Thursday, October 11, 2012

The Infidelity Script

"The Infidelity Script"

Sadly, all too many of us find ourselves actors in this drama.  Something alerts us to the fact that a spouse has been unfaithful.  It can be almost anything, from a whiff of perfume that you don't recognize;  credit card receipts for dinners or hotel stays you never enjoyed;  jewelry or clothing that you never received; or changes in customary patterns of behavior that suggest that something's not quite right.

At first, you're likely to feel extremely confused, perhaps you even doubt your own sanity and assume you're just imagining things.  After all, your spouse would never do that to you and your family.  The sad reality is that many of our spouses do just that.  Reliable statistics are very hard to come by, as people are reluctant to admit to betraying their marital vows.  But, some of the best numbers suggest that between 40% and 60% of men and at least 40% of women in first marriages will engage in affairs.

Disclosure of an affair can happen in any number of ways.  Occasionally, a spouse will simply come forward--whether out of guilt or fear of being caught--and admit to an extramarital affair.  More likely, however, a guilty spouse is confronted about an affair and denies it initially.  Eventually, after being presented with sufficient evidence about his or her behavior, the spouse who had the affair will admit to something.  The admission, however, may only be partial and may be a distortion of what really transpired.

This is the point at which spouses may end up repeatedly contending with each other over versions of the truth.  The spouse who had the affair may still be engaged in protecting himself/herself or an affair partner, while the betrayed spouse may feel in his or her "gut" that there is much more to be uncovered.  The parallel processes of denial or "damage containment", and attempting to discover ever more of the truth, can go on for months.

Eventually, a couple reaches a place where they need to make a decision.  They'll either part ways over the affair, they'll work to build a stronger marriage, or they'll live in emotional limbo, where nothing is ever resolved.  Arriving at a decision can, in and of itself, take time.  The betrayed spouse may feel such raw, searing pain that she isn't sure she can put any effort into the marriage.  And the spouse who had the affair may become impatient and want to "just get on with it".

When a couple decides to work on the marriage, there's no denying that they're in for a bumpy road.  There will be glimmers of hope, followed by setbacks that lead the betrayed spouse to think that any "progress" the couple made was merely an illusion.  But that's the typical course of affair recovery--two steps forward and one step back,  for a while.  But the promising news is that they're still one foot ahead of where they were before.

Strange as it may sound,  in my clinical practice, I've seen couples, while scarred by an affair, come through it stronger, closer, and much better friends than before.  So, for those of you who are stinging from a spouse's infidelity, there is hope.





Saturday, October 6, 2012

Fantasy: Your Safety Net

In my clinical practice, I do a great deal of work with individuals who struggle with sexual issues.  They may have had an affair, or they may have imagined having one, perhaps with someone at work, a neighbor, or even an in-law.  As you can imagine, there is often a great deal of guilt associated with these thoughts.

Of course, such thoughts are what we usually refer to as "fantasy".  Just the mention of "fantasy", however, is enough to fill make many people with feelings of anxiety and guilt.  It's as if they had already acted upon the promptings of their imagination.  For instance, a patient may come into therapy and confess that he's obsessed with a female coworker.  When he and his wife make love, he's actually imagining having sex with the other woman.  And, consequently, he's consumed with guilt, as if he has betrayed his wife with a real-life physical and emotional relationship.

Now this is a tricky topic.  And people will disagree on whether or not this kind of behavior constitutes betrayal.  One of my rules of thumb for which types of fantasies are "safe" and which can be potentially damaging to a marriage or committed relationship is how much access you have to the object of your fantasy in real life.  If you're imagining being with Angelina Jolie or Tom Cruise or Brad Pitt or Kim Kardashian, then you're on relatively safe ground.  For virtually all of us, the likelihood that we'll even meet these people, let alone become romantically involved with them, is close to zero.  These fantasies, however, can actually help couples through rather stale periods in their marriage.  The fantasy of being attractive to and desired by a celebrity can maintain a sense of vitality and interest.

On the other hand, if you're fantasizing repeatedly about someone with whom you're in close contact--a coworker, a neighbor, someone you play on an office sports team with, someone with whom you volunteer for a charitable cause--you could be in dangerous territory.  After all, you have real and repeated opportunities for deepening relationships with these people.  You can begin taking lunches with coworkers more frequently; you can sign on for extra projects with someone who's part of a charitable organization; you can look for opportunities to interact more frequently with a neighbor, and so on.

And, then, of course, there are our day-time non-sexual fantasies.  These fantasies tend to revolve around issues of achievement, self-esteem, and self-worth.  They may have to do with professional accomplishments and how we're valued by our peers.  For instance, do we see ourselves as perhaps doing our bosses' job better than he or she does?  Such fantasies can inspire us to improve our performance in our own spheres of employment.

And so, fantasy is a vast emotional terrain that allows us to explore possibilities in different aspects of our lives.  We can play out different roles and with different people.  It's important to consider the extent to which sharing fantasies (with anyone but your therapist!) is appropriate, as that can be either threatening or enhancing to a relationship.  The risk of sharing fantasies, however, is a subject for another time.











“Home”

Most of us have a physical address, for example, 333 Main Street, Anytown, USA.  But where does our heart reside?  Is it where we grew up as young children, with memories of riding tricycles and our young neighbors?  Is it where we spent our adolescence, feeling those pangs of attraction for that cute boy or girl down the street?

By the time we’ve completed high school, our sense of home is fairly well defined.  Later in life, as we contemplate “home” , that will function as a reference point.  “Home” was a place where, regardless of how we had failed our parents’ expectations, we could still return.

But, as adults, we also create our own sense of home.  This may have to do with the part of the country we choose to live in, a spouse’s personal history and sense of place, the career path we follow, and decisions we make for our children, regarding schooling, etc.

The idea of “home”  has recently been very much on my mind.  My elder daughter married a few weeks ago, and the ceremony and associated festivities were all held in areas of a city where I used to spend a great deal of time.  And, this weekend, my husband and I are traveling in our motor home through parts of the state that were home to me for many years.

A strange sense of disconnect during these last two trips led me to ponder how we establish that sense of home.  A number of years ago, as I was going through a major life upheaval, I was elated to travel to the city that would become my new home.  The sense of exhilaration as I departed was unparalleled.  The return trip was agony, except for the awareness that I’d soon see my college-age daughters. 

This process went on for several months, until I had my new residence established and resolution of legal matters under way.  And so the transition from home in one city, where I had resided for many years and where my children had been born and raised, began.

I immersed myself in the professional community in my new city and experienced a great deal of satisfaction in that.  I made rewarding connections and found that exciting professional opportunities emerged from those.  And, so, my new city has become home in a very vibrant and promising way.  And yet, a trip through my former home is enough to powerfully tug at my heartstrings.  The moral of the story is, I guess, that we invest ourselves emotionally wherever we go, and that that’s just fine.

Friday, March 23, 2012

Who Are Your Friends?

One of my favorite radio talk show hosts is Dennis Prager. He is highly intelligent, provocative, and yet retains a wry, but benign, sense of humor. He isn't afraid to tackle life's big questions, such as the nature of God, the meaning of the Bible, and relationships between men and women. During my commute, I'll often eagerly tune into his show. Other days, there's so much noise in my head from my clinical sessions and any writing projects I'm doing that I crave silence.

Today, Dennis was hosting his "Happiness Hour", devoted to exploring various facets of contentment and positivity in life. His specific topic today was friendship and how and why friendships end. I was fascinated by his callers and their stories. What most captivated me were the stories of decades-long friendships in which eventually one friend encouraged the other to take a course of action that violated that person's moral compass, for example, to actually take a test for one's child so that he wouldn't fail a college course, or to abandon one's family and "just go be happy".

There is a saying that "Friends want the best for each other and bring out the best in each other." Several of the calls I heard on the show today seemed to fly in the face of that conventional wisdom. I'd like to encourage you, if faced with a friendship dilemma, to consider whether your friend has your best and truest interests at heart, or has some other agenda.

Monday, October 10, 2011

My Best Friend's Suicide

Right up front, I'll be clear that names and other details have most definitely been changed. Suicide is about pain, the kind that never goes away, for those left behind. The last thing I want to do here is inflict more pain by exposing personal details that could reveal identities.

Several years ago, my best friend of twenty years killed herself. We had done our psychology internships together. Although we came at the practice of psychology from different perspectives (she was strongly behavioral and I was much more psychodynamic at the time), we had many stimulating discussions about our work. She and her husband also became an integral part of our family and became "Aunt Sheryl" and "Uncle Gary" to my two young children.

Gary was a physician in a fast-paced high-pressure trauma center. Years in that setting eventually wore on him, and he took a job with a small practice in northern California. Sheryl moved out there after handling the sale of their home on the east coast. She had practiced psychology only intermittently after internship, and hadn't completed the requirements for licensure, so still had to be supervised by others in her work. She spent the rest of her time in community and charitable work.

The move to California was hard on Sheryl. She was thousands of miles away from family, had no friends there, and no professional identity. While she had had some vague physical ailments over the years, her health took a definite turn for the worse after the move. Gary spent much of his free time researching possible diagnoses, but to no avail. To say that he became frustrated is to put it mildly. Sheryl, on the other hand, became quietly despondent and withdrawn.

The details of the night I got the call is forever seared into my brain. As soon as I heard Gary's voice, I knew Sheryl was dead, but I instantly assumed it was an auto accident. As he went through the details of coming home from work and finding her body, I was enveloped by a whirlwind of emotions--indescribable pain, anger, loss, bewilderment. I also knew that my life was forever changed by her act.

As Gary and I talked by phone during the next few days, more details came to light--the manner of death, how Sheryl had staged her death scene, the amount of planning she put into her suicide, and that Gary was even briefly considered a suspect in her death. To make matters worse, her family back East also accused him of somehow being responsible for her death, that perhaps he had neglected her after the move or hadn't done enough to ease the transition for her.

I was ready to get on the next plane and head to California to be with Gary and help him with whatever arrangements needed to be made. He asked me to wait a couple of months until he felt ready to face the task of going through her possessions. Of course, I honored that and actually shared a very special time with Gary when I finally did visit. He turned over the task of sorting her belongings to me. We sat around and talked and laughed and cried. Gary and I remain good friends. He has remarried, a very special lady who has introduced him to an entirely different way of life.

The thing about suicide is that, so often, you never get what it was really about. Sheryl left a very lengthy, cryptic letter to both Gary and me. I read that letter over and over on my way home to my family. I concluded it actually raised more questions than it answered, and I even wondered if that was Sheryl's intent in writing it. Certainly Gary and I kept second-guessing ourselves. What had we missed that might have saved her life? I read and reread her emails to me over the last few years of her life to see what was between the lines that I didn't pick up on. And I found nothing. I don't know whether that was a blessing or not. To think that I might have been able to do something, but failed to do it, would have flooded me with a sense of lifelong guilt. On the other hand, to find no clues as to her state of mind, what the tipping point between life and death was for her, has left me with a sense of helplessness that I'll carry forever.

Monday, September 12, 2011

The Intimate Hour (Part II)

What is a patient looking for when he or she comes to therapy? My experience is that, in general, he has tried everything he knows to do in dealing with an issue. He has exhausted his own personal resources. But making that initial call can be fraught with anxiety. The patient has delayed it and delayed it, while he struggles along with the situation. Admitting that you're unable to resolve a life problem on your own, that you'll have to address it with a stranger, can be a daunting prospect.

A patient is seeking first and foremost understanding. Whether in therapy or not, each of us ultimately wants our life narrative to be heard. Whether it's someone wanting to share her rage at her husband's infidelity; a person isolated and in the throes of hopelessness who writes a suicide note; or a serial killer who eventually feels compelled to describe his horrific crimes; we all desire for at least one other fellow human being to hear our story and understand our motivations.

A patient is seeking acceptance. The slightest whiff of judgment will taint a therapeutic relationship. The therapist must have a very high tolerance for dealing with attitudes, behaviors, even lifestyles that he does not personally endorse. If he struggles with this, it behooves him--and is in his patient's best interest--to either do some work in therapy himself regarding his discomfort, or to make a referral to another therapist.

Most patients are seeking some specific means for effecting change in their lives. For all but a few, gone are the days when an individual can spend an hour a day, four to five days a week, on a therapist's couch. The vast majority of today's patients come in with a specific problem or problems. Pursuing self-actualization in therapy is a luxury that few can afford. To that end, as a new patient and I wrap up our intake session, I help them formulate and prioritize their goals for therapy. The question might be something like, "What would you like to be different in your life as a result of coming here?"

Finally, patients frequently need what I call a "takeaway". This can be something as specific as an "assignment" to journal, to chart behavior (e.g., eating, exercise), to take turns planning special events with a spouse, to read certain portions of a book or listen to a podcast, to contact an estranged family member, to think about their goals at work. You get the point. A small task or bit of information at the end of a session can reinforce the work done in the session and enhance the patient's sense that she has gained something positive and concrete from her work in therapy.

The Intimate Hour (Part I)

The process of psychotherapy is as different as each therapist-patient combination. The chemistry between patient and therapist is undeniable and plays a key role in the process. My approach has been to address each patient as an unfolding life story, with its own unique narrative, and not as a diagnostic exemplar. As we work together, I listen for and identify recurrent themes, with their moments of triumph, as well as depths of despair; with their areas of strength and resilience, and their places of weakness and flagging hope.

As a therapist, my job is to assist the patient in writing a new chapter in his narrative. Perhaps his past has been marked by repeated failures at valued tasks. Perhaps her undertakings in life have been tinged by fear and self-doubt. The therapist is a companion on the patient's journey of self-discovery and healing.

As the companion on the patient's journey, I look at the elements of the patient's life as the pieces of glass in a kaleidoscope. When the kaleidoscope is held in one way, one picture emerges. However, when the patient rotates the kaleidoscope, a different picture comes into view. And with that different picture come new possibilities. New ways of understanding what has gone before in one's life and what could lie ahead. And this is where the therapist brings her experience and psychotherapeutic tools to bear.