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Coffee At Figaro's Recently I received an email from a young woman interested in beginning therapy at the Institute. She explained that she had been given my name by someone who had worked with me several years ago and who believed I might be able to help her. She told me she had been seeing a therapist for the last few years, mainly for depression, but according to her she was at a standstill with her current therapist. She liked her well enough, but at the same time she was feeling the need for what she described as a more authentic therapeutic relationship. She went on to say that she had recently discovered through a friend of a friend that at one point in her life her therapist had also suffered from depression. This was a bombshell of information as far as she was concerned. It was at this point that she began to question whether she could actually move forward with this particular clinician. She reasoned that there had been numerous times when it could have made a tremendous difference had her therapist shared anything at all about her own struggle with depression. In looking back over the years spent in therapy she realized she actually knew nothing at all about this person who knew everything about her. The young woman did make the effort to discuss all this in her next session but the therapist was once again silent. This therapeutic approach was all too familiar to me but at the same time a world apart from my own approach. There is, by the way, a philosophy behind the therapist's unresponsiveness that goes all the way back to Freud and Psychoanalysis. Briefly the theory was that for the client to fully explore their unconscious the therapist must be a "blank screen" that in no way interfered with the Analysis. As you can imagine this was contrary to everything I ever learned in training at the Institute and frankly conflicted with who I was as a person. My early training began at the original Primal Institute, which was located in West Hollywood. Down the street was a little restaurant called Cafe Figaro. What does this have to do with training and blank screens? Often while reviewing the tapes we made of our sessions Art or Vivian would say to the new trainee " It should be as though you are having coffee at Figaro's”. In some ways it became our mantra; coffee at Figaro's. There was nothing they hated more than the phoniness of the superior therapist hiding behind their rules about disclosure. They felt our sessions should be conversational and our job was to connect with our patients. The fact that we had all been through the therapy made it easy to relate to what each new person was experiencing - we had been there ourselves. Clearly we always want to keep in mind what is most appropriate for the individual patient. What is useful for one person is not always helpful for another. The skill and experience of the therapist hopefully allows for an understanding of how best to proceed but in Primal we want that to come from the inside and not from the intellect. That being said I personally have found that the boundaries between patient and therapist are, for the most part, increasingly irrelevant, at least for me. Barry said something once that relates to this I think. Of course it is a music analogy, he said to be a good musician you have to know all the fundamentals before you can have the freedom to improvise. The same holds true for therapists in my opinion. You do need an understanding of the basics and possibly it is useful to rely on certain rules when you are a new therapist or your instincts fail you but if you can't move beyond that to sense what your patient is needing the integrity of the relationship between patient and therapist will always be compromised. The therapist should feel and sense when a boundary is needed or a question should not be answered because it is in the best interest of the individual patient. They should also sense when to be anything less than real and forthright would inhibit and possibly damage the therapeutic process. I have often wondered if there are times when rules and philosophies serve the therapist and not the patient. It allows the therapist a distance or an idea to hide behind, it highlights the therapists need to feel separate and apart and makes clear his deficits, and as a result it can not take in to account the needs of the individual. A psychology teacher I once knew said this about providing effective treatment” When all else fails be silent". I think when all else fails I'll just be me. Gretchen ************************************************************************************************************************************
Paper Tigers The Time magazine cover story for January 31, 2011 has sparked a heated national debate on how best to raise children. Amy Chua, a Yale law professor and mother of two, author of “Battle Hymn of the Tiger Mother”, her proudly politically incorrect account of raising her daughters “the Chinese way”, arrived in bookstores last month. To simplify, the Chinese way appears to involve extreme regimentation, sever discipline, academic achievement, and a zero tolerance for activities not directly related to excellence and productivity. By contrast “the Western way” is characterized as overly permissive, indulgent, and obsessed with a child’s self-esteem. As is typical for this kind of emotional/intellectual jousting, supporters of each view trot out their respective horror stories, cite questionable research data, and when all else fails, resort to personal attacks. Ms. Chua has of course been demonized, called a monster, a child abuser and worse. Apparently a nerve has been touched for many, many people. However,we of the Primal minority have a much deeper understanding of raising children and parenting in my view. We know that parenting can never be condensed into any kind of manual or how to book, or even reduced to a one size fits all philosophy. We know all too well that a child’s experience of his or her life is more than just what a parent decides to consciously say or do. Better Than a 747 It seems to me that this whole quest to find the best way to raise children is itself a danger sign. It is certainly misguided at least, and for me, hints at a certain alienation from healthy parental instincts, a kind of estrangement that can cause many parents to seek out experts for what should be the most natural thing in the world. After all, we were all children at one time. So, the 747 I mentioned above refers to Boeing’s widely known commercial airplane. This jumbo jet has something like 5 backup systems for all crucial operations. This built-in redundancy I believe they call it, backs up many times over, all vital systems. The engineers know that indeed things can and do go wrong, but the plane is over-engineered so that it can survive numerous types of failure. Only if many, many things go horribly wrong all at once, is safe flight compromised. Children are also over-engineered, equipped to thrive in a wide range of conditions, including highly stressful environments. This wonderful capacity liberates us from having to vision quest some notion of the best way to parent. All styles of parenting across a wide variety of conditions will allow a child to thrive within certain parameters. What exactly are the parameters? Well, even our 747 with all its back up systems cannot survive a wing falling off mid-flight. The failure is too great; it exceeds all reasonable parameters for safe flight. You will go down! A plane without a wing is an easy thing to spot, not so for parents with equally dangerous structural problems. What then separates the parents that can support and nurture a new being into adulthood from parents that fail their children? We know from 40 years of clinical experience that the repressed (unconscious) unmet needs of the parent become the child’s mandate. This is the parameter, which if overburdened, endangers the child, i.e.; brings the plane down in flames. Whatever is repressed or unconscious in the parents become the demands placed upon the child. The tentacles of repressed pain spread out covertly and overtly for the child, and like the iceberg that sunk the Titanic, the biggest danger is below the surface. Our understanding of dialectical processes helps us to see the many forms that parental pain may take in the parent-child dyad. Make no mistake; they can be quite lethal for a child’s natural development. As Dr. Janov brilliantly stated many years ago, often the very reason a person decides to become a parent sets the child on a path towards neurosis. Examples of parental pain becoming a child’s mandate are all too familiar. The more obvious ones are having a child so we can finally be loved, or the ultra popular parental opiate, insisting on the child’s success at school, sports, music, etc. to quell the parents own sense of failure. Parents do not do this knowingly, but the damage is great nevertheless. The fatal flaw (for the child) of these parents is their need to use the child for pain mediation. A parent with significant repressed childhood pain has no choice but to use his child to keep that pain under wraps. If a parent grew up with Nazi style discipline, he or she will often raise their child in much the same way hoping to validate and perpetuate their own self-deception. To be more flexible, or permissive, or softer, requires at least some painful acknowledgment of the cruelty and sadness that was their childhood. What a miraculous yet lamentable situation, without significant repressed parental pain, almost all styles and approaches, across a wide spectrum of conditions, will allow children to thrive. With significant parental pain, albeit unconscious, no approach, style, or set of ideas will protect the child, making a child’s natural development unlikely. Both sides in this debate may make the occasional good point, both sides may have the best intentions for the well-being of their children but without a deeper understanding of Primal forces they are doomed to failure. “The Chinese way” puts great emphasis on preparing children for the future, which is simply code for career and earning potential. Ms. Chua even states, “Excellence builds self-esteem”, I would agree, provided there is a self to build it upon! Achievement and excellence, no matter how hard-won, if imposed upon us in parental indentured servitude, leaves behind bewildered adults with a dull ache and emptiness they find difficult to define or articulate. For many, it is a treadmill they can’t get off. Perhaps, they reason, more achievement will stop the ache. Such is the price for childhood lost. Nor is blind permissiveness and overprotection and lack of childhood demands any better. Over the years, we have seen how the post WWII generation has done equal damage. The same repressed parental pain, acted out but stylistically different, has produced legions of what we call handicapped royalty, adults who have few skills and resources to navigate through life. The dialectic again, born from parental deprivation, I will give my child everything I never had (whether the child wants it or not), produces anxious, fearful adults with a pseudo sense of entitlement that masks a Kafkaesque self-loathing. The most important thing about childhood is to actually have one! A time to grow and develop at ones own pace, versus playing the lead in a parent’s repressed drama where every day is Showtime! Oppression is oppression no matter how well-intentioned or well executed. Fascism, whether political or personal is still fascism. Choice is never an option. Primal pain removes real choice and freedom for both parent and child, what a tragedy!! It is really quite sad that despite ones best intentions, a parents unresolved pain will always undermine the child’s welfare. We see this everyday at The Primal Institute. We are powerless to act in truly healthy ways regardless of our great desire to do so. One cannot do right by our children or ourselves unless and until we embrace our own history of suffering and sadness. Most parents today desperately want to raise healthy and happy children. The cycle of repression and oppression spares no one until the courage can be found to face the past. Child rearing debates and philosophies of the moment can never address the more potent forces at work. Oppression always serves the needs of the oppressor, never the oppressed, and on and on we go… Barry M. Bernfeld ************************************************************************************************************************************ Secret's Do Keep You Sick Not to long ago I saw a patient for a re-entry week. He had traveled quite a distance to see me and was clearly very serious about getting follow up help at the Institute. He came in to the first session and immediately began filling me in on his life and the problems that had brought him back into treatment. The following is quite difficult to describe but throughout that first session I had the distinct impression that there was something that was being withheld. I, of course, told my patient what I was feeling but he quickly assured me that I was mistaken. By the middle of the second session my feeling had intensified and I once again confronted my patient and pointed out that his therapy could be impeded should he be concealing something from me. Suffice it to say a confession as to what he had been hiding followed soon after. Then and only then could we really begin the work we needed to do. Here is the Primal perspective on secrets. As a Psychologist and Primal Therapist, I have seen many different kinds of secrets at work. At any given time, I'd say fifteen percent of my patients are at some sort of impasse or plateau in their therapy. This is to be expected, it is a normal part of the cycle of therapy. We all pass through these ups and downs in the course of our therapy as reflected in the variations in our access to Primal pain. The question is how best to move forward and spend as little time as possible stuck? More often than not, I have found a secret is involved. I often find without too much pressing, that something important is being withheld. Despite the intense intimacy of the therapeutic relationship, patients often hold back all sorts of information and feelings. As you might guess, sexual feelings, rituals, compulsions, fantasies and addictions are particularly difficult for many to reveal. We are also very creative when it comes to convincing ourselves that it is not important to talk about these things. Some part of us knows we are kidding ourselves! Feelings about our therapist, the good and the bad, are difficult but crucial to open up about. Any secret seriously impairs therapy! This is so important I'll say it again. Any secret seriously impairs therapy! All secrets are a re-creation of our childhood, often with our families, where it was unsafe to be ourselves. Speaking our "truth" was not tolerated, not possible and certainly not encouraged. As a result, therapy requires a total commitment to speaking with complete candor. If your therapy/life is not what you want it to be, take a little inventory. Chances are you might discover some aspect of your life that you have kept concealed that needs to see the light of day. I promise you, letting go of those things we have kept hidden is the key to building a new life. When we begin to expose who we truly are, we take a leap of faith in trusting the person we reveal ourselves to, that is called intimacy. We also pave the way for deeper feelings and resolution and that is called freedom. Greater freedom, more intimacy, I call that a life worth living. Barry Bernfeld *************************************************************************************************************** The Hardest Thing To Do Recently I have been thinking about how difficult it is for people to say what they feel. It should be so simple really, we have a reaction and we respond with how we feel. So why do we all struggle with something that should come to us so naturally? Obviously, it begins quite early, we are told from the moment we can speak that we should be quiet, we should not talk back and that what we feel is in fact, wrong. Maybe it is surprising under these circumstances that there is any real communication between us at all. We are afraid to speak at this point, terrified really. In therapy, with much encouragement, we begin to say what we really feel to each other. Clearly, after years of censorship, speaking out, for possibly the first time in ones life, can be a powerful trigger for our memories of the past. I began thinking about our difficulty in saying our feelings while working with someone not to long ago. My patient was most certainly agonizing over having to say something very important to me, that was clear. He told me that there had been a time when he felt I had let him down, I had not been there for him in the way he needed me to be. I could feel how painful it was for him to verbalize these thoughts and it occurred to me this was something he had never been allowed to do as a child. To make matters all the more distressing, he was in fact right in his perception. But here is the miracle - he said what he felt, he was given an honest response from me and I believe he was that much closer to the pain of his past and therefore resolution. That is not to say that it is ever easy to be honest and straightforward about how we feel, it isn't. We know it can be a painful struggle, but I really believe we have to break the pattern of silence and repression in our lives to begin to heal. In ending, I want to tell you about something that happened to me many years ago while I was working at hospice. I was seeing a patient who was quite young and dying of Aids. He had unfortunately lived a life of secrecy and denial and had not felt he could "come out" to his family till quite late in his life. As a result there was so much that had not been said between this young man and his family. A few days before his death he asked me to come to his home where a hospital bed had been set up in his living room. I was surprised to find that when I arrived he had arranged to have his parents and his siblings there as well. This was unusual as we normally met alone. He asked that I pull a chair up close to his bed and that his family sit about a foot away on the couch. I sat down next to him and he began to speak, but very LOUDLY, about his life, his secrets, his regrets and his impending death. He never turned towards his family and he never addressed any comment directly to them but he was surely speaking to them in his conversation with me. It was the end of his life and he knew that. He had much he needed to say and he found the only way he knew to do that. Interestingly, there was an intensity to the way in which the family listened as well that is impossible to describe. I think they all needed this final "conversation" in any way it could come but still it is obviously quite sad that we should have to wait till the end of our lives to make ourselves heard. I have thought and spoken of this incident many times over the years. Mostly because it so illustrates how desperately we want to say what we feel and how formidable the task can really be. Gretchen *************************************************************************************************************** I'm Afraid Of The Water! Which Way To The Beach? Several years ago I did a session for a young girl that I thought was fascinating. When the patient arrived and we began to walk toward the treatment room I could feel something was very wrong. She could barely look at me and it was clear that she was close to tears and struggling to hold herself together. Before I could even get the door closed she began to tell me about an incident that had occurred that day which had left her devastated. Someone she knew had badly hurt her feelings and she told me it had resulted in her feeling both shamed and belittled. There had been an angry exchange with this person that she felt had not only exposed her, as she put it, but also left her quite vulnerable. Within a few minutes of describing this incident she began to cry and to say how defenseless she had felt as a child and how punishment in her home had often included humiliation and harsh confrontation. Her father for instance, had not only spanked her but also forced her to pull her pants down first. As she began to cry more deeply about the past, she suddenly stopped, looked at me and said the following "Gretchen, The worst thing I could ever imagine would be to stand naked and exposed in front of a room full of people, that is how I have felt so often in my life!" Now here is the thing, this young girl was a nude dancer! Every night, for years, that is exactly what she did and yet there was a clear disconnect between what she described as her worst fear and what she did every night to earn a living. I have seen hundreds of examples of these counter phobic reactions over the years. It is not so uncommon a defense against our pain as one might think. The man I worked with who is afraid of sex and intimacy but has slept with hundreds of women. The girl who was panicked by heights and decided she absolutely must learn to fly planes. We are taught to suppress our fear, "manage" those fears and ultimately extinguish them, but rarely to truly confront our fear with authenticity. On the surface it can appear the counter phobic has faced his apprehension and moved forward, but we know that the truth is in fact several steps removed from what we initially see. What he has really done is circumvent and deflect the truth of his life and there will always be an inevitable consequence for that approach. Counter phobia is, I believe, THE COMPLETE DENIAL OF OUR FEAR! I maintain, to begin our recovery, with genuine courage, we must first affirm, concede and acknowledge how frightened we truly are. Gretchen *************************************************************************************************************** Shush!!! Growing up as part of the "baby boomer" generation, I naturally watched a great deal of television. Television was used as a babysitter for much of my generation. On the one hand, television is a poor substitute for family and real parenting, but the silver lining may be that all that time in front of the T.V. meant less time being exposed to the toxicity of my dysfunctional family life. That said, I think most of what passes for entertainment on the tube is pretty much a waste of time. I generally watch The History Channel or Turner Classic Movies and the occasional important sports event. Regardless, I hate myself for watching any television and see it as primarily voyeuristic and a waste of valuable life opportunities. Self-loathing aside, I do watch with interest the way media (T.V. and movies) represent my profession. The movie "Ordinary People" depicted the therapist, played by Judd Hirsch, in a humane and caring fashion, but in general, therapists of all kinds, (psychologists, psychiatrists, marriage therapists, etc.) are not portrayed in, to my mind, a flattering light. I do not really have a problem with that, as I also feel there is much to criticize about the profession and its practitioners. Recently, despite my best intentions, I have been viewing episodes of the reality television show, Dr. Drew Pinsky's Celebrity Sex Rehab (I am so ashamed!) Dr. Drew, as he is affectionately known, has been around for many years, an M.D. not a Psychiatrist, I believe. Dr. Drew is quite knowledgeable and appears to be a caring, supportive and sincere health care provider. Despite the obvious pandering to the demands of television (quasi celebrities, women in questionable attire considering they are in treatment for a sex addiction) the show has had moments of genuine emotion. The program has its patients participating in group therapy and in individual sessions with Dr. Drew and/or members of his rehab staff. His staff also seems to care, and they too provide support and nurturing to the patients in their charge. So far, each patient's individual history has been horrific, complete with childhood sexual abuse. As a psychologist, it is no mystery that these histories would manifest in exactly these adult symptoms, or from a "Primal Perspective" these are people in pain, severe pain originating in childhood. As many of you are aware I have just returned from our Thanksgiving retreat. We have two Retreat formats, 6 day and 4 day. We always limit enrollment in the 4-day retreat to approximately half of the 6-day format due to time constraints etc. As a result, the atmosphere, given the holiday and fewer patients was particularly intimate and relaxed. The groups in my opinion were almost magical. I do not mean that in a Southern California, spiritual, ditzy, "everyone in the hot tub" kind of way, just warm, relaxed and safe for people to be themselves. What really struck me though was how much time and space we give people. Reflecting back on Dr. Drew and his staff, as I mentioned previously, genuine pain and emotion are triggered on his reality show; however, those feelings are often quickly glossed over and interpreted away. The demands of television and editing aside, intolerance to painful emotion are representative of not only media portrayals of therapy but also the state of psychotherapy in general. At the Thanksgiving retreat I could not help but be struck by how much time and space we not only give, but in fact, create for our patients. Time, not to go on and on, but time to hear and feel what each of us is really saying. Time and silence, space within the time to actually experience one's emotions. Time is a precious commodity and an integral part of the healing process. I often understand things in a musical context and it occurs to me that music and therapy have much in common. All musicians instinctively understand that the space in between musical notes is possibly more meaningful than the notes themselves. That is why Carlos Santana or B.B. King can rip your heart out with one soulful note while a less talented musician will play hundreds of notes in the same musical measure. It takes a certain amount of confidence to be quiet. One must trust what one knows and sees to allow nature to run its course. Insecurity and doubt can compel us to action, any action to distract ourselves from uncomfortable feelings. We need time and room to feel, there can be no substitute! If it sounds as if I am blaming the media, I am not. The media is simply reflecting reality and the reality is most therapists cannot recognize or tolerate emotional pain. A couple of tears are alright but any deeper and it is out with the prescription pad or possibly a straitjacket. In matters of music and therapy, it is the heart not the head that must be engaged. I have had many, many moments of deep appreciation for this grand experiment we call Primal Therapy, and this past Thanksgiving Retreat is but the latest. We really do have something special that I believe exists nowhere else. A place to go to speak the unspeakable and to feel the unfeelable. A place where one is allowed, no, encouraged to criticize, to doubt, to be weak or to stand up and be strong. A place where we do not have to hide who or what we are, where our tears renew us and help us face the future. It is interesting to note that many years ago, in order to try and increase our staff, we accepted only professional therapists into treatment. We thought this would give everyone and ourselves a head start and that training time might possibly be shortened. What was the problem? We could not get them to shut up! Issues of mental health aside, therapists are trained to "do", to intervene, to coach, to interpret. Understandable, yes, but where is the trust in feeling, the trust in the healing properties of listening and allowing feeling and painful emotion to unfold? It may be impossible to teach I suspect. As the saying goes, you cannot take someone to a place you have never been to yourself. *************************************************************************************************************** LENNON Recently, I received a phone call from a writer for Rolling Stone magazine. He was working on a book that would explore memorable events throughout the seventies. He hoped to explore my recollections of that period particularly of going to London at the request of John Lennon and Yoko Ono for Primal Therapy. It was a very exciting time in my life. John Lennon was at that time, and clearly still is universally famous. When I reflect on my initial impressions, I must say I found him to be not only outgoing and quite charming but he also had a wonderful sense of humor. Browsing through my old notes from that period, I found a yellowed newspaper article from The London Daily Telegraph dated April 1970"Beatle John Lennon and his wife Yoko Ono are not talking to each other and not sleeping together on Doctor's orders. Two leading Psychiatrists who have been flown in to help Yoko through her pregnancy have imposed these restrictions. Now the couple communicates by letter. John called in the Psychiatrists, a woman for Yoko and a man for himself. After an examination, Yoko was told to take things very easily. A spokesman for the couple said that neither of them would be making any public appearances in the near future." Although this article was not completely accurate, it reawakened the exciting days of our time spent with the Lennon's at Titenhust, their beautiful estate in Ascot. More to follow Vivian Janov *************************************************************************************************************** Rats! The other day my wife, Gretchen accused me of being "old-fashioned", a charge I vehemently denied whilst slowly removing my monocle. After careful self-examination and "ruthless soul searching", and by ruthless soul searching I mean figuring out how to use her remark as an intro to this blog I promised to write, I decided she might be on to something. Therefore, pursuant to the aforementioned soul searching, my psychological rebirth if you will, and last but not least, to make Mrs. Bernfeld proud, I present the "new" Dr. Barry Bernfeld. Even the most casual scrutiny of today's and future blogs, will reveal a most decidedly modern Dr. Bernfeld. The topics themselves, as well as the use of contemporary vernacular will attest to my up to date, cosmopolitan nature. Speaking of nature, this would not be the first time my vulpine wife "Manchurian Candidated" me into doing her literary bidding. I have met my match, my Abbott to her Costello, my Simon to her Garfunkel, and her ying to my yang. ****************************************************************************************************************** "Serious Stuff" What the hell is wrong with Scientists? It seems like they spend millions and millions of dollars proving things every sensible person already knows! Last night one of my "favorite patients" gave me an article from the L.A. Times (12/12/09). "Lonely Rats More Prone To Deadly Tumors" The L.A. Times article explains that rats, separated at birth from their social group had a three times higher risk of developing tumors than did rats living in social groups. Also, the tumors in the isolated rats were more deadly. I told you to attend Retreats! Damn it! This is an important study I suppose, linking psychology and social conditions to healthier lives, but don't we have enough evidence of this already? I think scientists still have trouble believing soft data. Perhaps some psychological denial is at play that keeps them from totally accepting that early experience, for rats as for people, can result in massive deficits leading to life and death health consequences. There are literally thousands of studies across many, many disciplines that demonstrate the importance of not isolating oneself. Whether it is depression or faster healing post operative, or living healthier and longer, you cannot do it alone. Even from an evolutionary perspective, social interaction equaled evolutionary success. When your therapists tell you to reach out and socialize, it really is a matter of ones health, So Do It! Particularly over the holidays, when so many feelings associated with family (our original group) are being triggered. We are often not completely aware of the pain that is being activated during this time of the year. The sights, sounds, and smells will rapidly take us all back to a time when most families are together. Depending on one's history this can trigger feelings ranging from nostalgia to searing pain. The worst thing one can do when confronted by these memories is to isolate. I hope to see many of you at the Christmas Group. Happy Holidays to everyone. Remember, if you cannot attend the Christmas Group, do not be alone. Barry ******************************************************************************************************************* Unavailable Everywhere My college girlfriend lives in Santa Barbara. We moved from New York to California together. The relationship part lasted 5 years, the friendship still remains. Typically when I’m in Santa Barbara for the retreat, we often have lunch and catch up with each other’s hectic lives. Her oldest daughter is at Harvard Law and my daughter is just down the road at another Boston Institution of higher learning. Obviously she knows about Primal Therapy and the personal and professional impact it had on my life. She witnessed the lightning bolt jolt when I first read The Primal Scream. Despite her familiarity with Primal through our association, she is what I term a “civilian”. Civilian is an affectionate term for someone not in therapy – Primal Therapy. There are many benefits to being a civilian. I shall mention just a few with space being at a premium. Civilians can drive economical, compact cars without 1st line birth intrusion ruining the day for everyone. Civilians can go to any movie! They don’t weep at the sad ones and they don’t denounce mankind when viewing films that are either violent or brimming with action. Civilians take things at face value, example; “A headache is just a headache”, “Thanksgiving at my parents – what’s the big deal?” I enjoy being with civilians as it often gives me a new perspective on my life. So, I’m at lunch with my “ex” and she remarks "Isn't this around the 30th year you’ve been having retreats up here?” She asked a few more questions about who exactly attends these retreats, what we do here that is different from what our patients experience in Los Angeles and how often our patients return to do another retreat. Her questions, though informed and reasonable are not the point. My answers, which in many situations I’ve given numerous times before, somehow had a greater significance this time. My “ex” happens to be a board member at Santa Barbara Hospital. As a career healthcare provider, she’s quite familiar with all manner of healthcare, from hospitals, clinics and/or private practices. One question, or should I say answer, shocked her. The question was "Who attends these retreats?" I answered, “Let’s see… hmmm. At this particular retreat we have people from Austria, Germany, Belgium, Australia, New Zealand, England, Wales and the U.S.” Her response, “Clearly you offer something not available anywhere else.” She also said, “Most doctors or therapists lose half their caseload if they move to a different part of town, and you have patients from New Zealand!” Now of course I’ve always known this, that we have created something unavailable anywhere else, but it’s important to see it through another’s eyes periodically. This is my 34th year with The Primal Institute and this is why I’m never leaving! What is it exactly that we offer that is not available elsewhere? I think what we offer has several important ingredients. Primal Theory informs our clinical practice and makes for accountable patient care. That means that 40 years of clinical experience guides every interaction in patient care. One may disagree, but every therapeutic decision has a scientific rationale in Primal Theory. Primal Therapists can plan a course of treatment, recognize and adjust for the ever-changing landscape of patient’s needs. Even mistakes, if honestly confronted, can result in therapeutic progress for the patients and sometimes the therapist. Experience speaks for itself. If I’m having a knee operation, who do I want cutting me open? Do I want an intern with little experience (not to mention sleep deprived), or do I want his supervisor with thousands of hours of this procedure under his belt. Experience equals confidence, which not only puts us at ease but also additionally creates a sense of safety. Feeling safe can mean we don’t have to protect ourselves, at least not in the way we do if we feel at risk. A sense of safety liberates resources usually reserved for protection. This is one critical element that may allow us to feel, connect and resolve the issues that have crippled many of us over the course of our lifetimes. I really believe that’s why for over 40 years people continue to seek us out from literally all over the world. Everyone has his or her conscious reasons for coming here at first. For some, they are drawn by the case histories in the literature. Some investigate because they read about John Lennon’s experience in Primal Therapy. Some are drawn to the technical aspects of Primal Theory or to the “counterculture” aspect of the Theory. A few even come because of my human tear study. More often than not, they have met someone who did well at the Institute and suggested they too give therapy a try. Why they come is interesting. Why they stay is what really matters! All this adds up to a real sense of safety. The unconscious cannot be fooled as only a truly safe environment can promote healthy neuroadaption i.e.: healing! Once the spark of true consciousness is intuited, a blazing fire of consciousness is ignited. I mean to say that our commitment to Primal is both personal and professional. Each of us were patients first, and therefore know first hand how difficult and rewarding this path can be. We are far from perfect, but perfection isn’t necessary or in fact useful. What is crucial is that “synergy of consciousness” whereby one can sense on the deepest levels that this place, these people, respect and trust feeling. Just maybe, they think, they hope, a place I can be me. This is the gift of Primal Therapy. To those of you already here, you have my utmost respect. To those reading these words that wonder if such a place can exist, I say, “It does!” I hope you’ll consider this an invitation of sorts. Barry M Bernfeld PhD ************************************************************************************************************************ Silence When I was 16 I was invited to visit a girlfriend in Los Angeles. Soon after arriving she introduced me to a guy she had met not long before my arrival. I remember that he was older than we were by several years and that his affect felt somewhat "off" to me. In any case, the visit went well and we did not spend that much time with this new friend. I also remember feeling vaguely relieved that I did not have to be around him too often but I was not sure why I felt the way I did. I guess we should call it an instinct. Unfortunately, in those days I did not trust my feelings the way I do now so it would have probably been impossible for me to verbalize what I was sensing. Eventually it was time for me to go home and the plan was that I would travel by bus. My girlfriend told me that her new friend had volunteered to drive me to the bus station and asked if that would be a problem. I said nothing despite this feeling of uneasiness that was escalating with each moment. He picked me up and we began to drive towards the bus station and I began to think that maybe I would be all right. Around halfway to our destination he suddenly turned the car in another direction and without a word began driving away from the bus station until he pulled into the driveway of a home that I did not recognize. He said very little but it was clear that I was in grave danger. Of course my mind was racing, I could feel I had better do what he said if I wanted to make it out of this situation alive and so I did. I want to reiterate that almost nothing was said between us and yet even at sixteen I knew what I had to do to survive. I want to add that I have had this instinct protect me several times in my life. Looking back I am just grateful that I was able to trust what I was feeling and act appropriately. I, of course, called my girlfriend as soon as I was safely home and told her what had happened. I was obviously traumatized and struggling with how to explain what had occurred. In those days we had not heard of date rape and how do you explain that you simply "felt" in danger. It was less than one week later that my friend called to tell me this guy had just been arrested. He had violently molested a young girl and smashed the side of her head in with a rock. I remember that my friend seemed almost surprised that what I had told her turned out to be so obviously true. My intuition had been crystal clear and I had possibly saved my own life. Now here is the point- I have worked with countless numbers of victims of childhood sexual abuse over the years and have observed some almost universal truths. The victim often feels exactly the way the perpetrator wants them to feel. We are manipulated to question our instincts and deny our feelings, the perpetrator's every action is designed to leave us questioning the truth. I believe that even very small children sense the reality of their situation and act on instinct just as I did. At the same time I have found that each and every victim questions how he or she handled the abuse. Should they have fought back? What if they had screamed? What made them blindly follow the directions of the abuser? Why did they not tell anyone what was happening? Why were they so often silent in the face of the abuse? The answer is always the same; they did what they had to in order to survive. Gretchen ************************************************************************************************************************ Giving Each year, if possible, the Institute plans a long weekend retreat with a holiday theme. Last year we met for Halloween (costumes included!), another time it was Christmas in Ojai and this year we are gathering for Thanksgiving. The plan is that the entire group will prepare the Thanksgiving meal and each person will contribute something to the celebration. The obvious premise is to recreate the feelings we all associate with the holidays and the coming together of our families. Sometimes those memories can be warm and nostalgic but sadly for some of us they can also be dark and disheartening. This Saturday I met with the retreat participants who live locally to plan the Thanksgiving meal. This would clearly insure that the meal would not consist of twenty sticks of butter, four potatoes and an avocado. In any case, we began to decide who would bring the salads, who might make the stuffing and how many pies should be baked. I have to say I had the warmest feeling during that meeting, I felt moved by something almost intangible. In looking back, I began to understand that what I observed, what touched me, was a feeling of generosity within the group. Everyone was so willing to contribute, to help in any way they could, to give. That ability to give is, in my view, one of the first signs of health in the recovering Primal Patient. So often, because of the deprivation in our lives, the capacity to give and for that matter receive is virtually nonexistent. It can be intolerable to even conceive of giving when you have felt nothing but emptiness in your life. Interestingly, at each retreat we address this issue with what we call our "Giving Exercise". At the beginning of our first meeting each person draws a name at random, they are to keep that persons name strictly confidential till the end of the retreat week. During the retreat they are to perform a variety of kind and thoughtful acts for the person whose name they have chosen - and this must all be done anonymously. They might write that person a special letter or take a walk with them when they sense it is needed. It does not really matter what they do but that they begin to allow themselves to not only give generously to another but to accept what others might have to offer. Over the years, I have seen this simple exercise trigger and frankly expose feelings from the past that may otherwise have taken longer to unearth. I will tell you a story that might further illustrate my point. I was leading a group many years ago when a patient of mine came in and announced to the group that her mother had just died. She began to cry in the most heartbreaking way and you could sense that the group was right there with her. The room was extraordinarily silent and the entire group was listening raptly - well, almost the entire group. Suddenly, from across the room a guy interrupts to say, "I want to speak! I need to talk about why I can't get close to people, I cannot connect with any one in this group!” Yes, he really did say that! I remember thinking you really don't need to tell us what the problem is because you have so clearly shown us. His inability to give in the most basic form was the answer to what kept him from relating in an authentic way to anyone in his life. I knew that his therapy would not truly progress until he began to explore what in his childhood had left him so completely bereft. Simply put, an inability to give will always mirror the reality of our past, always.
Gretchen Post Script- Before I hear from those of you who have spent your lives give, give, giving - that is another blog all together. ************************************************************************************************************************************ Good Grief I’ve decided this month to forgo my usual introductory personal anecdote. My quoting of old blues songs, and though it pains me, attempts at all forms of humor. I shall get right to the point. In an OP.ED piece dated August 14th in The New York Times titled “Good Grief”, Professor Allen Frances, former chairman of Psychiatry at Duke University, cautions us about proposed changes for the 5th edition of the Diagnostic and Statistitical Manual of Mental Disorders. Better known as the “DSM”, this book used by virtually all medical and mental health professionals, purports to set the boundary between normal functioning and psychopathology. According to the proposed changes, if your spouse or parent died two weeks ago (or any major loss for that matter) and now you feel sad, take less interest and pleasure in things, can’t sleep well, or suffer from loss of appetite and energy or don’t feel like going to work your condition would be diagnosed as a Major Depressive Disorder. Dr. Frances writes that “this would be a wholesale medicalization of normal emotion, and it would result in the over diagnosis and overtreatment of people who would do just fine if left alone to grieve with family and friends, as people always have.” Think of the marketing opportunities that the drug companies would pounce on to target and medicate the bereaved. Dr. Frances adds, “What is proposed for the “DSM-5” is a radical expansion of the boundary for mental illness that would cause psychiatry to intrude in the realm of normal grief.” According to Dr. Frances, “the bereaved would lose the benefits that accrue from letting grief take it’s natural course. What might these be? Who can say exactly?” We Can! First, let’s applaud Dr. Frances for standing up for good old common sense. Whether or not he is aware of Primal Theory, his views are certainly consistent with our 40 years of clinical experience. He instinctively understood the advantage to allowing our grief to unfold naturally. We, of course,understand that this is a central theme in Primal Theory. One could say that Primal Therapy is all about grieving – feeling loss in all its contexts. Loss of parental love, loss of childhood, loss of time, youth, innocence, and finally, loss of self. As is often the case, mainstream psychiatry/psychology, seems to miss the boat, abandoning all common sense and failing to see what should be so obvious. As I write this in September 2010, it feels like perhaps we are a little less alone in our Primal perspective. There are many Dr. Frances's out there, and that is a good thing! I continue to see increasing evidence of Primal Theory in mainstream clinical thought, or more specifically the “depathologizing" of intense emotion? And again, that is a good thing. “Good Grief" indeed. Barry Bernfeld, Ph.D ****************************************************************************************************************************************** Taking Inventory! Something interesting came up in a recent staff meeting! We were discussing the summer retreat (which is just around the corner) and examining the usual matters when something new was introduced. We obviously make a point of reviewing who will be attending each retreat, analyzing possible "buddy matches" and brainstorming potential exercises to introduce at each retreat. Our hope is to create a dynamic and life changing experience for all involved and I think we do! I will avoid the details but lets just say it was brought to our attention that with all the thought we put into creating the retreat we might be overlooking some likely red flag issues within the population. In other words, lets take a closer look at the various ways we act out within the therapeutic environment! Those of you who have attended the retreats know how intense that week can be. In fact, for some, the magnitude of the experience can often take some time to completely process. It makes sense that these are the very conditions and surroundings likely to exacerbate the symptoms we most need to investigate. With that in mind, it occurred to us that it might be useful for all participants to create a kind of "inventory" to reflect on before the beginning of this retreat. Mark has drafted some examples of the types of things we might want to explore in creating our inventories, which I will list below. Clearly these issues can vary widely but the point is to seriously consider in what way our pain is most significantly manifested, how we defend and why the group experience is the compelling trigger that it is. I believe this exercise could be a useful one at any point in therapy! To simply spend the time to contemplate what we might still be avoiding and resolve how best to confront the feelings associated with our childhoods. After all, that is what brought us to Primal to begin with. The truth is we have to tackle our pain and defenses with equal fervor, from the beginning, through the middle and to the end of therapy! Lastly, I would suggest each of you bring in your inventories before the start of the retreat. Why not get a jump-start on the process and take the time to review what you have written with your therapist or with your group. In fact, as I mentioned earlier bring in an inventory whether you are attending the retreat or not!
Please consider these possibilities. 1. Isolating 2. Censoring your thoughts and feelings (or editing). 3. Overeating 4. Smoking, alcohol and caffeine (particularly before and after group). 5. Care-taking and or people pleasing. 6. Spending time only with those you already know. 7. Avoiding participation in groups, buddying or retreat exercises. 8. Not asking for or accepting help. 9. Waiting till the end of group to speak up or waiting to be asked to speak. These are only a few of the things we might want to explore-remember; when it comes to repressing our feelings the possibilities are endless! We look forward to hearing what each of you will be focusing on. **************************************************************************************************************************************
Retreating
Barry and I drove back to Los Angeles on Sunday having spent four days in Santa Barbara at our Thanksgiving retreat. As we drove home we spoke at length about our experiences, what we had learned and what we found most meaningful about this particular retreat. For me, most meaningful had to be the Thanksgiving meal! Barry and I arrived as dinner was being placed on the table and I cannot begin to tell you what a warm atmosphere we walked in to. Each person had brought something to contribute, twinkly lights hung from the ceiling and the table had been beautifully decorated. I noticed that everyone was helping to put the meal together and that most people had put a great deal of care into the dish they were sharing with the group. We had given someone the task of being our "Thanksgiving Mom For A Day" and she approached the assignment with gusto complete with donning a "Donna Reed" style apron for the occasion. The meal began with an exercise that was, of course, geared toward our Thanksgiving theme. Each person stood and described something they felt thankful for. I believe that each an every person spoke from the heart and naturally some tears were shed including a few of mine. Looking back, I think that first evening set the tone for the rest of this retreat. I do have to confess however, that going into this retreat I was feeling a little concerned. A couple of patients had signed up to attend that frankly, worried me. The retreat is an extremely intense experience and we needed to be certain that this would be productive for all involved. After much discussion it was decided that the pros did indeed outweigh the cons by a large margin and the patients in question would be allowed to attend. These were not patients who would be disruptive in any way but clearly were both in a very fragile state at this point in their lives. Simply put, we wondered would they be better served with a series of sessions instead of the accelerated retreat experience. As an aside, I am quite sure I can hear a few of you chuckling at this point! It is a well-known fact that no one is more pro retreat than I am. I have seen the retreat trigger feelings that I believe would have taken longer to access in most other settings. The retreat is unique in that it recreates the many feelings associated with all other group experiences from our pasts and allows a place to resolve those feelings as quickly as they are provoked. The old joke at the Institute is that I will always find a way to sneak in a few extra participants no matter what our limit might be. I have no doubt about the effectiveness of the retreat, but there are always a few applicants that will be discussed and possibly told to apply at another time. That being said, I will now move on to what I learned during our Thanksgiving event. The staff arrived with the concerns I mentioned earlier and a vow to keep a protective eye on the situation. Obviously, we had no plans to discuss our misgivings with the group and frankly, at that point, it felt counterproductive. But here was my lesson - we did not need to! Feeling people have a "sixth sense" if you will, when it comes to the suffering of those around them. It feels nearly impossible that if we are open to the pain in our own lives that we could be oblivious to the pain of others that certainly proved to be true in this case. Looking back over the years, having led thousands of groups, I can almost always trust the instincts of the group as a whole. Lesson learned! Gretchen **************************************************************************************************************************************** More Hellos
“Why can't we get all the people together in the world that we really like and then just stay together? I guess that wouldn't work. Someone would leave. Someone always leaves. Then we would have to say good-bye. I hate good-byes. I know what I need. I need more hellos.” Snoopy from the comic strip Charlie Brown by Charles M. Schulz Recently I have been thinking about how difficult it is for most people to say goodbye. It occurred to me that when it comes to goodbyes most of us are at our defensive best, frantically circumventing any possible farewell. Freud wrote about a defense mechanism known as reaction formation that is loosely defined as a form of behavior substituting or concealing a diametrically opposed feeling or impulse in order to protect against it. Never is that defense more evident than when we deal with separation it seems to me. I remember having worked with a patient from Europe over a period of about a year. Over time we developed an open and honest relationship and what brought this patient to therapy was eventually resolved as the patient uncovered the pain of her extremely toxic childhood. Subsequently she would be returning to Europe and of course we spent some time discussing how she felt about leaving and the possibility of future visits to the Institute. As the time for her departure grew closer she made some effort to discuss how she felt about leaving but you could see that something was being triggered that at times was overwhelming. Having been abandoned (in a variety of ways) as a young child this was a particularly painful issue for her and frankly much of this pain was focused on having to say goodbye to me and how that connected to her past. I believe we only had a session or two left when an interesting thing happened. It went something like this, and I am paraphrasing - she walked into the session room and honestly you could feel the rage before she even opened her mouth to speak. At some point she mentioned she had just had her hair cut and I said "Well, it looks really cute!” her response "Fuck you, is that your way of saying you hated the way it was before? How could you lie to me like that, I guess I really can't trust you at all!” With that she shrieked "You really are a bitch!" and before I could respond she stormed out of the room and away from goodbye. It all happened very quickly but fortunately she had done enough therapy to recognize she might need to return and explore what else might be going on with her, which in fact, she did! I am happy to say not only did she ultimately confront and deal with the pain of goodbye but also we could laugh about her incongruous response to "Nice haircut!". Later she explained that although she was aware of how painful this parting felt at the time she had no real awareness of how she was using her anger to avoid the existing goodbye. Not until she began to feel the pain of previous abandonment was she able to process how often she had protected herself in exactly this way. Sadly, some of us never come to the point of understanding my patient did. I have seen couples react similarly in ending a relationship. Rather than feeling the pain of that ending they will often focus on how angry they are at their partner, which often feels easier than feeling the loss of their union. Even couples that have not fought much in the past are suddenly filled with fury. I am certainly not implying that there can't be legitimate anger to explore when dissolving a relationship, but one can often feel the difference between that and a total inability to allow the sadness in. It is interesting to note that in this state there is complete amnesia as to what might have attracted them to this person in the first place. On a lesser level I have even witnessed this when people leave a job that has been meaningful to them. It is so painful to leave that suddenly they can only focus on their complaints and dissatisfaction often manufacturing issues in the hopes of creating a diversion. Most painfully of all, when someone we love dies saying goodbye and feeling the finality of that can seem impossible but is truly necessary if we are to move forward with any kind of resolution. In the end we must examine not only the many goodbyes we have faced in our lives but equally important the ways in which we either avoided or confronted these extremely painful feelings. Gretchen
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