An open letter to my students V: Most of you won’t do therapy, but that doesn’t mean you won’t be therapeutic

Enter your email address to follow this blog and receive notifications of new posts by email.

I was out with a few colleagues the other day. We went to lunch and as I was chowing down on my southern relish sandwich listening to the two of them talk about work, one of them, who just became a professor said, “we tell student’s they’ll get out and have this ‘skill’, as though they’re going to go out and hang their own shingle. Really most of them will have to go out and get a J-O-B.” I stopped mid bite, bits of sandwich hanging out of my mouth.

That captured exactly how I felt for a long time. I remember when I graduated. Diploma in hand I was ready to start making those big counselor bucks. Surely all I had to do was walk into an interview and say, “I’m here! I have a MASTERS degree!” and they’d pay me what I’m worth. Right?

Not exactly. It’s not that getting a job was hard. Getting a job was easy. The problem was that my training was in how to do therapy, and the jobs, well they didn’t quite have therapy in mind. Over the past few years I’ve had a series of “therapy” jobs and it seems to me that these jobs have fallen into three basic types: Social Worker, Agent of Social Control, and Camp Counselor. 

Social worker is what I did until really recently, (as in I still work there but I turned in my 30 day notice).  At least every other weekend you could find me on the Behavioral Health Unit of the local hospital doing bio-psycho-socials and conducting a group or two. The majority of jobs like this entail making sure people have the resources they need. It’s a lot of phone calls and paperwork. It can feel … well its not always the most engaging work.
I worked with people who made the job enjoyable, but the work itself was not fulfilling. When I was in my Ph.D program my dream was not to set up after care appointments for 7.5 hours a day.  

Image result for agents matrix gif transformAgents of social control sounds like something from the matrix because, well, that’s exactly what the Wachowskis had in mind. I did this kind of work a few years ago when my job was working as an In- Home therapist. My job was to use my therapy skills to keep kids out of trouble, so I was a “kind” alternative to a parole officer. Trouble was most of the time the kid’s behavior was a normal reaction to insane circumstances. In-Home therapy is really hard because you have little control over the context, and the stakes are very high for you, as the therapist to bill, which requires you having to see the family face to face. One of the things that bothered me the most about In-home therapy was feeling pushed by my agency to do therapy with people for whom therapy wasn’t a priority. I’d drive by houses and people wouldn’t be home. I’d call phones and people wouldn’t answer. When I finally did get a hold of the family I’d learn that they moved to a whole new school. Strangely, the pressure wasn’t to help these families change. Most of my referral sources were too  tied up trying to survive the politics of their own agencies to question who effective therapy was. As long as they could check the box saying they had enrolled the kid in therapy they were happy. 

“Camp counselor” is what I’m doing now. I run groups for elderly persons who have Image result for Ouroboros gifbeen referred to therapy by their doctor or nursing home. Most of the time I wonder if they really need counseling or just friends. When I first took this job I didn’t know that when an elderly person goes into a medicaid-funded-nursing home the government takes away everything they own in order to pay for the patients stay. It’s been really sad to see how we take away everything our elderly have worked for their entire life, their homes, their cars, etc, and send them to live in dorms where they don’t know anyone. In that situation it makes sense to me why so many of them suffer from anxiety and depression. But, instead of changing the system, they get sent to people like me for group therapy because hospitals can bill for psychotherapy groups and nursing facilities want the grumpy elderly out of their hair. Add to this the open secret that many of our elderly are overly medicated which often leads to their psychiatric symptoms (more on this later), and you have a system incentivized to support itself. This is the fate of all of those hoping social security will take care of them upon retirement. 

If you don’t find yourself as a Social Worker, Agent of Social Control, or Camp Counselor you can still find yourself hoodwinked into not doing therapy. Your agency will send you patients with autism, who’ve had a stroke, or who have some sort of developmental delay, and because insurance will reimburse for providing “psychotherapy” for this population you’ll get tied into providing them with therapy. Problem is psychotherapy isn’t what they need. They need something like ABA, which is a behavior modification therapy. Or they need an occupational therapist to help them redesign their lives so they can function in society with appropriate modifications. Both OT and ABA are needed. Neither are psychotherapy. But congratulations- you’ve now been exposed to how insurance dictates treatment. More on that later.

However, you are being trained to be a therapist. Part of the skill of therapy is to be able to provide therapy to people despite the context. By following the fundamentals and avoiding some of the bigger mistakes you will give many clients an experience they have never had and be a fighting force against shame.

I’m Jordan Harris. I have a PhD in Marriage and Family Therapy. I’ve dedicated myself to being an excellent father and a thoughtful husband. I’ve studied hypnosis with Douglas Flemons, one of the most innovate and imaginative therapist on the planet, and I’m pretty sure, after specializing in couples therapy, that emotional connection is what it’s all about. PLEASE leave a comment. I’d LOVE to hear from you. 


If you don’t fall into this you you might end up an agent of social control. So a teacher sees that a student is acting out, either they don’t know how to deal with the student, or they don’t want to deal with the student, and so they call you in as the therapist to stop the behavior. You job as a therapist is NOT to stop the behavior. It is to help the client manage the unfomfortable emotions behind the behavior. Usually the behavior stops, but sometimes it doesn’t. Whether it does or not is not your concern. And strangely I don’t think most supervisors, principals, EBPs and insurance companies care if you succeed or not. It seems they just care if they are getting their cut of the patients insurance (or in the case of insurance companies not giving up their cut). But in order to get you to do you job and go along with the system, they will pretend that they care. I’ve heard many insurance companies argue that removing addicts from treatment was in their best interest (it helps them re adjust to real life).

I know one of the things is lobbying for equality. See for a long time, mostly because social workers were around first, LPCs and LMFTs were seen as inbred second cusins to social workers and especially to psychologist. So, like everyone in this country, we got some money and started lobbying for equality. But with equality came equal work. Social workers do a lot of case management. Once we achieved equality with them, we were expected to do the same- hence many of you will get pushed into case management and won’t see actual therapy for a few years.


Advertisements

An open letter to my students IV: The BIG mistake and what to do about it

The other day I was talking with a therapist about the job we do. She was asking for my advice on how to run a group for senior citizens. I gave her a few thoughts then asked, “what do you usually do with these sorts of groups?”

“Well you know, I usually do a lot of self-esteem building. I might say, ‘I know things seem bad and you don’t feel like you’re getting anything accomplished, but for you getting out of bed is an accomplishment. That is progress.'”

I almost barfed.


 

The other day I was talking with a friend whose a therapist about the job we do. He was about to go into a session with a client, Sam, with whom he felt stuck. Sam has pretty serious anxiety to the point that at times he can’t leave his house. Because I was curious I asked my friend, “What’s your approach? Where are you trying to get with Sam?”

“I want him to realize that what he’s thinking is irrational. Other people aren’t really always looking at him. It’s all in his head.”

I squirmed a little.

frustration-gif-3.gif


The other day I was talking with a friend. She was telling me how she went to a therapist for a while, but it wasn’t helpful.

“Why not?” I asked.

“Well, after a while, like the fourth session, I kinda felt like she thought I was done. She kinda hinted that we’d already prayed about it. Now I just had to deal with it.”

SorrowfulMediocreEuropeanfiresalamander-max-1mb.gif


It is hard to teach to do therapy from a letter. You miss out on context and feedback and techniques get misunderstood.  While it is difficult to teach what does work via letters, letters are excellent at conveying what doesn’t work.

The above are all examples of therapist negating their clients’ experience. You will be tempted to negate your clients’ experience for several reasons.

First, those surrounding your client’s will negate with such elegance, sophistication and matter-of-factness that going against them will feel like going against common sense. Parents will attempt to seduce you into negating their sons (“he’s just defiant”), husbands will attempt to seduce you into negativing their wives (“she’s just too needy”), probation officers will attempt to seduce you into negating their parolees (“he just needs a good kick in the —“), coworkers will attempt to seduce you into negating the clients (“we got another frequent flyer”) and so on and so forth. 

The problem is, at best, negating another’s experience will leave it unchanged, but more likely it will make the painful experience worse.


When we invalidate people or deny their perceptions and personal experiences, we make mental invalids of them. When one’s feelings are denied a person can be made to feel crazy even when they are perfectly mentally healthy. – R.D. Laing  


Our colleagues find it easy to negate when they  have lost hope and are frustrated that change is not happening quicker. They find it easy to negate when they feel hopeless (some of which is caused by ineffective technique). They feel frustrated and don’t know how to help relieve the suffering they’re facing. So they try to pull us into their pain because relationship relieves suffering. We all spend some time in that exhaustion. Part of writing these letters to you is to help light the way so that when you are in that place you can sit, rest a while, then when your ready continue the struggle.

Furthermore negation is so seductive because good negation points to a truth. The guy who comes to you and complains about his marriage just has to stop having affairs. The mom who’s frustrated with her daughter just has to stop smacking her. The frequent flyer is a frequent flyer and has to just keep his followup appointment. The addict needs to finish rehab and not leave early, no matter what. These are all true things and the seduction of truth is strong


A truth that’s told with bad intent, beats all the lies you can invent.- W. Blake


What do you do instead? The antidote to negating an experience is to validate. At times validating the other’s experience is scary because we don’t want to want to condone the uncondonable. If someone is suicidal you don’t want to give them permission to kill themselves by validating suicide. The technique is to validate emotions not behaviors. You can always validate emotion because emotions always make sense. Emotions are our bodies way of making relational sense of the world.


There was once a guy named Elliot who had brain surgery and lost his ability to have emotions. At first he was fine, but then, over time, he began to do strange things. He’d go out to eat for lunch and would be gone all day because he’d start thinking, “well if I go to McDonald’s it’s faster and cheaper, but if I go to Subway it’s a bit healthier, then again Subway did just put cement in their bread, so maybe Mcdonald’s it is, but Mcdonald’s doesn’t degrade and the long term effects of that on my body would be drastic, but right now it would taste really goo. Maybe I should go out for Chinese instead? Well which Chinese spot should I go too, the one on 4th street is closer, but the one on 7th has fortune cookies, “and on and on. Emotions are actually the foundation of logical thought partly because they tell us what to value. Without knowing what he valued Elliot couldn’t make a logical decision. 


There are at least seven universal emotions. Each emotion, in addition to having its own logic, is a message about relationship.

  • Joy pulls me to move toward the other to extend the feeling.
  • Sadness pulls others close to me. Shame and guilt are some of its siblings.
  • Fear pushes me get away from the other for safety.
  • Anger pushes me towards the other in order to remove an obstical, which is why anger is “sticky”.
  • Disgust pushes the other out of relationship. It’s a way if saying we have no relationship.
  • Surprise tells me to pause until we know what kind of relationship we have. It asks the question “Do I need to move forward or away from this?”

anigif_enhanced-buzz-23469-1435276061-5.gif

Certain emotions can feel overwhelming, like a wave that will envelop us and drag us a million miles away in just a few moments. To protect ourselves from these emotions we often negate emotions. Trouble is that if we negate an emotion and it can’t move then it often builds, which is why it gets worse. Sometimes we even negate an emotion with another emotion. In some circles it’s not okay for men to feel sad so men negate sadness by using anger. For lots of Christians it’s not okay to feel the joy associated with sex, so joy gets negated through disgust or shame. This is how people get tied into all sorts of knots. But if you want it to change you have to move toward the emotion. And it will change. Emotion means to move after all. 

How do you move towards an emotion? Well the foundation is validation. Validation unties the knots by which we find ourselves bound. When a suicidal client comes in and says, “I’m a burden and I think everyone would be better off if I ended it all,” you can say, “Yeah, you feel like a burden to everyone, and when you feel like you’re this massive burden dragging everyone down you want relief. Who wouldn’t want that?” You’re not saying “go kill yourself,” you’re showing “your emotions makes sense”. This act begins the process of untying the knots which bind people.

 

Enter your email address to follow this blog and receive notifications of new posts by email.

I’m Jordan Harris. I have a PhD in Marriage and Family Therapy. I’ve dedicated myself to being an excellent father and a thoughtful husband. I’ve studied hypnosis with Douglas Flemons, one of the most innovate and imaginative therapists on the planet, and I’m pretty sure, after specializing in couples therapy, that emotional connection is what it’s all about. Please leave a comment. I’d LOVE to hear from you. 

 

 

An open letter to my students III: Techniques and the problem with books (from someone whose read them all)

So what about all the techniques? I can hear you griping now, “Surely therapy is not only about the relationship between me and the client right? I mean you have to know how to do something? Right?

My masters program was HEAVILY focused on us students and our personal growth, and by extension our relationship with our clients. Technique was shunned. As a result I graduated with a degree of confusion (#lolpunnylol). On the one hand I felt like I ought to know how to help people change, but on the other hand I saw myself failing again and again and again. I couldn’t reconcile the two. Once I learned a few techniques I was pissed at how much more effective I was. I felt like I’d been swindled. I mean I spent 40k+ on a masters degree and didn’t even know how to help people with simple problems. 

In my training it was assumed that if you were “healthy” you would just know how to do good therapy. Nothing could be farther from the truth. 

So now I advocate for technique. Hear me now, I am PRO technique. I’ll even give you an example. 


About a year ago I went out for a bike ride. As I left my house, I passed my neighbor’s five year old daughter, Leslie. She was outside playing with some friends.

“He lives across the street. I don’t like him.” She told her friend and wrinkled her nose as I passed.

What the heck. I was taken aback. I hadn’t done anything for her to be so disgusted with me. At least nothing that I knew of.

About a week later I was at my neighbor’s house sitting at the dinner table chatting when she came to the table, sat down, and *Hiccup*.

“You got hiccups.” I said.

“Yea.” She nodded. *Hiccup*

“You know, I can help you with those.”

“I know,” Leslie recoiled, “by scaring me.” *Hiccup*

“I could do it that way. But I’d prefer not. Can you feel the hiccup coming?”

Her eyes rolled upward as she thought for a second. *Hiccup*. She nodded.

“Okay, this is what I want you to do. The next time you feel your body making a hiccup I want you to do one at the same time. Got it?”

She nodded and waited and then: HICCUP. I mean it had to have been two, one from her mind and one from her body because she nearly bounced out of her seat.

“You finished?” I asked. Leslie hiccuped a few times on purpose to check and nodded. Then she bounced down from her chair and went off to her room. She returned a few minutes later with a small pink bag which she promptly dumped on the table. Out poured a hundred tiny dolls. For the next 30 minutes she explained to me the difference between Princess Sugarplum, Princess Butterscotch Cupcake, and Princess Vanilla swirl.

 

Most therapists don’t know that there is a difference between automatic experience and intentional behavior. This is a fundamental distinction and most are ignorant of the divide. Automatic experience is something that your body does but you don’t feel like you’re trying to make it happen, like feeling thirsty or hiccuping. Your body hiccups regardless of whether your mind wants to or not.

Intentional behavior is something that you do willfully. Like lifting your hand to pick up a glass of water. 

Got it? Thirst you experience as automatic. Picking up a glass is a behavior you have to do intentionally. 

One of the easiest ways to change automatic experience is to switch to intentional behavior. Most people have experienced this when they’ve been asked “what’s your locker combination?” If they’d been asked to open their locker a minute before they could have done it effortlessly. But once they’re asked they can’t remember for the life of them. I’ve also seen this with sports. A few years ago I had a buddy who played college level tennis and he was telling me how he wasn’t doing too well. He was having trouble with his serve.

“How come?” I asked.

“I’m thinking too much. I just get caught up in my head.”

Something that used to be smooth and automatic, because he’d practiced it so much, was now something he was thinking about and attempting to intentionally correct. He’d accidentally changed the automatic experience of serving into an intentional behavior and it wasn’t working well for him. I didn’t know how to help him then. Little did I know all he needed was of the right technique

 

This technique of switching automatic experience to intentional behavior is what I used with Leslie. By asking her to do an intentional behavior we short circuited the automatic behavior of hiccups. Most therapists don’t understand this. Some have heard of “paradoxical interventions” or “reverse psychology” which are poor concepts that don’t capture the nuance described here. I mean if you use “paradox” how do you know what to paradox? How do you know what the client should reverse? In the approach described here all you have to do is determine what the automatic experience is and then make that intentional.



So yeah, I like techniques. The right technique is crucial in helping you deal with issues, just like there’s no replacement for the right form while lifting weights, or the right wrench when working on the car.

But there’s a problem.

First I know of no way to teach technique in a book (or blog). If you find a way please, please, please, let me know. I don’t think it can be done. And I’ve tried. I mean I read ALL of Douglas Flemons’ work on hypnosis and relational therapy before I went to go see him, and ALL of it paled in comparison to what I learned by spending a mere week with the man. I also read a lot of EFT before going to the training. I mean I’d read articles, watched Sue Johnson do a live session, read the EFT manual. I thought I was doing EFT. Not even close. Nope. 

Why is it so hard to learn from a book? One reason it’s so hard to teach techniques in a blog or book is that you can’t convey context. Take the example above. You don’t hear the playfulness in my voice when I engaged her. You don’t notice the fact that we were sitting in her dining room and that her dad was at the kitchen counter, all of which probably helped her feel more comfortable approaching someone she didn’t like. You may have missed that that nose wrinkle indicated disgust rather than fright. You might have missed the fact that I tested how receptive she was by asking multiple questions. You might have missed the fact that I asked a question in a way that presupposed a response that I wanted to get. You can’t get all that in a book.

Context, context, context. 

There’s another reason why it’s difficult to learn from a book. Books don’t give you feedback. For example, if you read from a recipe and you mess something up you won’t know until after the meal has been prepared and you take your first bite. By then it’s much too late to fix, and if you’re a novice odds are you won’t know what you did wrong. However, if you’re making a meal with with a chef, he might see you add too much salt, let you know and advise you to add sugar. This is why having a mentor who watches your work is SO important.

Feedback, feedback, feedback.

But there’s another reason why teaching techniques is difficult. Teaching technique is difficult because it obscures the change agent.  Technique is not medicine. Technique is how you deliver the medicine. Technique is the syringe. The relationship is the medicine. Sometimes this can get confused because we forget that the purpose of relationship and connection is so we can go out and face life’s hiccups, NOT so we can remain locked in a bunker so that we can’t be hurt. We don’t have safety for it’s own sake but for the adventures we will inevitably be drawn into. Adventure without safety is trauma. When we can face the world from within relationships then life becomes an adventure because we have the confidence that we can face our problems or spend ourselves on behalf of others. 

I say this because it works. Therapy is the art of helping people manage emotions they push away. When you know someone has your back, your nervous system calms. That calming is your body handling emotions instead of stiff arming them, and we know that when we don’t have these relationships, techniques which should work don’t. 

The important part about what happened between Leslie and me is not that she overcame her hiccups, in life there will always be hiccups, but that our relationship changed. We’ve laid the ground work for a win-win. She knows where to go to learn how to face life’s hiccups, and she had the experience of not being alone in the midst of hiccups.

Enter your email address to follow this blog and receive notifications of new posts by email.

I’m Jordan Harris. I have a PhD in Marriage and Family Therapy. I’ve dedicated myself to being an excellent father and a thoughtful husband. I’ve studied hypnosis with Douglas Flemons, one of the most innovate and imaginative therapists on the planet, and I’m pretty sure, after specializing in couples therapy, that emotional connection is what it’s all about. Please leave a comment. I’d LOVE to hear from you. 

An open letter to my students II: Why most client’s only come for a few sessions

Once, when I was still in school, I sat with a woman who informed me that she needed help but she had a hard time trusting. “I’ve got paranoid personality disorder so you’re going to have to push me,” she said, “cause at some point I’m going to think you’re out to get me.” Halfway through the session I left the therapy room and went back to the viewing room to consult with the team.

“This woman wants me to take responsibly for the therapy process,” I grumbled to my team. “Besides, paranoid personality disorder! What’s thImage result for charlie brown's teacher gifat? That’s not even a real thing!”

“Wah waw wah wah,” My processor said, her words only half registering. I picked up my clipboard and went back into the room. I don’t remember what happened, but I do remember she came back only once more.


Retention of clients is a huge problem. I’ve seen several things which say that the average client is in therapy for 4 to 5 sessions. I’ve also known many brief therapist who assume that client’s don’t come back because the client’s problem is fixed. I tend to not believe them, mostly because I’ve done in-home therapy. What I learned from my time in homes where I had to follow up with clients week after week, whether they wanted therapy or not, was that the intensity of problems cycle due to stress.

For example:

A kid might routinely talk back to mom, but, even though mom and dad bicker, dad doesn’t put up with kid talking back to mom. When kid is rude dad punishes kid and mom has some support. Then dad goes to work offshore. Mom is more stressed. Kid goes to school and talks back to teacher. Teacher, in an attempt to not suspend kid, refers the kid to therapy. Mom cooperates with therapy for two weeks because she’s in “crises,” mostly because she’s now got the added stress of the school breathing down her neck. The third week of treatment the family has disappeared cause dad is back from working offshore and took the family on a trip to visit grandma.

This is where in-home differs from in office therapy. If it’s in office therapy and you’re of the brief therapy persuasion you assume that things are “done” and you pat yourself on the back. If it’s in-home therapy no one cares about your “therapeutic orientation” you continue to follow the case cause your boss tells you to and as you do you notice that in a few weeks dad leaves and the troubles flair up again.

It’s like shingles. Or eczema. The problem is always there but flairs out of control because of stress. When problems flair people feel like they are in crises. It’s important that you as a therapist take this seriously but not literally. Take it seriously because there is a person in front of you who’s in serious pain. Do not take it literally because it’s happened before and the person, who thinks the world is going to end, has already survived this multiple times.

So if problems cycle around stress, and people come to therapy because of a felt crises, why don’t people stick with therapy? Because of shame. Shame is an emotion in the sadness family which leaves you with the feeling that you are bad, so bad that you don’t deserve connection, even though that’s what you secretly want more than anything. Shame is about identity and says you, not what you do, you are “bad” the best way to protect yourself is to hide. I’ve even had several clients, and have been the client, who’ve come into therapy with no “problems” just a sense that something was wrong. What I didn’t know, nor the therapist I went to, was that therapy was about managing emotions and that the emotion of feeling like something was wrong with me was the feeling of shame.

You HAVE to know this because this is the question which defines your relationship with your client and your relationship with your client is the intervention. When therapist don’t attend to this clients don’t come back. It took me a long time to figure this out. Client’s talk about this as “feeling judged”. When a client comes into therapy they are bringing their deepest darkest secrets with them. Even if they don’t tell you what the secrets are, it doesn’t matter because the emotion of the secrets is in the room. It’s as if the emotional lens through which they are viewing everything you’re saying and doing is “if I tell you this will you reject me and confirm my worst fears about myself…

that I really am a bad mother,

that I really am a dead-beat dad,

that all the things they say about me at school are true,

that all the white folk are right about me,

that maybe I am nothing.”


When I went in with that client, I didn’t realize any of this. When my teacher was hinting at, but I was too deaf to hear, was that the underlying message my client was sending me was, “I’m feeling vulnerable. Please show my acceptance.” My flippant response, even though I didn’t say it to her, seeped into how I did therapy. Hence she didn’t return because I didn’t convey, “hey you can share here. I don’t believe those things about you.”


Most therapist are completely unaware of this. Each client is asking “if I tell you my secret will you confirm my worse fear?” and they will drop out if we fail to convey “I believe in you.” So how do you do that? Well you have to be present so that you can read your clients emotions in the moment. Then when you see that shadow of shame you can just say, “hey I could be wrong, but I get the sense that I need to say that I believe in you. I think that’s hard for you to take in. And probably for good reason. But I still feel like I need to let you know that even though you’ve made mistakes that’s not who you are.” 

That’s it. That’s the secret. Of course if you do this your no-show rate won’t be 0%. People will still drop out before you think they are ready, but you will keep clients longer and your colleagues will wonder, “how do you have such a steady stream of referrals?”

When they ask you can smile back and say, “I dunno. Magic I guess.”

Enter your email address to follow this blog and receive notifications of new posts by email.

I’m Jordan Harris. I have a PhD in Marriage and Family Therapy. I’ve dedicated myself to being an excellent father and a thoughtful husband. I’ve studied hypnosis with Douglas Flemons, one of the most innovate and imaginative therapist on the planet, and I’m pretty sure, after specializing in couples therapy, that emotional connection is what it’s all about. PLEASE leave a comment. I’d LOVE to hear from you. 

My Favorite Web Comic About Sex: maybe the beginning of a new series on sex

Most of us think we know a lot about sex. Why wouldn’t we think we know a lot? Our culture is sex obsessed while at the same time tells us that sex is taboo. The result is sex ends up always being in the air while also being shrouded in myth and mystery. 

It’s not much better for therapist. Most counselors don’t have a class on sexuality. Heck in my own training as a therapist, even though saying this feels like betraying my favorite professor, basic information about sex was painfully lacking. The worst part was being caught between feeling like I ought to know a lot about sex and knowing that I had no idea how to find good information. Enter Emily Nagoski Ph.D, a sex educator who makes the science of sex fun and simple. I just fished her cleverly titled book Come as You Are (affiliate) and was floored. So I looked her up online and ran across the web comic where she describes sexual desire and women. I thought it only right I pass it on. Enjoy!

TL;DR:

Sexual desire, especially for women, is a combination of an accelerator AND a break. Most of the time couples have trouble with sex/desire/arousal the major issue is the accelerator being pushed when the break is still on. The break is sensitive to stress. So the best aphrodisiac is to ease off the break instead of push harder on the accelerator. 

Action Question: What turns my woman off? How can I remove that barrier? 

Come As You Are is a great read.  If you’d like your own copy click the link below (affiliate). This books is a must read for every woman and everyone in a relationship with a woman. Oh, and if you know anyone who needs to know about this stuff, please share it with them!

Come as You Are: The Surprising New Science that Will Transform Your Sex Life

P.S. I’m playing with the idea of talking more about what I learned from this book in a series called ‘Not Safe for Work Christianity’ (NSfC). NSfC would talk about things like: 

  •               Why BDSM makes (a strange sort of) sense
  •               How vaginas and scrotums are the same thing #homology
  •               Why your friend always goes back to that jerk 

I’d address all of these issues from my perspective as a christian and as a therapist who occasionally deals with sexual issues. If you think that would be cool, let me know in the poll. 

Enter your email address to follow this blog and receive notifications of new posts by email.


I’m Jordan Harris. I have a PhD in Marriage and Family Therapy. I’ve dedicated myself to being an excellent father and a thoughtful husband. I’ve studied hypnosis with Douglas Flemons, one of the most innovate and imaginative therapist on the planet, and I’m pretty sure, after specializing in couples therapy, that emotional connection is what it’s all about. Please leave a comment. I’d LOVE to hear from you. 

***the links for the book are affiliate links meaning if you buy from this link I’ll receive a small commission at no extra cost to you.

An open letter to my students I: What therapy is about, how to do it, and what most therapist get wrong

Hello!

So you’ve decided to become a therapist. I hope that it is as fulfilling as you hoped it would be when you enrolled. For me therapy, at times, has been filled full with magic. I mean that in the most literal sense of the word. Therapy is magic and practicing therapy well makes you a magician, but as with all magic there is a cost. Therapy will break your heart. I once heard a wise man say that you give advice not to avoid struggle, struggle is inevitable, but to help someone find their way through struggle. I hope these letters are a light in dark places.

Image result for patronus hermione gif

 

As a therapist, researcher, scholar, and student I have had a few fundamental truths. The first thing I’ve learned is that we know a lot less than we say that we know. Twenty years from now most of the “latest” and “greatest” discoveries will not only turn out to be duds, but actually actively harmful, like how we used to irradiate appendices to reduce their size and ended up giving thousands cancer, or how we would blood let people to get ride of disease, or drill holes in to peoples heads, or would remove the eyes of blind people which disrupts their sleep cycle, and so on and so on. “Progress” has made lots of costly mistakes.

However, I’ve also learned a second thing, in every field there are fundamentals that nearly everyone agrees on. These fundamentals often have high upsides and small downsides. I’ve made it my life’s mission to not do the fancy therapy I read about in textbooks but to simply master the fundamentals. Ironically, the more I simply pay attention to the fundamentals, the more I find myself enacting magic.

In our field of psychotherapy there are a few fundamentals. One of these is that first and foremost psychotherapy is about helping people to manage their emotions. That’s it. That’s all we do. We do not give advice. We do not try to convince or change a client’s mind. When someone comes into therapy your only job is to help them managage emotions which they would rather not feel.

That’s it.

Others will say that therapy is about “cognitive restructuring” or “self actualization” or “finding solutions”. They are wrong because when people can manage their emotions they find themselves thinking differently (#cognitionsrestructured) and they come up with their own solutions. This is because emotions are the lens through which we navigate the world. If you assist people in changing their lens, then all sorts of options open up for them. This is a hard thing to swallow because we’ve been sold a false view of rationality. The funny thing is that the people who propose the false view of reason are the same ones who get the most frustrated when people don’t behave “rationally.” We all know that false view of rationality is false because we’ve all had the experience of saying “man, I’m not going to eat that doughnut,”

or, “I’m going to go work out tomorrow,”

or, “I’m going to study for this test,”

or, “This is going to be my last drink,”

or, “okay this is my last cigarette. I mean it this time.”

or, “I’ll read that book after I read watch this one show.” 

We all know what happens. We know what would be good to do, but we just don’t feel like we can do it. Going against emotion is a Sisyphean effort. 

Image result for sisyphus gif

The real problem is that most of us weren’t taught how to work with emotion or how emotion is the foundation of logic

Your job as a psychotherapist is to help people with the emotions they negate, or don’t want to feel. The primary way we (humans) deal with difficult emotions is through relationships. Others will tell you that we need to be “independent”. Bullox. We are either healthily dependent or unhealthily dependent. There is no independent.

So what your clients need most is you. They need you to show up and care and listen. If you do that you are 50% of the way there and MILES ahead of many therapist I meet. Too many therapist think therapy is accomplished through some sort of technique or intervention. The relationship IS the intervention. The research on Common Factors bears this out. The research on trust bears this out. The research on attachment and affect regulation bears this out.

Your job as a psychotherapist is to help people mange difficult emotions. You do this when you listen and care. If you do this you are 50% of the way there.

On a practical level this means learning and investing in therapy models which focus on the relationship as the main method of change. This is why I love Emotionally Focused Couples Therapy. This is why I think Trust Based Relational Intervention is a great model. This is why I think you can not learn Solution Focused Brief Therapy without also learning Motivational Interviewing. And this is why you almost never go wrong studying on Carl Rodgers and Client Centered models.

Enter your email address to follow this blog and receive notifications of new posts by email.

I’m Jordan Harris. I have a PhD in Marriage and Family Therapy. I’ve dedicated myself to being an excellent father and a thoughtful husband. I’ve studied hypnosis with Douglas Flemons, one of the most innovate and imaginative therapist on the planet, and I’m pretty sure, after specializing in couples therapy, that emotional connection is what it’s all about. Please leave a comment. I’d LOVE to hear from you. 

 

 

My most embarrassing moment (or; the one thing which ruins them all)

When I was a young boy, I mean like really young, I remember going to a magical place called Camp Saint Joe. Camp Saint Joe was a sports summer camp hosted at a private catholic school which had found itself, due to migration over the years, in inner city Baltimore.

That’s me. Right in the middle!

In the morning we’d play baseball, late mornings we’d go swimming, and in the early noontime we’d walk across the parking lot and have lunch in the cafeteria. In the afternoon we’d play video games in the basement of the gym. This is where I was first introduced to Sonic the hedgehog and Sega Genesis. Camp Saint Joe was a young boys dream.

thumb.jpg

The best day of summer camp, hands down, was Oriole Day. On Oriole day if you wore Baltimore Oriole swag you got free ice cream. So of course, the five year old nerd boy that I was I had to have an oriole shirt. And of course, the good mom that my mom is she took me to Wal-mart and got me one. The next day I was Jazzed! I coming back from swimming and changing in the locker room while a friend and we’re talking, and I’m jazzed I’m at summer camp, and I have on my oriole shirt, and I’m about to get free ice-cream.

BANG BANG. I jump and Coach Norton (far right) comes barreling into the locker room. “Comon!” He yells.

My friend and I rush upstairs and across the street. We were late for lunch. I’m standing in the back of the line when another boy asks me, “hey man. Where are your pants?”

“They’re under my shirt” I reply, and look down thinking man my pants are really short today. I lift up my shirt to show him and all I see are tighty whities. I’d forgotten to put on my shorts. “Hey please don’t tell anyone” I look up at the older boy and beg.

“Okay.” The older boy says. We go in and I sit down. A few minuets later another older kid comes up to me and asks, “hey I heard you didn’t have any pants.” He told! Then another kid comes, then two, and pretty soon I look around and can feel all the other kids looking and whispering. I look across to one of the adults and I can see that they know.

And they know that I know.

     And I know that they know that I know.

          And they know that I know that they know that I know.

               And no one does anything about it.

At some point I get up the courage up to ask one of the counselors if I can go back to the gym and get my pants. “Sorry. We can’t get back into the gym until after lunch.”

No! No! No!

I sat at that table, with everyone knowing, feeling alone for what felt like an eternity. The worse part of it all was I knew I wasn’t going to get any ice cream, because how could I walk across the cafeteria in my underwear? I began to feel a stupid for even being so excited.


Shame. It’s the thing no one wants to talk about. It’s that sinking feeling that tells us that we are bad.

Shame is very different from its brother, guilt. Guilt says you did something bad. You violated one of your values and now you need to fix it. Guilt is about behavior.

Shame, on the other hand is very different. Shame is about you. Shame is about who you are. Shame says you are bad, dirty, disgusting and because of that you are unworthy of love and belonging. In our moments of greatest needs we need each other. We need to reach out and connect. Shame is the biggest barrier to resolving our pain because shame tells us we don’t deserve connection.

Funny thing is shame is dispelled by the same thing as everything else. The darkness of shame can not stand to the light of truth. When you feel shame you need to talk about it. You need responsive relationships. We need people who can say, yeah, I’ve been there. So let me be the first to say, “yeah I’ve been there. And not just when I was a little boy.”

When we have someone we can share with at this level it’s deeply and profoundly healing. My wife does an excellent job of giving me space to share at this level and slowly, slowly I’m learning its okay to have these feelings. I am safe with her. She’s home.

This is what a good parent does. A good parent dispels shame. This is also what a good therapist does. It doesn’t have to be a therapist or a parent though. It could be anyone who’s a little further down the path of life.

For me, in that moment, when I was a little kid sitting in that cafeteria it was old man Ruckawitz.


Mr. Ruckawitz was old. I don’t know how old, but he felt old. I was around five, so he must have been, I don’t know around 40 maybe. He felt like he was 100. I wasn’t in his group at camp. I never had him as a counselor. I only knew him because he manned the ice cream shop on campus.

I didn’t see him come up behind me that day. I just remember his face. He tapped me on my shoulder. I turned around.

“Hey. What kind of ice cream would you like?”

I was shocked.

“Um, I guess. I don’t know.”

“You can have any you want.” He said and twitched his nose. He had a tick, and seemed a nervous man.

I don’t remember what kind I got. I think I got cotton candy. I may have just gotten an ice cream sandwich. I don’t remember but it doesn’t matter. What mattered was that he showed up.

The number one thing which haunts me as a therapist

All that we see or seem

Is but a dream within a dream

-edgar allen poe


I have dreams about clients. From time to time tiny doppelgangers of clients roam around my head at night. It’s understandable. Because we’re working with clients all day therapist spend more time with clients than co workers, so naturally clients roam the hallways of our minds.

Not to long ago I had a client, Kyla, roaming around my mind. I’d not seen Kyla for a few months. She’d discharged from the Medicaid funded treatment center where I worked and within in a week relapsed. Her dad found her in a car cradling a bottle of vodka.

I had to go to a training the week she was discharged so I missed seeing her off. The week before she was discharged she and another client gave me a gift.

img_0057.jpg

After I got the call from Kyla’s dad telling me what happened, I looked up Poe and the poem. Something about it haunts me.


I stand amid the roar

on a surf-tormented shore

and I hold within my hand

grains of the golden sand

how few, yet how they creep

through my fingers to the deep.

while I weep, while I weep.

Oh god, can I not grasp

them with a tighter clasp?

oh god, can I not save

one from the pitless wave

is all that we see or seem

but a dream within a dream?


After I’d heard about her cradling that bottle I was a man possessed by doubts. Maybe if I had been there working with her instead of at the training … maybe if I had requested an additional week of treatment from her insurance company…. maybe if I had known then what I know now… maybe if the Medicaid system wasn’t designed to fail…

There are many clients I have not helped. I’m not ashamed to say that. I feel guilty not being guilty, but that’s about it. I simply wast trained nor given the guidance to help certain people when I first became a therapist. So I don’t feel bad about the past because I couldn’t have done anything and I don’t feel bad about the present because I now know my limits. That helps me sleep at night. If clients I’ve failed are ghost, then most of them are of Casper’s brood– friendly.

Yet there are some that linger. There are some that haunt me.

I’m haunted by Jamiel. Jamiel was abused by his grandmother and deemed a lost cause by his elderly foster mother. I still remember that moment when I knew I was going to fail him. The image of Jamiel is forever frozen in a frame of him squatting outside in the summer heat, with a stick in hand poking at the dirt. Meanwhile foster mother sits inside and grumbles at me about how she’s sending him to a state home because at night Jamiel rummages in the dark recesses of the cupboard and devours whole boxes of Little Debbies delights.

That was the beginning of the end because foster mom did send him away to a group home where at best he’d be overlooked and forgotten. All because I couldn’t convince foster mom that him stealing food was not the problem.


how few, yet how they creep

through my fingers to the deep

while I weep, while I weep. 


I’m haunted by Jamie. She was a little on the cousin of a client and a little on the slow side. In my mind the movie begins with me helping her with her homework.

“What’s this?” I asked looking over a math problem with her.

“I don’t know” Jamie answered.

“Count it out.” I prompted.

“1,2,3,4,5,” she started, “6, 7 ,8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, … 100?”

And suddenly I was very aware that this 8 year old couldn’t count past thirty, that that was not a very good sign for her future, and that I had neither the time nor the skill to help her make up the gap her public school had left her.


Oh god, can I not grasp

them with a tighter clasp?

oh god, can I not save

one from the pitless wave


Some times in my daydreams these two come back to me. They are older now and I know in that dream like way where you just know, but have no idea how you know, that Jamiel is in jail. He’s been in solitary confinement several times for being violent. I also know that Jamie has several kids. She’s dropped out of high school and never went back. In the dream they just stare.

“I’m sorry!” I plead. “There was nothing I could do. I didn’t know how.” But they don’t respond. Their stare is conviction enough.

The thing about the failures is not that I failed. Failure in and off itself is painful but failure doesn’t haunt me. Failure is washed away with the next success. The thing about failure is the nagging feeling that because I failed, they will never have another opportunity. Because I couldn’t do it, the hopes they had for their future are now merely a dream.

Maybe to think this way is hubris or craziness. I don’t know. All I know is that life works because we make it work. Because we go out into the world and make change happen. If we don’t there is no guarantee someone else will come along and fix it for us. No, I am not the last hope for Kyla, Jamiel, or Jamie. But someone has to stand up for them, and there is no guarantee that someone else will.

Enter your email address to follow this blog and receive notifications of new posts by email.

I’m Jordan Harris. I have a PhD in Marriage and Family Therapy. I’ve dedicated myself to being an excellent father and a thoughtful husband. I’ve studied hypnosis with Douglas Flemons, one of the most innovate and imaginative therapist on the planet, and I’m pretty sure, after specializing in couples therapy, that emotional connection is what it’s all about. PLEASE leave a comment. I’d LOVE to hear from you. 

Passive Income 101-your set it and forget it portfolio 

I recently got off of a long talk with my friend Katie Riley. We talked a long time about how easy (but scary) it is to fly anywhere for free, how to get a cheap masters degree (it involves an extended stay in Europe) and the set it and forget it way to invest in real estate. Afterwards it got me thinking, and I decided to skip a few steps and just tell you about the set it and forget it way to invest in stocks.

So a bit more of a pre-amble.

  1. This is about investing. You and I can not time the market. We can not win trying to buy low and sell high. This will crush us every time. We are looking for long term gains (at least 5 years out and more likely 10 years out).
  2. There is another crash coming. The market will tank again. We know this. If you’re going to invest, you have to be comfortable with this, knowing that the market always has recovered and soared to even higher heights. This is the nature of stocks.
  3. You need to do your own investing. Advisers don’t work for you. They work for their company. This means their interest and your interest are not always aligned. If you do get an adviser, they should be a fiduciary. Most of that is too complicated for us. Besides most advisers do not out perform the market over time, which means if you just do what the market does, overtime you will outproduce most advisers-hence you don’t need them.
  4. You need to use Vanguard. Hands down they have the lowest fees for investing. Low fees means you have more money in your accounts, due to the magic of compound interest adds up to a lot of money over time.

To invest you only need four tools.

  1. VTSAX- this is Vangaurd’s Total Stock Market Fund. This is probably the most powerful tool in your passive income portfolio. Because stocks are so powerful this will give you the most bang for your buck with the least amount of risk. the big thing to remember, of course, is that we are investing. That means looking for long term gains through the magic of compounding. there will certainly be crashes and bubbles bursting, but over time this will give us the strongest return on our investment.
  2.  VBMFX- So, say you don’t want to invest all your money in one fund, despite that fact that the larger the fund the more security we have. Or say you simply want to smooth out the ride that stocks can be, then you’re going to want bonds. In fact, some studies show that a 10-25% allocation of bonds (can’t believe I just said that, I sound like one of those investment people now) actually outperforms an all stock portfolio, but only slightly. If you just want the stability that bonds produce, and the added bump in income then you’ll want to invest 10% of your portfolio in Vangaurd’s Total Bond Market Fund.
  3. VTIBX (Vangaurd’s Total International Bond Fund) and VTIAX (Vangaurd’s Total International Stock Fund). If you want to invest internationally, well all you need is VTSAX! Yes, it is the US fund, but most US companies are international companies, which is part of what makes VTSAX so stable, as far as investing goes. Think about it companies like Google and Apple have HUGE international markets. However, if you just want to increase added security look at Vangaurds Total International Stock Market Fund Ex-US. if You’d like to add security to this security you can add Vangaurd’s Total International Bond Market Fund.

The major downside of these international funds, to my view, are the increased amount of money spent on fees. The US based VTSAX has an expense ratio currently of 0.04%. The international stock fund VTIAX has an expense ratio of 0.11%. nearly triple. However these small expenses mean a lot of money is because compound interest. However, it’s still a LOT better than most other companies. This is also why you want Vanguard funds, they are by far the cheapest. Other companies can charge you up to 1% in expenses. This is enormous! But they know most people don’t understand compound interest and and terrified of investing good thing you’re not one of those people anymore.

That’s it. This is the simple path to wealth. It will take time. Investing even a small amount and letting it grow will have exponential effects on your retirement accounts. Investing 50 or more of your income every year will allow you to become financially independent in 16 years or less.

 

Enter your email address to follow this blog and receive notifications of new posts by email.

Jordan Harris just passed his PhD defense and is waiting for conferral in august of 2017 (YAY). He is a Licensed Marriage and Family Therapist and a Licensed Professional Counselor. He has over 5 years of experience counseling individuals, couples, and families from a wide diversity of backgrounds. He sees clients both in his office and consults online. You can contact him at 318-238-0586 with him online or connect with him through email at jharris@cccofwm.com or follow him on twitter @changeencounter. Also, he is not your financial adviser and information provided should be used at your discretion

If my mom went to therapy (or how to pick a therapist)

Momma!

How are you? I finished S-town. Incredible. I love brilliant people like John B., and I get now why you are disappointed in him. He was a racist. It makes me a little sad that he would not like people like us. Although he didn’t just hate black people, he hated everyone. Even himself. I think that’s what’s sad about the story. You can’t hate others without hating yourself, and in the end that hate killed him.

Anyway, yes, so therapy. You want to see someone or are you asking for a friend? Either way, here is my advice.

First, you should like and respect your therapist. Everything else I’m going to tell you should be filtered through this lens. If you break one of my recommendations but you like and respect your therapist good for you! If it ain’t broke don’t fix it! The single biggest predictor of success in therapy is the therapist-client relationship.

Next, you want to look for a fully licensed Marriage and Family therapist (LMFT), Professional Counselor (LPC) or Social worker (LCSW). Do not under any circumstances go to anyone who isn’t fully licensed. See what happens is after we therapist graduate from therapy school we have a degree, but we have no idea what we’re doing. Licensure boards know this and make us gain experience for 2-4 years in order to become “fully licensed.” In the mean time, the agencies that new therapist work at offer counseling with them at low cost. One clinic I worked at charged $10 and another one $25. This is really cheap especially since most fully licensed therapist charge anywhere from $100-$150. Trouble is going to a new therapist verses a fully licensed professional is like going to see a Nurses Aid instead of the Physician.

Also, I’d stay away from someone licensed as a drug or alcohol counselor. Most addiction counselors just try to convince and shame you into not using drugs.  But one of the things we know is that addiction is a way to self medicate past wounds. So if the best way you can deal with your pain is by using drugs, I assume your pain must be pretty bad and I’d rather not take away your most effective strategy for dealing with that kind of pain.

So what should you look for?

It might help if I break down the different degrees

  1. Psychiatrist- these are MDs trained in medication. Most are not trained in counseling. Truth is medication doesn’t have a great track record for much besides stabilization. Most medication takes about a month to get working, so you shouldn’t be changing very often. Also, any decent psychiatrist will give you a referral to a counselor. So if they change your meds regularly and don’t recommend counseling you need to switch to a different doctor.
  2. Psychologist- these used to be the most highly trained therapist. Now they mostly focus on testing. Testing is helpful if you think you have autism, a learning disability, or some sort of delay. But we’re not looking for those things. We’re looking for clinical skill.
  3. Social workers- they are trained mostly in case management. They are great at making sure you are connected to local resources like food banks, getting medicaid, or enrolling in other assistance programs. Some of them do work clinically. You’ll want to look for a LCSW- Licensed Clinical Social Worker.
  4. Professional Counselor- They are trained in counseling from a individual standpoint. Typically they are licensed as an LPC- Licensed Professional Counselor.
  5. Marriage and Family Therapist- These are NOT marriage therapist. They actually are just as bad at marital counseling (the hardest form of counseling) as anyone else. They are trained to look at how your problem makes sense in the context of your relationships. You want an LMFT- Licensed Marriage and Family Therapist.

So, on top of being fully licensed you want to find someone who has a certification. Most clinical training for therapist is abysmal. If your therapist has a certification that often times means they’ve had a master therapist give them moment by moment feedback on how to work with an issue. This is what we want. Also, if someone has a Ph.D ignore it. I went into a Ph.D program to become a better clinician and …well…eh… it didn’t help me become a better clinician. All a Ph.D means is you’ve read more books and written more papers. If someone has a Ph.D ignore it. I means nothing about clinical skill. If I could do it over again I’d have just found things I wanted to get certified in. We are looking for clinical skill.

Here’s a short list of some of the top certifications in the field

  1. EMDR- top trauma certification.
  2. EFT- the top marriage certification. DON’T GO TO ANYONE ELSE FOR MARRIAGE ISSUES.
  3. MBST-general anxiety, bipolar, depression stuff.
  4. DBT -general anxiety, bipolar, depression stuff.

There are a few other ones, but as long as your going to a fully licensed therapist with a certification they you are MILES ahead of the game. It will cost you, but every dollar will be worth it. If you need help paying let me know. I’ll talk to Laura and try and help you out.

The final thing is that you should like and respect your therapist. Yes, I’ll say it again. The single biggest predictor of success in therapy is the therapist-client relationship. A good therapist should be trained in helping you feel comfortable- which means you should like them. So if your gut is telling you it’s not a good fit, then bounce. Just please, keep looking until you find a good one.

Anyway, that’s my advice. Let me know how it goes. Oh, and sorry I didn’t call you on Monday. I got busy writing for my blog and then it was 11 o’clock … so yeah. I’ll try and call you later this week okay?

Love you!

Your manchild.

Ps. What’s our next podcast going to be? I’m thinking Revisionist History, Making Oprah, or LaVar Burton Reads? Whatcha think?