Acceptance Application

Recently I've been hearing about a lot of Narcissistic Fellows with Sex Addiction.  In fact nearly every male friend who is currently going through a breakup or has been having relationship issues has been diagnosed by their significant other as a narcissistic sex addict.  A few of my friends and colleagues have also had the misfortune of having partners afflicted with this combination psychological conditions.

Firstly, I would like to remind everyone of the dangers of diagnosing something as serious as narcissistic sex addiction in your husband and partners. Even trained psychiatrist and psychologist have trouble with this kind of diagnosis.  The Diagnostic tool used for this kind of diagnoses is often questioned as being the most effective methods.  Many psychologists, psychiatrists and counsellors believe that the DSM 5 isn't helpful professionally or in fact to the clients who see them.

A professional would never diagnosis their family member or friends or someone who they haven't seen themselves.  For example a counsellor told a friend of mine "Your husband sounds like a narcissist" My friend took this as a diagnosis and went directly home and told her husband. This was a very unprofessional thing that the counsellor did, even if at the time she felt that my friend was married to a narcissist she should never have made this assertion as she had not met the husband and is not qualified to make a diagnosis of this kind.  This is a very unethical practice.

Let's work from the basis that the worst possible scenario has occurred and you find yourself married to and in love with a Narcissistic Sex Addict who has been appropriately diagnosed and is refusing treatment. The percentage of men in the general population under 40 with Narcissism is about 6% this number decreases with age. So, the likelihood of this happening is pretty low. For argument sake let us imagine the worst scenario.

Going back to the poem by Francis is your partner's Narcissistic Sex Addiction diagnoses something that you can change? If you can't change your partners diagnoses or his reaction to it e.g. refusing treatment what can you change? If you think nagging your partner will be an effective method you could try that. Perhaps you could accept that your husband is a Narcissistic Sex Addict who doesn't want treatment perhaps he is getting some benefit from his condition and wants to stay in this state. The benefits may far outweigh the negative aspects.

What can you change maybe you can write a list of things you can do.  You might consider ending the marriage, you may consider looking for benefits to being married to a narcissistic sex addict and embrace those and accept the negative attributes, you might question the diagnosis, you might change how the marriage works to incorporate the difficulties of living with a Narcissist Sex Addict.  You might seek out counselling yourself to decide how to approach this diagnosis. You might research Narcissism and Sex Addiction to increase your knowledge.

There are a lot of things that you can do in this example which might give you a sense of empowerment and peace of mind.  I'll return to my initial concern regarding diagnosis.  You probably aren't married to a narcissistic sex addict most probably you are married to a stubborn normal guy who is a bit of a pain to you at the moment. Next week we will do some exercises from Acceptance Commitment Therapy.

References

Saxena, Shekhar, Esparza, Patricia, and Regier, Darrel A., eds. Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders : Refining the Research Agenda for DSM-5 and ICD-11. Washington, DC, USA: American Psychiatric Association, 2012. ProQuest ebrary. Web. 31 October 2015.

Emmelkamp P. & Kamphuis J "Personality Disorders" Published by Taylor and Francis (2013)

Ronningstam, Elsa. Identifying and Understanding the Narcissistic Personality. Cary, NC, USA: Oxford University Press, 2005. ProQuest ebrary. Web. 31 October 2015.

Acceptance of Differences

This morning I was having a lovely online chat with my soon to be daughter in law (fingers crossed) about acceptance.  We were actually talking about a lot of stuff the topic of accepting differences was one. I thought it might be interesting to look at this concept over the next few weeks. In relationships accepting differences can be a very difficult thing to do. However, often the differences between us is what makes the relationships we are in interesting. Who wants to be married to or friends with someone who is just like us really. It would be highly unlikely because no two people are exactly the same.  Even if it were possible to clone people its our experiences that shape us. Your clone would go off and end up being completely different from you living their own life, having their own experiences and shaping them in a different way. That's my hypothesis on clones.

Acceptance is a tricky thing in relation to yourself and others.  I remember as a young woman I read the Al Anon poem and thought it was a wonderful idea, despite it having a heavy religious tone. It goes like this:

God, grant me the serenity to accept the things I can not change, 

the courage to change the thing I can

and the wisdom to know the difference.

The author of this poem, Francis of Assisi, an Italian Monk, believed that laughter is divine as tears. I agree, I'm sure most of you have heard me say "you need a good cry, it's like lancing a boil" nobody could dispute the therapeutic value of a good belly laugh. It's very nice to know that even in the 1200's when Francis wrote this poem, people were struggling with acceptance. I'm sure shed a few tears and had a few good belly laughs on this journey.

How do we accept things that we can not change? How do we relax in the face of situations which seem almost unbearable. In my work as an Assistant in Nursing particularly in palliative care supporting people through the process of acceptance has been a large part of my job. Finding meaning in what would appear to be a meaningless situations such as the death of a child, the death of a partner and my patience's own death or change of circumstance such as adapting to a disability or having to learn to get around with an Acquired brain injury or a wheelchair or just simply adapting to getting old. As one of my clients said, "I'm 96 years old, everyday brings a new disaster, I hear less, I see less or I can't move as well as I did last year. I don't know why I'm here, I really don't even want to be here, I just have to accept that I'm here and make the best of what I've got".

The next few blogs will be about acceptance. What steps can we take to reach the serenity Francis of Assisi wrote about. I'll be looking at the different approaches and philosophies of acceptance. Hopefully we will all learn something of letting go and living life without the burden of running ourselves ragged trying to change things that are unchangeable.

References 

Assisi Francis, Amstrong J(editor)Brady I (translator) "Francis & Clare: The Complete Works. Classics of Western Spirituality"(1988) Publisher Paulist Press.

Hayes S. phd with Smith S. "Get out of your Mind and Into your Life: The New Acceptance Commitment Therapy"(2005) New Harbinger Publications Inc

Changing Behaviours

Last week I talked about the difference between Behaviours and Responses and this week I'm going to write about how to change behaviours that are unwanted and replace them with wanted behaviours. For the purpose of understanding how this can be done I'm going to refer to my own addiction to nicotine and how I kicked the habit of smoking.

The first step to changing a behaviour is understanding that behaviour.  By this I mean understanding why you are choosing to use this behaviour in your life. What are you getting out of it? Why did you start in the first place? What is going on before you start the behaviour? Do you really want to change the behaviour what are the pro's and con's? How much do you want to change the behaviour? Are you prepared to do whatever it takes to change elements in your life to remove the behaviour? Then you need to monitor the behaviour before even thinking about changing it. This will give you a better understanding of how this behaviour is impacting on your life.  It helps you to be honest with yourself.  Food diaries are something that is used in changing behaviours related to weight and weight gain or loss. Exercise journals and apps such as Runkeeper help to monitor good behaviours. All of this leads toward being accountable for your actions. It also identifies key times or danger times where the negative behaviour is most prominent and least prominent.

In my smoking addiction key times for me were in the morning, times of stress and after the evening meals. I loved my cup of coffee and ciggy in the morning.  I still love a cup of coffee in the morning and it taste so much better now that I am a non-smoker.  However, when I first gave up I had to stop having that morning coffee for a little while.  I replaced it with a herbal tea which was also lovely and instead of having a cigarette I had a slice of toast. Lemon herbal tea isn't compatible with a ciggy but it is with toast and lemon butter. In times of stress instead of going outside to have a cigarette I replaced that behaviour with 20 sit ups or 20 push ups, sometimes I would just go for a walk. A rather fast paced walk with a bit of swearing under my breath about what was annoying me. After the evening meal I worked  a tapestry while watching TV.  I lapsed a few times as my husband was still smoking. I just got back to the program I had made for myself and didn't beat up on myself or considered myself a failure. In fact the few times I did lapse back into smoking I found that I didn't enjoy the cigarette and it reinforced that I didn't want to be a smoker anymore.

This brings me to the stages people experience before they can attempt change.  The pre-contemplative stage which is the part where smokers might think "I'm going to die anyway it may as well be of smoking related illness or my grandmother lived for ages and she smoked so I'll probably be the same". The contemplative stage this might be signified by the smoker saying to themselves "Do I really want to die of smoking related illness" or "My Grandma did only smoke one or two cigarettes a day while I smoke a whole packet" this might lead to "Maybe I should give up smoking"
This thinking might be followed by some actions like phoning up the quitline researching ways to give up smoking. The next stage is the planning stage. During this stage you might start putting some things into place as I did regarding methods of replacing the unwanted behaviour of smoking with some healthier behaviours. You may return to the planning stage periodically and adapt to your changing circumstances for example I can enjoy my morning coffee now without thinking about having a cigarette yet in the early stages this would have been impossible for me. The next stage is the Action stage this is where your plans are implemented. The first steps toward changing the behaviour are underway. The final stage naturally is the maintenance of the wanted behaviours over the unwanted behaviour.

There we have it behaviour change in a nutshell.  I do hope that if you are considering changing a behaviour this is helpful to you. You can apply these to family patterns of behaviour as well for example if there is a history of smacking kids you can apply a plan for change. An example of this would be to think about alternative methods of relating to your children.  You could withdraw a favourite toy or send your child to their room. You could even talk to your child in an age appropriate way to teach them that throwing a tantrum is not an effective way of getting what they want. Persistence and consistency is the key to any kind of change.

Image from website (http://www.livestroo.com/?p=32)

References

Bowles T."Developing Adaptive Change Capabilities Through Client-Centered Therapy" Published in Journal, "Medical Sciences Psychiatry-Neurology". Australia, Bowen Hills (Dec 2012)

Caltabiano M, Safafino E. &Bryne D. "Health Psychology Biopsychosocial Interactions" Publisher Wiley & Sons Australia (2008)

Watson & Tharp "Self-Directed Behaviour" Publisher Wadsworth (2007)

Patterns of Behaviour

The description of "Behaviour" has somehow evolved into meaning things people do which are disruptive or bad.  As I have worked in the Disability Service Sector, the word Behaviour has become very negative.  I worked for one organisation that attempted to call a Behaviour a Response. While these two things a similar the definitions are very different.  The problem with how we define behave is really more about our treatment of the person who is demonstrating this behaviour. We tend to attach behaviour to the concept of character and personality which blurs the lines between what a person does and who a person is.

To clear things up a behaviour is an action a person takes.  A toddler throwing a temper tantrum is an example of an action being taken. A response is a reaction to an event. A response is I pinch you, you say "ouch". A response is reactive and spontaneous.  I have an anaphylactic response to penicillin.  When I get angry I tend to yell and give lecturers. My behave is yelling and giving lectures the antecedent to this behaviour might be leaving dirty laundry in the bathroom. If I treat this as a response it almost mitigates my responsibility in the event of dirty laundry being left on the floor.  If you didn't leave dirty laundry on the floor, I wouldn't respond by yelling and screaming. A behaviour can be changed, a response is not so easy to change.  Just try getting pinched and not saying "ouch".

Now personality and traits are a different thing completely, worthy of a blog of their own.  So, let me say this your behaviour is not part of your personality or character. One of my parenting phrases constantly in use when my kids were young was "I love you very much, it's your behaviour I'm unhappy about".  This separates the behaviour from the person.  However, we can learn behaviours and this is how we end up sounding like our own parents when we ourselves become parents. You might have had an experience where you've been saying something to your children and your mother's words just came out of your own mouth.  This is why last week's learning about genograms can come in handy for recognising some of the behaviours that you may have inadvertently learned from your parents.  The good news is we can change behaviours.  Its very difficult to do.  I gave up smoking almost two decades ago, every now and then I'd love to have a cigarette.

Next week we will have a look at some of the ways behaviours can be changed.  Break down behaviours and replace bad behaviours with good ones.  Instead of yelling about the laundry on the floor we're going to behave like the adults we should be and be reasonable.  We might even learn to take this as an opportunity to reward the good behaviour of our partners or kids when they put their laundry in the washing basket.

Genograms Maps of Why we are Who we are

Families are amazing micro universes from which we are launched into life and adulthood. The people within our families who are known to us and even those who are unknown to us are linked to us in so many ways.  The ties are strong and last generation upon generation. Behaviours are handed down to us.  The family like the country we are born in form cultures that make us who we are. I remember my mother and aunty traveling to Scotland to find our family roots.  They excitedly returned with a prayer from a church they found in Keltie.  It went something like this: "Lord I pray that my family always have good food, a hot bath and a good strong cup of tea".  We all had a good laugh.  These things are important to most families I would say.  The prayer should have also said "Lord I pray that I can control my urge to be hyper-critical, cynical and Judgemental of those I love while completely ignoring my own failings as a human being" I'm pretty sure these things are also pretty common among families around the world.  I hope not too common.  To change anything in our lives the first step is knowing what the problems are.  A genogram is one way of exploring the family patterns, understanding the culture or the system of the family. Once you know what you are dealing with then you can keep what you like and discard what you aren't too happy about.

The first thing you will need is a nice big piece of paper.  Get yourself some colourful pencils and an eraser. Start by drawing your family tree. I think we've all done one of those in primary school. Circle for Women, Square for Men, a little cross for dead people.  Now for the exciting bit. The lines of connectivity between the members of the family.  You can draw whatever lines you like to signify  those connections or you can go to last week's youtube link or this one as a guide. Now you can add things like abuse, depression, academic success, careers really anything that is part of your families big picture. Try not to worry about doing a great job like the ones on youtube just do something meaningful to you. You might like to choose to look at how many men cheated on their wives. There might be a theme that emerges as you work your way through your genogram.  There might be a few themes that pop up through the process of doing your genogram.  You could phone up your parents and ask them about things like what was Grandma's mum like.  I found that there was a real pattern of depression going back three generations by asking my Grandmother a few things about her life and her parents.

Once you discover where things like abuse or depression come from it helps with understanding and also treatment.  It's possible to change the culture of your family and to create something meaningful and positive for the following generations.  When the next generations come along they can see where all the bad stuff stopped and all the good stuff began.

When you do your genogram it might bring up a few tears, in fact you might feel a gamut of emotions.  I highly recommend that you do yours slowly with a therapist if you can or a good friend. Have a packet of tissues handy.  Use images that mean something to you, for example my mother drew black dogs to signify depression and I drew black clouds. Try to include some of the strengths for example all the women in my family had paid employment some even dressed as men to get the jobs they wanted.  My mother drew a dollar sign.  I drew a stack of books for the women who worked.

I do hope you have a lot of fun in the end doing your genograms and shed a few cleansing tears.  I hope you find themes that help you to really understand yourself and your family members.  I wish you luck.  Feel free to contact me  via facebook or by calling 0425 730 629 if you are having a hard time with it or need help. I am offering 6 months of free counselling as part of my placement so this might be a good time to get into a genogram with my help. Good luck :)

References

Chizastowski "A narrative perspective on genograms: Revisiting classical family therapy methods" in Clinical Child Psychology and Psychiatry (2011) Vol14(4) pp 635-644 Sage Publications

Galindo, Boomer & Reagan "A family genogram workbook" publisher Educational Consultants (2006)

McGoldrick "The Genogram Journey: Reconnecting with your Family" publisher Norton & Company (2011)