How Do I Approach the Process of Change, and How That Can Work For You

Why We Are Never Alone, But Too Often Lonely

There are an infinite number of ways to be lonely. Struggling with heavy depression or insurmountable anxiety. Facing empty days following the ending of an important relationship. Waking up to empty days in a relationship that has for a long while seemed entirely hollow and empty. Finding temporary refuge in a bottle or through a mind-altering substance only to face far too soon the lonely reality of the temporariness of the escape from emotional pain that the substance offered. Counting the days until the next imaging study’s results that will confirm or disconfirm our worst and unique fears about our suddenly threatened prospects for a satisfying and fulfilling future. Wrestling with daily pain, which is entirely invisible to others and yet all-consuming to the person who suffers with it.

These descriptions are the shorthand for the multitude of concerns that my clients have brought to my attention as a clinical psychologist, neuropsychologist, and behavioral medicine specialist, over the last 35 years. Each of the individuals and couples I’ve had the privilege to meet present their concerns in unique and uniquely personal ways. Nevertheless, the infinite variety of concerns people bring,  there are several core assumptions that shape my clinical, teaching, and training work beyond the particulars of their troubles. Those assumptions are rooted in my professional experience, my decades of study of our contemporary, science-based understanding of our brain, mind, and body, and are informed by my ceaseless efforts to extract timeless truths from the world’s wisdom traditions.

In brief, while we are often lonely, we are never truly alone. Each of us is a walking, talking, living, breathing, dynamic ecosystem, that is forever interacting with other dynamic ecosystems. That is true of our biology, our psychology, and our social nature. Our physical and mental health ultimately derives from the nature of the internal relationships that regulate the 30-trillion cells that comprise who we are. Also, we are always interacting within ourselves consciously and non-consciously across the sulci and gyri of our richly textured brain. We are inescapably immersed in a social world filled with many other social beings who influence us and are influenced by us in return. Even more so, we are embedded (or embodied) within a global ecosystem with which we have co-evolved over billions of years. We still carry the imprints of these evolutionary influences in everything from our sleep patterns, metabolic health habits, genetic predispositions, and psycho-emotional preferences that all exist to keep us as safe and secure as we can be.

None of these influences guarantees our happiness, success, or health. Life can be and often is an intense struggle. These influences do, however, leave us richly resourced creatures, whether we recognize it or not. The challenge is to learn how to best utilize those internal and external resources in ways that support personal, social, and general relational health. For nearly 40 years, mining and channeling those resources in positive, adaptive, and satisfying directions has occupied the epicenter of my professional work.

I remain skeptical of “new and improved” therapies that too often yield empty promises. I too often find that “cutting edge” approaches are little more than offers of “old wine in new bottles.” This is because while 100,000 years have passed since modern humans appeared on the earth, in certain critical ways, we haven’t changed that much even as our life circumstances have changed enormously. Cro magnon beings could only gaze up at the moon. Today’s humans walked on it. Still, our biological wiring remains largely the same as theirs. Our primal needs for safety, security, and stability remain essential to our physical and psychological well-being.

Therefore, my therapeutic and personal philosophical approach to my work, whether as a therapist, writer, teacher, trainer, or adventurer, reflects how I’ve integrated modern understandings of human functioning with ageless wisdom about what it means to be human. I utilize change-activating strategies that have withstood the test of time and that are fundamentally relationship-based and scientifically grounded. After all, despite tragedy, loss, pain, and struggle, which can leave us feeling desperately lonely, we are richly endowed with the capacity to adjust, adapt, survive, and thrive, as we work together - because we are never really alone - to blaze a path forward that expresses our best selves. I look forward to assisting you on your journey to discover the wonder and reward of your – as yet – unlived future life.

Conversational Hypnosis

Hypnosis: What It Is and Is Not

There seem to be few subjects in the field of healthcare that are surrounded by more misunderstanding and mystery than clinical hypnosis. This unfortunate reality deprives clinicians and clients alike from availing themselves of the many proven benefits that hypnosis and hypnotic processes have to offer. This blog is intended to address some of these misunderstandings: to set the record straight (or straighter, anyway), if you will.

Hypnosis, a term coined by Scottish physician, James Braid, in 1842, has a history that goes back much farther, probably having its origins in Egyptian and Greek temple practices thousands of years ago. While different labels were used to describe it, and different rituals surrounded its use, they all built on the basic truth that human beings are highly responsive to suggestions, both negative (nocebo) and positive (placebo). That responsiveness is wired into our physiology. It is an enduring legacy of our evolutionary heritage. That response to suggestion is an essential aspect of our capacity for resilience in the face of adversity. That response to suggestion is a core element enabling us to adjust and adapt to changing life circumstances. That response to suggestion is, at its core, what enables “hypnosis” (by whatever name we call it) to evoke the effect it does.

The essential point here, which I’ve written about in a number of peer reviewed journal articles, is that hypnosis is merely the modern name for an interactive, relationship-based process by which a person’s innate capacity for change is evoked through individualized suggestions. Hypnosis is NOT something magically done TO the person; it is NOT something that requires a person to give up their control or autonomy; it is NOT something that exists separate from what the interaction between client and clinician co-create together. (While self-hypnosis exists, the point often missed is that even in that context, a person is simultaneously the one offering the suggestion and the one listening to the suggestion - a fascinating example of people’s ability to be of two minds at the same time.)

The essential elements of a successful hypnotic interaction involve:

• Creating a subjective sense of safety and security with the client, which reduces client defensiveness and enhances their mental flexibility in the context of open-minded curiosity

• Creating suggestions that foster the client’s ability to turn their attention inward or, in the case of peak performance states (e.g., sports, musical performance, test-taking), outwardly but with a state of narrowed attentional focus

• Creating the room and space for the client to become increasingly absorbed by the suggestions offered by the clinician and attuned to their internal cues that ratify their subjective sense that the suggestions are “landing”

• Practiced utilization by the clinician of the client’s capacity to respond at both conscious and non-consious levels to suggestions for relevant and therapeutically beneficial sought after changes

What does trance have to do with it?

Trance, like hypnosis, is a word weighed down with lots of unnecessary baggage. Think of trance as simply describing a shift in attentional focus that is characterized by the experience of being absorbed in an altered state of mental awareness where ideas or responses to suggestion arise without deliberate intention. That does NOT mean against your will. There is NO loss of control. There IS a shift in how control is perceived. It DOES mean that the client typically reports that the new and helpful shift in responsiveness seemed to arise automatically, bypassing the usual obstacles to change that typically bring the person to therapy in the first place!

Conversation, Hypnosis, and Trance

Hypnosis is too often thought to require a deep, eyes closed, immobile body sitting still posture. Not true. People are responsive to suggestions in all sorts of mental states. While an eyes closed stance can be useful, relaxing, and comforting in the same way that people experience the savasana pose at the end of a yoga session, such a posture or pose isn’t necessary.

In my work with clients and the consultation training I offer for licensed health professionals, I make use of suggestions throughout the interaction. I incorporate “formal” hypnosis only when necessary or when requested by the client. Otherwise, the benefits of utilizing opportunities to suggest subtle shifts in thinking, experiencing, and responding exist throughout the session. Learning how to recognize and utilize these opportunities is the essence of conversational hypnosis.

The same way that you can come away from a special musical performance, an engaging theatrical production, an inspiring speech, a moving book, an absorbing movie, a star-filled cloudness sky, or most relevantly, an intimate conversation with a trusted friend, conversational hypnosis exists as a powerful, ever-present capacity for positive change that exists within each of us, no matter our personal history or struggles with personal growth.

As a famous Harvard cardioloist once said (paraphrasing here): Change is always possible. The challenge is in finding the door through which change can enter.

Humility in the Face of Victory and Defeat

Victory and Defeat: Flip Sides of the Same Coin

When victorious, it is easy to become cocky, overlooking the temporariness of any success, attributing our success solely to ourselves and our individual efforts, and failing to remember that success invites us to spread the benefits of our success to others who are less fortunate.

Similarly, when experiencing defeat, it is easy to give in to despair and the fatalistic but false view that what is now will be forever. Defeat, like victory, is a temporary state. Life never wavers from its inherent stages of conception, birth, maturation, decay, and death. New birth and novel growth always emerges from death and defeat.

Winning or Losing vs. Necessary Fluctuations in Relationships

I often hear individuals and couples describe the search for the magical “work-life balance” or some other ideal of balance in their relationship to one another. This is an illusion, in my view. Life equals change and to seek a magic status that is stable, unchanging, and permanent is to abandon the need to remain flexible, adaptable, and to seek needed course corrections in the face of what we encounter, sometimes on a daily basis.

What is true in healthy relationships is true in the larger world of communal, social, and national relationships. At certain times, one party or set of ideas will appear to “win” while the other is seemingly relegated to defeat. To me, such views are antithetical to healthy growth, and healthy growth heavily depends on maintaining an attitude of humility regardless of whether we are up or down at any point in time. Ultimately, our current position will shift. Ultimately, we will need to lean on the other. Ultimately, we are not engaged in efforts solely for our personal benefit but are always and forever engaged together in the effort to “make things better” for as many as possible, though our opinion about what “better” means may differ. Hence, the need for ongoing and open-minded conversations.

There is a story that hales from Eastern Europe that serves to remind us of the futility of becoming too attached to the view that we’ve won or lost, whether as individuals and couples or in larger domains. We always know less than we believe and can always learn more from each other. Here it is:

When someone is honestly 55% right, that’s very good and there’s no use wrangling. And if someone is 60% right, it’s wonderful, it’s great luck, and let him than God. But what’s to be said about 75% right? Wise people say this is suspicious. Well, and what about 100% right? Whoever says he’s 100% right is a fanatic, a thug, and the worst kind of rascal.

Found in Czeslaw Milosz’s The Captive Mind.

Despite our differences, it is important to remember and remain committed to the fact that we are all in this together.

David Alter, PhD maintains his psychotherapy practice in Minneapolis, MN. To reach him, visit www.drdavidalter.com.

Gazing Into the Fog

The Morning After the 2024 Presidential Election

Taking Stock

The results of Tuesday’s election continue to reverberate around the world. There are many who are celebrating and just as many experiencing alarm and even dread. Regardless of a person's political leanings, the results are extraordinarily potentially destabilizing. Taking stock of that destabilization and learning how to navigate through it and with it is important if this momentous event is to eventually produce a better world for us all. Hannah Arendt, a major figure who devoted her life to the study of totalitarianism, having escaped in 1933 to America ahead of being hunted by the barbarism of Naziism’s growing reach, said, “when the experience of powerlessness is at its most acute, when history seems at its most bleak, that the determination to think like a human being, creatively, courageously, and complicatedly, matters the most.”

Her words ring loudly in the aftermath of the election results. Whether celebrating the results with a renewed sense of influence and power after feeling silenced and overlooked, or fearing the results in anticipation of a further erosion of influence and power, Arendt’s appeal to draw on our creativity, courage, and capacity to think beyond simplistic solutions is needed. To her list, I would add three more “Cs”: curiosity, compassion, and connection.

Curiosity can lead us to adopt an open mindedness in our interactions with others, especially with those with whom we may disagree. Compassion invites us to remain openhearted with others; to understand their concerns, fears, and convictions. Stronger and more stable connections can arise in such an atmosphere. Life, after all, depends on opposing forces for its very existence. Our muscles grow in opposition to gravity. Without it, they atrophy. Nerve impulses resist electrically firing unless the press of transmitting a pulse of electrical energy reaches a critical threshold. Too easy a transmission and we’d be flooded by too much nervous activity, while too resistant a force would condemn us to an electro-magnetic silence and death. In short, a healthy biological life requires active tension, and, I suggest, so does our political life.

Implications

You’ve heard the phrase, “what’s good for the goose is good for the gander.” My clinical experience has taught me that what is good for our personal relationships is often just as good for our communal and national relationships. We’ve seen too little of that nationally over the past eight (or more) years. Our leaders have spent an awful lot of time demonizing one another. Whatever we have achieved has often been at the expense of the other rather than through active collaboration with one another.

Here are three lessons from my work with couples that seems to me to apply both personally and politically. Perhaps we can work to mirror in our public behavior what can be so helpful in our personal relationship behavior.

• Conflicts can be seen as the moment when the potential for a transition to a new and better relational structure is at hand. Conflict needs to be viewed as creative tension and not a catastrophe to be avoided at all cost.

• Seeking to learn more about the other person, no matter how long you’ve known them, opens us to notice their depth, complexity, and mystery. This requires adopting an attitude involving less certainty, less self-righteousness, and less stridency. Paradoxically, living an “I don’t know but I’d like to learn” attitude actually infuses our days with the benefits of new discoveries and the experience of joy, even as it reduces the experience of fear and disconnection.

• Picture two circles that overlap. That zone of interaction is where “the relationship” lives. For some, the circles are like a solar eclipse, overlapping so completely that one circle (the moon) almost totally obscures the other circle (the sun). For others, there is hardly any overlap at all. Other than the two extremes, every other degree of overlap is to be negotiated between the partners.

To What Will We Commit

These relationship “lessons” seem, to me, to be relevant to the relationships that can be fostered with people who have different political persuasions. If we are going to successfully navigate this post-election landscape, we will face conflict but we can engage conflict and differences with curiosity and a commitment to mutual respect. Expect to receive what you offer. If in response to this other-directed behavior you receive nothing but disdain, rejection, and disrespect, step back but don’t lose hope. Look for other opportunities to re-engage and re-open a constructive dialogue. Our country’s health depends on it, as would any relationship’s long-term health.

I’ll close with a quote from Abraham Lincoln, expressed when our country was in the bitter middle of our Civil War. It remains as true today as it did on November 19, 1863, the anniversary of which we will soon honor. Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure…It is for the living, rather, to be dedicated here to the unfinished work…It is rather for us to be here dedicated to the great task remaining before us…and that government of the people, by the people, for the people, shall not perish from the earth.

CenterpointMedicine Interview

Dr. Ran Anbar, a developmental and behavioral pediatrician based in California, has a monthly podcast. In it, he interviews innovative clinicians from around the world about their approach to clinical and therapeutic practices. Here is Dr. Anbar’s interview with me from September 25, 2024.

Our conversation covered a wide range of topics that I suspect you’ll find interesting and even eye-opening. So, tune in and enjoy!

https://hrnradio.com/media/CP101624.mp3