Month: May 2024

  • Us-Them

    Loving Kindness is a compassion practice which involves both feelings and wishes. It mobilizes the prefrontal language and intention networks as well as limbic emotion and reward networks.

    Chenango State Park Area- New York State: 2022-October One of my thinking places where I try to expand my thinking on Ten Thousand Things about the factors and forces, DNA and Development of difficult persons. It helps in my Loving Kindness Practices

    Scenario – Ben (a composite) talked about his lack of assertiveness in the face of an angry aggressive landlord.

    Ben- I should have been able to stand up to this bully. He showed disrespect to my wife.

    Counselor (PB)- How did that make you feel towards yourself, your wife, the landlord

    B- It is a recurring theme, when I have not been able to assert myself.

    PB- Can we do a ABC worksheet and see how the situation leads to some beliefs, and what are the emotional consequences of holding on to these beliefs.

    We then did a ABC sheet, saw the automatic thoughts which arise, gave rating to the feelings related to these thoughts, examined evidence for and against and re-rating the feelings. This way of thought stop, cognitive reframing, seeing the cognitive distortions such as jumping to conclusions, fortune telling, mind reading, all or none thinking, emotional reasoning is a powerful way to gain perspective. (see worksheets below for download)

    Keeping the heart open-Being aware of Us versus them

    Another way to approach the above scenario calls for equanimity to keep the heart open, especially in the face of pain or provocation. Kindness for everyone “Omitting none” is an exercise in which all beings are held as “us” in your heart. 

             Five types of persons you can offer kindness is to : Benefactors, friends, neutral people, difficult people and yourself.

    In above scenario the Ten thousand things exercise is a way to decrease the ill-will

    B-I was not able to assert myself. He was rude, aggressive and inconsiderate to my wife.

    PB- Can we go back and scan yourself for ill-will. Where in your body do you feel that? How was your tone? What did you do as follow-up?

    B- I wrote a long letter to him to tell him how he was off the line, and it was not good.
    Pb- Let us step back and try to reflect on the ten thousand things that have led this person to act in this way. Consider his biologically based factors: like pain, age, temperament, or intelligence.
    B- Well that makes me see his day, how he must have felt when he got the news of the flooding of his apartment. He himself is an immigrant like me.
    Pb- Consider the realities of his life: responsibilities and stresses

    Commentary: The ten thousand things help consider persons in light of whatever you know or can reasonably guess about them, the factors and forces that have shaped their lives. It can be a powerful way to neutralize ill-will and bring a difficult person into being held as “us” in one’s heart and then offer loving kindness.

    References:

    Burns, D. D. (1989). The feeling good handbook: Using the new mood therapy in everyday life. William Morrow & Co.

     Hanson, R. (2009). Buddha’s brain: The practical neuroscience of happiness, love, and wisdom. New Harbinger Publications.

    ABC Worksheet

    Worksheet_ Loving Kindness

  • Intimacy versus Isolation

    Written by Prashant Bhatt

    Generations , Gender, Geographies make a rich kaleidoscope. In this blog we see how Erikson’s stages which considers broader psychosocial aspects, emphasizes the lifelong journey of self-disovery and adaptation can be used to help navigate tricky family situations.

    Serenity Prayer- when used in conjunction with stages of psychosocial development, helped deepen perspectives, develop trust and calm down matters, clarify issues and convey with confidence her own view point.
    (3 C- calm, confident, clarity)

    Scenario – An elderly lady despairs at the demands her children are placing on her. She feels pressured by her daughter’s lavish wedding plans which make her feel like an object, and not respected for her worth as a person.

    Lady (L) – I live on limited finances. I do not have the resources to spend money which I do not have. We are from a working class family.

    Counselor ( C) : What could be a compassionate way of looking at the situation from your daughter’s perspective? Is there peer pressure? Is there untold pressure from her future husband’s family?

    L- I did not think from that angle.

    C- Let us look at the causes and conditions, factors and forces which are shaping this narrative of spending so much money on shoes, make-up, travels.

    Reflecting on this case and integrating therapy with Erikson’s stages of psychosocial development is a powerful way to shape the therapeutic process. The stages are building blocks crucial to maturation. They overlap and extend to other stages of life. Lack of maturation may lead to imbalances which can be addressed.

    Eight stages of Erikson Psychosocial development are

    1. Infancy: Trust vs. Mistrust
    2. Toddler years: Autonomy vs. Shame and Doubt
    3. Preschool years: Initiative vs. Guilt
    4. Middle school years: Industry vs. Inferiority
    5. Adolescence: Identity vs. Confusion
    6. Young adulthood: Intimacy vs. Isolation
    7. Middle adulthood: Generativity vs. Stagnation
    8. Older adulthood: Integrity vs. Despair

    Commentary: As we went through the stages of development, she reflected on her issues of intimacy versus isolation, the way her marriage dissolved, the impact of those acrimonious years on the development of her children.

    The soup was further thickened by seeing the stages of development the children may be going through at present.

    Worksheet

  • Transference: ABC – Awareness, BASIC ID, Checklists

    Written by Prashant Bhatt

    Write the story of your relationship, how it began, what are the concerns which bring you to therapy now and if your partner told this story, how would they tell it, what would be their main concern or complaint? This is a way to broaden the way we think (cognition). Being in health sciences since 1985 (Maulana Azad, Delhi), having been taught about family history, social history and how this impacts the care of clients, I see this play out in many immigrant families who come to Canada, North America.

    Remembering Anthony Burns and William Ellery Channing : Worcester : On my trip to Barre Massachusetts for a Mindfulness Retreat- February 2024. As I finished my Masters in Counselling and the Academic requirements, I went a bit deeper into my Mindfulness practices. This led me to a journey to Worcester, Massachusetts and walk in the countryside, imbibe the spirit of thinkers like William Ellery Channing – who developed Unitarianism, and was one of the spiritual inspirations of the Transcendentalists. He did attend earlier meetings of the Transcendentalist club, but was older than the younger members.

    Diaspora-in Africa

    Having stayed in Libya for 13 years, I met and came to know the diaspora of Indian origin and also many other countries from other Arab , African countries and European countries. These experiences have made me consider the social and emotional factors, including relationships, identity, personal growtand faith. This is in alignment with Erikson’s stages which I had mentioned in my previous blog- Intimacy versus Isolation.

    My family professional background

    My father was a medical doctor (AIIMS-Delhi-1962 passing out)  who specialised in Anesthesia -Poona University 1972 and then in Cardiac Anesthesia (Christian Medical College, Vellore, 1974). 

    One of my formative childhood memories was to see him keep flashcards of important drugs, their main actions, indications, contraindications and how they may interact with other powerful drugs. Having a checklist is very important when many important parameters are concerned, there are tense situations and if overlooked can have grave implications. Another lesson he taught me as I entered medical school was to give your 100% to each patient. “For you it may be one in 100 patients, but for the patient it is 100%. Always give your best to each patient.” 

    Another lesson in self care he taught me was going for morning and evening walks and meditation. His duties to the Indian nation carried him to different areas where families could not go. He used to meditate at least 20 minutes in the morning, 20 minutes in the evening (sometimes more). Meditating in nature, by the banks of holy rivers, (sometimes even sitting within the river and meditating) were some of his more advanced practices. The priest in our ancestral village told me that he had seen him pray by the river Alaknanda in the mornings, when I went there with my mother to say prayers after he passed away-July 1999.

    See: 2011-October:  Walks by Alaknanda

    BASIC ID AND TRANSFERENCE

    Imbibing the lessons of flashcards and check lists in counselling made me zero in on issues of transference, countertransference, resistance, rupture, repair and seeing the flight, fight, freeze, forget, fawn, faint, flooding paradigms and help chart client journeys through the BASIC ID multimodal therapy of Lazarus (B-Behaviour, A- Affect, S-Sensations, I- Imagery, C-Cognitions , I-Interpersonal, D-Drugs/Alcohol) (Lazarus, 2019; Van Der Kolk, 2020).

    Transference: It is when one seems to have feelings, desires, thoughts, memories, sensations, interpretations related to an important figure in one’s life such as a parent, teacher, romantic partner, mentor towards someone who is not that person.

    For example: In my case, from the flashcards and checklists which I saw my father make in my childhood, right from my preschool days, this has become a way of life for me. Later, as I entered medicine and specialised in Radiodiagnosis (KEM Hospital, Parel, Mumbai-1993 joining) , the need to have a checklist was important to me.

    Applied in my work as a counsellor, I keep a checklist of whether the client is having any Behaviour which may be self-sabotaging and try to work on how these may be activated in certain circumstances, triggered by certain people, and then try to draw out with the client the emotional and life consequences of such behaviours on himself, his family, his outlook to future. 

    Incorporating a self-care routine, I encourage persons with whom I work with to take time out in nature, do thought stop, develop a meditation prayer practice, journal about these aspects to refine them further, track their growth and imbibe them in an overview of one’s life. I use the DOCTOR acronym- D-Direction, O-Organization C-Cash or Time T-Tracking O-Overview R-Refine.

    A psychotherapy counselling relationship will help create an alliance in which one can be more mindful of our conscious and subconscious thoughts, motivations, biases. One way to improve our awareness is to be aware of transference.

    Here are a few examples

    1. Therapeutic Transference: Persons with a difficult relationship with their father, may unconsciously project unprocessed feelings onto their therapist, either positively or negatively.
    2. Parental Transference: Expectations from parents may be transferred to authority figures. Strict authoritative parents may lead to expectations of such behaviour from their work supervisor 
    3. Romantic Transference: Qualities of a past partner (positive or negative) may be attributed to a new/potential partner. This can influence expectations, lead to exaggerations or extreme positions.
    4. Countertransference: A therapist having their own unresolved issues may be overly protective or dismissive of clients, may enter the victim, persecutor, rescuer triad..
    5. Cultural Transference: Stereotypes may lead to bias. Negative stereotypes about a particular ethnicity may lead to unconscious transfer of feelings onto an individual from that group.
    Worksheet to become more aware of one’s patterns

  • Labyrinths

    Author: Prashant Bhatt

      In the Middle Ages as today, pilgrimages in the form of maps, manuscripts, and pavement labyrinths engendered an experience of embodied pilgrimage for those who could not travel physically to far away sites and shrines. The Maps of 12-steps is one of the paths to spirituality which many follow to see their role in dysfunctional relationships and have a more personal powerful connection with a Higher Power. This blog tells of the Labyrinth at the Jesuit Retreat center of Manresa, Pickering, Ontario. It is examined within the context of 12-Step Spirituality, through the lens of the experiences of retreatants, fellows and the sense of spiritual presence while perambulating this space.(Barush, 2020)

    Drop the Rod

    In my experience, a senior in the program pointed out the pitfall of intellectualising the steps, but not grasping their essence. He listened to the step worksheet and pointed out that I am using this work as a way to show others that I am doing the work, but not having a spiritual program, not being kind. “You have not yet dropped the rod. Now you are using these inventories to beat others around you, with these lists and inventories.” Having been around these labyrinths many times, he could see the false paths which take one away from the core and primary purpose of the program of recovery.

    Embodied experiences serve as a pathway to enhance our comprehension of a Higher Power.

    Natural places where we develop and deepen our connection made me remember some journeys of yesteryears. Now such collages are a regular part of my creativity cycle. These are also my thinking places

    Readings- Childhood and Society-Erik H Erikson, Burlington Spencer Smith park-2024-March

    Erikson describes the difference between way boys and girls use forms. This exercise helps deepen our understanding of how people process thoughts, feelings, memories, sensations in different cultural contexts. Cultural sensitivity is one labyrinth where one is always learning (Erikson, 1963)

    Sympathy and Empathy- Readings in Riverwood- Mississauga- November 2019

    Empathy is feeling with a person, if someone is stuck in a hole, you climb down with them and say you know what it feels like- you think with the person, rather than about them or for them. Sympathy is saying- Huh- It’s is too bad, it will be ok, you want a sandwich? (Jiang, 2015)

    References

    Barush, K. (2020). Labyrinths as an Embodied pilgrimage Experience: an Ignatian Case
    Study. Material Christianity: Western Religion and the Agency of Things, 197-222.

    Erikson, E. H. (1963). Childhood and society (Vol. 2). New York: Norton.

    Jiang, J. (2015). Rejection proof. Random House.

    12 step worksheet to rebuild relationship with loved ones:

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