Meaning & Purpose

Many of my clients have struggled with deep questions of meaning and purpose. Do you have room in your life to ask what it all means? Or why you are here? Do others give you a real chance to voice these questions? Does the world respond to your desire for a deep purpose in life? Does the culture somehow tell you it’s not okay to ask these questions? Do you feel isolated? Despairing? Confused?

These questions can hit you at any stage of life. Midlife definitely is one. We look back on what we’ve accomplished and not accomplished, our work, family, and relationships, and turn to the future. We may feel uncertain, as well as excited at the potential for transformation.

As we move past midlife into retirement years, profound changes that happen in relationships, work, and sometimes health can bring feelings of loss and crisis. Friends and loved ones begin to pass on, things that once seemed important don’t anymore, and life can undergo a radical reorientation.

The late teen and college years often bring up questions of meaning and purpose. How will we find our place in the world, and what will our lives mean? This time of life sometimes brings serious crisis. Our hopes for a good life and a better world can feel shaky.

The mid-20s to the early-30s can bring a quarter-life crisis. It’s a time of launching into the world, leaving the nests of home, family, and college. First jobs can be fun and stimulating, and also can be exhausting and difficult. Is this really what my life is going to be? we may ask. Deep relationships might be hard to come by, or hard to sustain.

Questioning life’s meaning and purpose is a difficult process. It benefits from a trusting relationship with a therapist who gets it—someone who doesn’t dismiss your concerns or try to fix them in five easy steps. Someone who listens and responds from a deep place.

If you’re looking for a therapist who will truly work with you on these concerns, I may be a good match for you. I will follow the threads of your questions and help the answers come in an organic process. You can learn to let the questions live in you and bring you alive in ways you couldn’t have predicted.

Divorce

Therapy and Divorce

Divorce can act as a rite of passage—an initiation into a new life.

By describing divorce in this way, I am not saying that it is a good or a bad event. But it does happen, and it happens frequently, and finding meaning and perspective during the process of divorce is crucial to healing and transformation.

Many of my clients have felt stuck in a marriage or committed, long-term relationship. On one end of the spectrum, partners may grow in different directions and struggle with feeling limited by the relationship. Other marriages face more damaging patterns. In these relationships, partners unconsciously hurt each other. Often these damaging patterns stem from early life relationships with parents and get replayed with the partner.

Couples therapy can clarify what’s been wrong and lead to renewed connection. Sometimes this renewed connection allows for a relationship that works well for both partners. Other times it becomes clear that the couple will separate.

If either or both partners have felt stuck and miserable for a long time, separating can release a great burst of energy that was bound up in the difficulties of maintaining an unhappy state together.

Whether splitting up brings this release or not, it still hurts. The life the couple dreamed of having together comes to a stop. Profound feelings of loss and grief can last for some time, and when one or both partners didn’t really want the divorce, these feelings can go on even longer and cause more suffering.

Some individuals will find themselves plunged into a depression during or after divorce. The question then becomes whether this dark time is barren of new life, or instead can become a kind of pregnant darkness that initiates the person into a fuller experience of his or her life. This is one area where therapy is especially helpful—to help midwife the client’s newly emerging life and provide support during a hard time.

After a divorce, my clients report a whole range of feelings, all of which are important to feel and work through in therapy. Feelings of grief, uncertainty, excitement, fear, loneliness, new potential, anxiety around finances, and many other feelings are part of the mix.

Questions of self-identity and the future often come up. Who am I apart from this other person and my relationship with them? Will I find another partner? Do I even want a relationship? Will I replay my own old patterns? How will I parent my kids (if there are children from the marriage)?

Divorce is a rite of passage that often comes during the midlife years from about age 35 through age 60. For so many, these years are a time of deep changes in many areas of life—relationships, parenting, health, and career. Clients find themselves turning inward, searching for answers, exploring complex feelings, redefining self-identity, and wondering about the future. This is an excellent time to find a therapist who can help you navigate these waters and embrace the new life that is waiting for you.

Spiritual Struggles

Spirituality and Therapy

Struggles with spirituality or religion often cause significant emotional and psychological distress. I’ve worked with many clients who feel profoundly troubled by questions of spirit. However you define these questions, whether in a Buddhist, Christian, Jewish, pagan, atheist, agnostic, or any way, something about human nature wants to ask about the nature of soul, spirit, God, or other realities that we know very little about but find ourselves deeply curious to discover.

While certain individuals don’t seem so oriented to spiritual concerns, at least until trauma, illness, or the prospect of death comes up in their lives, others were either born wondering about these concerns or were brought up in families or religious communities that put spiritual questions at the forefront of consciousness.

So why and how do spiritual concerns become struggles that can cause a person to suffer emotionally? This is a complex question, but let’s consider a few of the reasons. We live in a culture dominated by the success of the natural sciences and an awareness of the historical origins of religions. Both of these tend to make us uncertain about the “old time religion” that we may have grown up with. What seemed like clear and certain knowledge of who God is and how to know God, for example, may crumble when a person starts studying the world through the lens of natural science.

Suddenly questions come up, such as whether what we call God might be the result of certain structures in the human brain that create an image of an ultimate reality. Or we start seeing that the holy scriptures of our religion contain contradictory information if read in a very literal way, and this shakes our faith. We don’t know what to believe anymore. Or the spiritual leaders we had trusted end up betraying our trust in some way, and we are left in a crisis of faith. Or it dawns on us that something we took for granted, for example a moral teaching on sexuality, has actually caused a great deal of unnecessary suffering.

Pushed further, a person of faith may begin to doubt that the God they trusted is really so trustworthy after all. I remember when I was studying theology in graduate school in my 20s, we had a professor who taught a course on theology after the holocaust. How are we to make sense of God, or are we, in a world where horrors beyond our imagining take place? This is an intensified form of what used to be called “the problem of evil.”

These days, especially in a town like Portland, many people explore spirituality outside of the major world religions. Westernized forms of various eastern traditions, such as meditation and yoga practices attract many seekers. Yet my clients sometimes struggle in these communities too. They may constantly seek for the true path that they hope will relieve them of life-long emotional struggles, and the constant seeking itself becomes a problem. Or they may beat themselves up for falling short of some imagined, perfectionistic standard of true meditation, for instance.

The many gurus that have sprouted up sometimes cause a lot of harm to their devotees as well. We would all like to idealize someone, a powerful figure who promises to deliver us from our problems. And it may work for awhile, but often the guru or teacher later is exposed as a mere human being, and is sometimes even abusive in the realms of money, power, or sex, and followers end up disillusioned and despairing.

More “pop” versions of New Age spirituality tend to commercialize the spirit. Every new method has a trademark, and turns into a profit-making system. They may promise to help you transcend the anxieties and struggles of living in the world. They may fantasize about escaping the limitations that we all suffer. Illness becomes something you should be able to visualize your way out of, and when you can’t cure yourself, you feel doubly guilty for somehow not being conscious enough, and you end up in a depression.

I studied philosophy and religion before I got interested in clinical psychology, and so I’m quite familiar with all of these questions and searchings, both from an intellectual standpoint, and from my own personal experience wondering and seeking answers to the questions that we all find ourselves asking about the nature of things.

I favor an open attitude to these questions. Wondering and questioning, in my view, are far more interesting than pretending absolute knowledge, or thinking we can pin God or Reality or the Cosmos down in a formula of doctrines. The ancient Greek philosopher Aristotle said that by nature we desire to know, but that this desire begins in wonder, and every question we answer leads to further questions! By shifting our focus from attaining certainty to lingering in our wondering and curiosity, we enter a far richer landscape, and one where we don’t get so caught in impossible dilemmas that can quite literally drive us mad.

True faith opens us to an infinite horizon that will never cease to stimulate our wondering nature and lead to further and further questioning. For me, living in this space is the essence of spiritual transformation.

Neglect

Neglect and Therapy

When we talk about the hurts that bring people to therapy, it’s easy to downplay the hurt that comes from childhood neglect. It’s much more obvious to point to dramatic trauma as the source of a person’s emotional suffering. If you were abused emotionally, physically, or sexually when you were young, then we have a clear sense of what caused the harm that continues to trouble you as an adult.

But neglect doesn’t seem so dramatic from the outside, unless you’ve experienced it yourself and know from your own experience how bad it felt. Each child needs consistent, loving attention over many years of developing in order to enjoy a healthy sense of self and a healthy emotional life. If your parents and other adults or siblings and peers ignored you, abandoned you emotionally, loved you only if you fit their idea of who you should be, or cut you off from human connection in some way, then you know that being neglected hurts deeply.

You may have felt isolated much of the time, as though no one was there to see who you were, to value what you said, felt, and thought, to give you physical affection, or even to let you know that you existed and mattered to them. Sometimes children of neglect had parents who were narcissistically self-absorbed. Such parents prefer to focus only on themselves, their work, their relationships, their obsessions, and children become an afterthought. Other parents become absorbed in addictions, mental health problems, or physical health problems.

On the other hand, maybe you got some basic attention in your childhood, but it was very conditional. If you didn’t measure up to some standard, then you risked losing the love of your parents. You had to believe, or act, or be a certain way, or you might get tossed out of the circle of the family. In this case, part of you got attention, but other parts of you got neglected or rejected as bad. This can create a feeling of being divided inside—like parts of you got lost along the way, left behind, all alone.

What therapy does in these cases is to create an atmosphere of trust and openness where all of you is welcomed, seen, nourished, and encouraged to develop in ways that enhance your life. Instead of feeling left behind and isolated, your therapist gets to know the you that suffered neglect. I’ve seen in my practice how a person can then heal and grow and feel truly known for who they are. This can have dramatic effects throughout the client’s life as the therapy moves along.

Trauma

Trauma

To be alive is to be vulnerable to hurt, and so trauma comes in many forms, at all stages of life. The world is full and rich, but it’s not entirely safe, and people who have suffered serious trauma know this very well. Some forms of serious and damaging trauma include: sexual abuse at any age, chronic neglect when you were a kid, getting beat up by parents, strangers, or significant others, living through a parent’s mental illness when you were little, warfare and violence, and even more subtle but very damaging experiences like being shamed by parents, religious leaders, teachers, etc.

We now understand that the human psyche responds to trauma in a self-protecting way. It’s rather ingenious, actually. Your spontaneous, open, un-defended self sees the trauma coming, and goes into hiding. In a sense, your true self “goes away,” and various false selves take over, so that you can survive what is happening to you.

On the one hand, this going away saves you from even worse hurt. On the other hand, at a certain point, it simply doesn’t work anymore. It limits you. You may find yourself sad, spaced out, disconnected from yourself and others, and longing for that true self you lost because of your trauma. You may wonder, who was I, before those things happened to me? Can I ever get in touch with the person I was? Will I ever feel truly alive again?

It’s definitely possible to reconnect with yourself, even after serious trauma and long years of separation from your true self. I’ve seen it happen. It’s not necessarily quick and easy, and that’s why a solid relationship with a therapist over a period of consistent therapy is so important.

You probably won’t feel too keen on revealing your true self at first. Your natural expectation is that you’ll just get hurt again. It’s hard to trust, and you may even fight against a healing therapy relationship. A sensitive therapist will realize this, and give you all the time you need to venture back into life. That therapist will notice when to encourage you to come out of hiding, and when to leave you alone and let you find your way in your own timing.

The way out of the effects of trauma is challenging, but possible, and you’re not alone. I would love to talk with you about your experience and hopes for therapy.

Anxiety

Anxiety

What psychiatrists and psychologists call “anxiety disorders” actually include a large number of very human experiences. We all have to cope with fear and worry. Anxiety is simply part of the human condition. But when anxiety takes over and our usual ways to cope with it no longer work, then it makes sense to say that something is wrong, and that you need help working through the problem.

Panic is one form of anxiety that you may be experiencing. Here the heart may race and pound out of your chest, you may feel unable to breath, think you’re about to die, and become utterly desperate, gasping for relief. The world is ending, so it seems. Terror. Then the panic usually passes after a time, and your body resets itself, while a fear lingers that this dreadful thing may happen again. Usually there is some trigger—anything from a walk through a “big-box” store to encountering certain difficult people to remembering suddenly a traumatic experience to facing a situation that feels impossible.

Some people find that they feel anxious almost all the time. You may feel constantly worried. Something as common as driving down the street brings fear. What if I hit a pedestrian? What if another car smashes into mine? It’s like you’re always expecting that something really bad is going to happen. You don’t know what it will be, but it’s out there, and it’s waiting to get you.

Others find that social situations make them anxious. Going to a party, or a meeting, or to visit friends and family stimulates awful fear. The body may express this fear with palpitations, fidgeting, crawling out of your skin, and the mind starts fantasizing about conversations going wrong, feeling shamed, or whatever your particular fear might be.

People who have experienced trauma in their lives usually struggle with anxiety at some level. Trauma is an intrusion on your sense of safety in your own body, among other things. The underlying feeling of walking around in the world is, “It’s not safe to be here.” You might even flash back sometimes to images and sensations of your trauma. You might find yourself spacing out—a natural way to protect yourself emotionally against what happened.

Different therapists will approach anxiety in different ways. A good therapist will even approach anxiety differently with each client, because everyone has a unique history and nature. What matters most is a solid, trusting relationship with your therapist. Anxiety tends to make you feel cut off from others and the world. Finding a therapist who will go right into these scary states of mind with you, stay with you in them, and not abandon you to them is crucial.

Like all psychological distress, anxiety is complex. It’s usually not any one thing that can be quickly fixed with the right pill or the right therapeutic trick or self-help book. Once you’ve struggled with anxiety for a long time, it has become part of you, and you need someone very skilled to help you through and out of its grip. The life you hope for is on the other side.

Depression

mood disorder

Everybody feels down sometimes. Life seems dismal, boring, stuck, irritating. But what if that down feeling comes along and never lets you go? What if you go from feeling bummed out to feeling deep despair? What if your hopelessness gets into your body, and you can barely eat, or sleep, or force yourself to get the basic tasks of your life done?

Then you’ve in a depression. To be de-pressed is to feel like some dark force is pushing you down. This can range from moderate but disturbing forms of depression, to debilitating forms where you really can’t function at all and may struggle with thoughts of suicide.

In more severe depressions, you may sense that no one understands what it’s really like. How do you explain to someone, even someone who loves you and wants to help, what it feels like to have your psychological skin torn off so that every thought, every sensation, every little feeling is unbearable? It’s one of those things that you have to experience to understand.

Less catastrophic depressions can be very destructive too. They may not completely take you down, but they can go on and on, chronic, and slowly take away your enjoyment of life and your ability to take hold of your dreams and make them real. Relationships, work, and play become drained of the energy they used to have.

I realize that this is pretty dark stuff—not so easy to think about. However, people who are suffering these states of mind feel terribly isolated. Often no one wants to hear what it’s really like, or simply can’t understand. So I’m choosing to speak these things out loud, for the sake of anyone reading who might be suffering badly, and for potential therapy clients who are looking for someone who gets it.

If you go to your doctor and explain your depression, you’re likely to walk away with an Rx for anti-depressant medication. These can be helpful, even life-saving. But without therapy, the underlying problems in the person’s life may never get addressed. The biological side of depression is real, but it’s more complicated than “a chemical imbalance.” The truth is, we don’t fully understand the biology of serious problems with mood. We have a few ideas, and a few medicines that sometimes work.

You don’t usually get badly depressed unless something is really wrong. Your psyche is responding to a real crisis when it goes into a depression. It could be any number of problems, including unhappy work situations, relationship problems, childhood or more recent trauma, neglect early in your life, spiritual crisis, chronic stress, and the list goes on. Life presents lots of difficulties, and you may need a good therapist to begin to sort out these complex issues.

I believe that a depression can actually lead somewhere. The symptoms of depression can become signposts along a path to deep change. Taking this perspective—that depression can be meaningful—helps relieve the pain of these states of mind. If this terrible experience means something, and maybe is even going somewhere important, then it becomes easier to get through.

I hope what I’ve written helps a few people who are suffering. Consider all your options, including therapy, and please contact me if I can be of help.

Counseling & Therapy & Psychotherapy

I think it must be confusing for anyone new to the world of counseling and therapy and psychotherapy to make sense of these three terms. In Portland, Oregon where I practice, or anywhere in the U.S., the questions are basically the same. What is counseling? What is therapy or psychotherapy? Are they different? To understand these terms is not quite so hard as it seems.

When you decide to “get into therapy” or “find a counselor,” typically you’re looking for someone to talk with, often for an hour a week, on a regular basis and for a period of time ranging from a few months to a few years. This can vary, but I’m giving you an idea of what’s typical. So, if you’re looking to work with a therapist or counselor for awhile, what do you need to know about the various terms you will encounter?

There are at least two ways to look at the terms: one is based in common sense, and a basic understanding of language; the other is based in the way various state and other official groups regulate the profession of psychotherapy, and in how these groups decide to use and regulate the various terms.

I’ll focus on the common sense version. This is according to me and is not an official view, though I think it’s pretty accurate.

Counseling and Counselor are common terms. To me they convey a more practical approach–helping to guide a client into strengths and away from negative ways of living. Some counselors seem to emphasize guidance and advice. But that’s not always the case, and often counseling is the same essential process as therapy or psychotherapy.

Therapy and Therapist are common terms as well. Sometimes they’re applied to fields like physical therapy which have nothing to do with psychological and emotional health. But in the context of working with psychological issues, they are general terms that refer to any practitioner who works therapeutically with individuals, couples, families, or groups.

Psychotherapy and Psychotherapist just make things more specific. When you’re working with a human being on psychological issues, you’re working with the “psyche” of that person. Psyche comes from an ancient Greek word meaning soul–the living reality of a human being. Psychotherapy is a therapy for the living human being. The word therapy itself comes from a Greek word meaning to care for, attend to, or heal some condition that ails the patient.

The terms your own therapist likes to use will depend largely on personal preference.

The state and the associations that regulate the various licenses that therapists hold have their own preferred ways of using the terms counselor, or therapist, or psychotherapist. I won’t get into these details here, and I can’t speak for any official groups. The important thing to know is that if you’re seeking counseling… or therapy… or psychotherapy (use the term that you prefer!) for something that ails you, just make sure you do a little research and inquire about your potential therapist’s background and qualifications. See if that person feels like a good fit for you, and then begin and see where the process of therapy takes you.

How to Choose a Therapist

Now that I’ve entitled this blog entry, “How to Choose a Therapist,” I should tell you that no one, including me, can really tell you the right way to choose a therapist. Just like therapeutic work itself, choosing a therapist is both an art and a science. You will need to use your intuition–calling on your deepest instincts as best you are able. You will also need to use some basic knowledge–keeping in mind the essentials to good therapy.

The bottom line is that you should respect your intuition about who is a good fit for you. But it’s also important to know the basics about what to look for, what to expect, what to want, and what not to want.

On the intuitive side of the decision, consider these thoughts:

Different therapists have different styles of working with clients. There is no one right style, but there may be ways of doing therapy that work especially well for you. It’s important to find someone who is a good enough match for you, your temperament, and your particular needs. The therapist should feel to you like an intuitive “good enough fit,” after you’ve had at least one introductory session, and perhaps a few sessions. A good fit does not necessarily mean easy and fun all the time, especially since therapy by its nature ends up dealing with a client’s difficulties. Working through difficulties can be challenging–another reason to find the right therapist.

Coming to therapy involves focusing a special kind of attention on your life and your self. Most people report not having many places (if any) where this kind of attention feels possible. The attention involves a certain kind of care towards, and tending of psychological processes. Some therapists will feel to you like a more natural fit for the job of attending you through these processes. And whatever the initial problem or symptom you brought to therapy, the more complex reality that you’re bringing to therapy is you and your way of being in the world. Things are rarely cut and dry, because we are all quite complex human beings with lots going on at any one time. That’s why therapy (in my view) is as much or more an art than it is a science.

Now for the basic knowledge side of the decision.

First, look for someone with at least these qualifications: a legitimate graduate degree in the field of psychology, counseling, social work, psychiatry, etc. You should also look for someone who is active in the field, who seeks consultation with senior colleagues, who follows the basic ethics of being a therapist, and who has undergone a significant therapy process as a client, as part of training to do this work. This last qualification has a strong basis in the history of modern psychotherapy. Personal therapy has been an important part of training therapists for over a century. Your therapist should also have a personal philosophy and approach to doing therapy and be able to talk to you about it in ways that make sense to you.

In terms of how your therapist should relate to you and the work you are doing together, it is important for a therapist to maintain a real, respectful, and authentic human connection with you, at the same time as maintaining a professional boundary, competence in the field, and commitment to keeping open, curious, careful attention on you, your emotional life, your relationships, dreams, struggles, symptoms, and development as an individual.

When you get to the point of wanting to make some calls, you can explore your options in various ways. You can ask for names of therapists from friends (though you may not want to share a therapist with your best friend or partner), or doctors, or other healing professionals. You can browse the web and read what various therapists have to say on their websites. Sometimes a client finds the right fit quickly. Other times it is good to meet two or more therapists for an initial consultation and then choose one to return to and see for a few sessions. Some therapists charge for a first consultation and some do not. You can ask, and you can also ask what the fee would be for ongoing sessions. Some take insurance, and some do not. Some will reduce the fee if there is a real financial need for a lower fee, and some will not.

These thoughts are not meant to be a complete guide to choosing a therapist, but I hope that they give some readers a good start.

Depth Psychotherapy

There are many ways of studying and working with the depth of the psyche. The term psyche denotes the soul–the very substance of who we are as human beings in the world. Psyche refers to what we know about ourselves, and to what we don’t know about ourselves. Both the known and the unknown. What we know is referred to as conscious, and what we don’t know as unconscious. In reality, we are always a complicated mixture of both known and unknown.

So-called “depth psychology” and “depth psychotherapy” or “analysis” are especially interested in how the deep unconscious levels of the psyche operate. Depth psychologies argue that–contrary to popular opinion in our time–the bulk of who we are exists unconsciously. For the most part, we are unknown to ourselves, or known only partially. We tend to think that we know more than we do, and that we are in control of more than we are in control of. Yet we cannot escape the fact that the psyche resists our attempts to know and to control, and ultimately demands a sacrifice of such attempts. What we can do is listen to the symptoms, dreams, ideas, feelings, human relationships, and images that the psyche sends our way. A new, less troubled, more creative relationship to our deepest selves can then take root and begin to change our lives.

Working out psychological difficulties in therapy therefore means facing the unconscious, and listening to what it has to tell the client and the therapist. That’s the nature of the conversation in therapy. It is a conversation with the psyche that generates therapeutic changes over time.

The depth psychologist Carl Jung elaborated a depth psychology in the early and middle parts of the 20th century. Jung was a close associate of Sigmund Freud’s for a period of years. Just as his career seemed to be advancing towards its high point, Jung left Freud’s movement of psychoanalysis, and spent the rest of his career developing his own theories. The depth psychologies begin with figures such as Jung and Freud, and include many other, more recent psychologists who have changed the field of psychotherapy. Many new theorists have added to, challenged, refined, and re-imagined the psychologies of these two founders of depth psychotherapy and analysis.

Sigmund Freud, Stanley Hall, and Carl Jung, in the front, from left.

Sigmund Freud, Stanley Hall, and Carl Jung, in the front, from left.

Now we are at a crossroads in the field of depth psychology. The old divisions between differing schools of thought are becoming less and less interesting. The points of connection between the depth psychologies and psychotherapies are what hold more interest now. The reason for this is simple. All of these ways of thinking about the psyche and about therapy are attempting to understand what happens in therapy. The point of unity is the experience of therapy itself, and there are many ways of trying to understand what happens there, and how individuals undergo processes of psychological change.