Living with the challenges of a family member with dementia

 

Dementia is becoming an increasing challenge, not only for many older people, but also for their close family and friends.

It is particualrly challenging for family members who find themselves in the role of carer or needing to support a parent or spouse with the illness.

If you find yourself in such a role you will doubtless experience a whole range of emotions. Many of these are so-called “negative” emotions – such as anger, sadness and helplessness. But, unpleasant as they may be, such emotions are completely normal in this situation.

You may also experience guilt if you find yourself feeling what you regard as “uncaring” emotions towards the loved one – such as anger.

I believe it is very important to normalise such emotions because much of the message we get from our culture is to hide such emotions, to medicate them or to judge ourselves harshly for having them. The more we can make a place for these emotions in our lives, the less toxic they become.

We need to see dementia not as not just a medical disease but also as something that has important psychological and emotional meaning, both for the person with dementia and the carer. That is why I encourage the carer, for example, to view the person with dementia’s unusual behaviour as not simply random acts caused by the deterioration of the brain, but perhaps as communicating a deeper meaning relating to that person’s life or experience.

Understanding the person with dementia’s history and early life can shed light on behaviour in the latter years. Unresolved issues from childhood may be reactivated and the carer may be drawn into this and have their own, earlier, unresolved issues touched.

The way in which the person with dementia copes with the ongoing loss and deterioration of the illness may in part be influenced by much earlier experiences in their lives.

By becoming empathic, trying to see the world through the person with dementia’s eyes, we can begin to understand some of the unusual behaviour. And in letting go a little of our expectations of a “normal” relationship we may become open to something new, something different. This could be a moment here and there of calmness and connection with the loved one, an awareness that we can temporarily let go of our everyday worship of time or a discovery within ourselves of unknown reserves of patience or love.

Letting go of our usual expectations of relationship opens the door so that, in this very difficult experience, there is the potential to find meaning. It is often through suffering that we learn, that we find meaning, even if that meaning does not become visible until long after the event.

Living with the Challenges of Dementia: a Guide for Family and Friends, by Patrick McCurry, is published by Sheldon Press on 16 July 2015. It is available for pre-order before then, at Amazon.

 

 

 

 

 

 

 

Why acknowledging our wounding helps our relationship

While most parents do the best they can, they cannot be perfect.

All of us, I would argue, have some degree of emotional wounding from childhood and the particular wounding we bring will be triggered in our intimate relationships.

While that may sound negative, and can cause lots of problems in relationships, it is also potentially positive because when we can acknowledge our own wounds – and become more aware of our partner’s – a healing can take place in the relationship.

Unfortunately, many adults are unaware of, or have buried, their emotional wounding. So, when their wounds are activated in their relationship they blame their partner for it.

Our wounding

For some children the wounding they receive from parents, or others with power over them, is severe – emotional, physical or even sexual abuse.

For many others the wounding may have been less traumatic. It could have been a parent who was not able to meet your needs because of a busy job or other commitments. Or perhaps having a sibling who seemed to get more attention or approval from one or both parents.

Some children will have grown up with a parent who was quick to anger or was controlling in other ways.

In some cases the child may have got the message that they were valued more for their achievements – their academic grades or sports performance – than just for themselves.

How it is triggered by our partner

As adults we take these earlier wounds into our relationships with partners, where they often get activated in a painful way.

Here are some examples:

  •  coupleKaren grew up with an angry father who sometimes scared her. She picked a husband who seemed very calm, but he seems annoyed more often and she feels afraid and panicked.
  • As a child Peter felt that his mother often disapproved of his behaviour, even though he tried to be a good boy. He now finds that his partner seems often disappointed in him and feels that he can never get it right for her.
  • Sarah’s father abandoned the family when she was a girl. In her adult relationships she finds herself with men who, for different reasons, seem to let her down and whom she finds it difficult to trust.

These are just some examples – there are many more.

Acknowledging and staying open to our wounding

One of the opportunities in couple therapy is for both partners to recognise and acknowledge – often for the first time – the wounds that they may be carrying from childhood.

Therapist John Welwood, in his book Perfect Love, Imperfect Relationships, says that when we find ourselves shutting down in our relationship it is often because our partner’s emotional wounds have triggered our own wounding.

So, our partner may be angry about something but because we associate that anger with rejection, we shut down when they are angry. Instead of shutting down, when our partner triggers our wounds, we can try and stay open to what we are feeling and to what is going on for our partner.

“If my partner and I can learn to speak together about the wounded places that give rise to our emotional reactions, this will also help us remain more awake when the wounds are triggered,” says Welwood.

My experience in working with couples is that when they are both able to talk about and feel the feelings of that earlier wound, something can shift in their relationship. Each is able to soften slightly, and to offer their partner (and themselves) more understanding and compassion.

“Coming to terms with our woundedness helps us navigate the complex emotional dynamics of human relationship and gradually bring a more all-embracing love into this world,” says Welwood.

What is sex addiction?

Sex addiction is a term that can invite scepticism – you may think of the movie star who cites it to explain his numerous infidelities. “It’s not my fault – it’s the addiction,” he protests.

While there may be some people who use the idea of sex addiction as a way of avoiding responsibility, there are many more who feel caught in a self-destructive but seemingly compulsive behaviour. It is a behaviour that can wreck relationships, drain bank accounts and even destroy careers.

For these individuals, more often men than women, an addiction to sexual acting out of some form is a sad reality. It can take the form of internet porn, the exchange of sexually explicit photos and messages on social media (sexting), paying sex workers, endless affairs or sex with strangers.

In this context “acting out” refers to sexual behaviour that has become a way of unconsciously avoiding painful feelings. In other words, the sexual behaviour has become a defence mechanism to deal with underlying pain, in the same way that an alcoholic uses alcohol or a gambling addict gambling.

What makes it sex addiction is the individual’s experience that, even though they recognise the behaviour is damaging their lives they feel unable to stop.

Sex addiction is a growing problem.

Never has it been easier to use sex to escape difficult problems or emotions. There is an almost infinite supply of free online porn of every kind, while the internet also makes it much easier to research and contact sex workers or find others to engage in sexually explicit chat or the exchange of images.

Psychosexual therapist Paula Hall, in Understanding and Treating Sex Addiction, identifies three kinds of sex addiction.

  • Trauma-induced – this includes sexual or other forms of abuse. It also includes major losses, such as the death of a close family member.
  • Attachment-induced – this happens when the child lacks a secure attachment to parents or caregivers. When attachment is problematic the child can grow up feeling insecure and find it difficult to soothe themselves when difficult feelings come up. There may be attachment problems if the parenting of the child is too harsh, too emotionally distant, abusive or neglectful. Or if the child is separated from parents for long periods.
  • Opportunity- induced – this refers to addiction that is not necessarily rooted in early trauma or attachment problems, but caused by easy access to internet porn, cyber sex, etc. The much greater accessibility of these, thanks to the internet, has led to an increase in this kind of sex addict, says Hall.

There may be an overlap between two or more of these categories.

The key issue in all this is that the individual realises that his or her use of sex is causing major problems in their life – and they can’t seem to stop. Frequently, the problems they bring to therapy may be about anxiety or depression or about how the use of sex has damaged closed relationships.

Although sex addiction has almost certainly been around for centuries it is only in recent years that it has become more recognised. “Advances in brain research and neuropsychology have helped us understand the nature of both chemical and behavioural addictions and appreciate the links with childhood experience and trauma,” says Hall.

 

 

The importance of acknowledging your Shadow

We all have a psychological Shadow. By this I mean those parts of us which we hide, deny or repress. Sometimes we may be aware of our Shadow, but much of the time we hide it even from ourselves.

But it is vital that we try and get to know our Shadow, or at least parts of it, because otherwise it can play an extremely unhealthy role in our lives.

So, what is the Shadow and how do we know about it? The idea was developed by Carl Jung and the Shadow basically refers to those parts of ourselves that do not correspond with how we like to see ourselves.

For example, we may like to think of ourselves as honest, respectable and hardworking and criticise those who are not like this. Almost inevitably there will, therefore, be a part of us that is (or could be) dishonest, disreputable and lazy. It is not that we need to act out our dishonesty or laziness necessarily, but more that we can acknowledge that we contain those parts within ourselves.

If we cannot accept all the parts of us, including the ones we judge as “bad”, we will project these unaccepted parts onto others and judge them.

This process is an unconscious one. We are mostly unaware of what we are rejecting within ourselves, as it has usually been going on since we were children. So, if as a child we were shamed by parents when we were too exuberant, we may have put that part of us in the Shadow in order to win our parents’ approval.

As a child this is not a conscious decisions, it’s just something that happens, so as we grow up we don’t even realise that we have disowned our exuberance and that it is in our Shadow.

But we may notice that we judge harshly those who we experience as being “too” exuberant.

The way we judge others, particularly, those people who really annoy us is usually a clue to what is in our Shadow. Another way we can learn about it is through our dreams. So, for example, being pursued by a tiger in a dream could represent how we run away from our own anger or wildness.

The Shadow can never be completely known. It is, by its nature, mysterious and unconscious. But we can get to know parts of it and own those parts instead of judging them in others. The more we can do this, the more integrated and whole we become.

Why fighting a problem can create a problem

 

 

2356337414_0aaa79313d_oMost of you will have seen that famous film scene, where a character is trapped up to the waist in quicksand but sinks even deeper the more he struggles. The best option in such circumstances is to relax because then your body, which is less dense than quicksand, will float.

In therapy, too, the more a client fights their “problem” the harder it can be to change.

Psychologist Steven Hayes has written powerfully about this process, in his paper Hello darkness: Discovering our values by confronting our fears. In what seems like a counterintuitive approach, Hayes points out that genuine change or healing only comes from moving towards our fears or what is troubling us.

It is about changing our relationship to what is troubling us. Instead of trying to eradicate uncomfortable thoughts or feelings we can learn to allow them to be present. By consciously choosing to allow them to be present they somehow become less powerful.

In this way we don’t fall into the trap of “experiential avoidance”, which is when we avoid what we are experiencing in the present moment because it is uncomfortable.

Hayes cites sadness as an example: “Instead of getting rid of sadness, patients learn to detect how sadness feels in their body, how it tugs at their behaviour, how it ebbs and flows, and begin to feel at a deep level that they can carry sorrow with them while still living the life they want. “

In therapy the therapist or counselling can help the client begin to change their relationship with what is troubling them. The client can explore what may be underlying difficult feelings or behaviour, and give these underlying causes attention also.

Usually we adopt a problem-solving approach in our lives, so if our car breaks down we get it fixed. In a way this is the approach of cognitive behavioural therapy, which attempts to change ‘negative’ thoughts and feelings into ‘positive’ ones. But when it comes to deeper emotional and psychological troubles we need a different, more subtle response.

It is only by genuinely accepting where we are right now, almost relaxing into it as in the quicksand, that we can create the conditions for change to take place.

I have found that in the moments when I am able to feel difficult feelings without trying to escape from them through distractions or addictions I feel a lot better about myself afterwards.

I think framing this response as a choice can be helpful, as in, “I am choosing to experience this sadness/emptiness/anxiety right now, in order to feel stronger, more whole and have higher self-esteem.”

By framing it as a choice we can feel more empowered and not simply a victim of our difficult feelings.

Photo courtesy of Cecilia Espinoza, Creative Commons, Flickr, https://www.flickr.com/photos/sasamaster/ 

 

 

 

The puer aeternus, or ‘Peter Pan Syndrome’

4885731902_9e2a428240_oDo you ever come across men who have an engaging charm, spontaneity and creativity but who somehow seem emotionally very young and perhaps ungrounded?

Chances are you are thinking of the puer aeternus* archetype, also known as the ‘Peter Pan syndrome’. Puer aeternus means ‘eternal boy’ in Latin and the name was coined by psychologist Carl Jung to describe an archetype, i.e. a kind of symbol of a certain type of behaviour or energy that is part of all our psyches.

These kind of men can drive women mad, as they usually have a very attractive energy and are fun to be with. Yet, deep down, they’re not really interested in a mature relationship with a woman.

Peter Pan is a great example of the puer (pronounced ‘poo-air’), as he is a boy who never grows up but who just wants to fly, to have fun. An obvious example of the puer is Michael Jackson, who was also besotted with the Peter Pan story.

The puer is a free spirit who lives for the moment. He represents youth, passion, idealism, beauty and creativity.   These are all positive qualities. The danger is when a man becomes so identified with this archetype, this energy, that he neglects other values that do not fit in with the puer. These other values include taking responsibility, sticking at things, and self-discipline.

The negative side of the puer is that he can be rather grandiose or self-centered an, shy away from the more difficult or mundane tasks of life. He often also struggles in relationships with women, enjoying the early excitement and passion but unable to stick with the demands of a committed relationship once the honeymoon period is over.

In his book Iron John, author Robert Bly describes these men as ‘flying boys’: “Peter Pan belongs among the flyers, as do most ashram habitués, devotees of ‘higher consciousness’…and some Don Juans who want such heavenly perfection in women that they are obliged to leave each one in whom they fail to find the missing pearl.”

There is an argument that the puer is the product of an overprotective and domineering mother, and an absent or passive father. Hence, while he may want to seduce or is ‘in love with being in love’, he struggles with making an authentic, deeper connection with a woman.

While the puer may appear happy and carefree, there is a depression in his soul. In fact his soaring is a compensation for the emptiness he is only dimly aware of.

Bly says that the task for the puer is to descend, in psychological terms, to experience hardship of some kind. This could mean experiencing major loss of some kind, such as a job, a bereavement, an illness, a divorce. Experiencing the descent enables the puer to become aware of the painful feelings that have always been there but not previously acknowledged. In working through the hardship, knuckling down to life’s blows where previously he would have flown away, the puer begins to grow up.

Accepting the parts of him that previously he ran away from – the shame, the sadness, the feelings of not being good enough – is another way of saying that the puer begins to discover his own ‘shadow’. This was the term Jung used to describe that part of us that we don’t like and therefore deny.

This also seems to be one of the lessons of Peter Pan, as Peter loses his shadow when he flies into the house of the Darling family. He becomes afraid of it because it is so big and seems to have a life of his own. He only gets it back when Wendy sews it back on.

Like Peter, puers need to acknowledge their shadow shelf, the part of themselves that they have rejected, in order to mature and truly be in relationship with a woman.

 

 

 

 

 

 

 

 

Why you should never see a therapist who is ‘too nice’.

Most people who become counsellors and therapists want to help people. That may seem obvious. But sometimes, if we try to be too helpful, it can actually get in the way of effective therapy.

At some point we will probably do or say something that annoys or hurts the feelings of the client. This ‘mistake’, this not being the ‘helpful’ or ‘caring’ therapist may be uncomfortable for us. But there will probably be learning in there about the client’s earlier relationships.

To clarify, I am not talking here about genuine misconduct by a therapist, such as intentionally harming a client or not respecting boundaries. I am thinking more about the ‘honest’ mistakes many of us make. This could be not seeming to understand what the client is saying, forgetting something that the client regards as important or finding oneself suddenly very sleepy and trying to suppress a yawn during a session. It could even be arriving late for a session or double booking a client.

At one time or another I have made all these mistakes. Because most of us therapists feel we should be helpful and caring, it can be tempting to be too ‘nice’ and apologise immediately for our not nice behaviour. But the nice response is not always the best therapeutic response. While we need to question ourselves about such mistakes and examine whether we may be acting out something from our own past, it can often be  helpful to look at the mistake as potential information about the client and the client-therapist relationship.

For example, if I am slightly late for our session and apologise immediately that makes it harder for the client to feel angry with me. And, because many of us struggle with owning our anger, it is important that the therapist is not over nice, otherwise the client senses that the therapist is uncomfortable with the client’s anger.

If I make a mistake and behave in a way that is unusual for me, I ask myself, why have I done this with this client and not another and why now? Often the answer relates to an earlier relationship of the client’s and to the developing relationship between therapist and client.

So, if the client feels let down and that he is not important to me when I am slightly late for our session, what does this experience remind him of in his earlier life? It may be that he didn’t feel he was important enough for his mother or father, that they seemed more interested in other things than him. That little boy was not able to express his feelings to mum or dad, but the adult client can be given the space to express his hurt or anger and for those feelings to be validated and accepted.

Often the mistake will occur at a stage in the therapy when the relationship between client and therapist is strong enough for the client to bring to the relationship some of these more difficult feelings, such as anger or hurt.

Psychoanalyst Patrick Casement talks about this in his book Learning from our Mistakes, when he argues that often the mistakes therapists make with their clients “have an uncanny parallel to key environmental failures in the patient’s past history”.

The key thing to remember is that unconscious processes are often at work in these ‘mistakes’. In some sense, the client needs the therapist to repeat the earlier wounding so that there is the potential for a different resolution.

Casement says: “Patients may revisit key experiences of early failure by their parents, or other caregivers, through their use of similar failures by the analyst…how much this…is fortuitous and how much it may be unconsciously determined, we may never quite know.”