpersonal work within those communities I hope to serve (Arredondo, et al, 1996; Hays, 2008).

Solutions.

Direct interaction with individuals in communities I hope to serve within will need to be a priority.  Finding volunteer work, and opportunities for exposure to other cultures will be important.

Professionalism & Valuing Others.   

“Interactions…respectful of differing opinions.  Treats others with courtesy, respect, and open-mindedness.  Listens to and shows interest in the ideas and opinions of others.  Seeks opportunities to include or show appreciation for those who may be excluded.  Demonstrates concern….” (Bellevue University, 2014).

Strengths.

When considering how this applies to multicultural competence, valuing others will start with a self awareness of my own cultural background (Arredondo, et al, 1996) Being open-minded and willing to respect other cultural perspectives will be vital (Arredondo, et al, 1996)   In these respects, I do believe I’m well on my way to expressing my desire to show I value others.  Nonetheless, a knowledge base and set of interpersonal skills is again essential to add to this attitudinal perspective.  Without it, I can have the best of intentions, but fail to meet my desired mark.

Areas of Growth.

According to an article on biculturalism by Theresa LaFramboise, a culturally competent individuals hold a strong identity, possesses a knowledge of cultural beliefs and values, is able to display sensitivity to the affective, behavioral and language components in a cultural, while negotiating their way through social relationships and institutions in that culture.  (LaFramboise, et al, 1993).  Its clear without these components, serious errors in communication can occur.   Culture can be seen as a paradigmatic foundation in a person’s life, defining not just values and beliefs, but how we feel, think, and relates to others(Hays, P., 2008).  As I’m well aware, within the familial cultural gaps existing in my own extended family, failing to understand this can relate to terrible misunderstandings.

Solutions.

As stated before, developing this skill and knowledge will mean: (1) developing a knowledge base of therapeutic interventions, (2) gaining opportunities to be exposed to other cultures.  While doing so, our Hays (2008) textbook mentions the importance of humility as a critical element to professional growth which I believe will be important throughout the learning process:

“When people are humble, they recognize that other viewpoints, beliefs, and traditions, may be just as valid as their own….people with genie humility are effective helpers, because they are realistic about what they have to offer….critical thinking skills are essential, because they involve the abilities to identify and challenge assumptions….examine contextual influences…and imagine and explore alternatives. (Hays, P., 2008, p29).

Professionalism & Networking.

“Counselor is highly active in professional organizations and views professional organizations as a valuable medium through which ideas and information can be freely and consistently shared.”  (Bellevue University, 2014).

Areas of Growth.

When reviewing the above criterion, it is clear this is an area in which much growth is needed.   I don’t honestly have a lot of opportunity for networking on the job.  I work the weekend night shift in a nursing float pool throughout the  Alegent Creighton Health System.  I also go to school, and have a family, while jet lagged from my night shift hours.

The crucial importance of networking from the perspective of multicultural competence is it provides an opportunity for others to challenge your views offering valuable counterpoints you may not consider on your own.  Without this, I’m leaving a critical opportunity for learning out of the mix, in my educational and career pursuits.

Solutions.

I intend to focus on developing strong supervisory relationships within any  internship and volunteer opportunities while earning my degree.   Getting involved in organizations opportunities as a student therapist is another goal.  Finally, taking time to talk with those in the field, has been an ongoing priority, so I can plan my career path accordingly based on any shared insights.

Professionalism: Appearance & Self Care.

“Reflects upon and revises counseling practices and expertly applies revised practices…consistently seeks out self-care and prevention of burnout…participates in various ongoing educational and staff development activities….Is a role model of professionalism through personal appearance, attire, and cleanliness.” (Bellevue University, 2014).

Areas of Growth.

As is often said amongst caretakers in the field, you have to take care of yourself before you can take care of others.  Making time to engage in adequate self care, is a critical priority in my overall life path.  As someone who spends much time caring for others, I’m at a high risk of burnout.  “Burnout is a state of physical, emotional, intellectual, and spiritual depletion characterized by feelings of helplessness and hopelessness, (Corey, et al, 2011, p69).  The critical problem with burnout and heightened stress, are their ability to rob your ability to care for others with any degree of competence.  You can’t give to others any more than you’re willing or able to give yourself (Corey, et al, 2011).   It goes without saying, that no headway will be made in attaining multicultural effectiveness, if I can’t make this criterion a priority.

Solutions.

First and foremost in my self care regimen, is the need for adequate sleep.  After having switched to a different work schedule, and paying of some lingering debt, I find I’m  able to cut down on my work hours.  As a result, I’m making time to take care of myself, and am currently exercising and eating healthier with the goal to lose weight.  Additionally, I’ve saved up some money, for a more professional wardrobe, since nursing scrubs will no longer be appropriate.

PART TWO:  Conclusion

From the outset, choosing to enter the field of therapy, has been more than a career move.  It is a new life path, and a logical extension, from my past personal life progression of personal growth.   Much of what I’ve learned through this education process, has taken on a very personally reflective quality.  My most critical steps from this point forward will involve taking action, through direct interpersonal experience, as well as consistency in effort and commitment over time.   With my greatest challenges being self care and the need for networking opportunities, these have been my biggest focuses, in moving forward.

References

Ajouga, P. (2014). Re: MCC 638 Week Two Overview. Retrieved from: https://ssoblackboard.bellevue.edu/webapps/portal/frameset.jsp?tab_tab_group_id=_2_1&url=%2Fwebapps%2Fblackboard%2Fexecute%2Flauncher%3Ftype%3DCourse%26id%3D_328162_1%26url%3
Amato, P. R., & Cheadle, J. (2005). The long reach of divorce: Divorce and child well-beingacross three generations. Journal of Marriage and Family, 67(1), 191-206. Retrieved from: http://ezproxy.bellevue.edu:80/login?url=http://search.proquest.com/docview/219746544?accountid=28125
Arredondo, P., Toporek, M.S., Brown S., Jones, J., Locke, D.C., J. and Stadler, H. (1996) Operationalization of the Multicultural Counseling Competencies. AMCD: Alexandria VA.
Bellevue University. (2014). MCC Graduate Student Disposition Rubric. [Class Handout]
Brown ,B., (2006). Shame resilience theory: A grounded theory study on women and shame. Families in Society. 87(1) 43-52.
Catholic Health Initiative. (2014). HIPPA & Privacy Rule.  http://www.chihealth.com/hipaaprivacyrule
Corey, G. ,Corey, M.S., & Callanan, P. (2011).  Issues and ethics in the helping professions.  (8th ed.) Belmont: CA:  Brooks & Cole.
Fortune, B.A. (2012). Acculturation, intergenerational conflict, psychological distress and stress in Filipino-American families. Regent University, Virginia.
Genz, S., (2010). Singled Out: Postfeminism’s “New Woman” and the Dilemma of Having It All.  The Journal of Popular Culture, (43)1, 97-119.
Hays, P. & Iwamasa, G. (2010) Culturally responsive cognitive-behavioral therapy. (3rd ed.) Washington, D.C. American Psychological Association.
Hays, P. (2008). Addressing cultural complexities in practice. (2nd Ed.) Washington, D.C.: American Psychological Association.
Jensen, B. (2012). Reading Classes : On Culture and Classism in America. Ithaca: ILR Press.
LaFromboise, Coleman, H.L.K. & Gerton, J. (1993). Psychological impact of biculturalism: Evidence and theory. Psychological Bulletin. 114(3) 395-412.
Leahy, R.L. (2008) The therapeutic relationship in cognitive-behavioral therapy.  Behavioural and Cognitive Psychotherapy. 36, 769-777.
Levy, Denise L. “On the outside looking in? The experience of being a straight, cisgender qualitative researcher.” Journal of Gay & Lesbian Social Services 25.2 (2013): 197-209.
Martin, C.A. (2004) “Bridging the generation gap (s).” Nursing2013. 34(12)62-63.
McCarthy, K. (2007). “Pluralist Family Values: Domestic Strategies for Living with Religious Difference” The ANNALS of the American Academy of Political and Social Science. 612(1) 187-208.
Root, M.P.P. (1998) Experiences and processes affecting racial identity development: Preliminary results from the biracial sibling project. Cultural Diversity and Mental Health.  4(3) 237-247.
Sue, D.W., Arredondo, R. & McDavis, R.J. (1992).  Multicultural counseling competencies and standards:  A call to the profession.  Journal of Counseling & Development.  70, 477-486.
 

 

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An Underdog’s Credo: “Choking vs. Panic”

As I mentioned on the welcome page of this blog, it’s taken just over five years for me to get it up & running. 

I honestly can’t tell you how many times I’ve attempted to start a blog, only to stop just shy of “going live”.  It wasn’t until I actually decided to go back to school, that I finally gave up on the idea.  I reasoned with “so much on my plate”, there just wouldn’t be any time.  I shoved all my ideas and well-laid plans into a few storage bins.  They remained there until late last 2015……

My goal for this blog, has simply been to finish what I start and cross something off my bucket list. I’m proud to say, I finally succeeded in producing forward motion in the direction of this goal.

I’m actually making slow and steady progress in the direction of my goal.  I regularly dig through these old storage bins in the back of my hallway closet for another source of “inspiration”.   While I’m grateful to not be stuck anymore, its taken me some time to understand exactly what was stopping me to begin with….

FIRSTLY, “What stopped me?”

Transactional Analysis on Stuckness…

attachment 3My therapist has nesting dolls in her office, and utilizes them to illustrate various ego states from transactional analysis.  When initially considering this issue of stuckness, my therapist’s nesting dolls came to mind.   Resistance from this theoretical perspective can be “explained as a battle between inner parts: one part wants to change, while the other does not…” (Ingram, 2013, p 234).   According to transactional analysis, within us exist ego states that represent experiential realities from various stages in life.  Within each ego state is a typical coping style or pattern of relating to those around us. As I recall, two in particular have been engaged in a perpetual lifelong battle….

My Hurt Child

The child ego state can be thought of as an inner mental recording of painful childhood experiences.  When encountering triggers that remind us of these events, we’re sent back in time.  Emotionally, we can re-enact these early experiences with those around us. For example, within me lives a “hurt child” who was bullied kid and had no friends.  This hurt child asks, “I know I am bad; what’s wrong with me” (Ingram, 2013, p. 295).  She is submissive, insecure, with no sense of self.  Filled with a sense of shame, she seeks validation and acceptance from others – wherever she can get it…

My Critical Parent

The parent ego state reflects messages we receive from authority figures in our lives and standards of conduct we were taught.  My own critical parent, consists of messages from my parents that emotions were bad and creativity was a waste of time.   My critical parent consists of message from parents and teachers who ignored and overlooked the bullying.

My critical parent might say “you should take those pounds off. What’s wrong with you?! Your an indulgent loser (Ingram, 2013, p. 295).”  
My hurt child will be filled with feelings of insecurity as a former “ugly duckling”.  Shame takes over in reaction to the random characteristics that happen to define my meatsuit

Malcolm Gladwell: “Choking vs. Panic”

The insights from transactional analysis described above, are useful in developing a historical context for my history of life-long stuck-ness.  Underlying this perpetual resistance was unresolved trauma, that I would later come to understand as PTSD.  Still, I have more questions:

In particular, how can I be certain I won’t get re-stuck? After all, the PTSD isn’t going away, and the triggers are still there….

Today, after “clocking some hours” at my internship site, I decided to dig in those old storage bins, and do more blogging.  As an INFP, I find it is a relaxing activity at the end of a long day.  Serendipitiously, I happened to come across Malcom Gladwell’s titled “The Art of Failure”.  In it describes the differences between choking & panic:

“If panicking is conventional failure, choking is paradoxical failure. (Gladwell, 2000)”

In order to explain what is meant by this statement, it is important to first understand the difference between explicit and implicit learning:

EXPLICIT LEARNING:   commonly utilized with novices and involves the conscious utilization of intentional focus & deliberate action.  For example, I don’t play golf, and if somebody teach me, I’m paying attention to the particulars of how to hold the club.

IMPLICIT LEARNING:  common with experts and occurs at a subconscious level, outside one’s awareness.  An unexplainable knowing guides our process, and we’re kind of “in the zone”.  I do this when I play the violin.  I’m not paying attention to the music, I’m not really aware of how I hold the violin or bow.  My fingers somehow know what to do.  My attention is instead on the music and playing what I hear and feel within me.

Choking:  Thinking To Hard

Choking is a paradoxical failure that comes when we are expected to perform and our brain freezes. This happened to me whenever I had a violin recital.  My teacher liked to schedule them at the local churches on Sunday.  Since we lived in a small town, it was inevitable that a classmate, (or two), were present.  As a bullied child, I was pretty much a social leper.  Fear rushed through me, and I my mind completely froze as a panic overcame me.  I tried so hard to do my best, I paid attention to my fingering, and tried focusing on the sheet music before me.  It never worked, I was “overthinking things”….

Panic: Not Thinking at All

With panic the fight-or-flight system takes over and we begin acting on adrenaline and instinct.  Whereas choking is about loss of instinct, panic is a reversion to instinct.  When we panic, we focus only on our end goal, and can’t generally see beyond our fear.  It is conventional in the sense that it is a byproduct of knowing being thoroughly educated in how to handle a situation.  For example, my son went into cardiogenic shock as a child, d/t an undiagnosed heart defect.  I panicked yet somehow managed to make it to the hospital – by the grace of God….

SECONDLY, How can I know it won’t happen again?

attachment 2I’m finally reaching the end of my educational journey, and look forward to launching a new career. The road hasn’t been without its hitches.  I wonder, from time to time, if I’m hitting stuck-ness again. Recently, I started my first internship class, and found myself teaching five group therapy classes independently.  The first few weeks were quite rough and riddled.  However, I’m relaxing into the role.   I have to admit honestly, there isn’t anything  I can look to for a guarantee I won’t get re-stuck.  Only a personal commitment can do that:

An Underdog’s Credo…

I am an underdog.

An underdog is an unlikely hero who rises from “modest beginnings” despite mounting challenges.  Overcoming “less than” conditions with few expectations of success at the outset I have stuck with it like a turtle.  Slowly but surely I’ve moved towards my goals.

I stick my neck out.

As that little engine that could, I overcome self-imposed limitations, and messages from everyone who doubted me.  I choose today to meet insecurity head on with passion and determination.  This happens everytime I chose to not let past mistakes define me.  I have faith in my abilities and the motivations driving me forward.

I have everything I need to get there.

Like Dorothy and her ruby slippers, I have everything I need to make things happen, I just need to believe in myself.  I now realize the key to empowerment is self-responsibility as I decide to critically examine my own self-imposed idiocy.  I become what I believe I am, and get what I believe possible.

I commit to owning my truth.

There’s more than a grain of truth to the saying that we perpetuate what we deny.  Owning my truth means understanding how I exist as a creator of my life.  If I do become what I believe I am, what do I believe I am?  If I become what I believe is possible, what is possible?  Where did these messages come from???

I understand that stuckness is a matter of my own doing & opportunity for personal growth.

I’m not running from somewhere or going to anywhere.  I’m at peace with where I’m at.  Stuckness for me has been a byproduct of a failure to understand the motivational forces goading me forward.  When based on insecurity and a desire to prove myself worthy, I end up creating more to be insecure about.  Today, I’m in a different place.  I’m content with where I’m at.  I’m good enough as is.  My life is splendid and I have a lot to be grateful for.  I flow in the direction life takes, and face every day fully present, and see it as an opportunity for personal growth.

I choose opposite action away from old habits & towards my personal goals.

The good thing about making mistakes, is you have them as a template for what doesn’t work.  I’ve gone down that road, where old habits, and personal insecurities have taken me.  The benefit of 20/20 hindsight is the clarity that comes with m extricating my head from my rear.

I do not fear failure, it is an opportunity to grow.

Insecurity is no longer a ruling force in my life.  I don’t fear failure since it no longer equates with the idea that I’m a “loser”.  I also don’t equate success with the idea of being a “winner”.   My value is independent of any success vs. failure tally.  Failure present an opportunity to learn.  Success presents an opportunity to reflect upon the journey to “here”.

I’m not worried about the goal itself, I focus instead on the journey.

My mother has a saying she likes to repeat often that “its not the journey but the destination that matters”.  I love this statement, and live by it.  Focusing on end goals, takes us away from the present. In the end, the present is all we have.  There is too much in this moment I have to be grateful for, I hate the idea that anything might take me away from it…

References

Gladwell, M. (2000, August, 21)  The Art of Failure. Retrieved from:  http://gladwell.com/the-art-of-failure
Petriglieri, G. (2007). Stuck in a moment: A developmental perspective on impasses. Transactional Analysis Journal. 37(3), 185-194.

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Feelings about Feelings

As an “INFP”, I’ve always been fascinated by the varied styles of affective communication that existed in my family….

While flipping through some old journals for another blog post idea, I came across the commentary above on attitudes towards emotions.  Understanding attitudinal differences towards feeling is critical in our attempts at communication of empathy.  Professionally, as a student therapist, my motives for understanding this issue should be obvious.  Personally, understanding attitudinal differences towards emotion has been critical in the healing of my relationship with my mother.

I will begin this post, by including relevant excerpts from a paper I wrote some time ago titled “Culturally Inclusive Empathy.”  

Against this backdrop of understanding, I hope to process some insights I’ve been mulling over after along week as wife, mother, blogger, student therapist, and caretaker…

#1. PAPER EXCERPTS: Culturally Inclusive Empathy….

Empathy is derived from the German word “Einfuhlung” which directly translated means “one feeling”, (Pedersen, et al, 2008, p42). From this perspective, empathy can be thought of as an ability to understand another’s experiences as if they are your own.   Best understood as an ability to relate to others due to shared experiences, the western Euro-American definitions predominating mental health are clearly problematic (Pedersen, et al, 2008). With traditional conceptions of empathy tending to reflect this cultural viewpoint, a more culturally inclusive perspective is vital. (Chung, 2002; Pedersen, et al, 2008).  What follows is a definition of this concept from literature:

“Inclusive Cultural Empathy describes a dynamic perspective that balances both similarities and differences at the same time integrating skills developed to nurture a deep comprehensive understanding of the counseling relationship in its cultural context.” (Pedersen, et al, 2008, p.41)

Understanding Emotion.

Emotion Defined

“Emotions can be defined as psychological states that comprise thoughts and feelings, physiological changes, expressive behaviors, and inclinations to act.” (Vohs, et al, 2007, p285). Overall, two divergent perspectives exist regarding research that focuses on the nature of emotion.  Appraisal theories are based on the premise that emotions result from the way we appraise and interpret our environment…Categorical theories tend to view emotions as universal, innate and discrete.

Categorial Theories of Emotion.

file000556357776Some research exists which focuses on a limited number of universal emotions, described as “basic” in nature. and byproducts of neural programming hardwired into the species overall.   Research reflecting this perspective utilizes a “Universality Thesis of Emotions.” (Effenbein & Ambady, 2002). While still asserting some degree of cultural variation, this perspective stresses the universality to facial expressions across culture. (Ellsworth, 1994; Ekman & Friesen, 1971). The Universality Thesis of Emotion proposes that facial expressions and attribution of emotion can be observed as universal across cultures,(Russell, 1994).

Emotion: A Cultural Perspective.

Appraisal theories of emotions interpret emotions as byproducts of the way people interpret and understand their environment, (Ellsworth, 1994). Research utilizing this theoretical perspective has traditionally focused on a few key dimensions such as:  (1) individualism/collectivism, (2) certainty/uncertainty (3) Attention to Novelty (4) Valence/Degree of Perceived Pleasantness, (Ellsworth, 1994). Differences in emotional expression are largely attributed to emotional regulation, stating that culture defines the beliefs about appropriateness of emotional expression. Accounting for differences in understanding of emotional expression, the assertion is made that culture “provides a framework for understanding culturally general emotional phenomena,” (Ellsworth, 1994)

For example emotions can be observed as a component of social interaction.   From this perspective they aren’t internal affective states influenced by cognition but a form of interaction. (Frijda & Mesquita, 1994). We “transmit important messages about ourselves in relation to our surroundings” (Leu, 2001), and behavior from within the framework of culturally meaning systems.  Emotion in this respect contains five characteristics reflective of culture including: “1. quality, 2. intensity, 3. behavioural expression, 4. the manner in which they are managed and 5. Organization.” (Leu, 2001).

“A cultural framework includes a group’s sense of and attitudes toward emotions, that is what emotions are or feelings are, why they are experiencing, and what their significance is in social life, as well as the implicit answers to questions like when does one feel, where does one feel, and how does one feel.” (Frijda & Mesquita, 1994, p.99)

When viewed within the context of a perceptual process, culture’s influence over emotions can also be observed. For example, individuals experience emotions in response to events they encounter that are deemed significant.  Our appraisal of situations reflect culturally relevant systems of meaning.

Inclusive Cultural Empathy.

empathyDefined as an ability to put yourself in someone else’s shoes, empathy is a culturally relevant concept. Traditional perspectives of empathy are self-limiting, based on a perspective that is empirical and individualistic in orientation. In contrast, culturally inclusive empathy is a useful dynamic perspective that requires two seemingly divergent viewpoints. Essentially, this concept requires a counselor to  hold onto their own cultural perspective while appreciating their client’s as well. can best be understood as a dynamic process that exists as an exchange between client and counselor, (Pedersen, et al, 2008). It comprises three key skills: Affective Acceptance, Intellectual Understanding, & Appropriate Interaction (Pedersen, et al, 2008). With intellectual understanding best understood as a knowledge of similarities and differences, it is an essential to note this is not enough in and of itself. Affective acceptance requires that a counselor acknowledge culturally learned assumptions underlying divergent forms of affective communication (Pedersen, et al, 2008).  Finally, effectively communicating this means developing key interactive skills and abilities through ongoing direct contact within the community (Pedersen, et al, 2008)

“Counselors will not be effective working with clients from different cultural backgrounds if they cannot communicate cultural empathy in a way that demonstrates that they understand and appreciate the cultural differences and their impact on the therapeutic process.   Ridley (1995) identified the following seven guidelines….(a) describe in words to the client his/her understanding of the client’s self-experience; (b) communicate an interest in learning more…; (c) express lack of awareness…; (d) affirm the client’s cultural experience; (e) clarify…communication; (f) communicate a desire to help the client work through personal struggles; and, (g)… help the client learn more about himself or herself …” (Chung & Bemak, 2002, p157)

#2. OBSERVATIONS: (Journal Excerpts & personal observations).

file000899275780

The above paper is a “cliff notes” version of research I’ve done on the subject of emotions.   Fueled by a desire for personal understanding and professional growth, this endeavor has been more than simply an attempt to complete assignments.  What follows are insights from direct observations with clients…..

Primary & Secondary Emotions

imageA fellow intern I work with is conducting an anger management class.  Since this facility is currently “reworking their curriculum”, we’re scrambling week-by-week to design it ourselves.  As we worked to determine the subject for this weeks classes, I noticed she began printing off material on primary vs. secondary emotions.  Hearing these terms brought back memories of a DBT skills group I had participated in “many years ago”.  According to Marsha Linehan, while primary emotions comprise our immediate reactions to an event, our secondary emotions our own interpretations of these emotional states. In other words, secondary emotions are “feelings about our feelings”.

For example, my mother has always reacted to the open expression of emotion with a perplexing discomfort that had always bothered me.  I desired support and understanding and instead I received stoicism.  While she hadn’t intended to, as a child I perceived this as rejection….

Today with the benefit of 20/20 hindsight I have an appreciation for our differences.  My mother was raised in a collectivist society in which daily life centered around the extended family. Identity, for my mother has always included an appreciation of her family role.  For example, to this day everyone calls here “Nene”, which in Tagalog means baby.  Additionally, I’ve come to understand her love as not a matter of words but a quiet and unspoken fulfillment of her “duty” as my mother.  This concept of “duty” is strange and unfamiliar as an American.  Individualism and pride are consistent with our way of doing things.

imageDue to these differences, my mother reacts to the open expression of emotion negatively, I become annoyed by this response, and an endless cycle of misunderstanding develops.   From my mom’s perspective if emotions cause disharmony and impede the fulfillment of her duties as a mother, it is selfish and unnecessary to do so.  Understanding this has been helpful in rebuilding our relationship.

Born in 1938 in the Philippines, I’m sure there is a history of familial trauma that plays a part as well.  The point, however, is her intention was not to make me feel “rejected”.  Instead, I see her own unique emotional resilience as a quiet offering of strength and support.

Ideal & Actual Affect

imageIn the paper I quoted above, I reference a research article titled “Cultural Variation in Affect Valuation”, (Tsai & Fung, 2006).   This article describes two interesting concepts pertaining to the issue of “feelings about feelings”.  Whereas our ideal affect reflects what we want to feel, our actual affect reflects our current emotional state.(Tsai & Fung, 2006).  For example, research has shown that individualistic cultural orientations are more strongly correlated with values such as elation and excitement (Tsai & Fung, 2006). In contrast, collectivist cultures tend to value a more calm, peaceful and relaxed state (Tsai & Fung, 2006).   When I read the first time, I immediately thought of my own mother and our relationship problems.  As fundamentally eye-opening as insight was, I ended up journaling on it later. Somehow, we never saw eye-to-eye on matters growing up. In retrospect, I am now able to understand my mother’s strange and perplexing discomfort with frank emotional expression.

Understanding a Cultural Syndrome….

file000831022860Being the nerd-girl I am, after reading this insight from a paper, I decided to do some personal research of my own.  I found an article that discussed cultural syndromes as shared sets of beliefs, attitudes, and norms that influence one’s behavior (Eid, Deiner, 2001).  It’s worth noting that my entire internship experience has required a trip to a foreign land where unusual cultural syndromes dominate all behavioral tendencies.   I come from an upper-middle educated background, my parents are happily married since ’68, and are both physicians.  I know little of addiction, or the experiences of my clients at the homeless shelter I intern at.   It is definitely a learning experience…..

…At any rate, expounding upon the insights of Frijda & Mesquita, B. (1994), the authors of this article on cultural syndrome describe three key differences between collectivist and individualist cultures…..

“Frijda and Mesquita distinguished among three aspects of emotion that are culturally influenced. First, they considered social consequences of emotions that regulate the expression and suppression of emotions. Second, they stressed the importance of norms for experiencing different emotions. Third, they discussed social-cohesive functions of emotions.”(Eid & Diener, 2001, p. 869).

Display Rules of Emotion…

Expounding upon the insights above, Eid & Diener, (2001) state that cultures have varied unspoken rules of emotional display.  Failing to understand these “unspoken rules” can often result in the violation of a social norm and some level of social rejection.   In my home, an unspoken rule of emotional display existed that involved a preference for restraint and stoicism.  As doctors, my parents led with their intellect.  It has always been a defense mechanism.  They are uncomfortable with honest expressions of emotion.

Feeling Rules “Should-Be’s”…

Eid & Diener, (2001), also mention Feeling Rules: “social norms that prescribe how people should feel in specific situations (e.g., on a wedding day, at a funeral)” (p. 869).  These sorts of cultural norms, greatly influence the appropriateness and desirability of certain emotions.  For example, in the research paper I excerpted from, I recall one  resource mentioning culturally relevant differences in response to the emotion of pride.  While I’m unable to recall the resource at the present, results indicated Collectivist Asian societies reacted more negatively to this emotion. In contrast, Americans were comfortable, openly expressing feelings of pride…

Final Thoughts… (I promise).

file000166887896In this old journal of mine is information I found from somewhere on “Emotional Coaching”.  It describes how to teach children to handle their feelings effectively.   My parent’s own style tended to flounder between dismissive and disapproving.  I spent my 20’s learning to overcome a lasting sense of shame, and inability to trust my feelings.  As a parent myself, I’ve promised to provide my kids the sort of emotional coaching I yearned for as a highly sensitive child.

This resource begins by describing three common emotional coaching styles:

THE DISMISSING STYLE:  parents ignore bad emotions and have a “get over it” attitude.   The child feels they are being ignored and have difficulty trusting their own feelings.
THE DISAPPROVING STYLE:  Here parents don’t just ignore bad emotions, they punish children for having negative feelings.   This “don’t feel that way” attitude, leaves children feeling a sense of shame: that they are somehow wrong and flawed.  
LAIESS-FAIRE STYLE:  Parents with an “anything goes” attitude provide no guidance whatsoever.  While there is plenty of acceptance, there isn’t enough nurturing guidance children need to manage emotions more effectively….  

In conclusion, with this typology in mind, what follows are steps on how to provide emotional coaching to your child…

STEP ONE: Be aware of your child’s emotions.  Parents who are emotionally aware are able to raise children who are also emotionally aware.  Acknowledge your child’s feelings, listen, & see things from their perspective.

STEP TWO: Using shared emotions as an opportunity to connect with your child.  Experience is the best educator I believe.  When emotions arise & become overwhelming, this is an ideal time to help them develop skills to manage them effectively.  Don’t avoid or dismiss them, instead listen and offer guidance.

STEP THREE:  Listening Empathetically.  listening involves supporting the child’s lived experience as if it were true in accordance with their level of understanding.  Reflecting the child’s feelings back to them, lets them know you are understanding.

STEP FOUR:  Help your child name the emotions.  Helping a child identify their feelings and allowing them to discuss why the feel that way is critical.  This allows the child to develop emotional intelligence and adaptive coping skills.

STEP FIVE:  Finding good solutions.  First, when disciplining a child for bad behavior, it is important to understand the problem is the behavior and not the feeling.  With firm limits in place, ask your child what they want to happen to feel better and then options are available to solve things.

References

Chung, R. C., & Bernak, F. (2002). The relationship of culture and empathy in cross-cultural counseling. Journal of Counseling and Development : JCD, 80(2), 154-159.
Eid, M., & Diener, E. (2001). Norms for experiencing emotions in different cultures: inter-and intranational differences. Journal of personality and social psychology, 81(5), 869.
Ekman, P., & Friesen, W. V. (1971). Constants across cultures in the face and emotion. Journal    of Personality and Social Psychology, 17(2), 124-129. Retrieved from:          doi:http://dx.doi.org/10.1037/h0030377
Elfenbein, H.A., & Ambady, N. (2002) On the Universality and Cultural Specificity of Emotion Recognition: A Meta-Analysis. Psychological Bulletin. 128(2). 203-235.
Ellsworth, P. C. (1994). Sense, culture, and sensibility. In S. Kitayama, & H. R. Markus (Eds.),   Emotion and culture: Empirical studies of mutual influence. (pp. 23-50) American         Psychological Association. Retrieved from: doi:http://dx.doi.org/10.1037/10152-001
Frijda, N. H., & Mesquita, B. (1994). The social roles and functions of emotions. In S. Kitayama,  & H. R. Markus (Eds.), Emotion and culture: Empirical studies of mutual influence. (pp.    51-87) American Psychological Association. Retrieved from: doi:http://dx.doi.org/10.1037/10152-002
Harmon-Jones, E., Harmon-Jones, C., Amodio, D. M., & Gable, P. A. (2011). Attitudes toward emotions. Journal of personality and social psychology,101(6), 1332.
Leu, C.M. (2001). Emotions as Dynamic Cultural Phenomena. The Journal of Linguistic and       Intercultural Education, 4. 62-75.
McKay, M.; Wood, J.C.; & Brantley, J. (20107).  The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation & distress tolerance. Oakland, CA : New Harbinger Publications.
Pedersen, P. B., Crethar, H. C., & Carlson, J. (2008). Inclusive cultural empathy: Making relationships central in counseling and psychotherapy (1st ed.). American Psychological          Association. Retrieved from: doi:http://dx.doi.org/10.1037/11707-003
Russell, A.J. (1994). Is There Universal Recognition of Emotion from Facial Expression? A          Review of the Cross Cultural Studies. Psychologial Bulletin 115(1). 101-141.
Tsai, J.L, Knutson, B., Fung, H.H., (2006). Cultural Variation in Affect Valuation. Journal of      Personality and Social Psychology. 90(2). 288-307. Retrieved from:           http://ezproxy.bellevue.edu:80/login?url=http://search.proquest.com/docview/131977868  0?accountid=28125
Vohs, K.D., Baumeister, R.F., & Sage Productions,  (2007). Encyclopedia of Social Psychology. Thousand Oaks, Calif: Sage Productions.

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What is DBT?

As I see it, a perplexing dualism exists within the counselor’s mind while providing therapy.  On the one hand, you have a Rogerian unconditional positive regard as an essential element in the therapeutic relationship.  On the other hand, you have the sort of confrontational style found with addiction counseling’s history.  Where is there a middle ground between these extremes? – Understanding & Handling Resistance

After reading my last post, It occurred to me that more can be said on the matter.  In fact, this issue of change vs. acceptance reminds me of Linehan’s DBT.  My first introduction to it was as a client.  I use many of the DBT coping skills today.   As yet another hectic week of interning comes to a close, the importance of these needs emerge in my interactions with clients.  It also reminds me of my youth as a depressed teen….

I felt hopeless and alone.  Enveloped by an unending well of self-pity, I felt suicidal yet “didn’t have the guts to go through with it”.  My memory of this time sticks with me.  I’m grateful to have survived it.  These feelings can goad you toward seeking a solution – any solution – to making the “hurt stop”.  Reality is worse than a death since the pain you feel is never-ending.  With no solutions available, all I could do is marinate in my misery.

From within this mindset two seemingly counterintuitive needs existed.  I wanted someone who understood my pain without needing to fix things.  My favorite advice to all the bullying: ‘Just Ignore Them’ & Be Yourself”.  It never worked.  I was that teenager with a “you don’t understand me” mental filter.  If you “didn’t understand” you weren’t worth listening to.  If someone had taken time to truly listen, I may have been open to their offering of changed-based solutions…..

Against this personal backdrop, I see a bit of myself in my clients.  Its for this reason, I wish to review DBT’s basic principles….

Linehan’s Biosocial Theory….

DBT is a useful in approach helping individuals “manage overwhelming emotions…[and] strengthens…[their] ability to handle distress without losing control” (McKay, et al, 2011, p. 11).  The coping tools taught within DBT Skills Groups are useful in managing emotional dysregulation, (when an individual’s ability to modulate their responses to life situations is ineffective).  According to Linehan’s biosocial theory, pervasive emotional dysregulation is the result of an interaction between biological vulnerability and an invalidating environment (Koerner, 2012). Biological vulnerability is the result of three individual characteristics: (1) heightened sensitivity, (2) heightened reactivity, and (3) prolonged arousal (Linehan, et al, 1999).

Emotionally invalidating environments provide the second causal component in Linehan’s biosocial theory.  Defined as a failure to show respect for and acknowledgement of someone’s feelings; invalidation makes us feel our emotions are being neglected, mocked, and ignored (Linehan’s, et al, 1999).  Emotionally invalidating environments provide consistently invalidating responses to our maladaptive emotional regulation strategies, thereby reinforcing them, (Koerner, 2012). When these two factors coexist, the result is a poor fit between one’s emotional needs and their environment.

“Let us imagine the following: a child grows up and never experienced any validation of thoughts or feelings. He is an emotionally feral child, but lives within a community of other people who ignore validation. His parents have a radical behaviorist approach…adhering to the strictly behavioral position that emotions and cognitions are meaningless constructs” (Gilbert, 2005, page 199).

DBT’s Unique Solution…

A Dialectical Perspective

The word “dialectic” is defined as a perspective that aims to contend with opposing ideas. When I think of dialectic philosophy, Hegel’s work immediately comes to mind. In a nutshell Hegel’s dialectical perspective can be summed up in the fact that the whole is not equal to the sum of its parts.   Each component part, of this whole, has pieces missing.  Additionally, these component parts, focus only on certain elements of a situation.  Attaining wholeness requires us to see what you’re missing. DBT is based on this insight that reality is comprised of interrelated parts that must be seen holistically for the sake of clarity (Lynch, et al, 2006). Dialectical philosophy sees solutions as arising from opposing viewpoints that can be combined into a holistic perspective. DBT applies this philosophy to its treatment of emotional dysregulation with the use of change strategies, acceptance strategies, and dialectical techniques (Koerner, 2012).

  1. CHANGE STRATEGIES include the utilization of techniques to encourage change and behavioral modification (Koerner, 2012). DBT skills such as distress tolerance, chain analysis, and opposite action are useful in addressing pervasive emotional dysregulation (McKay, et al, 2010).

  2. VALIDATION STRATEGIES exist as a useful counterpoint to these techniques and emphasize acceptance and empathy (Koerner, 2012). These strategies are based on the fact that deep emotional wounds can’t be healed with logic (Lynch, et al, 2006). Validation reduces physiological responses to dysregulated emotion and allows a therapeutic alliance to develop (Linehan, et al, 1999).

  3. DIALECTICAL STRATEGIES address a “tension between the need to accept a client’s…vulnerabilities [while encouraging] them to make necessary change[s]” (Koerner, 2012, p15). DBT skills such as wise-mindedness and radical acceptance provide clients with the insight that underlies this dialectical balance. (McKay, et al, 2010)

Treatment objectives.

Initially, DBT was developed as a treatment for Borderline Personality Disorder, however research has shown it as effective in a wider array of clinical situations (Dimeff & Koerner, 2007). As an empirically supported approach, it is used in inpatient as well as outpatient settings.  It is also effective in group therapy, individual therapy and family therapy (McKay, et al, 2010).

In order to standardize DBT across all these contexts Linehan states that DBT should address five key objectives (Koerner, 2012).

  1. DBT provides clients with skills training to regulate emotions (Koerner, 2012).
  2. DBT strengthens a client’s motivation for change (Koerner, 2012).
  3. DBT helps clients apply skills in their daily lives (Koerner, 2012).
  4. DBT provides therapists with the skills needed to assist clients (Koerner, 2012).
  5. DBT provides a nonjudgmental, structured, and safe environment that allows both therapist and client to function effectively (Koerner, 2012).

Validation & Acceptance

When it’s missing….

While treating chronically suicidal patients with BPD, Linehan noted a critical shortcoming in traditional behavioral and cognitive approaches (Lynch, et al, 2006).   In particular she states the following:

“Focusing on client change, either of motivation or by enhancing capabilities, is often experienced as invalidating by clients who are in intense emotional pain.  In many clients it precipitates noncompliance, withdrawal, and at times, early drop from treatment”  (Linehan, 1997, p. 354).

Traditional behavioral approaches fail to address certain critical needs: validation and acceptance of how one feels.  Admittedly, from a pragmatic viewpoint, the idea of validating a suicidal patient’s feelings might seem idiotic.  After all, doesn’t validating a suicidal patient’s feelings mean we implicitly approve of their actions??? This attitude is quite prevalent in the hospital settings I work in.  Fortunately I’ve have the benefit of seeing things from both “sides of the fence”.

The other side of the fence…

All actions to save my life, however well-intended, resulted me feeling like a prisoner.  (This was after I left “it”.) I did a bad and needed to be constantly reminded of this.   It didn’t matter why I was doing it.  It didn’t matter what I felt or what I was going through.  I did a bad thing….

My mind is now flooded with fuzzy images of that event.  Medical personnel hovered around me as I remain strapped to the gurney.  One tech called me crazy nut and started cursing at me.  Strange hands started grabbing me all over as a tube with black crap was shoved down my throat. I screaming silently inside.  I was scared, hurt and alone.  Didn’t they understand?  Why wasn’t my family there?

After a period of rest, a student doctor sat down briefly to talk.  He was different.  He sat next to me, grabbed my hand and listened.  HE LISTENED.  He didn’t tell me I was bad or wrong.  He didn’t rush to judgment. I didn’t get a lecture. Instead he listened to how I was feeling and told me he was here if I needed to talk.  Just to ask for him…..

It’s been 20+ years since I attempted suicide. Right now I work as a CNA for a large hospital system.  Consequently, I often see patients like this – ALL THE TIME.  On occasion I am assigned as a “Safety Advocate”, for one.  This means staying within an arms reach of them at all times, to ensure safety.  My own experiences on the other side of the fence remain with me.   I witness as hospital personnel work fulfill their list of duties.  They are stressed & have lots on their mind as they attempt to stablize the patient.  They act with the best of intentions, and are guided by a strick moral code.   However, one thing is often missing: counseling experience.

They forget the human being sitting next to them is simply in pain.  They don’t take time to listen to their story.  It doesn’t occur them to ask: “How is it, that this patient’s emotional state can be understood from within the context of their life situation?”

Encouraging Change

When Acceptance Alone is Inadequate….

When a person validates your feelings, they acknowledge the reality of your lived experience “[as] understandable within [your] current life context or situation (Linehan, 1993, p. 222-223).”   You feel an implicit empathetic acknowledgement of who you are as a human being in pain.  You notice your emotional responses are taken seriously and not discounted, trivialized or mocked.  However, despite its vital importance alone it is inadequate as an approach to therapy…

“focusing treatment [of suicidal patients] on exploration and understanding, in the absence of a clear focus of efforts to help the client change, is often experienced by these same clients as invalidating because it does not recognize the ‘unendurability’ and therefore the necessity for immediate change (Linehan, 1997, p. 354).”

This statement resonates with another personal experience of mine.  As a high school student, I was depressed and alone.  I had no friends and only my school counselor to talk to.  A comment made during one of our sessions sticks with me to this day.  I shared with her the bullying I was dealing with.  She expressed sympathy and added that its just a matter of waiting it out.  “Once you graduate you’re out of here”.  When I asked her what she meant by this, she noted this small school was very cliquey & that finding friends would be difficult for me.  My reputation was pretty much cemented in the minds of my classmates and there was no changing opinions at this point. Her solution: Just wait it out.  I was already half way through high school and in the grand scheme of things, two years was nothing.

While I don’t recall my exact response to this explanation an inescapable sense of hopelessness fell over me like a foreboding and dark cloud.  It then occurred to me that my parent’s advice had a similar message to it: “They’re in cahoots!”

In retrospect, I remember my first experiences with dissociation in this moment.   This out-of-body “unreal-ness” was my only coping tool to the emotional traumas of bullying.  With no other solution at hand, this was my only coping mechanism.  It has taken much of my life to work through…..

The need for “a way out”

As I noted earlier, DBT provides a balanced solution that includes both acceptance and change-based strategies.   Based on the idea that the whole doesn’t equate to the sum of its components, the solution is to see those things you’re missing.  Hegel describes a process of transformation much like this in his philosophy,  It is a perspective that’s applicable to mental health, fields of study, and even society as a whole.

Hegel’s dialectical stages of growth begin with a THESIS, (another fancy word for idea, i.e. change is bad).
Change happens when this THESIS encounters an ANTITHESIS, (a fancy word for a contradictory idea, i.e. change is good).
When an individual resolves two conflicting ideas, (THESIS vs ANTITHESIS), the result is SYNTHESIS...(change can be scary but isn’t always a bad thing).

Wrestling with seemingly counterintuitive ideas like, leads to a cognitive dissonance, that urges us towards resolution. Using my example above, I’ve learned that my fear of change isn’t always warranted. While its not bad to move forward with caution, avoiding change at all costs results in stuckness. Sometimes a unique approach to things can create new solutions and positive transformation.

“The most fundamental dialectic is the necessity of accepting clients just as they are within a context of trying to help them change (Linehan, 1997, p. 354).”

It is a goal of mine to learn more about this method, and utilize it as a key approach in my future practice….

References

Koerner, K (2012). Doing dialectical behavior therapy: A practical guide. New York, NY: Guilford Press.
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
Linehan, M. M. (1997). Validation and psychotherapy. Empathy reconsidered: New directions in psychotherapy, 353-392.
Lynch, T.R., Chapman, A.L, Rosenthal, M.Z., Kuo, J.R., & Linehan, M.M. (2006). Mechanism of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology. 62(4), 459-480
Mckay, M., Wood, J., & Brantley, J. (2007). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation & distress tolerance. New Harbinger: Oakland, CA.

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Coercion & Confrontation….

This post continues with a ‘train of thought’ I left off at with my last post titled ‘Understanding & Handling Resistance’

Confrontation & Addiction Counseling…

Recently, in the ensuing stress associated with a 70+ work week, I decided to meet up with my long-time therapist (even therapists need therapists).  As I began describing my internship experiences, she gave me a cursory overview of addiction counseling’s history.  In my last post, (link above) I make the following comment:

Defined as “process by which a therapist provides direct, reality-oriented feedback to a client regarding the client’s own thoughts, feelings or behavior” (White & Miller, 2007, p. 2), therapeutic confrontation has a long history in the field of addiction counseling.  Historically, this counseling style was utilized in chemical dependency treatment to overcome denial & resistance (Policin, 2003).  Aggressive confrontational styles like “Synanon’s attack therapy” Pokin, (2003), were utilized to break down the defense mechanisms underlying an addict’s utilized to deny their problems.  White & MIller (2007) described this confrontation as a highly varied form of confrontation ranging from “frank feedback to profanity-laden indictments, screamed denunciations of character, challenges and ultimatums. (p. 2)”.

Honestly, as described above, I’m really troubled by an approach like this.  Rather than encouraging change through personal growth and increased insight, it sounds very shame-inducing.  Admittedly, there are many aspects of addiction that are infuriating for addiction counselors.   After all, Substance use disorders encompass a complexity of physiological, behavioral, and psychological symptoms.   Physiological dependence is a byproduct of alterations in brain function due to prolonged exposure to an addictive substance, which produce strong cravings and withdrawal symptoms. Psychological components can include self-destructive patterns of behavior, poor self-control and ineffective coping skills.  Treatment is rather complex as a result.  In addition to addressing any long-term health issues, it is also essential to manage physiological symptoms of withdrawal. Addressing a client’s ambivalence to addiction treatment is complicated in light of these multifactorial issues and any lingering cognitive deficits.

So what is Coercion?

“The crux of coercion is to motivate the patient to comply with addiction treatment by enforcing consequences” (Sullivan, et al, 2008, p. 36). In examining the ethical nature of such practices, it is useful to consider the instances in which coercion is used throughout treatment. An obvious example of coercive treatment includes situations in which drug users are given a choice between treatment and penal sanctions for crimes committed (Stevens, 2012).   Less obvious instances include staged interventions, contingency contracts, and pharmacological coercion via Antabuse (Sullivan, et al, 2008).

Ethical Considerations

There appears to be much controversy surrounding the issue of coercion in substance abuse treatments. Those who oppose coercive treatment techniques state that these interventions are a violation of an individual’s personal liberties, and right to informed consent (Sullivan, et al, 2008; Stevens, 2012). Advocates, however point out that “few chronic addicts will enter or remain in treatment without some external motivation, or legal coercion” (Sullivan, et al, 2008, p. 42).   At first glance, I find legitimacy in both perspectives.

Proponents of Coercive Interventions

On the one hand, it is clear that long-term use of addictive substances can produce cognitive deficits that interfere with one’s ability to participate in the treatment planning process. This fact alone seems to support the notion that some coercive efforts may be called for, (including the less obvious forms discussed earlier). Some proponents stress that it is a duty to act on behalf of those who are impaired to make treatment decisions (Marlowe, et al, 1996). From this perspective it is presumed that “once treated the individual will be grateful in retrospect for the intervention” (Marlowe, et al, 1996, p. 77).

Critics of Coercive Techniques

In addition to violating an individual rights, critics counter by stressing the fact that treatment is often ineffective if the individual is unmotivated to change. The Transtheoretical Stages of Change Model, is in fact a great illustration of this and provides a useful perspective that allows us to assess a client’s level of ambivalence to change. Instead, helping the client increase their level of motivation to change is preferred (Sullivan, 2008).

Cultural Considerations

One resource provided an interesting discussion of cultural considerations pertaining to the use of coercive techniques that is also relevant. Collectivism and individualism each provide different perspectives of one’s “self” in relation to others, that is likely to determine effectiveness of such techniques. Individualistic societies promote the idea of self-responsibility, independence, and autonomy (Sullivan, 2008). As a result, from this perspective the individual is perceived to be responsible for their addiction, and coercive techniques are often less effective. On the other hand, collectivist societies provide a different view of the “self” as part of something greater.  Individual well-being is a societal concern and coercive techniques are often much more effective. However, “collectivist families can also impede recovery if the group perceives drinking or drugging behavior as normal or an indication of weak character” (Sullivan, 2008, p. 44).

Conclusions.

Regarding the utility of coercive techniques, Marlowe, et al, (1996) notes that many of the less obvious forms of coercion, often involve forms of negative reinforcement. In fact throughout the treatment process are coercive influences that involve an “escape or avoidance reinforcement schedule…[in which] the aversive stimulus precedes the target event” (Marlowe, et al, 1996). With this in mind, Marlowe, et al, (1996) suggest that a comprehensive assessment of coercive influences may assist treatment planning. In fact, when reading this resource I’m reminded very much of behavioral therapy. The use of naturally occurring contingencies that influence one’s behaviors and decisions is common throughout treatment. If utilized in this way, I’m not against the coercive influence of a contingency contract, or staged intervention, as described by Sullivan, et al. (2008).  However, I’m very “wet behind the ears”, and my thoughts on the matter are likely to change as time progresses….

References

Marlowe, D. B., Kirby, K. C., Bonieskie, L. M., Glass, D. J., Dodds, L. D., Husband, S. D., & Festinger, D. S. (1996). Assessment of coercive and noncoercive pressures to enter drug    abuse treatment. Drug and Alcohol Dependence42(2), 77-84.
Polcin, D. L. (2003). Rethinking Confrontation in Alcohol and Drug Treatment: Consideration of the Clinical Context. SUBSTANCE USE & MISUSE, 38(2), 165-184.
Stevens, A. (2012). The ethics and effectiveness of coerced treatment of people who usedrugs. Human rights and drugs2(1) 7-16.
Sullivan, M. A., Birkmayer, F., Boyarsky, B. K., Frances, R. J., Fromson, J. A., Galanter, M., & Tamerin, J. S. (2008). Uses of coercion in addiction treatment: clinical aspects. American Journal on Addictions, 17(1), 36-47.
White, W. & Miller, W. (2007). The use of confrontation in addiction treatment: History, science and time for change. Counselor, 8(4), 12-30.

 

 

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