the bittersweetness of mother’s day

May 13th, 2017

Not all people look forward to Mother’s Day. In spite of the Hallmark hype of the holiday, everything doesn’t always come up roses. For example, I had a mom who did her best with four sons and a marriage that wasn’t always a loving one. My mom had a big heart but didn’t always know how to show it to others. I don’t believe she intended to be self-absorbed and walled-off, but unfortunately, this was her way of being in the world–not just with me, but with all people in her life.

As a kid, I always tried my best to do something special for Mother’s Day, and I believe, on some level, it was appreciated. But as I grew older, I felt more resentful and less inclined to go out of my way to find the right gift or the card that accurately expressed how I felt toward my complicated mom.

Six years ago my mom died of lung cancer after having been a lifetime smoker. In the final months when she was on hospice, we found a way to connect just a little bit more to one another. I believe it was a mutual desire to get a little closer before it was time for her to take her final breaths.

Nowadays I hold the memory of my mother with bittersweetness–the occasional, intimate moments that were few and far-between, but I remain grateful for them. And more than anything, I know that my mom will always be a part of me–I wouldn’t be who I am today if it wasn’t for her influence. The good, the bad and the ugly.

Tomorrow is really just another day of the year, but for those of you who have a complicated relationship with this particular day, keep in mind that it’s ok to have mixed feelings about it, and Monday is just around the corner.

intern search

April 14th, 2017

April is upon us and the rains in Southern California have finally come to an end-much needed storms but quite relentless this year. As spring unfolds around us, I wanted to let you know that I’m starting my search for an MFT intern or MSW associate in my practice. I’ve been training associates for many years, and I always feel so fortunate that I get to give back what was once given to me. And my associates truly keep me on my toes as I also get to learn from them.

In the early 90s, I was invited into a group practice called West Coast Counseling Center, and two very talented therapists took me under their wing and helped me take flight. I’m so grateful for their wisdom, patience and love.

Here is a brief description of the intern position available in my practice, and please spread the word if you come across anyone who might be a good fit:

Private Practice Internship: Part-time, post-graduate position available for MSW associate or MFT intern with fewer than 1500 hours. Addictions experience required. Group and somatic therapy experience preferred. Saturday hours required. Email CV to Andrew Susskind, LCSW andrew@westsidetherapist.com.

Thanks in advance for keeping me in mind, and please let me know if you have any questions.

neuroscience of traumatic memory

March 28th, 2017

The Neuroscience of Traumatic Memory
with Bessel van der Kolk, MD
and Ruth Buczynski, PhD

Sometimes people can remember what seem like the smallest, most insignificant details of their lives – their 8th grade locker combination, a story they heard at a party years ago, or all the lines from their favorite movie.

These memories – full of facts, words, and events – are explicit memories.
But there are different kinds of memories – ones that are evoked by sights, sounds, or even smells.
For example, the smell of coffee percolating atop a gas stove could bring back Sunday afternoons around the table with beloved grandparents, aunts, uncles, and cousins.
On the other hand, being surprised by the scent of a particular aftershave, for instance, could elicit feelings of fear, panic, or even terror.

A person who was traumatized as a child might re-experience the all-too-familiar sensations of quivering in fear or breaking out in a cold sweat.
And it may have very little to do with the verbal thought process of, “Oh, this reminds me of the incident of my father hitting me.”

Traumatic memory is formed and stored very differently than everyday memory.
So let’s take a closer look at what happens when a person experiences trauma.

How Traumatic Memory Is Different from Everyday Memory
Dr. Van der Kolk: If a person was abused as a child, the brain can become wired to believe, “I’m a person to whom terrible things happen, and I better be on the alert for who’s going to hurt me now.”
Those are conscious thoughts that become stored in a very elementary part of the brain.
But what happens to adults when they become traumatized by something terrible they’ve experienced?
Simply put, the brain becomes overwhelmed. That’s because the thalamus shuts down and the entire picture of what happened can’t be stored in their brain.

“Instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context.”
So instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context.
And certain sensations just become triggers of the past.
You see, the brain continually forms maps of the world – maps of what is safe and what is dangerous.
“The brain continually forms maps of the world – maps of what is safe and what is dangerous.”
That’s how the brain becomes wired. People carry an internal map of who they are in relationship to the world. That becomes their memory system, but it’s not a known memory system like that of verbal memories.

It’s an implicit memory system.
What that means is that a particular traumatic incident may not be remembered as a story of something that’s happened a long time ago. Instead, it gets triggered by sensations that people are experiencing in the present that can activate their emotional states.
It’s a much more elementary, organic level of a single sensation triggering the state of fear.
A person might keep thinking about the sensation and say, “Oh, this must be because it reminds me of the time that my father hit me.”
But that’s not the connection that the mind makes at that particular time.

How the Lack of Context Impacts Treatment
So what difference will it make in our work, knowing that a traumatic memory was encoded without context?
“It’s important to recognize that PTSD is not about the past. It’s about a body that continues to behave and organize itself as if the experience is happening right now.”
It’s important to recognize that PTSD, or the experience of trauma is not about the past. It’s about a body that continues to behave and organize itself as if the experience is happening right now.
When we’re working with people who have been traumatized, it’s crucial to help them learn how to field the present as it is and to tolerate whatever goes on. The past is only relevant in as far as it stirs up current sensations, feelings, emotions and thoughts.
The story about the past is just a story that people tell to explain how bad the trauma was, or why they have certain behaviors.
But the real issue is that trauma changes people. They feel different and experience certain sensations differently.

“ . . . the main focus of therapy needs to be helping people shift their internal experience.”
That’s why the main focus of therapy needs to be helping people shift their internal experience or, in other words, how the trauma is lodged inside them.

How Talking Can Distract a Client from Feeling
Now, in helping people learn to stay with their sensations, we need to resist the temptation to ask them to talk about their experience and what they’re aware of.
This is because talking can convey a defense against feeling.
Through the use of brain imagery, we’ve learned that when people are feeling something very deeply, one particular area of the brain lights up.
And we’ve seen other images taken when people are beginning to talk about their trauma and, when they do, another part of the brain lights up.

So talking can be a distraction from helping patients notice what is going on within themselves.
“ . . . some of the best therapy is largely non-verbal.”
And that’s why some of the best therapy is very largely non-verbal, where the main task of the therapist is to help people to feel what they feel – to notice what they notice, to see how things flow within themselves, and to reestablish their sense of time inside.
Why Restoring the Sense of Time Can Make Emotions More Bearable
“All too often, when people feel traumatized, their bodies can feel like they’re under threat.”
All too often, when people feel traumatized, their bodies can feel like they’re under threat even if it’s a beautiful day and they’re in no particular danger.
So our task becomes helping people to feel those feelings of threat, and to just notice how the feelings go away as time goes on.

The body never stays the same because the body is always in a state of flux.
It’s important to help a patient learn that, when a sensation comes up, it’s okay to have it because something else will come next.
This is one way we can help patients re-establish this sense of time which gets destroyed by the trauma.
“Once a patient knows that something will come to an end, their whole attitude changes.”
Sensations and emotions become intolerable for clients because they think, “This will never come to an end.”
But once a patient knows that something will come to an end, their whole attitude changes.

groups as a change agent

January 20th, 2017

Tomorrow I will be fortunate enough to be part of a faculty of four very seasoned and passionate group therapists as we will be teaching a 2-day course called Principles of Group Psychotherapy. The title of the weekend may be a bit dry but the deeper implications are not.

When I was in the graduate school of social work at UCLA in the late 80′s/early 90′s I was a member of a group of 75 students with a passion for making some kind of difference. At the time I don’t think many of us knew exactly what that difference might be, and I certainly didn’t know either, but something was instilled in us that spoke to the idea of being change agents–social workers who would bring about change in others whether that be intrapsychic, interpersonal or in larger groups and systems.

I’ve chosen to devote my career to helping others learn about themselves, and as a result, hopefully bringing that growth and wisdom to others one person at a time. Group therapy holds that same principle–learning about oneself and helping others learn about themselves–as a result, it may seem like a pebble being thrown into a still pond, but I believe it has a super meaningful ripple effect one person at a time (e.g.families, friends, colleagues and loved ones).

During the unfortunate series of events these last few months, I’ve been deliberating on what to do, how to do it, when to give my time and energy, and it feels like the time is here. Whether it be giving my all in my practice every single day or showing up at a rally or donating to my favorite activist organization or signing a petition, it all counts. As a group of sane, loving, respectful and sometimes angry people, we can make a difference. Bernie Sanders said that it’s not about going into despair, it’s time to fight for equality of all kinds. And the magnitude of our majority group will prevail in spite of the speed bumps ahead.

2017

December 31st, 2016

On this morning of New Year’s Eve 2017, I sit at my desk wondering what the new year has to offer. Or better yet, I can choose to turn it around and decide what I have to give to the New Year. Sometimes the inner child in me wants to throw a tantrum about what isn’t being offered to me, but one of my New Year’s intentions to cultivate an attitude of gratitude and focus on what I have to bring to this world, to my clients and to my loved ones.

Because New Year’s Eve sometimes brings back mixed memories–fun, joy, hope as well as loneliness, isolation and depression, it can be a challenging time. In recovery it takes an intention every day to ride the waves of emotions that will inevitably arise in all shapes and forms, and today is simply another day.

I encourage you to consider the possibility that we are truly here to bring all of who we are to others and to our communities. In an unpredictable time in our country and possibly around the world, we can be change agents one person at a time, one community at a time.

I wish all of you a very safe, pleasant and resilient 2017!

tis the season

December 8th, 2016

This year is unlike any other year. Regardless of your political inclinations, the polarities in this country are indisputable and look like the grand canyon between progressives and conservatives. There can also be canyons and disputes in families, circle of friends and in the workplace, but in spite of the differences and conflicts, life goes on and so does the holiday season.

In recovery it’s often a challenging time as the broken-heartedness of the past can creep into the present tense when you least expect it. Additional contact with family can cause regression and instead of a grown adult, you may find yourself feeling like a child or even an infant. Instead of getting down on yourself, I have a few suggestions:

1. Observe yourself without judgment. Not an easy thing to do in the best of times but more of a challenge during the holidays. Be mindful of your “inner critic” (aka your inner Grinch?) and practice acceptance of yourself and others.
2 Be patient and gentle with yourself instead of treating yourself with harshness (i.e. give yourself the gift of self-compassion). By being self-compassionate, you can catch yourself going into shame and self-judgment and try to replace it with understanding and acceptance. The acceptance prayer in the Big Book is a valuable tool with this practice.
3. Be of service to others. The holidays can be either a time of self-centeredness of other-centeredness. By practicing your generosity, you will automatically feel better.
4. Practice gratitude. Look out for the little things–a kind word someone shares, a beautiful sunset, a delicious meal and savor the moment.

As you lean into the gratitude and acceptance, let go of the regrets and resentment. It’s up to you how you chooses to design this holiday season. In theory, this can be a time of unity and respect for our fellows, and by practicing these elements this holiday season, there is more likelihood that the contagion of “peace on earth and goodwill to all” will fluorish.

sexual health

November 24th, 2016

When I was in graduate school, we were required to take one course in Human Sexuality to fulfill the national curriculum requirement, but it was sorely lacking in the bridge between theory and clinical application. As an addictions and trauma specialist since the early 90′s, I admit that my training in “sexual health” has been intermittent at best. I’ve learned a lot about problematic sexual behaviors but not as much about the true integration of sex and intimacy as we help clients feel more liberated with their sexual identity and sexual health.

I have been very fortunate through the years to collaborate with Patti Britton, a local clinical sexologist, sex coach, sex educator and author. Dr. Britton (Patti) and Doug Braun-Harvey recently gave a 6 hour workshop to the Group Psychotherapy Association of Los Angeles which was very well-received and a breath of fresh air for those of us who don’t specialize in this area. At this particular time, it seems like it’s even more important to express oneself sexually with freedom, expansion and empowerment.

As I continue to expand my personal and professional journey in this area, I invite you to consider the limitless possibilities for learning and opening a dialogue with those in your life. It’s an often overlooked discussion, but my hope is that we will continue to integrate sexual health into addiction recovery as a vital element of finding one’s recovery voice.

For more information, feel free to contact myself, Dr.Britton, Doug Braun-Harvey or someone in your area who has the expertise in this specialty area. AASECT, the American Association for Sex Educators, Counselors and Therapists is the largest and most reputable organization for training and resources. I wish you all a very safe, pleasant and fun holiday on this day of gratitude–gratitude for all of the limitless possibilities that exist within us regardless of external circumstances.

group institute in review

October 16th, 2016

This weekend we had seven courageous participants in the Group Institute–a 12 hour group therapy experiential process. With my colleague, Maria Gray, LMFT we hosted this weekend group immersion which was sponsored by the Group Psychotherapy Association of Los Angeles (www.gpala.org).

Having been in a Group Institute for the past 7 or 8 years at our national conference (AGPA), it was an honor to be asked to co-facilitate this group learning process and witness all participants learn and grow in a very short period of time. We saw the phases of group development unfold before our eyes as group cohesion, trust, visibility, loss, and finally goodbyes were all naturally demonstrated.

Because I’ve been leading groups for many years, I sometimes forget about the power of Group Institutes for newcomers, and it’s hard work but quite gratifying for group members and group leaders as the honesty and the emotional risks expand in the room. By the end of Day 2, we were all quite tired (“spent” as one participant shared), but also gratified that something significant happened.

apples ‘n’ honey

October 4th, 2016

Yesterday marked the Jewish New Year (aka Rosh Hashanah) which begins a period of the High Holy Days as we reflect on the past year and hopefully look forward to being “written into the book of life” and a sweet, healthy new year. As a symbol of the sweetness, apples and honey is a long-standing tradition to share the ritual of ringing in the upcoming year with loved ones.

This has been a bittersweet year with the loss of our beloved cocker spaniel, Cooper as well as a close family member, but it’s also been a time of new life with our adopted spaniel, Bowie and a birth in the family. Being present for the beginnings and the endings is a gift of recovery and healing–a gift of living in the here and now and living life on life’s terms.

Whether you celebrate the New Year in October or January or any other season of the year, I wish you a very sweet, healthy year with love, gratitude and laughter.

polarities

September 28th, 2016

Without getting too political, we are living in a country of polarities as exemplified by our two presidential candidates and the people who support them. Addiction is also about black and white, rigid “stinkin’ thinkin’. It leaves people polarized and often isolated from one another.

On the other hand, recovery is about humility and tolerance of the “gray” rather than the extremes. It’s an opportunity to be open-hearted to other’s opinions and perspectives without reacting or retaliating.

Polarities divide and recovery fosters community. Which do you choose to practice today?

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