Therapeutic Focus

Once upon a time, I was speaking to a counselor. He uncovered that I would not take medication for cyclothymia, anxiety or anything else because I classed them as mind altering. As I pointed out to him, this is my issue, and it is a phobia. He seemed to have some significant issues accepting that I had this phobia since it was unusual. I suspect, although I am quite willing to be wrong, that he believed I was just being difficult. After all, the perfect solution for him was probably for me to take medication rather than work through the issues of discomfort that I was experiencing.

I asked him if he had any phobias and he said that his experiences were irrelevant to this conversation and that we should just focus on me. Strangely enough, I really didn’t like him. The reason that I asked him was to point out to him, through his example, that phobia doesn’t make sense. It just is and is something you either work through or around, but you don’t just say “my goodness, this phobia makes no sense so now it is gone”. He really didn’t understand that.

Two issues were raised for me in this. The first is that the therapist didn’t want to work on my discomforts in a way that was compatible to my beliefs. The other was to do with his cold inhuman clinical detachment.

This first issue is fairly common in the therapeutic industry, but it is not universal. Professionals need to remember that people are not universally the same, but are unique and different to each other. If we humans were all the same, then we would not need professionals, we would only need technicians, ticking a box as we progress, working on all of us in the same way as we all respond exactly the same. Clearly we don’t, so it is up to the professional to demonstrate the artistry behind their profession and adjust to the situation in front of them. Those who use professionals who will not budge should find those who are willing to compromise their rigidity and work with you instead of on you.

As for the second, it is important to be human when interacting with another person. Why on Earth would I trust a person who is clinically detached and perfect? How can they possibly understand or empathise with my life if they have only ever lived a book perfect life? Of course, very few have lived such a life, and even fewer choose to go into a professional health career. Or simply put, most people who go into health careers have lived interesting lives. By refusing to professionally and responsibly share your own experiences, you deny your humanness and the necessarily real element in a dialogue.

To accomplish this well, one must consider where the focus of the conversation is. It must be more towards the client than the professional, but it must not be divorced from the professional. Real interactions require genuine content. Another important consideration is why are you, the professional, telling the client this part of your life? If it is to frame an idea, to give context to a method of health, or to give an example that promotes empathy, then you are using your own stories well. If you find that you are processing your story for your own gain, or your story is becoming a one up man ship kind of contest, then this is definitely straying into inappropriate use of your experiences. Of course it is important to not out friends, family, phone numbers and addresses in your stories. I will usually tell my stories and refer to people indirectly, since the who is not as important as the what of the story.

A collision of differing worlds

I am going to use computers and the internet as an analogy for people and society. There is a certain irony here since the computing process has been inspired by the human thought process.

Basically, most people think and process information in mostly similar ways. We will refer to them as Microsoft Windows based machines. There are several different version which have somewhat different capabilities, but on the whole, they work mostly the same, have the same basic assumptions of how things are done and if you’ve used/met one, you’ve used/met most of them. The hardware statistics vary, but the way they process information doesn’t vary that much. That is, some computers are faster, but they get the same result in the same way in the end.

Other computers are different, they are apple machines. Each version was mostly a re-write of the very fundamental ideas, but each handles processes in significantly different ways. As such, even though they have the same appearance, and have the same label, they operate quite differently and get valid results in different ways. Someone who is use to dealing in the Windows world will feel very out of place and not really know what is going on, yet the machine works and operates fine in isolation. Apple machines are a bit odd, in effect, kind of like a different culture. They all pretty much work the same way, but it is radically different to what you are use to.

Some computers are Unix based. These linux machines vary widely from each other, and each is built specifically for the machine it finds itself running on. While each Linux machine uses similar assumptions, each differing stream of Linux goes about using and interpreting those assumptions in wildly differing ways. From a Microsoft Windows perspective, Linux machines are much like people who have some kind of illness. Why on Earth would you do things that way, and why can’t you just do it the way everyone else does?

Yet all these machines talk to each other quite nicely on the internet. The web, or you could see it as society, has a set of rules that all machines communicate to each other in. When you create an idea and package it for the internet, all machines can look at that idea and not know that the logic behind how it got there was radically different, or completely the same as, the logic behind the system looking now.

Computers that can not look at and interpret the internet have no reason to ever work in a similar way to others for the specific purpose of fitting in, so become very isolated and quite different in the way they work.

Now that the scene is set, let us see how this analogy works for us people. Most people in the world are Microsoft Windows people. In general you work fine, assume that files are stored and interpreted the same way. On average you have similar enough statistics and software. Some have really fast processes (high intellect), huge hard drives (great memories), awesome graphics cards (visual artistic ability), brilliant sound systems (musical ability) and so on. But they fundamentals behind how you tick is the same operating system – Microsoft Windows. Sometimes the operating system has a problem and we call a specialist to fix it, but mostly it just works. 

Then there are those who are consistent with each other but work on different base assumptions. These are other cultures (and if there were more standardised systems out their than Apple, I would have a better analogy here, but go with it). When we look at the logic of these systems, they are consistent with each other, so you wouldn’t define a specific machine as ‘wrong’, but you may label the whole culture as ‘different’ and ‘needing to improve and mainstream’. Similarly, the operating system just works and those who use it need to make very little adjustment to keep things going. Rarely is a specialist called to fix problems. (And I am aware that OS X.Y is basically Unix these days, but it is a neat standardised package).

The weirdo’s are the Unix based machines. Linux is the most common example of Unix, but even Linux has many different streams (Red Hat, Ubuntu, Gnome etc). Those who know how to tweak the system often spend large amounts of time doing so to make it work. Those who don’t know how to tweak it live in a state of repeated frustration as they try to do the same things they hear everyone else does easily. When people create documents on Linux and try to share it, they find that their file is either not compatible or often misinterpreted by the other peoples systems. The easiest way to communicate is to simplify, which often reduces the sophistication of the system and it’s possibilities down to a frustrating common interface. Then the non Linux Unix systems are even odder and harder to function with.

People who are a not so much of a different specific culture, but work quite different internally to the main stream may sympathise quite well with the Unix computers. We do what we do well, we do it differently and get very interesting and equally right results, but often those who are mainstream think that we are very odd and should just do it their way. Often they blindly try to fix us without understanding that what they are doing is wrong for our system and may cause a nasty system crash. Good professionals learn our individual quirks and work with us in our way so that we can function well enough to provide a good internet interface.

The internet solves a whole bunch of communication issues. The information presented via web pages is universal (mostly), so pretty much any computer system has no idea who is presenting the information, but each person looking at this interface, this society, can understand what is meant by the other. The rules of society must be adhered to, but the logic behind how to create the content is up to the individual computer’s operating system.

Often people think that the operating system is the problem, yet each computer in isolation works fine the way it is on the problems you present it. Each has a good method of displaying information, processing information and interfacing with the user, so long as the user know how to use it. It is when you try to get these systems to try to talk directly to each other that you have difficulties, or when the user doesn’t know how to use the system they are on.

The operating system is not the problem. It is how the operating systems talk to each other that is the issue. If the computer/person, can not communicate effectively to other computers/people, then that computer/person finds themselves in isolation and a great deal of frustration. It can also be the operator/conscious mind trying to assume that the system they are working with is the same as other systems that they can directly see.

For example, try to eject a CD on a windows system. You press the eject button, or in a window/music program, you press the File menu option and then Eject. Simple. Move over to an Apple machine and you either drag the CD icon to the trash can, or you Option Click the CD and choose eject. Both make sense internally, but if you watched one person do it on their machine and tried to emulate it on your different machine, you would be in for a world of woe.

The take home message here is, learn your own system and accept that it works perfectly well for you in the things you want to do. You can learn new things (load new software) that helps you achieve what you want, but the way you learn it (the particular software) needs to be for your system – your way of doing things. Don’t try to emulate how you do things based on what you see and assume others are doing. Yet you must interface and communicate effectively with others. So, learn the rules of the internet/society and use them to present your ideas.

After all, the web is only full of results, not the process used to get there. See their results, show yours.

The Thriving Framework

How does thriving feel to you? Or, how should it feel?
Defining the Thriving Framework
The Thriving Framework is a heuristics for achieving a State of Thriving. It takes advantage of person centred planning, personal empowerment, the right for people to choose their own destinies and methods of achieving these destinies.  It does not require people to admit to some ill, being faulty, broken or helpless.
Achieving a State of Thriving is the end goal which is defined by individual people as their destination at the end of their progress through the framework.While the emotional experience of most people who have reached this stage is similar (safe, satisfied, confident, content, empowered, capable etc), the specific context will vary widely and the string of goals needed to achieve this state will be individualised such that the journey through the framework will be the individual persons, not anyone else’s.

Defining the State of Thriving
Thriving is a state of doing well, being well and succeeding at all of the important things in your life. If life were a game, it may defined as winning. Thriving does not mean that your life is over, only that you now have abundant resources to do what you want, how you want and as you want. People who are thriving are generally happy, are not struggling often, have most of what they want, have all of what they need and are generally fully integrated into society in such a way that they feel both wanted by and useful to society.

The State of Thriving is made up of two components. The Feeling of Thriving and the Context of Thriving.

Separating the Feeling and the Context
The State of Thriving is defined as the context you would fine yourself in to achieve the feeling of doing well and having “made it”. Core to thriving is feeling like you are thriving. Their is no point to living prosperously if you are miserable.

The Context of Thriving allows you to define the most likely situation that you are going to find yourself thriving in and the components of this context act as the elements of your goals. The goals create a flexible path for you to journey over from where you are now to where you wish to be such that you are thriving.

An emotion that I may identify as being part of my thriving might be safety. To understand why this is important I need to look at how safety plays a part in my current and past experience. For this example, it is because I have moved houses many times and could not rely on my home being home. To achieve the feeling of safety does not mean bars on the window, or a security force, or that I think I am being followed. To achieve a feeling of safety I want my own home, which can’t be taken I can not loose. In this example, the feeling is safety and the context in which I will feel safe is security in housing. If I do not recognise both components to this sub goal, then I may very well attempt to achieve the wrong thing and find myself escorted by safety professionals who do not actually address my feelings of fear at loosing my home.

The Spectrum of Thriving
Thriving is the end point on a spectrum of well being. In this case I define well being as how well my being is. My spectrum looks like this:

Death – Existing –  Surviving – Coping – Achieving – Thriving

The size of the steps between each of these increases exponentially. 

Death is the end of life, it is clinical death.

Existing is moving through life without feeling, without thought or personal power. It is close to death in that you can not or will not act and life just passes you by. Some people may wish to put this in a separate spectrum, but I feel it is the state of being just passed death. It can be placed alongside Surviving. People who  are Existing do not feel a future that is different is possible and often have no motivation to change. People in this stage may feel that they are not worth goodness or positivity. Self esteem is the main challenge, followed by motivation.

Surviving is that state of managing minute by minute, or hour by hour, or day by day the meager resources you have so that you have control over your destiny. This is the point where you can act to prolong the event horizon (the point where you can no longer influence) of your destiny. People who find themselves in this state are generally worried about personal safety, housing, food, paying the next bill and just making it through the day.

Coping is easy to mistake as Surviving, however it generally means you are managing to succeed at Surviving and are further away from slipping down to Existing or Death. Often people who are coping have a plan for a week or two and the resources to influence that. The focus is less on the immediate now and more on goals for the future. A person who is Coping can actually make plans for more than today because, on the one hand, they can see a future is possible, and on the other hand, they have command of enough resources that they can start to make future plans. This shift in controlling resources is the primary distinction between surviving and coping.

This is the beginning point of where discussing the Thriving Framework makes sense. Before this, it is too vague to make sense since it does not answer the immediate needs.

Achieving is the making progress in plans made towards Thriving. Often people feel capable and accomplished during this part of the journey. It is easy to feel that this is the whole point to life and just to stay in this aspect of the Thriving Framework. It is particularly appealing to those who have spent some time Existing, Surviving or Coping. Some people may become disillusioned with Achieving if they spend their whole lives Achieving and never quite accomplishing Thriving. Generally people who are Achieving have very few supports as they are managing this stage on their own.

Thriving is the end goal of the Thriving Framework. It means having achieved the majority of the Context Goals and feeling like you are Thriving. If you have achieved the Context Goals and do not have a feeling of Thriving, then it is important to go back and look at what you want to feel and what you may need to change to achieve this.

If the stage of Thriving can never be achieved, why aim for it? It must be achievable. This does not mean that the early Thriving Goal should be practical or achievable. When first working with your own or someone else’s goals, allow for unrealistic goals. This helps you to determine the governing emotions behind the unrealistic goals. From their you can work out how else to achieve these goals that is practical. The person on the journey through the Thriving Framework must choose and own these goals and this journey, otherwise you achieve nothing.

Depression and Catatonia

Sometimes we are reluctant to act because we are no longer certain what is right to do and we fear the consequences of doing wrong, so we focus on the little that must be right. Sometimes we have no energy to act so we focus our energy on what must be done. Sometimes the hurt of peering out from beyond our walls of safety is too much so we only venture out to do the minimum. This is often called depression. Our actions are depressed and we look like we are achieving very little.

Sometimes we can no longer be certain that anything is right, or have so little energy it is a struggle to breath, or the pain is so much that we do not venture beyond our walls. This can be described as psychotic catatonia.

In general there is a turmoil behind your eyes, in your mind, that is taking up a lot of thinking and feeling space. Something has change your tolerances so that wrong is more important, or sensory/emotional input is too high, and it saps our energy. Sometimes we forget to eat, or we eat all of the wrong things and run out of nutrients. 

Memory plays a key part to recovering from this. We can look to our past and compare it to our present to discover what the external source is for our changed tolerance and try to do something about that. We can look at what we are eating and get back to what we remember was good and return to that diet. We can remember that this state of affairs began at some point, that it wasn’t always like this, and so it won’t always be like this because every beginning has an end. Thus, even when we can’t act against whatever it is that has prompted this, we can wait until it stops affecting us.

Catatonia is harder. Generally this is just a waiting game because your inability to act negates your ability to change the situation and yourself. Instead of physical actions, the change must be internal. Find out what about you is negating your ability to physically act. Work on changing this.There will most likely be a great fear regarding the consequences of what this change will do to you and you may fear death of body or persona. I’m sorry, but if you have hit catatonia, you are already dying. It is better to change than to lose everything. Consider how much you will keep by making this change and hold on to that as a good reason to make the change.

Start with small physical actions – move a toe, move a finger, consciously blink or move your eye. The more you do, the easier it gets. When you are ready, speak. Speak about what needs to change in your environment to help you survive. This may be uncovering a secret, or asking for something selfish, or pushing someone or something away. The faster those around you know, the faster your environment can support the change you have made, the faster you can get back to living.

Feel free to contribute further ideas to how to escape from depression and catatonia below. Feel free to add other types of these conditions.