Steven J. Bartlett

“ As we will see, a few approaches to counseling and psychotherapy preserve, to some extent, the traditionally passive role of the patient. Most of them, however, require a good deal of initiative and just plain hard work on the part of the patient or client.
In building the house of one's life or in its remodeling, one may delegate nothing; for the task can be done, if at all, only in the workshop of one's own mind and heart, in the most intimate rooms of thinking and feeling where none but one's self has freedom of movement or competence or authority. ”

“ We are all inheritors of a tenacious past: the influences of past events have a certain power over us, and we must either resign ourselves to being controlled by the past or fight its influence. The attitude we take toward the past will usually affect how we meet the future, often diminishing our freedom to change old habits and undermining our hope and faith in ourselves.
For example, if Jeff blames his limitations today on his parents, on the ways they influenced him, he may set goals for himself that are far from being freely chosen. ”

“ For such people, anxiety, depression, and loneliness can be especially devastating because they have walled themselves in to such an extent that emotional growth and change are blocked.
Yet most of us share, to some extent, this belief in self-sufficiency. It is one of the most tenacious forms of self-imprisonment that we have available to us, literally at our own disposal. It is a prison we often take great pride in. Pride, control, and self-sufficiency are usually close friends. They keep us from having real friends and stand in the way of our being good friends to ourselves. ”

“ Sometimes a therapist can help clients become aware of their deep-seated but habitually ignored feelings of warmth toward one another. At other times, marriage therapy may lead to separation and divorce, if a couple comes to realize that their goals really are not compatible and what each needs or wants from the relationship the other is not able or willing to give. Marriage therapy and family therapy are not magic wands that can be waved over trouble to make things better. ”

“ It can create the bars of a prison, a grillwork of defenses that stands between us and others who are able to offer encouragement, warmth, understanding, and direction.
There is no lonelier person than someone who has decided to take his or her own life. The decision is the ultimate form of self-isolation. It is the ultimate admission that one's imprisonment is final and that there is no escape. ”

“ Caught up as most of us are in our jobs, families, and daily worries, we are unaware that, in a very real sense, mental and emotional health problems have assumed epidemic proportions. If you bear in mind how fearful our society encourages us to be of admitting such difficulties, you can perhaps imagine how substantial the "iceberg" of psychological suffering is: most of it lies below the waterline of public consciousness.
The NIMH study results should encourage you, if you suffer from personal emotional difficulties, to realize that you are not alone in the problems you face. ”

“ Congruence means a close match between what you feel and how you think and act. Congruent people are well integrated, no longer in need of "masks." When we admire a person's sense of "integrity," we often feel that the person not only behaves in ways that show self-respect, but that he or she is self-accepting, is genuine, and appears to be comparatively free of inner conflict. Such individuals are, in short, able to be themselves. People who no longer are engaged in a battle against themselves and against others will tend to show congruence. ”

“ For some time now therapists have recognized that a client's personality often tends to incline him or her toward certain approaches and away from others. In the second step in identifying a potentially promising approach to therapy, you are encouraged to take traits of your own personality into consideration. It is not merely the goal or problem that suggests a particular approach to therapy, but—what is often more important—the nature of the person. Too little attention is given to the appropriateness of an individual for a given kind of therapy. ”

“ Techniques of meditation share the goal of disciplining the mind to do one thing at a time. Until you have made a serious attempt to meditate, you will very likely be unaware of how perpetually distracted your attention is. We seldom make the effort to stand apart from our thoughts, to take note of how numerous and varied they are and how chaotically they tumble into and out of our consciousness. ”

“ I sometimes will give myself a treat, something I never used to do. I will buy myself something that maybe is a little bit frivolous, but I think of this as my own therapy. I feel better about myself and deny myself less. ”

“ The responsibility lies with him who suffers, originates with him, remains with him to the end. It will be no less his if he enlists the aid of a therapist; we are no more the product of our therapist than of our genes; we create ourselves. ”

“ To ignore all except those that are physical would be like saying that we are only bodies, without feelings, without humanity.
When you are in pain, whatever its source and kind, pay attention to it! Pain is often what points to a better life. ”

“ The therapist does not associate positive regard with implicit conditions of worth that the client must satisfy. In other words, client-centered therapy attempts gradually to reverse a habit that has come to undermine the client's sense of self-worth. It is a habit that we all, to differing degrees, develop as parents and society teach us to relinquish self-acceptance in favor of the conditional love or appreciation of others. Eventually, the habit becomes so ingrained that it can jeopardize our own feelings of self-esteem. ”

“ If fictitious treatment by a mock therapist works as well as treatment provided by a man or woman who has trained long and hard for a Ph.D. or M.D., wouldn't you feel ill at ease—perhaps very much ill at ease!—charging your clients $75 to $100 an hour for your time for a service that is no better than none at all and may even cause your clients to get worse? ”

“ Therapy is a temporary crutch or a cast in which to heal, a comfort, a source for renewed faith in yourself, and an experience of learning. It cannot solve all the problems of future living, for these pose new challenges that require of us all that we readjust our goals and expectations, become more resilient and less easily troubled or broken. ”

“ But psychiatry goes a step too far when it claims that people who become emotionally helpless, hopeless, lonely, or agitated are actually sick. Szasz claims that they are not sick; they are helpless, hopeless, lonely, or agitated. These are not "illnesses" but, rather, some of the tragic conditions of life. They are problems of living. For Szasz—and for therapists like Viktor Frankl and Alfred Adler—psychological problems resemble "moral problems" much more than they do "physical diseases." ”

“ Some clients, in spite of what they say, do not really want to change. Their habits are deeply ingrained, serving purposes they may be only dimly aware of at the beginning of therapy. Sometimes it becomes necessary in therapy to reappraise the goals that have been set. The decision to pursue a certain course of change may result in so much anxiety and upset that both therapist and client must pause to reconsider. Some changes may turn out to be too difficult, too taxing; some clients may be unwilling to put in the work required to bring about a certain change. ”

“ If you are in emotional distress, you may have to face a dilemma: whether it is prudent to try to conceal your difficulties from people because you believe that some of them may judge you harshly and critically if they find out you are in therapy, or whether it is likely that they would understand, and perhaps even sympathize, if you were able to be open and had the courage and self-confidence to help educate others on a psychological level. Unfortunately, people in real emotional distress don't have the energy, the courage, or the self-confidence to fight social battles! ”

“ Like the Gestalt of the psychologists, the closed Gestalt of therapy signifies an organized whole. In the example, the man suffering from thirst in the desert has a Gestalt that impels him to find water. When he does, his thirst is satisfied, and the Gestalt is resolved into a whole that no longer stands in need of completion.
Perls saw life as a succession of unfinished situations, incomplete Gestalts. No sooner is one closed than another takes its place. To cope effectively with living, we must be able to deal with life's problems and challenges, yet not all of us can. ”

“ After regular practice over a period of months, many people, when they face a suddenly upsetting situation, can quickly offset their emotional and physical reactions to stress by inducing a calm and relaxed state in themselves. They are able to neutralize the stressor's potential for doing damage. If you can learn to do this, you have learned a skill in controlling your own life that is of great value. It is a survival skill that can help you protect yourself against being worn down by stressful events that otherwise eventually lead to learned habits of anxiety and tension. ”

“ If so, you have defined an objective that you may use to decide what type of counseling or therapy may be a most promising first step.
What I am suggesting is that an obstacle that makes it hard for you to gain a sense of direction can itself point you in a direction. If there are blocks, it can be helpful to meet them head-on. In therapy, the phrase working through a problem often means exactly this.
Choosing what kind of person you wish to be is a process, not an event. It is not something that happens and then is over. Choice is something implicit in each day of your life ”

“ When you do not immediately get what you want, can you tolerate fairly well what may seem like a long route to get where you want to go? (Do you cope well with the frustration of getting lost in your car, for example?) Can you tolerate, without serious irritation, anger, or hurt, being pushed to confront some of the pretenses or distortions or illusions you may have lived by? ”

“ Cantwell then asked Anne to think of a way she could reply to her mother's "nice" criticism, without feeling bad about herself, without "getting hooked."
ANNE: Well, one way you've taught me would be to use humor: I could say to her, "Mom, anytime you'd like to come over to do the dishes, it would be fine with me." And then laugh.
DR. C.: That's a good approach. But you don't want to be offensive; you don't want to laugh mockingly. How you do this is important. You want to set a good-natured feeling. Humor can be very useful to offset the sting of criticism. ”

“ It can sometimes take more strength and courage to break free from a pattern of frustration and unhappiness than to remain on, slowly wearing down your resources and growing older fast.
Much of successful living after therapy is a matter of prevention: of being aware when you begin to tax yourself more than you need to, when your body and mind begin to tell you that you are developing new habits of anxiety or depression or are starting to reinforce old ones. At these times, take stock of what you are doing, of how your daily living may be in conflict with your values and attitudes. ”

“ Some people are more amenable to certain approaches to therapy than others; for example, some people like and benefit from group therapy, while others hate it. Sometimes what a person likes or would prefer needs to be overlooked in favor of treatment that is believed to be effective. But the vast majority of people who enter therapy do this of their own volition. If the therapy they enter is unsatisfying or downright distasteful to them, they will soon give it up. We simply tend not to learn and profit from experiences we dislike or that don't fit the kinds of people we are. ”

“ The greater our sense of responsibility—the more we emphasize personal control over our inner and outer affairs, the more we see ourselves as individualists whose individualism is based on strength of will, discipline, guts—the more we are trapped by the myth of self-sufficiency. ”

“ The clearing of consciousness, the ability to find a central focus within, the delight of a clear mind, the sense of refreshment of the soul are reported both by those who practice meditation and by long-distance runners. The difference between the two techniques is in the physical effects of the running. It is as if those who meditate have found one half of the picture. The runners who just compete and do not reach for the psychological aspects have found the other half. The runners who are able to slow down and search for the psychic aspects will have both—the soul and the body. ”

“ You must not manage your life just to avoid the potentially critical judgment of people who are ignorant of, or who refuse to acknowledge, the realities of human psychology. You can feel sure that among well-informed people, if you have had to deal with alcoholism, drug abuse, a difficult {16} marriage, job depression, or any other "psychological" problem, you will be thought to be just as "respectable" as if you had coped with major surgery after an automobile accident. ”

“ In fact, very seldom are the details of therapy divulged to others without a client's advance consent. Most of us do not need to be worried by legal exceptions to confidentiality: most of us are not actually homicidal (though we may feel very angry at times!) ; most of us are not determined to take our lives (though we may at times feel very disheartened) ; most of us are not concerned that a court will order us to be examined by a psychiatrist. ”

“ When the family decides to enter therapy, it is usual for family members to feel troubled, scared, and confused. They realize that something is wrong, but they are uncertain about what is amiss and don't know what to do. The usual response to this perplexity is to push the "identified patient" forward—usually a child who is "the problem"—and try to make him or her the focus of treatment. ”

“ Animals do not practice medicine, though many species are capable of offering moral support and even a certain amount of physical assistance, as in the case of a sick whale who may be supported by its fellows in the water in order to breathe. But only we have developed medicine, and we have more recently begun to develop ways to treat problems that affect our emotions, attitudes, and behavior. When individuals, perhaps instinctively, distance themselves from others and bottle up their malaise, they turn their backs on the educated assistance and goodwill that are available. ”

“ Positive thinking can undermine a client's already shaky confidence if he fails to achieve the goals that positive thinking led him to expect.
These are undeniable shortcomings of therapy. They can reduce the effectiveness of therapy, or negate its constructive effects, or even cause clients to accept the therapist's belief that their condition is worse than they thought and so persuade them to feel, and to be, even more troubled. ”

“ It is obvious that individual responsibility is central to existential therapy. You are responsible for the person you choose to become. You may choose to be genuine, or you may choose to lie to yourself and others. It is when you abdicate responsibility for becoming authentic that you will often come to feel anxiety and a sense of guilt. Anxiety and guilt are often present, in other {147} words, when there is a fundamental lack of congruence, of being whole, of being in accord with yourself. ”

“ Specifying clear-cut goals and understanding why you feel troubled are not essential now. Certainly it will be helpful if you can translate vague complaints into concrete problems, to help both your own understanding and eventually your therapist's. The more specific you can be about what is troubling you, what situations especially distress you, and what has motivated you to come to therapy, the easier it will be for you to find help and for the therapist you choose to help you. But in times of crisis, clarity can be very hard to gain, so be patient. ”