Thursday, January 20, 2011

Monday, January 17, 2011

Sandboxes and stones

Often in my work, as many therapists do, I use metaphor to help clients access and articulate emotions that otherwise they could not express. Today I came across one that I found moving – it was the metaphor of a sandbox, and how a partner, the boy, could not get in to the same sandbox with the girl – who was sadly, instead, throwing stones and keeping him and others out. I found that powerful. It spoke to me of child-like longing for connection, it spoke to me of loneliness – I saw this boy wanting to play, wanting to join her in the sandbox – but being prevented from doing so out of a need to protect himself. I saw a sad little boy. Conversely it was easy to imagine the sad little girl in the sandbox, so afraid is she that she needs to keep everyone out. Yet that loneliness that she experiences just exacerbates her pain, her mistrust of the world so she throws those stones with a passion that would knock Goliath out.

Who do you allow into your sandbox? Who do you allow to see your playful side? Your fearful side? Who would you throw a stone at? Who might you lay them down for? How might you reach across the sand to someone to quell their fear long enough that they might hear you say hello, it’s me, it’s ok? How do you trust that another stone won’t come hurtling toward you?

When I think about my own experience I recognize my own stone throwing going on when I worry I won’t be taken care of. So I see now that when I am vulnerable, and while it totally defeats the purpose, that is when I decide it’s time to pick up my stones and prepare to throw … just when I should be saying please come in and join me.

We are curious creatures are we not?

Monday, January 10, 2011

The Invisible Elderly

Over the holidays I had the sad misfortune.. wait let me correct that, my father had the sad misfortune of coming down with the Flu and needed to be hospitalized – on New Year’s Eve no less. When I arrived at the hospital, it seemed there were a disproportionate number of elderly suffering from dementia there – apparently also with a Flu bug.

My father suffers from Vascular Dementia. He has been on a steady decline for well over ten years now. I feel compelled to say I’m lucky because my father is compliant, easy to care for, not moody or aggressive, does not wander, yet, and in general has been more or less stable. He lives in a residence for like-afflicted folk who can get themselves to the washroom and the dining room.

Back at the hospital, the nurse tending to my father was trying to put in an IV for hydration, as he had ripped out the one before. At the same time, an elderly lady stationed next to my father was growing ever more agitated. Her dementia seemed farther along than my dad’s. She had a beard – this indicating to me that a certain level of care might be missing. There was no one there with her. She was becoming agitated because there were hospital products on her table – gauze, ointment, and so on.  The things on her table didn’t belong there – rightly so. However, no one was responding to her. No one was indicating that she was there, speaking, had a problem .. nothing. I wonder how it might have taken away from my father, had the nurse turned and said I hear you, I’ll be with you in a moment, or barring that .. how about making eye contact, smiling, nodding?

There is still a bias out in the world toward the elderly. Working for a year in long-term health care – with a population mostly stricken by Alzheimer’s disease, sensitized me to their plight. People don’t want to see the elderly, don’t want to acknowledge the decline, they see in their loved ones their own mortality. Family members of those with Alzheimer’s often admonish their loved ones for forgetting – but the stricken are not in control of that.

There is a wonderful book out – Learning to Speak Alzheimer’s, which explains to readers how to be where the loved one is. While it acknowledges the importance of the many losses, the author’s focus is on what remains of the person, what the person can still do, and on being respectful of those strengths. The author reminds us that while a person may forget how to lift a leg to get into a tub; affection, love and care still register deep within a soul and should not be forgotten.

How lovely would it be for the professionals among us to learn this as well? Everyone deserves respect. If it were to have been a healthy young person in that bed beside my father, expressing concern about something an orderly had left behind – do you imagine the nurse/doctor would have responded? I’m inclined to think yes.

Let’s stop making the elderly invisible.


Sunday, January 2, 2011

The problem with the Narcissist

I was recently invited to discuss the psychological themes in the play Lies My Father Told Me, with the director for a production at a local theatre.

Without getting too much into the story – “Lies” revolves around a family growing up in post-depression Montreal, where the father could be classified as suffering from “Narcissistic Personality Disorder”.  According to the DSM IV, Narcissistic Personality Disorder is described as being “excessively preoccupied with issues of personal adequacy, power and prestige and includes a pervasive pattern of grandiosity, need for admiration, and lack of empathy”; this lack of empathy being the hallmark, in my opinion, of the Narcissistic Personality Disorder.

In Co-Narcissism: How We Accommodate to Narcissistic Parents by Alan Rappoport, he states that a large percentage of the population that come for therapy are people who have had a parent or partner with narcissistic tendencies if not out right disorders, thereby speaking to the universality of this experience.

I wonder if readers can relate to Annie’s (the wife) experience when engaging with Harry (the Narcissist) in “Lies My Father Told Me”. Annie is always shown to be “caught up” in Harry’s “energy”. Narcissists are like that, aren’t they? Charismatic, entertaining, boisterous even, looking for you to see them, recognize their greatness, cheer them on. Narcissists get excited, they love to be in the spotlight, to be the centre of attention, they crave it as a matter of fact. Their excitement is often contagious. You see Annie dancing, joyful, excited … when Harry withdraws and begins to sulk, she is left hanging. In one scene she even breaks down and weeps. I think Annie speaks to the universal experience of emptiness in a relationship with a narcissist, which is most often the reflection of the narcissist’s own deep emptiness. Narcissists can not feel empathy – so they can not really connect emotionally, or engage. This feels to the “co-narcissist” as uncaring, selfish on the narcissist’s part, and empty.

I had a colleague who was definitely a narcissist. I very much used to like this person. Of course I would, their energy was what I grew up with. I was comfortable around the gregariousness, the excitement, the self-aggrandizement. And yet, and yet – after every exchange with this person, I felt flat, empty, and sad. Because no matter how I spun our exchange and interaction, it was never between us – it was never for me, it was never reciprocal. After a while I had the clear image in my head that as soon as the person turned away I was out of sight, out of mind, and out of heart – presuming I was ever there in the first place – and I’m pretty sure I wasn’t.

Many of us who grow up with a narcissistic parent grow up with this emptiness inside ourselves. We question our own value and worth. I remember my own experience, always feeling like I needed some “hook”, some incentive, for a person to want to be in a relationship with me. I needed to offer something, give something of myself, little regard what I got in return. A dear friend and colleague of mine saw through this. When we first began our relationship I remember offering her my help with her computer, I could do this for her or that for her. Please, I begged, let me do something. I remember one day, clear as a bell, being on the phone with her – offering, offering – and her saying “No Heidi-Pie, I don’t ‘need’ anything from you, wanna go for coffee, wanna talk?’” – and I remember the image in my head of me standing there, in my mind’s eye naked – that is how vulnerable I felt being looked at not for what I had to offer but just for me. That was a pivotal moment in my life. That someone would want to engage with me, just for the sake and loveliness of engaging with me, that was a real gift. That I allowed myself to engage, feeling that vulnerable, was possibly my first real gift to myself. I know now I am worthy and deserving of real connection. Know that you are too.