Some say that God will never burden us with more that we can endure – those words seem like idle chatter – it was all too much to bear.  I braced myself for the predictability and shock of my pain and sought to manage its effects.  There has been no single road that has brought me solace.  Each day I meander within trying to find a place of peace or respite from it all.

I’m supposed to know this stuff.  As a psychotherapist, I teach people how to grieve.  It’s different, however, when you are the patient rather than the teacher.  You become as everyone else, relying on your instincts, courage, hope and faith to guide you through the darkness.  What good is it to recite Elizabeth Kubler Ross’ stages of grief when you are the griever?  Talking about loss is not the same as experiencing it.

Each of us, in our own way is frail and vulnerable.  As psychotherapist Sheldon B. Kopp used to say, “No one is any weaker or stronger than anyone else.”  Each of us has a story, some of it wondrous and much of it challenging.  Our narrative is about learning, and our losses teach us about the meaning and value of life – to cherish every single moment.  Grieving our losses gives us an opportunity to take stock and review our life direction.  We hopefully assess what really counts and focus our attention on that which lasts – the content of our character and the quality of our most precious relationships.  That is all we have.

Unfortunately, as we age, our losses mount.  We grieve the loss of youth, physical prowess, time, missed opportunities and fading friendships.  Each must grieve in his own way.  I have learned that there is no such thing as closure – some wounds never heal.

I have told others that we don’t need to stay stuck in our pain.  All of us can find ways to manage our grief so that even if it lingers, it doesn’t overwhelm us.  Like others, I must remember to: 

• Seek the emotional support of friends and family.
• Acknowledge and embrace my pain rather than minimize its significance.
• Refocus attention on activities that bring pleasure.
• Learn this self-nurture.  Treat myself the way I would a dear friend.
• Keep the positive memories of loved ones alive.
• Try not to fight my way out of depression.  It will lift.
• Live in the present and re-evaluate life priorities.
• Rely on faith to provide me with hope.
• Realize that being vulnerable makes me more human and is a connecting asset.
• Learn to leave the self-pity behind.  Accept the fact that I am a grown-up who experiences life as unfair.  There are no sufficient reasons why certain things have happened to me.

As a grieving patient, I have a better understanding of what it takes to wind oneself down a path of profound loss – no words are adequate to describe the experience.  Contrary to what others think, I do not believe that what I have encountered will make me stronger.  I only hope that my experience with lingering loss will make my vision clearer as I look through the eyes of those who have suffered and continue to seek my help.

James P. Krehbiel, Ed.S, LPC, is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine. He has contracted with New Horizon Press to publish his latest work entitled, Troubled Childhood, Triumphant Life. This book is about the impact of “unavailable” parenting on adults and the people they become. His book will be available March 1, 2010 but now can be pre-ordered through Amazon.com.   James can be reached at KrehbielCounseling.com.

However, recently Amy came of age.  At 36, she finally decided it was time to lean on dear old Dad.  On this rare occasion, during a recent phone call, a bombshell was hurled.  Amy retorted, “Dad, what can I do to rein Malia in a bit?  My feisty four year old daughter is wearing me out!”

As a psychotherapist, with plenty of parenting expertise, I’m sure that Amy was waiting for my most profound response.  However, my spontaneous reaction took both of us off-guard.  Impulsively, I replied with, “I don’t know Amy – I sure as hell didn’t know how to cope with you – maybe it’s payback time.”

We both had a good laugh as we processed the parallels between Amy and her precocious, pesky daughter.  Here are a few of the significant similarities: 

• They both are a strong-willed handful.
• They became non-stop talkers before they were developmentally capable of walking.
• They both love to carry the show with intensity – camera, anyone?
• They are both too smart for their own good.  Going to school comes disgustingly easy, but is filled with the challenges of unmet academic needs.
• They both are similarly assertive, bordering on aggressive; please look out when they’re unhappy!
• They both appear affectionate, but seem to be overly-sensitive to other’s feelings.
• They are extremely independent people.  They know what they want and you don’t dare hinder their progress!

One area of temperamental variance is worth noting.  It is a fascinating distinction and the area where I believe my daughter is being punished for her past.  Malia insists on wearing pink clothes and accessories at all times.  Malia has a pink handbag, beret’s and beads to match her feminine looking clothes.  This fashion statement, required by Malia, is a foreign concept to my daughter.  At first, Amy tried to encourage Malia to wear different colors, but to no avail.  Malia resisted wearing anything but pink. 

Amy wonders where she went wrong.  She was the queen of the Gothic look, wearing black as her only color scheme throughout school as a theater buff.  However, when Amy came home from the first semester of college, a miracle occurred.  I found a pastel colored sweater lying on her bed.  “What are you doing with this pretty sweater?” I replied.  Amy laughed and said it was a new day in her life.

When I see Malia, I see the wonderful reflections of my daughter.  I see the smile, the passion, the precociousness, and the personal need to be understood.  They are versions of the same person.  Being out-of-state, I don’t see Amy or Malia that often, but when I do, I’m so grateful that my granddaughter has not forgotten who I am.  She’s a slice of my daughter and a good one indeed!

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona.  James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine.  He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood:  Saying Goodbye to the Magical Illusions of Childhood.  This book is about the impact of “unavailable” parenting on adults and the people they become.  James can be reached at www.krehbielcounseling.com.

Learning to process and accept our past is a necessary step in one’s search for adulthood.  Instead, people often choose neurotic suffering as a way of coping with painful memories.  Neurotic suffering consists of coping mechanisms that put a salve over our wounds.  Rather than confront one’s painful past, adults will convert their grief into physical symptoms, and mask their losses through over-activity, intellectualization, avoidance, self-blame and projected anger.

Neurotic sufferers ignore the stop signs, transcending their grief as if it weren’t there.  They pretend that everything is running smoothly, ignoring what their bodies, mind and feelings are trying to tell them.  They diminish the truth in the pursuit of coping, choosing to ignore their emotional distress.

Holding Ourselves Together

Anxious sufferers hold themselves together like a ball of yarn.  They fear that if one strand were pulled from the ball, they would slowly unravel into a mound of scattered threads.  However, protecting oneself from the realities of the past eventually creates insurmountable fatigue.  One’s sympathetic nervous system reacts to the stress of trying to ignore the reality of stored and unprocessed psychic pain.

We must move through our grief and loss in order to get to the other side.  There is no substitute.  We cannot short-circuit the grief process without paying a price consisting of unnecessary suffering.  Grieving our pain allows us to legitimately navigate our loss, finding closure over past perplexing problems.

Mourning and releasing our losses takes time.  There is no way to short-circuit the process.  There are strategies that we can employ to facilitate moving through the grief process.  Here are a few ideas:

• Share one’s painful narratives with friends.
• Seek the emotional support of family.
• Journal one’s thoughts and feelings.
• Write a letter (not to be delivered), focusing on the impact of a significant other as you grieve the loss.  Explore difficult emotions and thoughts.
• Give up the illusion that people (particularly our parents), will change into the people we have always wanted them to become.
• Face our mortality by grieving the aging process and its affect on us.

Learning to Get Our Power Back

Once we face our grief, our past will no longer have power over us.  We are freed from being straddled with false guilt, remorse, regrets, and the inability to connect on an emotional level with others.  Grieving is like peeling an onion.  There are layers, and it takes patience and persistence to navigate through our turmoil.

If one holds tightly to metaphors of pain, refusing to acknowledge its presence and impact, the lack of resolution creates the conditions to foster self-defeating thinking and behavior in the present.  Often, individuals who have thwarted the grief process, continue to play out interpretations and narratives of behavior similar to scripts present during childhood.  Individuals may have failed to squarely face their painful past – as interpreted through the eyes of a childhood burdened by emotionally unavailable parents.  They may never have come to terms with the pain generated by those who failed to love them unconditionally.

Saying Goodbye to the Magical Illusions

People, who experience the pain of a turbulent childhood, often cling to the illusion that someday their parents will magically morph into the loving parents they longed for.  Rather than swallow the “bitter pill” of how our parents dealt with us, we continue to hold out hope that someday, somehow, they will change.  By holding out false hope, we minimize the significance of promises un-kept, thus cutting ourselves off from the part of us that needs individuating.

The search for adulthood involves recognizing the power of our painful past, creating and releasing it, and learning to rationally respond with fresh interpretations in the present.  The search for adulthood involves finding integrity, authenticity and adventure.  By appropriately grieving roadblocks from our painful past, we are able to move forward and become adaptive, functioning adults in the present.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona.  James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine.  He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood:  Saying Goodbye to the Magical Illusions of Childhood.  This book is about the impact of “unavailable” parenting on adults and the people they become.  James can be reached at www.krehbielcounseling.com.

As M. Scott Peck eloquently articulated in his work, The Different Drum, it is important that as thinkers we look at problems multi-dimensionally.  We must not get trapped by any one side of an argument, but stay open to multiple sides of an issue; by doing so, we show integrity.  Staying open to the truth wherever we find it allows us to be more grounded, rational and informed.

Within the last several years, many clinicians within the counseling profession have started to under-cut the role of prescription psychotropic medications as a facet of treatment.  Some of the arguments from these naysayers of medication management are: 

• There is no evidence that serotonin or norepinephrine levels affect mood.
• A quality therapist’s treatment is sufficient to free us from the dependency to psychotropic medications.
• Primary care physicians and psychiatrists have a propensity to push medication, thus justifying the need for their professions.
• Touting the use of antidepressants and other mood-stabilizers is primarily a marketing ploy.

Lately, high profile cognitive-behavioral therapists have been down-playing the efficacy of antidepressants and other mood-elevating medications by stating that CBT is sufficient to “cure” any problem without a crutch, thus “ditch the Zoloft.”  Although many research studies support the synergistic effect of cognitive therapy and antidepressants, CBT therapists are dismissing such findings as misguided.

Existential therapists are also following suit.  Since they believe that all suffering is legitimate, using medications to stabilize mood remains unnecessary.  In fact, existentialists believe that taking antidepressant medication thwarts the grieving process, thus delaying the natural progression of growth.  According to their viewpoint, we must not pathologize the human experience.

I believe that a more pragmatic, balanced and useful position is to acknowledge the legitimacy of psychotropic medications in curbing anxiety, depression and other disorders of mood.  We should accept these medications because for many sufferers they work.  Antidepressants serve as an aid, an emotional “floor” while patients undergo therapeutic treatment to derive more long-lasting benefits in coping with emotional distress. Furthermore, it is essential that those suffering from bipolar disorder take mood-stabilizing medication to treat their symptoms.  There is no other viable option for treatment.

Why is it that many therapists now embrace a philosophy which discounts the use of psychotropic medications?  It is true that people generally do what’s in their best interest, and many therapists hold a position which dismisses the legitimate use of medication for several reasons:

• It enhances their belief that their therapeutic orientation is unique and sets them apart from the competition.
• It increases their ability to generate income.  Therapists postulate that marketing an approach that will fix you without the use of medication (prescribed by a PCP or psychiatrist), is more enticing and potentially lucrative.
• Therapists, who disown the use of psychotropic medications prescribed by physicians, are driven by their feelings of exclusivity about their approach, coupled with the desire to market themselves.  The practicalities of what is in the best interest of the patient are ignored.  Marketing takes precedence over pragmatism and utility.

Another danger involving dichotomous thinking relates to mind-body therapies.  Holistic thinking has taken root in the mental health profession.  Many therapists integrate alternative therapies that claim to remedy behavioral and emotional conditions.  Some of the treatments are evidence-based, but many cannot be supported empirically.  Case in point is reflexology and therapeutic touch, which claim to explore and heal energy systems.  The therapeutic community needs to do a better job of ferreting out modalities that have functionality versus those which are of questionable utility.  Once again, in the process of propagating the mind-body connection, we may error on the side of discounting physical medicine, including psychotropic medications.

As a therapist, one must carefully weigh all sides of an issue before making value judgments.  Therapists must be honest and informed when making statements about psychotropic medications and the mind-body connection.  At a recent mental health conference that I attended, a participant claimed that she was dismayed by the over-use of stimulants for students experiencing ADD.  However, it is clear that ADD has been under-diagnosed, not over-diagnosed, and those who receive treatment with stimulant medication in concert with therapy do significantly better than those prior to treatment or without treatment.

It is imperative that therapists represent their profession appropriately.  This means that we take a carefully crafted approach to treatment based upon sound research and a sense of balanced thinking and integrity.  Being blinded by any one perspective only polarizes the profession.  Theory and practice must come together in a way that provides our patients with the best chance of making improvement.  Part of the answer is to offer our clients a multipronged approach with the best quality evidence-based theory, medication management (if needed), and alternative adjunctive treatment modalities that have a history of demonstrated effectiveness.

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona.  James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine.  He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood:  Saying Goodbye to the Magical Illusions of Childhood.  This book is about the impact of “unavailable” parenting on adults and the people they become.  James can be reached at www.krehbielcounseling.com.

Over time, Alex associated his less than perfect performance with his personal identity.  If what he did was less than acceptable, then by all means he must be defective.  His father never encouraged or coached him on a better way to wash the car, so he was left to feel inadequate about any task he attempted.

Alex evolved into a self-critical, angry youngster.  In Little League, he excelled as a player.  He was known for his outstanding skills and performance.  Nevertheless, he berated himself, other players and the umpires during his occasional unsuccessful at-bats during games.  He recalls running feverishly towards first base, being called out, and throwing his helmet, stomping his feet and raging at the officials.  Although he was conflicted and confused about his poor sportsmanship, he wasn’t capable of stopping his inappropriate behavior.  His parents never got involved, intervened and discussed the “why” of his self- defeating thinking and behavior nor tried to correct it.

In adulthood, Alex was able to trace his painful memories of personal performance-related criticism and anger through the filter of his son’s experience.  His son, Damon, was a very talented basketball player.  Alex was perplexed because he never recalled Damon losing his “court presence” during a game.  His son was grounded, focused and in control.  These qualities actually helped enhance the level of his game.  Alex was thrilled that the legacy of persistent perfectionism never created a problem for his child. 

As he sat in the stands and watched one of his son’s tournament games, Alex recalls reflecting on what parenting skills he had implemented with Damon that were different from the way in which he was raised:

• Like Alex, his son was very sensitive.  Alex made sure that he never harshly scolded him.
• His form of discipline was facilitated through coaching, instruction and encouragement.
• He always let Damon know that he was proud of him.
• He believed that mistake-making was a necessary part of child-development.
• He challenged his son to excel without motivating through intimidation.
• He remained involved with Damon and attended his activities at school and in the community.
• Alex’s limits were firm, but reasonable with logical consequences for positive and negative behaviors.
• He always differentiated Damon’s behavior from his personal worth.

Alex gave his son what he found difficult to provide for himself – support, soothing, comfort and affirmation.  Ironically, he learned through role-modeling his son’s behavior how to begin parenting himself.  The process of learning to self-nurture involved facing his past, grieving and releasing its emotional impact while creating fresh interpretations of his thinking and behavior.

He cut into the “pedestal of perfectionism” and learned to allow himself the freedom to perform less than admirably at times.  He practiced selective mistake-making as a way of giving up some control and allowing for a measure of vulnerability.  Alex worked on being less self-critical and judgmental of others, and eventually learned the art of being less than perfect.  He learned to push less, and relax more as his performance, like his son’s, actually improved.

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James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona.  James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine.  He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood:  Saying Goodbye to the Magical Illusions of Childhood.  This book is about the impact of “unavailable” parenting on adults and the people they become.  James can be reached at www.krehbielcounseling.com.

Nathan came back to see me three years after he had “graduated” from therapy.  He brought his new guitar and treated me to few melodies in the privacy of my own office.  He was serenading me – it was a gift for being there for him.  However, Nathan’s visit took on a more important purpose.  He came to tell me, in so many words, how he had become a different kind of thinker – the type of young person who inevitably would change the very foundations upon how we view matter and energy and life itself.  At age 16, Nathan had graduated from a college preparatory high school and made his way to a prestigious university to study nanotechnology.

As I intently listened, Nathan explained that nanotechnology will allow us to snap together the fundamental building blocks of nature more easily, more cost effectively, and in a way that is permitted through the laws of physics.  Nanotechnology has the ability to transform our thinking about science, physical health and disease, emotional well-being, computer programming, and travel to outer space.  Not only was Nathan “studying” this complex, molecular thinking, but he was actually conducting research with the world’s greatest scientists in this technological field.

Like an H. G. Wells of his time, Nathan passionately projected what the world would look like in the next 15 years due to his work.  His words seemed prophetic and powerful, and I sense that I was sitting before one of a new age of young people – the dreamers, the problem-solvers, the visionaries who would create a new way of thinking about thinking.  These are not “egg-heads,” but balanced, well-rounded kids who have the capacity to not only reflect on problems but to communicate about how the world will dramatically change due to their influence.

Nathan represents an influx of thinkers among thinkers, who will quietly work behind the scenes to make things happen.  These are not our future leaders or managers, but those who empty themselves of all internal clutter or preconceived notions about how the world works.  By staying open to the truth, wherever they may find it, new, exciting discoveries will be made that will impact all aspects of the human condition.

Like Nathan, our future thinkers can recognize the qualities and significance of emptiness.  They can handle the perplexing nature of uncertainty and ambiguity.  They understand that there are multiple dimensions to any problem with conflicting and paradoxical meanings.  They are willing to surrender conventional notions about how the world works in order to make room for the new.  By cutting a path through the clutter and letting go of a traditional means of thinking, these talented young people will open themselves up to what Robert Schuller referred to as, “possibility thinking.”

In the midst of all the incivility and strife that we are faced with, Nathan will make a difference.  He has not forgotten what it was like to stand face to face at a young age with problems that were bigger than he was capable of solving.  He will use that experience to empower and propel him in a direction to bring peace as he thinks about and humbly solves problems that raise hope and healing for all humanity.

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James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona.  James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine.  He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood:  Saying Goodbye to the Magical Illusions of Childhood.  James can be reached at www.krehbielcounseling.com.

Dana kept getting hooked in a relationship that was going nowhere.  He came for counseling because he understood the self-defeating nature of his association with Kim.  What he didn’t comprehend was how to break a convoluted connection that had a tight grip on his life. 

Dana confided that Kim would steal his prescription medication, exploit him for money, “guilt” him for not caretaking for her kids, and abusively berate and belittle him.  According to Dana, no woman had ever treated him this poorly, and yet he kept going back for more torment.

For brief periods of time, Dana would avoid taking phone calls from Kim.  Then, due to feeling of aloneness and shame, he would yield to the temptation to contact her again.  He described Kim as a substance abusing rager who knew how to push his buttons.  She had mastered the art of emasculating and shaming him into submission. 

Dana tended to minimize the volatility of his other relationships with women, including his mother.  Dana learned to follow a script that placed him in the role of the nice guy who was sent from heaven to fix the world’s moody females.  This trend started with his mother who was a critical, manipulative, over-functioning figure.  He acquiesced to his mother’s every desire. 

Dana failed to make a connection between his shame-based relationship with his mother and his current perplexing dilemma.  Dana’s need to get “slammed” in relationships was born out of a desire to hopefully untwist the notion that he was defective.  Since he had no history of healthy relationships with women, he learned to accept the verdict of the ladies in his life – “I am worthless.”

Since shame-based feelings are the driving force behind any pattern of addiction, Dana easily became vulnerable to re-engaging in relationship situations that would perpetuate abuse and reaffirm his concept of an enfeebled self.  Each time that Dana picked up the phone and contacted Kim, he hoped that things would be different – “Maybe this time I can change the dynamics of the relationship; maybe this time Kim will nurture and affirm me as a kind, compassionate individual.”

Many of us live with the illusion that those who have hurt us can be saved.  Just like we do in a disruptive childhood, we perform to please in an effort to get those who have damaged us to change their ways.  When the change we yearn for is not forthcoming, and our loved one’s do not morph to meet our needs, we turn our disappointment and anger inwardly and invalidate our worth. 

One of the things about maladaptive human behavior is that it tends to repeat itself.  The essence of healthy change is not doing the same things repeatedly that do not work. We must be creative in our quest for new thinking and behavior if we are to recover from the wreckage of our history. 

Dana needed to see his life through a new prism.  His shame had tragically been foisted upon him by those who had no capacity to meet his needs. Eventually, Dana began grieving the loss of those who would shame him.  He let go of the need to try to fix relationships that were irreparably damaged.  He began processing the truth that his self-identity was in no way connected to other’s evaluation of him.  He began realizing that he was a poor picker – that the women in his life mirrored his relationship with his mother.  He would never again assess his worth based upon a history with mood-disordered females. He would look elsewhere in a search to find healthy, connecting relationships with women

All addictions have the same, pervasive features, and this one was no different. Like Dana, many of us must grieve and release our losses, give up our shame and rationally respond to life with altered interpretations of who we are and what we need to do to feel empowered. 

James P. Krehbiel, Ed.S., LPC is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona.  James is the featured Shrink Rap columnist for TheImproper.com, an upscale arts, entertainment and lifestyle web magazine.  He has contracted with New Horizon Press to publish his latest work entitled, The Search for Adulthood:  Saying Goodbye to the Magical Illusions of Childhood.  James can be reached at www.krehbielcounseling.com.

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I pushed Todd to explain to me, in every conceivable manner, how “this time” things would be different from all of his other failed attempts at sobriety.  In a straightforward, yet probing way, I took him apart in the process of working to hold him accountable for his wasted life.  Fortunately, he didn’t run away from therapy.

Todd came to see me every week as we combined my cognitive-behavioral treatment with a local outpatient rational recovery program.  Since the efficacy of inpatient substance abuse treatment programs is marginal, I felt that this would be a more effective treatment approach.  This two-pronged strategy appeared to be the perfect mix.  Naltrexone, a medication employed to stop the urges and cravings of alcohol was used with my patient.  The goal of treatment was to focus on his lifestyle of excessive drinking and to rationally, reconfigure patterns of behavior that were consistent with a lifestyle of sobriety.

Todd began drinking when he was eight years old.  His father would take him on camping trips and would provide him with hard liquor during their journey.  Todd recalled his father handing him small, open alcohol bottles for consumption which had been purchased from the airlines.  Todd reminisced about how he would eventually end up vomiting during stops along the way to the camping sites.  According to Todd, his father was too “wasted” to be of any assistance to him. 

This father and son drinking dynamic went on throughout Todd’s adolescence.  Todd began being admitted to residential treatment programs by the time he was thirteen years old.  Each time Todd was placed in a rehab program for drugs and alcohol, Todd’s father would make a special effort to visit him during recovery.  Ironically, he would wish his son well and then would depart.  On one occasion, Todd remembered his father drinking and smoking pot with him in their car just prior to his being admitted.

I found it fascinating that Todd never thought about the peculiar, symbiotic, outrageous abusive nature of his father/son relationship until we began exploring it.  Even then, Todd deflected the experience through anxious laughter.  As I “turned up the heat” on the emotional impact of what he experienced, Todd’s vision of his past became clearer.  He began to understand the betrayal, shame and humiliation foisted upon him by his father’s alcoholic enmeshment.  It was painful for Todd to learn to hold his father responsible for the hurt, disappointment and destructive behavior he created.

As we moved through therapy, Todd was afraid of his anger and where it would lead him.  We addressed that fear along with ways of coping with his enfeebled, alcoholic father in the present.  Todd set more appropriate boundaries related to any contact with his father, and on several occasions broached the subject of his father’s past behavior to no effect.

Todd learned to accept the fact that his father would never change, and that he would need to grieve and release a history filled with horrible memories.  Todd’s rational recovery, based upon cognitive-behavioral therapy, is working.  He has a positive support system, medication for his urges and cravings, and takes full responsibility for his recovery.  Every day is a choice about whether to allow his father to continue to have power over his life or to choose to forgo a pattern of drinking that started many years ago  during his father/son camping trips.

This narrative is a composite.  It has been deliberately altered in order to protect an individual’s right to confidentiality and privacy.

The idea that homework must be assigned is a premise that is rarely examined by the school establishment or parents.  Why should it be explored?

1. There is sufficient empirical and practical evidence that homework actually detracts from the concept of quality work.
2. Most kids deplore receiving homework and it tends to detract from developing curiosity and a love of learning.
3. Teachers complain about the lack of compliance they get from students in completing homework.  This reality typically creates an oppositional pattern with students. 
4. Parents complain about the way in which homework prevents their children from engaging in family-related activities, but rarely inform the school of their concern.
5. Parents feel pressured to involve themselves in directly instructing their children over content they know little about.  Invariably, this issue creates power-struggles at home. 
6. There is no evidence that spending more time on schoolwork or homework actually leads to increased achievement.  The issue of quality taking precedence over quantity is missed.
7. Homework puts enormous stress on students as they try to balance various activities in their life. 
8. Schools are providing homework to students at earlier ages, starting with worksheets in kindergarten and pre-school. 

According to William Glasser, psychiatrist, educational consultant and author of The Quality School,  the way to solve the homework problem is to drastically reduce compulsory homework and emphasize the importance of quality class work.  Students should be taught to evaluate their own work and be given the opportunity to raise their grades by improving it.  Students should be encouraged to take their work home to re-evaluate its quality and most students would do this without question. 

Currently, most students do homework because they are supposed to, not because they want to or consider the work meaningful or relevant to their experience.  Compulsory homework promotes a climate in which students, parents and teachers lose respect for the educational system.  Coercive approaches to gain compliance generally spike, and the opportunity to promote quality work is undermined.

Although the merits of compulsory homework are questionable, student can easily be persuaded to do meaningful homework as an extension of  classroom work.  For  example, students can finish uncompleted assignments or improve classroom work.  They may also do tasks such as interviewing people regarding careers, watch educational television programs associated with school themes, do research within the community, volunteer service to the community, or play educational games with family members.  There are many enjoyable experiences and games that involve reasoning, problem-solving and logic that may be valuable learning resources.

Schools need to promote academic programs to reflect quality.  As psychiatrist William Glasser indicates, quality may be hard to define, “but teachers and students tend to know what it looks like when they see it.”  It certainly is not the rote, meaningless, irrelevant busy work that students currently receive in many of our schools.  As administrators, school board members and teachers re-evaluate their curriculum and add meaningful, purposeful tasks to the learning experience, quality work will emerge.  Students will be more willing to “buy-in” to a program where quality work is the norm, not the exception.  Once quality work becomes a commitment and is established in the schools, students will be more likely to adhere to non-compulsory learning experiences that can be accomplished at home. 

James P. Krehbiel, Ed.S., LPC is an author, educator, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona.  He can be reached at www.krehbielcounseling.com.

It appears that “as the world turns” many are having a difficult time falling asleep and/or staying asleep.  Our fast-paced lifestyle can leave one feeling fatigued, apathetic and restless as a result of a cycle of sleep deprivation.  Some turn to sleep medications as a way of rectifying the problem of insomnia.  Others look for naturopathic remedies to provide respite from a sleepless night

Certain chronic insomniac conditions that result from pain-related problems may warrant the use of sedating medications.  Other cases, however, may respond to various non-medicinal treatments, including the use of cognitive-behavioral therapy.

Cognitive-behavioral therapy is at the forefront of treatment for various disorders, including depression, anxiety, pain management issues and insomnia.  Insomnia may be caused by life stressors, physical illness, emotional discomfort, environmental factors, self-medicating or disruption in one’s sleep pattern due to work-shift changes or jet lag.

CBT seeks to work with insomniacs through their thought processes, ways of viewing the world and underlying beliefs about sleep.  Many adults become anxious about their lack of sleep.  They may ruminate about the horrible things that they believe will happen to them if they fail to promptly fall asleep.  I often tell patients, “Where is the evidence that not sleeping tonight will cause you undue harm?  What’s the worst thing that will happen?”  Frequently, it is the anxiousness about not sleeping that sets up a self-defeating dynamic of frustration and restlessness.

CBT uses paradoxical intervention strategies for dealing with sleeplessness.  The fear of sleeplessness results in a hyper-intention to fall asleep.  Trying to fall asleep then immobilizes the patient’s efforts to do so.  The fear of sleeplessness is usually based on the patient’s lack of awareness that the body provides itself with the minimum amount of sleep necessary to function.  I recommend that patients who experience insomnia stay awake as long as possible prior to going to bed.  Individuals should be sufficiently fatigued and drowsy before lying down. The bed should always be used for sleep purposes and never used for reading, relaxing or ruminating.  If the patient’s sleep is interrupted, the sufferer should get out of bed and read, watch television, until sufficiently tired enough to resume sleep.

The human body is a wonderful organism.  It will automatically self-regulate.  If one only gets three hours of sleep on a given night, the body will automatically compensate, eventually providing appropriate rest.  It is the fear of not sleeping that sets up a negative dynamic for the insomniac.  Individuals may set up a self-defeating cycle by remaining in bed as they ruminate about sleeplessness.  Ironically, this process only compounds the problem by leading to further restlessness.

Learning to relax the body and mind is important to getting quality sleep.  Learning mindfulness meditation helps the insomniac to calm the sympathetic nervous system, setting the stage for restful sleep.  Often, guided imagery is the most effective way of promoting a “relaxation response.” 

What people do with their time prior to going to sleep is important.  Playing stimulating music, working at the computer and using alcohol close to bedtime will negatively affect one’s ability to sleep.  Learning to let go of work-related stressors is imperative.  Individuals who are “driven” are more likely to carry their workday into the night.

Patients, who experience insomnia, generally suffer from the following self-defeating thoughts and assumptions:

• “If I don’t sleep, something awful will happen to me.”
• “I must sleep or else I won’t be able to function anymore.”
• “I’m afraid to go to sleep because something might happen to me.”
• “If I don’t fall asleep promptly, there must be a problem.”
• “I have so much work to do that I don’t have time to sleep.”
• “I must stay in bed until I fall asleep.”
• “Worrying about things helps me to control my life.”
• “I must complete everything on my list, especially work tasks.”
• “Being alone at night is a scary thing.”

Assisting patients to reframe negative thinking is essential to treatment for insomnia.  Anticipatory anxiety in the form of negative self-statements must be replaced with more adaptive ways of thinking about sleep.  By employing strategies that emphasize the“reverse-effort” of not trying to fall asleep, patients learn to relax their bodies through passive volition and secure needed rest.