When life hands you lemons and you can’t make lemonade

Has anyone ever told you to simply turn a negative into a positive? Maybe people have told you to get over it, move on, keep your chin up, or let it go. At some point someone may have suggested returning unfavorable actions with kindness, acting happy when you were not, or being pleasant despite unpleasant circumstances.

Is this kind of feedback actually helpful? Here are some thoughts on this manner:

There is some value in being able to shift perspective, look at the bright side, or even create positive emotions by doing things that are enjoyable and pleasant. It can also be quite beneficial to “shift gears” by getting your mind off your problems and distress, see things differently, or look at the bigger picture.

Sometimes, however, when the focus of our attention is always on the “positive”, it can prevent or inhibit us from fully experiencing emotion, approaching or addressing conflict in an adaptive manner, and having those “difficult conversations” in which disagreement means risking sharing what we really think and feel. Sometimes focusing on the “positive” can create environments in which there is very low tolerance for negative emotion, pain or sadness is never acknowledged, and people remain isolated in their inability to connect more deeply with each other.

However, the other extreme for this situation can also be that persons are chronically down, depressed, moody, irritable, or aggravated. Sometimes emphasizing or holding onto these experiences are a testament that pain exists, that pain is real, and that the world should acknowledge it more. Sometimes people get “stuck” in these places, however- and have considerable difficulty shifting out of it.

A full, rich, and meaningful often involves the ability to connect to others in a meaningful way, to express vulnerability and not be alone in our pain, to take emotional risks in sharing what matters, and to (also) show up for the pleasant, mundane, simple, and joyful experiences that life has to offer. This means neither getting “stuck” in painful emotions nor living a life of hiding, masking, “sucking it up”, or denying what is painful. In reality, emotions come and emotions go. Sometimes they are intense and sometimes they are extreme. The key is to allow them to be there when they come and allow them to leave when they are ready to go. When we can both acknowledge our own pain and participate in the happiness of what life offers (taking into account the truth of both perspectives), we will have better ways of managing the lemons of life.

Parenting the adolescent, DBT, and dialectical dilemmas: From Miller, Rathus, and Linehan

In 2007, Alec Miller, Jill Rathus, and Marsha Linehan published Dialectical Behavior Therapy with Suicidal Adolescents. In the book, they outline specific dilemmas related to adolescent development. I think their work is quite clever and clearly fits the dialectical theme: Two opposing concepts can both exist at the same time, people can get “stuck” in extreme polarities, one extreme does not negate the existence of the other extreme, a person has to look for the truths in both extremes in order to get unstuck, and the “middle path” is a place where both parents and adolescents to be understood and acknowledged.

The extremes that parents of adolescents can get stuck in include the following: Being too loose vs. being too strict, making light of problem behaviors vs. making too much of typical adolescent behaviors, holding on too tight vs. forcing independence too soon (page 308).

One of the assumptions in DBT is that clients are doing the best they can. This assumption is held for both parents and teenagers. Parents sometimes parent with an intention to give their children what they didn’t have or prevent their children from making the same mistakes they’ve made. The pain of “letting go” and watching their children become more independent, make decisions, and be faced with extreme consequences can be hard. Sometimes parents can get stuck in extreme ends of these dialectical dilemmas because they are trying so hard to be the best parents they know how to be.

Consider your own childhood for a moment.

  • How did you experience your parents (in terms of polarities) as a teenager?
  • Where do you see yourself as a parent now?
  • Where do you think your teenage son or daughter sees you? Where you see yourself and where he/she sees you may be very different.
  • Consider what kinds of things get you to move towards one polarity or another- and what gets you to move closer to the middle.
  • Consider the consequences (including the impact on relationships) of being in the extremes.
  • Consider the necessity of both extremes- and how they can be effective vs. ineffective.

Are your walls keeping people in or keeping people out?

With crisis comes vulnerability. When the unexpected happens, we are often confronted with the limits of our mortality. We realize that we can be deeply affected and influenced. The walls that we build around us get shaken, questioned, or torn down.

Fear is on our horizon.

Sometimes, when we are really scared we try to build more walls. We don’t want other people to see us. We snap at people we care about and become strict with ourselves about who sees our pain. We deny our pain to others. We can’t let other people in. We make promises to ourselves that we will never be that open, intimate, or invested in a relationship again. We can’t let other people care about us, and we become calloused to influence.  We aren’t able to receive compassion or see how much alike we are.

Last week I read a post about some people who were trying to make sense of 9/11. This book really touched me when I read it. Ultimately, there was a question of what walls we wanted to build. And in general how much of the world we want to let in. Surviving a crisis forces us to consider those questions.

Sometimes disappointment can be so unbearably painful that it makes sense to be a little cautious. On the other hand, allowing our fear to dominate our ability to be human, to make mistakes, to feel pain, to take risks, and to be vulnerable can prevent us from experiencing intimacy and connection.

Are the walls you build keeping you safe and protected or are they preventing you from reaching out, taking risks, and having a fulfilling and meaningful life?


What is mentalization-based therapy?

Last week I had the opportunity to observe a mentalization-based group therapy. Mentalization was developed by Peter Fonagy and Anthony Bateman and is the only other treatment (besides DBT) that has strong empirical (scientific) support for treating borderline personality disorder.

What exactly is mentalization? This is my own attempt to describe what I know about it so far: We are constantly making interpretations about the intentions of other people, and we tend to be pre-occupied with their intentions towards us.  When we assume the intentions of others we think we “know” what other people are wanting, thinking, or feeling. While sometimes this is perceptive and accurate, poor (or inaccurate) mentalizing can often exacerbate conflict or add stress to relationships.

Consider the following scenario: You are late to work. Consider what your reaction might be if your employer insisted that the following scenarios are true:

“You must really hate me. You do hate me, don’t you? Why don’t you tell me why you hate me so much and we can get everything off our chests. Come on. You can be honest. Tell me what your problem is with me.”

“You think you are too good for other people. What makes you think you are better than everyone else? If you think you are better than everyone here, then maybe we should give you extra work so you can keep proving to the rest of us how important you are.”

When other people do not “mentalize” accurately, it can increase defensiveness and emotional arousal. And talk about being misunderstood! When other people insist that their interpretation of your behavior is accurate (when it is not), it makes it more difficult to keep emotions on an even keel and steer clear of more conflict. Can you think of a time in which this has happened to you?

In a mentalization-based group, group members are encouraged to generate many “interpretations” of reported or observed behaviors. Some of these “interpretations” may be accurate and some may not. Some may be entirely out of this world! Attempts at accurate mentalization (“You must have been really taken aback when your boss said those things!”), may increase understanding, lower emotional arousal, and enable a person to use the group for perspective-taking and problem solving. Additional benefits include seeing things from a wide variety of viewpoints (What might have been going on with your boss that day?), considering things that have not been previously considered, increasing compassion when others misinterpret intentions, and staying level-headed when there are strong urges to engage in extreme ways of responding.



The dialectics of depression

Dialectics has to do with the concept that two seemingly inconsistent or incompatible ideas can both be true. Conflicting realities have elements of truth that can both fit together despite being conflicting. One is not more true than the other, and one is not more true at the expense of the other.

The treatment for depression generally involves behavioral activation- taking some sort of action to increase contact with pleasurable events or rewarding activities. Depressed people become easily overwhelmed, tend to avoid people and activities, and withdraw from life. This inactivity also decreases contact with naturally rewarding interactions.  The agenda of behavioral activation is to get people engaged with with people, activities, or events that generate pleasure, give meaning, and provide a sense of accomplishment. Without these things, it kind of makes sense that people get depressed. So the message is essentially: Put your energy towards getting active, engaged, and connected!

On the other hand, people who are depressed often feel a great deal of misery. Often they struggle with unreasonable guilt and low self-esteem. They may have made multiple attempts at making connections and have had bad experiences.   They may have reached out and been punished for it. They may feel so bad about themselves-and have worked so hard on changing who they are- that they got lost along the way.  They may have stopped liking themselves because they worked so hard to make things different. They may have become exhausted at the prospect of change. They may have a very strong need to be accepted as they are- without having to do something, keep changing, and keep trying.

Do you see the dialectic? 1) Changing behavior is a part of the treatment for being less depressed. Get involved! 2) Don’t try to be or become something that you are not. You are fine just the way you are!


A note on dialectics and relationships

Person A is described as miserly, grumpy, short, and abrupt. We’ll say that Person A doesn’t offer any extra information when asked personal questions, rarely smiles, and almost never makes eye contact.

Now, one way of responding to this situation is to simply say that Person A is kind of a jerk. You could sort of see how Person A is pretty unlikeable, and you could even kind of get yourself on a non-liking tangent.

While being on the non-liking tangent may have some benefits to you, it actually may not help you solve interacting problems with Person A. If anything, it may make interacting with Person A slightly worse- if not downright uncomfortable.

Assuming that Person A is someone you can’t avoid, and assuming that you could get more relaxed and self-confident around people that drive you a bit crazy- you’d probably have to do something besides walking around thinking that Person A is a jerk.

Thus consider alternative interpretations of Person A’s behavior. Start with the potential benefits of “miserly, grumpy, short, and abrupt.” I would have to guess that Person A is not a time waster- he probably doesn’t like to chit- chat. This in turn might mean that he is more efficient, which could be an attractive trait to some.  He probably also doesn’t have a lot of people around that bug him very much. Who knows? Perhaps he likes his privacy. Perhaps he is lonely. Perhaps he didn’t grow up with a lot of easy going personalities. Perhaps he grew up around people that were really harsh and abrupt with him.

You see how coming up with different interpretations for Person A’s behavior can change your feelings about Person A? Alternative explanations might provide understandable reasons for behaviors that may be hard to understand. And when we can be more understanding, we can be more accepting of ourselves and of others.