We could begin by making “Jewish guilt” jokes or jokes about neurosis a la Woody Allen, but the truth is that the fundamentals of psychoanalysis, psychology, psychotherapy have very strong connections with very ancient teachings of Judaism. In fact, they go back as far as Adam and Eve!

In part that’s because character analysis and character improvement are a way of life in traditional Judaism. There is a densely interwoven theme of self-knowledge and self-improvement in ancient—and modern—Jewish commentaries on the Bible (aka Torah). These topics are also overtly discussed in Kabbalah, numerous ancient ethics manuals, and numerous other sources. There are several schools of thought and different approaches and virtually every major scholarly work either focuses on or touches on the subjects of what it means to be human and what it means to work on one’s character.

Because all these teachings are regularly studied by observant Jews today as they have been for thousands of years, they are ingrained in our outlook.

Of course, psychology itself has Jewish roots. Others have commented on this, but we’ll leave that to Freud’s biographers and the many authors, both Jewish and not, who have written volumes on this subject.

I find it natural that the deepest of Jewish teachings as well as common-sense life lessons of Judaism inform my clinical work but then again, they inform every sphere of my life, just as being male, being born in America, and being very tall do, too. It’s hard to dissect and pull out what is the Judaism and what is the Richard, but there are several Jewish concepts that really do keep cropping up. We’ll start with one, “teshuva”.

Teshuva means “return” (though it is often translated as repentance).  Judaism teaches that when one errs or does something harmful, one is able to “return” to the state he or she was in before the error. This return is ideally a return to one’s true self.

This return will necessitate the use of various processes including but not limited to: confession (to God and self—not through intermediaries), honest reflection and assessment, self-education, sincere regret, apology—if another was harmed and if appropriate–prayer, implementing practical courses of reparative action, and resisting repeating harmful future actions.

In fact, sincere teshuva can bring a person to a higher spiritual state of being than before. According to Jewish teachings, teshuva can literally transform the actual harmful deed into a positive event. In other words, through corrective action one can actually change reality. There is even a saying that what a true penitent (one who achieves a rectification of his actions and himself), achieves spiritually, a saint (one who has done no wrong), isn’t able to achieve.

I find that sharing this general concept, especially when working with substance abusers or those who have harmed others or themselves, to be incredibly powerful. To believe that one has the power to change and repair not only himself but the world itself is a theme that to me is worth emphasizing in virtually every course of psychotherapy or addiction treatment.

Does this minimize the harmfulness of actions that have hurt others? No. It does not because there are consequences to one’s actions and teshuva does not generally negate consequences.  But it does transform self.

Part One of God in Therapy: Let’s Talk inspires some intense discussions! Let’s talk more, with Wendy Young.  Wendy Young, LMSW, BCD is an award-winning child and family therapist and the founder of Kidlutions: Solutions for Kids.  Read more, here. ]]> http://www.richardzwolinski.com/zwolinskisite/2010/06/08/god-in-therapy-talking-with-wendy-young/feed/ 0 http://www.richardzwolinski.com/zwolinskisite/2010/06/03/god-in-therapy-lets-talk/ http://www.richardzwolinski.com/zwolinskisite/2010/06/03/god-in-therapy-lets-talk/#comments Thu, 03 Jun 2010 22:48:32 +0000 richard http://www.richardzwolinski.com/zwolinskisite/?p=556 You can read this post at PsychCentral.com where it was originally posted, or continue, below. There are a couple dozen very interesting comments and a heated discussion at the Psychcentral post so check it out!

It’s the 21^st century. You can talk about—and do—it all. Infidelity, sexuality, violence. Drugs, suicide, gambling. Perjury, double-standards, politicizing. Hey, even taxes are a hot topic. However… if you want to talk about God or “do” religion, well, just about everybody’s knee jerks. Sometimes it seems that we don’t so much have a culture of freedom of religion as freedom from religion.

Therapy culture is no exception. And, with very good reason, in many cases. In therapy, the therapist must do his or her best to not (implicitly or explicitly) force his or her morality or religious viewpoint on the patient. The general rule is to avoid instigating any discussion of codes of conduct or sets of beliefs that don’t reflect the mores of a purely secular-cultural way of life. (This is nearly impossible for mere mortals to do in totality, by the way).

Still, this doesn’t mean that the therapist cannot have his or her own deeply held religious and moral beliefs and viewpoints. And it doesn’t mean that basic morality, such as preventing someone from committing a violent or self-destructive act, can’t come into play in therapy. It can and should.

But there is a blurred line—so blurred as to be a hazy, foggy mess—between a therapist not bringing his moral or religious viewpoints into therapy overtly, and not having them.  By the very nature of their being, deeply held beliefs color each and every therapeutic choice he makes.

The ability to relate to people from “where they’re at” is helpful, and is a skill that can be cultivated.  And, with practice, this strong leaning towards non-judgmentalism can be implemented much of the time. Still, we contend that our moral/religious/spiritual outlook is so much an integral part of who we are that there is truly no such thing as a “blank-slate viewpoint”—we aren’t, after all, robots or computers.

In fact, if we are honest, we’ll acknowledge that secularism, too, is a moral/religious/spiritual outlook. Non-religion, like religion, has its own system of weights and measures, its own values, its own set of deeply held beliefs. Secularism isn’t, as some believe, a plain-vanilla blank slate. Atheism is as much a part of a person’s worldview, impossible to prevent from filtering into one’s every thought, word, action, as is Christianity, Judaism, Islam or any other religion.

When comparing one’s beliefs with someone else’s, we naturally think that we are the ones who are free from bias—(that “we” includes you and me by the way)! It is very challenging to step back and see that our beliefs are utterly interwoven into the fabric of our being, especially if we are convinced by majority viewpoints or passionate minority viewpoints, that our particular way of thinking is the only one that is free from bias.

If we value being bias-free (and that is a whole other topic—because that may not be the most desirable state), and we want to be really honest, we are obligated to examine our knees very carefully when they start to twitch.

Here’s one story: Author and PsychCentral blogger Therese Borchard frequently writes about her Catholic faith and how her relationship with God has profoundly helped her. Yet upon recommending her books to someone who we felt would find comfort in reading them, we were told, “Oh, you recommended her to me because she believes in God.” Actually, we recommended her for her honesty, her commitment to her family, her willingness to share her life with others, her bravery, and many other reasons. We personally hold quite different beliefs about God, and don’t agree with her on several fundamentals—but that doesn’t mean we don’t find her work valuable.

On the flip side, we haven’t yet been in the situation where we’ve recommended a book and the recipient says, “Oh, you recommended that book because the author is an atheist.”

Another thought worthy of trembling-knee examination: More than a handful of therapists openly speak about incorporating Buddhism, Taoism, Yoga* and other eastern religions and spiritual philosophies and practices into their therapy methods. Many offer up suggestions based on these religions and philosophies. Why are some sets of beliefs given a pass and allowed to be openly suggested to patients but not others? That’s an invitation for you all to share your comments, by the way!

Also, going back to an earlier question: Is a lack of bias even always desirable? If a set of beliefs is to have real meaning, does this mean we have to praise beliefs that openly contradict ours? We have invited therapists, patients, and others to discuss these topics with us in this new Therapy Soup series, “God and Therapy”. Over the next few weeks we will post interviews and discussions.

We want to open up a serious conversation where everyone can be honest, even if that means being politically incorrect. We touched on this subject in our first book, Therapy Revolution (now finally available in Kindle), and we’re also addressing this in our next book).

Let’s talk about God and Therapy–we invite your comments!

We are in the process of interviewing therapists and patients about this topic. Next: Interview with Michigan-based therapist Wendy Young, coming soon.

*Here we refer to Yoga as the general name for several physical and meditation practices that were developed as a part of Hindu worship and currently regarded in India, though not by most American proponents, as still being an integral part of that religion.

Mental Health Education & Awareness at Valley National Bank

By Richard Zwolinski, LMHC, CASAC

How do we know when mental illness has truly become less stigmatized? When a bastion of corporate respectability hosts an event that encourages open discussion of mental illness and related issues!

Although we speak and do workshops for a variety of organizations, usually sponsors are either in the mental health and addiction fields or corporations looking to learn about mental and emotional well being and addiction prevention in the workplace. Last week, that all changed. In honor of the end of National Mental Health Month, 2010, Valley National Bank, the largest bank headquartered in New Jersey (with many branches in the NY metro area), broke charitable ground and hosted a community mental health awareness and education event at one of its Brooklyn branches on 13^th Avenue.

VP and assistant branch manager Anna Gelardo came up with the idea to host the free event which took place during regular banking hours. She and her team opened their doors to all who passed by, sent out dozens of news releases and personal invitations, handed out fliers, and set up a free, lavish dessert buffet. There was a table in the lobby where free educational materials were available including the Therapy Patient Bill of Rights developed with the help of PsychCentral readers on this blog. The bank also raffled off several copies of our book, Therapy Revolution: Find Help, Get Better, and Move On Without Wasting Time or Money.

Most of the bank’s customers joined us when they were done with their banking business. Also, many people stopped in just to schmooze with us about mental health issues and enter the raffle. They stayed for the warm atmosphere and the buffet—not a typical day at the bank! A large number of guests had family members with mental illness or were mentally ill themselves, but many were simply curious. The entire bank staff, including the tellers, was genuinely welcoming.

We hope to do many more stigma-busting, awareness and education events—the more that people feel that the topic of mental illness (and addiction, too), can be discussed openly and brought into the public consciousness, the less they have to struggle with the additional burdens of shame and blame.

Many thanks to Valley National Bank and their wonderful team including Reetu Chokshi; Jr. Graphic Designer; Anna Gelardo, VP and Assistant Branch Manager; Inderia Ram, District Manager; Vincent Demeo, Regional Manager; Marc Piro ,Vice President, Marketing/Public Relations;  Maureen Zegler, Senior First VP; and Gerald Lipkin, Chairman, President, and CEO. (Please accept our apologies if we overlooked anyone).

Are there any benefits to just doing medication visits? For example, it is less expensive for the patient to see a psychologist or other psychotherapist for regular therapy appointments.

If a psychiatrist and a psychologist (or social worker or MFCC) work closely together, in the same office or same clinic, and have regularly scheduled meetings to discuss the cases they have in common, they could, theoretically provide good treatment to a patient, with less overall cost. However, in the real world, this doesn’t happen as diligently as it should. Regularly scheduled weekly meetings to discuss cases become five-minute telephone calls every six weeks, if that. Continute reading…

Can you tell us briefly about why you chose to share your story of Therapy-Gone-Wrong in Therapy Revolution?

What most defined our story was this scenario of the professional, austere therapist, sitting in his mahogany office, bearing all the trappings of authority, and myself – an intelligent but essentially vulnerable woman trying to make sense of her life and her marriage. There was virtually no input from the therapist, no continuity from session to session.

Because it was my first time in therapy, I had nothing to compare with – so I went with it. But being the non-intimidated person I was – though the setting itself was intrinsically domineering –  I started asking the therapist to give me a sense of structure, an outline of what to expect. He told me “Wait and see – this is how therapy works,” and more insinuatingly that my constant asking actually stemmed from my trust issues. If I would but trust him then that itself would be therapeutic.

It all ended in a show-down…read more here.

The American Psychiatric Association and others adhere to a mental health bill of rights,  which is important for every patient/patient’s advocate and mental health/addiction professional to read. The bill is comprehensive but quite legalistic in language and content, so we decided to create a list of some practical and relatively easy-to-put-into-practice patient rights, some of which are based on the good work of the APA.

No matter what methods or techniques your therapist uses, there are universal recommendations for the process of therapy.  In themselves, these are not revolutionary in the least, but when taken in context of what some views of accepted practice are, they may very well be. Also, it’s important to note that there are exceptions to every rule and not all of these rights may be applicable in every situation.

In honor of National Mental Health Month, here’s our user-friendly Therapy Patients’ Bill of Rights:

1. A therapy patient has the right to know their therapist’s credentials, experience, and professional background. 

2. A patient has the right to ask any therapist their outcome rates. These rates are determined by doing follow-up tracking with a reasonable percentage of patients after they leave therapy to see how they are maintaining. One year follow up is ideal. Outcome rates (successful or not), should be made available to all potential patients/clients upon request but of most use to the patient are outcome rates that are specific to the patient’s disorder.

3. A therapy patient has a right to receive a comprehensive and thorough psychosocial evaluation/history.

4. A therapy patient has a right to a diagnosis and prognosis at as early a stage of therapy as possible. Additional experts including, but not limited to, psychiatrists, addiction specialists, and so on may be required to assist the therapist in reaching a diagnosis.

5. A therapy patient has the right to a written treatment plan that should be created together with the therapist and utilized, with necessary amendments and changes, throughout the course of therapy.

6. A therapy patient has a right to understand the costs of individual therapy sessions and projected costs of total therapy sessions upon request, before committing to a course of therapy.

7. A therapy patient has the right to a beginning, middle and an end to therapy. If protracted or ongoing therapy is required, then the patient has the right to understand why their diagnosis might warrant this course of action.

8. A therapy patient has the right to expect to achieve specific goals and objectives by agreed-upon target dates.

9. A patient has the right to have his or her own treatment responsibilities explained thoroughly as well as understand the therapist’s responsibilities to the therapy process and to the patient. This includes the responsibility of the therapist to try a different course of treatment and/or refer patients to another therapist if therapy is ineffective after a reasonable period of time.

10. A patient has the right to complete confidentiality as provided for by state and federal laws and regulations.

11. (Submitted by TPG)  A therapy patient has the right to review and copy his or her patient records to the fullest extent permitted by the applicable Federal and State law. If under the law the therapist is not required to release the applicable records to the patient, but must, if the patient requests, release to a third party of the patient’s designation, the therapist must inform the patient of that fact

12. (Submitted by Makeitplainonline) A patient has the right to terminate treatment at any time if they feel dissatisfied in any way. (I think too many clients stay in therapy for long periods of time with therapists they feel bullied and badgered by, or simply feel that they are not getting anywhere. They need to know they can say no, enough is enough)

Did we leave out any essentials? Do you have an addendum? Should we get rid of anything? We want to hear from you!

In our book, Therapy Revolution, I strongly advocate for the use of mental health treatment plans for all therapy patients/clients. One therapist commented, saying that using a treatment plan during therapy was “rigid” and “unsophisticated” and that she liked to “go with the flow.”  She was emphatic—a treatment plan “constrained her creativity as a therapist.”

But therapy is not about the therapist.  It is about helping patients.  And, as we mentioned before, the greatest creativity is actually supported by structure, such as the Sonnet, Haiku, the use of the musical scale and chords, the mathematical rules, the rules of basketball, and so on.

Read on!