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August 18, 2011

PERIPATETIC PSYCHOTHERAPY

And now for something completely different ... Dear Reader, I'd appreciate your feedback on the following, a form which I would (should my professional order accept it) present to my clients the first time we meet. So what do you think? A crazy idea ... or would you go for it?
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"Therapy has typically been done with both/ all parties talking face to face while sitting together in an office. (This is of course not to mention the traditional psychoanalytic approach where the patient lies on a therapy coach and the analyst sits invisibly behind him or her). The present note is to present you with a further possibility: simply stated, that all or some sessions or parts of sessions consist of the two of us talking as we walk together outside the office rather than as we sit together in the office. (At the present time, due to issues of complexity, only individual therapy will be offered in this mode).

The two following issues make this approach somewhat controversial:

1) Confidentiality: the possibility of running into someone you might know. (We will discuss how you would feel about this and if and how you would want to introduce me to your acquaintance should this occur).
2) Boundaries: a less-clearly defined therapeutic space. Obviously, leaving the formal setting of the office behind might create a new dynamic which would be less traditional, structured or predictable. (We will talk about such issues if they occur).

An additional issue for me would be note-taking: in order to allow 5 minutes for this activity at the end of our time, walking sessions will be 45 rather than 50 minutes.

Why then consider this new approach to therapy? What are the potential benefits for you?

1) Physical activity component: in particular, in therapeutic situations involving depression or anxiety I have always discussed the importance of physical activity and movement in beginning to feel better - partly because of the benefits of increased serotonin production and partly because of an increased sense of self-efficacy, that is, your perceived ability to take charge and make concrete changes in your life. (Because of solid research on the psychological benefits of physical activity - cf. the Duke University study of 2000 - I have sometimes felt more like a coach than a psychologist!) In the walking approach to therapy, we would actually build in some physical activity even as we discuss other aspects of your situation.

2) Real-world generalization: a key challenge in therapy has always been the integration of therapeutic progress in the office into real life outside the office. Some of my family therapy colleagues tap into generalization effects by actually meeting with the family in their own home. I believe that walking outside the office might similarly encourage the generalization of therapeutic effects to other settings

3) Easier flow of discussion and ideas: personally, in discussing important matters in my own life with friends or confidants, I have always found it easier and more natural to talk as we walk side by side rather than as we sit face to face. It is my contention that some clients might find it easier and more 'natural' to talk about the journey of their lives while we are making a symbolic walking journey together.

[If I am to be honest, I might mention a personal benefit to myself of this approach as well: therapy is a decidedly sedentary type of work, and the occasional walk will change the pace for me as well and potentially increase my own energy level! (cf. Montreal Gazette article of Thurs. Aug. 18, "Watching too much TV could take years off your life: Prolonged sitting is just as detrimental for mortality as obesity or inactivity")]

The beginning and ending point of walking sessions will be my office. Walks will occur within the 45 minutes of therapy, either for the entire time or for part of the time. Payment will occur in my office, either before we leave or when we return from walking. Walks will be as leisurely or as rigorous as you choose, on the quieter back streets near my office or even on the trails going up Mount Royal.

Even if you should decide to try this approach, no pressure will ever be put on you to walk, and you will decide before each session whether you would prefer to walk or to remain seated in my office for that session. The choice will be yours.

I declare that I have read this document and understand its content".                                ______________________

March 15, 2011

. . . AND MY HEART SOARS

“Joy is the serious business of heaven, just as play is the serious business of childhood”. ~ C.S. Lewis
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In his 1988 speech as incoming president of the American Psychological Association (APA), Martin Seligman made a riveting statement (which I now paraphrase): “On the scale of happiness, we psychologists have given ourselves the job of helping people move from - 5 to 0 . . . and we’re content with that. But what about 0 to +5? How do we get beyond mental illness, how do we help people find ways to increase their happiness?”. And so began the exploration of a new frontier which has come to be known as Positive Psychology. Seligman, who had already become famous for his study of depression (“learned helplessness”) eventually wrote books entitled Learned Optimism (1998) and Authentic Happiness (2002), reflecting his new orientation.


In the second of these books, Seligman documents an exercise which has been empirically proven to increase one’s global level of happiness.  This exercise, much like a gym workout, must be practiced at least several times a week in order to bring about lasting change.  Would you like to know what it is?  Would you like to be happier?


Well then, just send $29.99 to the following address. . . lol, just kidding!  Here it is; but I warn you, this exercise may seem too simple to really make a difference.  (Maybe you’d take it more seriously if you did have to pay for it?) Ready? OK, here goes:


Tonight, before you go to bed, think back on the day you have just completed . . . and identify your three favourite moments.  


Umm, basically, that’s about it. If you like, you can write down your good moments—which could be anything from eating a really great cinnamon bun to receiving a sincere compliment to hearing a bird sing while you were waiting for a bus—in a “Gratitude Journal” . . . but the main point is to simply identify and acknowledge them. This exercise, sometimes called “Three Blessings”, will quite likely increase your overall level of happiness. How? By causing you to focus on what is right about your day, to look for positive exceptions (if you are going through a difficult time), to cultivate gratitude and appreciation for your life, to enable you to fall asleep with the expectation of good things for the day ahead.  When I read the research on this exercise several years ago, I decided to put it into practice with my young sons.  We began to do it together every night at bedtime. I knew it was beginning to ‘take’ when my son Zac, who was about four at the time, told me one day when we were doing something fun, “Daddy, this is going to be my favourite thing.”


So, what gives you joy?


I love looking for flashes of joy in the midst of my days.  Often these come through the little moments that I might easily pass by in the often-frantic business of living: the laughter of one of my sons . . . a good breakfast shared with a friend . . . gliding my canoe through the mist of a mirror-still wilderness lake early in the morning (ahhh!) . . . an autumn run through dried leaves on Mount Royal . . . unexpectedly hearing “Here Comes The Sun” played in the métro by an itinerant guitarist . . . and I would invite you to make your own list. If you like, leave a comment with one of your three good moments. 


I close this reflection with a poem I love by Chief Dan George, "My Heart Soars”:

The beauty of the trees,
the softness of the air,
the fragrance of the grass,
speaks to me. 
The summit of the mountain,
the thunder of the sky,
the rhythm of the sea,
speaks to me. 
The faintness of the stars,
the freshness of the morning,
the dewdrop on the flower,
speaks to me. 
The strength of fire,
the taste of salmon,
the trail of the sun,
and the life that never goes away,
They speak to me. 
And my heart soars. 

    January 16, 2011

    “SLOW DOWN, MON!"

    Life goes fast. Some twenty years ago, a friend and I who were working in Toronto decided we wanted a change of pace. It was February, we were stressed out, and we badly needed some sun. We asked a travel agent to make us her best offer, and a few days later, found ourselves sitting in a Holiday Inn dining room in Montego Bay. It seemed surreal that only hours earlier we had been plodding though a Canadian winter, and now we were in paradise. It soon became clear, however, that it would take a while for us to acclimatize ourselves to the Jamaican tempo. My friend dropped a fork and beckoned impatiently to a waiter, “Excuse me, could I have a new fork?” The waiter’s bemused answer, accompanied by a calming gesture, became our mantra for the rest of our stay: “Slow down, mon!” As we gradually did manage to slow down, we came to appreciate a very different pace of life; when I would ask when the next bus was scheduled to arrive, the answer would invariably be, “Soon come!” No hurry, no worry. It turned out that a less sped-up approach to life, more focus on relaxation than on efficiency, was exactly what the doctor ordered. My then-girlfriend who came to pick us up in the Toronto airport a week later found two happy and decidedly unwound guys wearing tropical shirts and giggling like schoolgirls, and she wondered if we had perhaps partaken a bit excessively of Jamaica’s famous herbal offerings.
    Life has not shifted out of the fast lane since. In the first decade of the 21st century, the almost-unlimited leisure predicted back in the 1960’s somehow never did materialize. If life seemed fast before . . . now it is even faster.  We are connected 24/7, and we find ourselves struggling to keep on top of our email, not to mention our Facebook. Our iPhones and BlackBerrys make it possible to react almost immediately to client requests as well as family crises, and the old paradigm of Work/Personal Life Balance seems almost quaint as we negotiate the brave new world of Work/Personal Life Blend.

    And the Internet, an amazing and magical tool, increasingly inhabits our thinking and provides us with the means of even greater efficiency, not just in our work but also in in our relationships. In 2000, only 46% of Americans were online; now the figure is 80%. In 2004, people began to speak of the Web 2.0, or “Social Media”: this medium was no longer simply an efficient method of finding information; it became a way of life, a way of making our relationships more efficient. It is astounding how our lives have changed, bit by bit, under the influence of such social media as Facebook, Twitter, LinkedIn and YouTube. Now there are 200 million blogs we can follow . . . 2 billion YouTube viewers, watching 30 billion videos each month. . . as of last July, 20 billion Tweets . . . and 550 million Facebook members, now citizens of the third largest ‘country’ in the world. And everything is just getting faster and faster.
    In 2010, Nicolas Carr published The Shallows: What the Internet is Doing to our Brains, an expansion of his thought-provoking 2008 essay “Is Google Making Us Stupid?" . Carr’s premise is that the Internet may actually be changing how we think—that our neural networks are being pruned towards quicker but shallower thinking, like sampling from a smorgasbord rather than sitting down to enjoy a gourmet meal. This new way of thinking may be diminishing our capacity for higher-order cognitive processes: abstract thinking and metaphor, mindfulness, reflection, inductive problem-solving, critical thinking, imagination . . . and my particular concern, our capacity for empathy (part of which is predicated on imaginatively being able to put ourselves in another’s position, and caring about that other feels).
    We are beginning to react against the superhuman speed of life, in several domains; in a society of fast food, a new trend becoming popular is that of “slow food": taking a whole day to plan, prepare, and savour a meal with friends who are not in a hurry. Courses on “Mindfulness”, a basic model of Buddhist meditation, are being presented to leaders of industry. And in a world of ever more frenzied multitasking, I recently read on Mashable about a radical new approach to time management: “Single-Tasking", doing just one thing at a time!
    But in this sped-up, plugged-in world, just how do we stay human? In fact, how can we become even more human, more humane, in our inner lives and in our dealings with each other? I would like to offer a few suggestions which I believe might help:
    • Slow down! Find activities —like eating, walking, running, or talking—that you don’t have to rush through, activities you can savour like fine wine.
    • Read a book. Fine, read on your Kindle or your iPad if you must, but read a book from beginning to end, don’t just leapfrog from hyperlink to hyperlink.
    • Exercise your imagination. “Imagination is more important than knowledge” was not spoken by a lazy thinker but by Albert Einstein. And imagination still differentiates us from the computer. Make up stories with your kids, pretend, daydream.
    • Practice inductive thought. Be mindful, meditate, pay attention as you go through your day. Before going to sleep each night, ask yourself, “What was my favourite moment today?”
    • Get into nature. My absolute favourite way of slowing down is wilderness canoeing. It has a way of reconnecting me to what is essential.
    • Unplug—from the Internet, from your cellphone, from your laptop, from technology, even from your wristwatch sometime (if you still hang on to that 20th-century artifact!) When my family leaves on a canoe trip into Algonquin Park, we ceremoniously stow our watches in the glove compartment and begin a “timeless” week. It’s a refreshing way to go through a day “time-free”. (And if you miss a movie, there’s always Netflix, lol!)
    • Reconnect with loved ones in real, face-to-face time, and cultivate the decidedly slow art of listening.
    • Keep a journal: “Reading makes a full man; conference a ready man; and writing an exact man”. (Francis Bacon)
    • Play a sport or practice a physical activity like gardening or knitting or yoga or illuminating manuscripts.
    I personally love the art of therapy: my office is a place where I can turn off my cellphone, disconnect from technology, tune in to the human story, and connect with another person at a deep and personal level. It’s a rich way to spend my days, and I think it is helping me become more and more human.
    Do you have other activities, strategies or tricks that work for you, that help you slow down and help you preserve your humanity? I’d love to hear them. I’d also like any ideas about what kinds of articles might be interesting for me to write. (I’d like to journal more this year—and don’t worry, I’ll make future articles shorter!)