The Power of Connection
March 10, 2010
As a therapist, one of my primary professional responsibilities is to help others see the need for, and to seek out, connection to others. Being in “relationship” with other souls is at the very heart of emotional health. We are social beings and therefore we require a sense of intimacy with others. By using the word intimacy, I am referring to relationships that allow one person to be truly vulnerable with another. This type of connection allows us to put our guards down, be honest and feel understood.
Connection comes in all shapes, sizes, and flavors. My daughter is about to graduate from nursing school and she shared a writing assignment with me that powerfully illustrates the power of connection even when connection appears unwanted. She wrote the following:
“Abraham Lincoln once said “I don’t like that man, I must get to know him better.” Never in a million years did I think I would find that statement truer then on an Oncology floor during my second medical surgical rotation at a large Boston Medical Center. Mike (not his real name) was a middle aged man, with a life I immediately deemed as average. He was married, had three children, and worked as a laborer. Mike was receiving chemotherapy for spinal cancer he had believed was in remission and he did not want a student nurse.
After begging my instructor to change my assignment, many unsuccessful attempts to engage Mike in conversation, and nearly getting my head bitten off when I gave him an injection, I finally used the oldest trick in the book and gave him a foot rub. He slowly dropped the “tough guy act” and started to tell me how angry he was that he was back in the same bed, with the same illness tugging at him. Mike longed for a chance to once again do the simply things, like watch his son playing football. I sat quietly and just listened.
The next week when I returned he had taken a turn for the worse and was very confused, but amazingly remembered me. I spent all my free time during that shift sitting next to him and he told me I had surprised him. A few hours later, he was placed on comfort measures only and died after a brief time. After his death, his family told me that he had spoken all about the student nurse that he didn’t like who ended up being his greatest caregiver in the hospital.”
Laura learned a great deal from her time with Mike. She learned not to be discouraged by seeing someone’s anger and defenses. She came to see that underneath it all, Mike, just like all of us, had a soft and tender need to be cared for, loved, heard, understood, and held. Laura had a life-changing experience with the power of connection.
Consider for a moment what type of connection others may need from you, AND, what connection you may need from others. Don’t be afraid to ask for connection. We all need it…we all require it! Why then, do so many of us sit alone with our suffering? Why do we worry so much about “burdening” others? Why do we think it’s up to us to figure out everything for ourselves? Maybe it’s time to put our fears aside and ask others to listen to us, be patient with us, hold us, and comfort us. That is how we become a part of something larger than ourselves.
Best,
Walter
“Instant connection! Our teenage daughter had been professionally diagnosed with ADHD at a young age and had been struggling with self esteem and anxiety for years. We met with many different professionals, had team meetings with educational consultants, neuropsychologists, teachers and tutors. They all said that this child was carrying around too much stress and absolutely needed to have someone to talk with, who could help her with this heavy burden. This was easier said than done, she simply did not connect with anyone until she met Walter. He has been an invaluable resource to our daughter and our family ever since.”
Parent of an ADHD Child
Walter Sherburne, Psychotherapist
walter@sherburnecounseling.com
www.sherburnecounseling.com
978-470-HOPE
Mindfulness Training
February 21, 2010
When I began studying mindfulness, what struck me most interesting was how regular practice in “paying attention” allowed one to be more efficient. When you’re in the present tense you’re hot on the task at hand. But a recent review of my books by Ellen Langer ,in particular her 1989 book “Mindfulness,” refreshed the scope of my understanding of mindfulness to include “flexible mind.” I think that there are those who want to embrace mindfulness, but their brains are in a place where they are incapable of such thoughtful engagement.
On the brain maps of some patients we can see regions of the cortex that are suppressed. Interviews with these patients reveal patterns of rumination, one track thinking and automatic responding to people and situations. When suppression is released, or when these regions begin to show greater variability, via relaxation therapy or neurofeedback for example, awareness increases, and there is greater cooperation and less resistance to new ideas. At this point the brain is more flexible and better able to benefit from mindfulness training.
A New Non-Stimulant Medication for ADHD
January 8, 2010
INTUNIV is the new long-acting, non-stimulant medication approved in the fall of 2009 by the FDA for treating ADHD. Studies on Intuniv were completed for children and adolescents, ages 6-17 years old.
What you need to know about Intuniv:
• A long-acting, once daily medication for ADHD
• Non-stimulant, not a controlled substance. Unlike stimulants, your doctor can put refills on this prescription.
• Approved for children and adolescents
• Helps with core ADHD symptoms (Hyperactivity, Impulsivity, Inattention) as well as the associated features of behavioral dysregulation, oppositional symptoms, emotional reactivity, or being “out of control”.
• Has a different mechanism of action in the brain than stimulants
• Doses range from 1-4 milligrams per day
• Clinical benefit is seen within 1-2 weeks of starting Intuniv
• Intuniv may be safely used either by itself or in addition to taking other medications to treat ADHD
• Tablets cannot be crushed, broken, or chewed
• Side effects may include sedation, fatigue, headaches, stomach aches, or decreases in blood pressure
Families often ask me what is the “best” medication for ADHD?
My answer:
There is no one-size-fits-all medication approach for ADHD. Response depends on many factors including individual symptoms, medical history, body chemistry, family history, co-existing conditions, and even the patient’s daily schedule.
Talk to your doctor to find the right medication for you or your child. It should be a collaborative process between the patient and the treating team. And don’t be surprised if it takes a few months to find what works well with the least side effects. This is very normal. The good news is that 70-75% of people do respond to ADHD medications with minimal side effects, so there is much hope you will find “the best”!
Listening for Leaders
December 28, 2009
I happen to catch the Green Beret Qualification trials on the Discovery Channel last week. Tirelessly, these sleep-deprived candidates had to climb walls, run through sewers, jog for miles with 150lb back packs. During one maneuver the group was divided into four teams. Each team had to construct a harness from a few pipes and rope and carry a 400lb barrel of fuel on foot for six miles. The teams were given strict time limits to carry out this rigorous mental and physical task.
Aside from the physical strength, endurance and clear thinking required to haul this barrel; it all came down to the leadership to make it happen. The winning team, as determined by the Green Beret instructor, was the group leader who put his ego aside to listen to his team, construct the most efficient harness and motivate his team to pull the weight. The winning team’s leader took into account all members’ suggestions. As time was precious, each member made suggestions built upon the previous contributor. It was up to the leader to pull the ideas together, commend those who offered suggestions, assign roles and supervise the execution of a plan. The leader of the successful team made all members of the team feel valued, whether their ideas were used or not. This process of mindful listening kept spirits high and was key to mobilizing the strenuous follow through effort to haul that barrel to the finish line.
Releasing Toxic Shame
December 21, 2009
“To feel shame is to feel seen in an exposed and diminished way. …you turn your eyes inward, watching and scrutinizing every minute detail of behavior. This internal critical observation is excruciating.” John Bradshaw
There is perhaps no human emotion more paralyzing than shame, greater even than fear itself. Unfortunately, many of the people who walk into my office are consumed with an overwhelming sense of personal shame. The reasons are as varied as the people themselves.
• I have not succeeded in school because I am too lazy.
• I was victimized as a child and I believe I should have done something to stop it from happening.
• I gamble because it’s the only way I can imagine finding financial freedom, but when I lose, it only makes things worse.
• I don’t speak to my wife the way I should.
• I don’t trust other people.
For one such shame-filled client, I put a sign up in my office which reads:
Attention: You have just entered a shame-free zone
The wording of this sign is purposeful since I believe that therapeutic progress cannot be made if one is mired in that sense of shame. The coat of shame needs to be taken off and left at the door before the real work can be done.
It is important to define the type of shame I am referring to. When we mess up, whether it’s joking with someone in an insensitive manner, or something more egregious, embarrassment assists us in the process of recognizing our mistakes, taking responsibility for them and then making amends for our transgressions. Shame, on the other hand, is a toxic belief that we are unworthy, loveless or unredeemable. “Toxic shame feels much worse than guilt. With guilt, you’ve done something wrong; but you can repair that – you can do something about it. With toxic shame there’s something wrong with you and there’s nothing you can do about it; you are inadequate and defective.” (Leo Booth/John Bradshaw)
Toxic shame seems to condemn us to an existence of self-loathing, endless emotional pain or existing in a state of numbness to the world around us. Shame anesthetizes us to the possibilities of growth and relationship with others. Shame binds us and holds us captive, no different than a prison cell. It is the toxic shame that we need to recognize as destructive and unhelpful if we ever hope to find peace and connection.
There is always a reason why we do the things we do. The fact that we blame ourselves or see ourselves as defective is a construct that most often other people gave us. Take my examples above.
• I have not succeeded in school because I am too lazy.
o If, like many of my clients you have ADHD, you weren’t organically designed to be immediately successful in a classroom. If teachers and parents keep telling you that you just need to work a little harder, what option did you have other than to blame yourself and feel shame?
• I was victimized as a child and I believe I should have done something to stop it from happening.
o This is common reaction of children who have been abused. Adults have the power. It is their responsibility to keep a child safe; not the child’s, and yet most victims take on the burden of trying to figure out how they could have prevented the abuse.
• I gamble because it’s the only way I can imagine finding financial freedom, but when I lose, it only makes things worse.
o When we find ourselves in this type of financial bind, it is easy to understand how desperation drives us toward unlikely hopes about how we can be delivered from our anxiety and fear. Most people don’t confront overwhelming challenges with rational thoughts. And while it is normal to wish financial woes away by gambling, it virtually never works. These are times to ask others for help and ideas about how to move forward to resolve the dilemmas.
• I don’t speak to my wife the way I should.
o While there are many reasons why this may be true, there is usually some environmental factor which fuels this difficulty. If we lacked role models, for example, on how to speak with a spouse, or we struggle with a low self-appraisal, intimate communication with others is never easy.
• I don’t trust other people.
o Trust is something we learn from our parents and other important people in our early years. If adults proved to be untrustworthy, why would we trust anyone? In my experience, most individuals with this type of history have a “wish/fear” related to intimate connections with others. They both long for intimacy and, given the dominant, fearful expectations held tightly within, they reject it. The promise of intimacy and unconditional love is experienced as nothing more than a shallow or empty gesture. The recipient of such an offering, in order to keep themselves safe from the harm of disappointment, believes that they must reject the overture and assume it is not real. They remain “safe” but alone, isolated and shame-filled that they cannot obtain that which they crave.
All of these situations involve people who are simply doing what they were programmed to do, or are responding to painful situations the way most of us would. Why then, is it appropriate to feel guilt and shame for doing what makes sense? I don’t like it when I see people misunderstand their capabilities, or blame themselves for being victimized, or utilizing flawed strategies to make things better, or keeping a distance between themselves and others, but I understand it. I don’t judge it, rather, I attempt to help those “afflicted” with shame understand where it came from and how to put it down! If there is “fault” to be assessed, usually the fault sits with someone or something else. And when people are caught up in shame and guilt, they almost always fall back on the very behaviors and attitudes that keep them in distress or alone.
Once freed from the shame, individuals can then utilize all of their cognitive energies to managing their lives more effectively. No one deserves to sit with crippling and paralyzing shame. Shame doesn’t move people forward, it merely keeps them held back from experiencing life in its fullest form. While we all need to learn from our mistakes, we all too deserve to live an existence free of toxic shame.
Walter Sherburne, LICSW
68 Park Street
Andover, MA 01810
617-797-8739
walter@sherburnecounseling.com
A Little Bedlam is Good for the Soul
November 11, 2009
I went home to Chicago last week and dropped in on an adult day care center to check it out for my 84 year old Dad for a visit. When I arrived the assistants were very cheerful and kind, walking around serving the members lunch. “It’s all about structure,” they said. “Our activities are very predictable so no one gets confused.” As the manager led me to a chair in the back of the dining room, many of the folks looked up and followed me with their eyes. Their expressions reminded me a first grader meeting his new teacher for the first time – hopeful, cautious. The hot turkey and mashed potatoes on their plates was apparently no match for this stranger in a bright yellow running suit.
I sat in the dining room and after a few minutes a couple folks put down their forks and hobbled over to sit with me. The others watched silently as the bold ones came forward. They sat down at my table and just looked at me. I greeted them and introduced myself to the welcoming committee. I might as well have been from Mars. One woman muttered a brief “hello” and that was it. The silence could have gone on for days; they just stared at me. The others, hesitant to join the three others at my table, watched in earnest waiting for me to say or do something. I reached into my pocket and pulled out a new deck of cards (“Old Maid”, go figure!) that I had bought for my little niece. I said to the group, “Does anybody know how to play cards?” At that moment, members of the group turned in their chairs, laughed and some raised their hands as if they were waiting to be called upon. Others shouted out names of card games they had played years ago. I heard “Vegas!” from across the room. Before I knew it, a dozen members surrounded my chair and the lively discussion began, leaving lunch behind. Interruption, overlapping, furniture bumping and a few cheers from the crowd jolted the staff out of the kitchen to witness “a break” in the structure. Horrified and stunned, the staff tried to temper the disarray and return the folks to their tables, but with little success. Yep, I blew the lid off “structure.” Clean up was late, bingo was cancelled that afternoon. But, according to the manager at the day care center, the girl in the yellow suit and the deck of cards will keep them talking for weeks.
Nothing Changes Until Something Moves
October 5, 2009
Dear Friends:
Pinned to the wall in my waiting room, hangs a quote by Albert Einstein that reads, “Nothing changes until something moves.” I confront it every morning as I walk into my office. There it waits on a bland, white, 8 by 11 piece of paper. It waits for anyone walking past to notice it, to read it, and to ponder its meaning.
When I stop to consider it, Einstein was likely thinking of physics when he wrote it, but it makes perfect sense in the world of human emotions. When it comes to how we understand ourselves and others, you see, nothing does change until we decide to imagine and construct our thoughts differently.
I frequently speak to men, for example, about the relationships they have with their wives, children and partners. Too often, I hear these men talk about wanting to tenderly reach out to those they love and tell them how they feel, but that they hesitate to do so. Hesitation to fully express oneself emotionally can be the result of many influences. Sometimes these men had no role models to teach them, through their actions, how to love and cherish another. Sometimes they feel their words are inadequate. And, sometimes they fear the possibility of ridicule and rejection of others. For whatever the reason, powerful hesitation persists.
When confronting hesitation and avoidance, I often think of Einstein’s quote, along with the age-old advice, “time and tide wait for no man.” Life does move along on its own timeline, doesn’t it? The opportunities we have today to reach out to others may quickly vanish tomorrow. I wonder how we would act if we knew that we only had today? How much would we express to others? What of ourselves would we want to give to others? For as many times as I have raised these questions, I am too often met with, and perplexed by, that all too familiar and deeply entrenched avoidance and hesitation.
Hesitation to create movement in how we see ourselves or how we relate to others can be painfully obvious to the afflicted. I frequently ask the avoidant person if the avoidance they know so well is working for them. The nearly universal response is “no.” If we avoid, we do it for a reason. We do it because that’s how we were trained to deal with life’s challenges and upsets. That is all we know. Burying is another form of avoidance. As one client recently noted, “burying is a survival technique, but not a happy technique.” Burying, avoiding, denying and hesitating are all part of the human need to survive. But, if by avoiding conflict we keep ourselves from others, our “survival” comes at a tremendous cost.
And so, for all who wait, vacillate and hesitate, I am reminded of yet another quote. “There are none so blind as those who will not see.” What I sometimes find myself wondering is what will it take for the “blind” to see? Whatever it will takes, please remember that time is not on our side.
Best,
Walter
Walter Sherburne, Psychotherapist
walter@sherburnecounseling.com
www.sherburnecounseling.com
617-797-8739
Cogmed’s Life Lessons
September 25, 2009
by Rebecca Shafir
Summer is a popular time for Cogmed Working Memory Training – kids have no homework and more free time. Now that it’s fall and “my Cogmed kids” have a few weeks of school under their belts, it’s time for the wrap up meetings. At these face-to-face or over the phone discussions we talk about what has changed. Aside from noticeable and sometimes dramatic changes in working memory functioning (the ability to hold information online while doing a task, i.e. mental arithmetic in figuring out how much college will cost!) there appears to be a surprising hidden component from the training – some important life lessons are learned. Here are some of the reports from our wrap up meetings:
§ How to push through when the goin’ gets tough.
§ Time management – learning what is possible in a span of 30-40 minutes
§ How to pace themselves and learn the best times for their brain to do challenging homework assignments.
§ How to deal with frustration by taking short time-outs, and the value of a handful of push-ups or deep breathing to get back on track
§ Self-acquired strategies for managing their carelessness on tests and quizzes.
§ The benefits of remembering names of new friends and teachers
§ A feeling of pride and improved confidence for taking on challenging mental tasks
§ Following conversations – no longer being the “the spacey oddball” in the group
§ Greater independence with homework
§ Being able to talk easier with adults on the phone (coaching is done by phone)
§ Feeling really smart for a change.
Who would have thunk it?
Dementia Prevention Factors
July 12, 2009
One in seven Americans 71 and older has some form of dementia.
A new Swedish study shows that people who are socially active and not easily stressed maybe less likely to develop dementia. This study involved more than 500 older adults without dementia. They were given personality questionnaires that measured how easily stressed they were, how open they were to talking to other people and how often they participated in organizational leisure activities.
The study found that people who were not socially active but calm and relaxed had a 50% lower risk of developing dementia compared to those who were isolated and prone to stress. The dementia risk was also 50% lower for those who were outgoing and calm compared to those who were outgoing but prone to stress.
The “White Paper” on Cogmed Working Memory Training
May 17, 2009
by Rebecca Shafir May 16, 2009
What is a white paper? It is an authoritative report or guide that educates readers, addresses problems and how to solve them.
Cogmed just came out with a “white paper” (www.thecogmedstory.com) on the importance of working memory functioning at any age. Attention, concentration, problem solving, reading comprehension, organization, multi-tasking, math are driven by working memory. Some researchers describe working memory as the ‘engine of learning’ or the RAM (Random Access Memory) of our brain. Cogmed Working Memory Training is a five-week intensive training done independently in one’s home, school or workplace. It’s just you, your computer, the software and brief weekly phone sessions with a Cogmed coach to support progress.
Cogmed’s white paper is a fascinating account of how persons with strong working memories have an extra edge in academics, sports and in the workplace. As it refers to ADHD, our own Dr. Theresa Cerulli was quoted as saying “We used to view working memory as a co-existing deficit in ADHD, but now we see that it is the core deficit.”
Some other interesting points that are addressed in this white paper that you won’t see in most reports on working memory include how working memory training:
1) can be “a tremendous asset” for athletes as they depend on a working memory for making split decisions under stress.
2) can make or break one’s future. Test-taking ( SAT, LSAT, GMAT,) requires one to recall information, do mathematical and logical calculations, manage one’s time and stay focused for several hours of testing.
3) alters the biochemistry of the brain (Klingberg 2009) and may restore clarity and working memory capacity for patients who have undergone chemotherapy and radiation treatments.
Finally, what about those persons over 50 without ADHD – can we benefit from Cogmed? It has been at least 7 months since my Cogmed coach training. All Cogmed coaches are required to experience the program. As of today I continue to benefit from the “sharpening effects” of the program in several ways that I cannot account for otherwise. On a daily basis, aside from the normal barrage of emails and phone calls, I attend to 5-6 different projects (creating CDs, working with patients at three medical practices, writing articles, teaching martial arts, a pile of readings, and managing a household). My obligatory multitasking has become more efficient; I can move between tasks and keep bits of data like numbers,deadlines, lists and other bits of information in my head for long periods of time without having to re-check. It surprises me and those I live with and work for. I even remember more of the sequence of complex moves in my martial arts class! The Cogmed Working Memory Training has allowed me to accomplish more than the average person on an average day. Carpe Diem!
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