RUMI

Cada árbol y cada planta del prado
parece estar danzando;
aquéllos con ojos comunes
sólo los verán fijos e inmóviles.

21 ago 2012

3 Steps to Healing from Betrayal

By Dr. Margaret Paul
August 20, 2012


It is devastating when someone whom we believe cares about us betrays us – lies, cheats, breaks a sacred promise, hurts us behind our back, steals from us, turns others against us and so on.
The Steps to Healing From Betrayal
  1. Releasing the feelings rather than staying stuck with them
It is vitally important to find healthy ways of releasing the outrage, heartbreak and helplessness over the other person that occurs in betrayal. The first step in releasing these very painful feelings is to move into compassion for yourself. Too often, we may blame ourselves for not seeing the signs of betrayal and getting caught unawares, but we must remember that we are human and can't always know what's happening.
It is unhealthy for us to get stuck with the deep pain of heartbreak and helplessness, or stuck feeling like a victim. Stuck feelings can cause illness, and this is the last thing we need while dealing with betrayal.
The way to release stuck feelings is to be very kind and gentle with ourselves, acknowledging how very hard it is to go through a betrayal. You might want to roll up a towel and beat the outrage out on a bed, saying all you wish you could say to the person who betrayed you. This might release tears and when the tears come, allow them to flow, being very tender with yourself. It's healthy to cry it out and unhealthy to be stoic.
  1. Open to learning about what the betrayal can teach you
Every challenge in life has lessons for us, and once we move some of the very painful feelings through, we can then learn. The two primary things we want to learn about are:
  • Is there some way I betrayed myself by giving myself up – abandoning my self in some way?
     
  • Is there some way I betrayed myself by not listening to my inner voice, my gut feelings? What did I ignore that I needed to attend to?
Try to answer these questions honestly, but without any judgment toward yourself. Often, but not always, if we had been alert to our gut feelings, we could have known ahead of time that bad things were happening.
Recognize that we all ignore things that are painful for us to see, even though it may eventually result in even more pain. Again, be very compassionate toward yourself for being human and avoiding knowing the truth about some situations.
On the other hand, there may not have been early signs. Sometimes others are very good at seeming to be caring and honest, and we can all get pulled into the illusion of caring and charm. Again, be very compassionate with yourself for not knowing.
  1. Keep letting go and moving into acceptance
Each time the pain of the heartbreak and helplessness comes up, feel it fully with compassion and then be willing to release it. Don’t allow yourself to get stuck in self-blame, rumination, what-ifs or anger toward the betrayer. None of these will help you to heal. We tend to blame ourselves, stay in anger at the other person or ruminate as ways of not feeling so powerless over the person who betrayed us, but allowing ourselves to get stuck in these feelings only serves to continue to hurt us. The deed is done and cannot be undone. No matter how much you blame the betrayer or yourself, it doesn’t change the fact that it happened. Acceptance of the truth, and of your helplessness over what happened, will help you heal much faster than holding onto anger, blame or rumination.
Keep doing these steps over and over and the times of deep pain will get fewer and fewer. It does take time, but eventually you will have long periods when you don't think about it. There may always be situations that trigger the pain, and when this happens, be very gentle, tender, caring and compassionate toward yourself, again allowing the feelings to move through you.

13 ago 2012

La filosofía de la Terapia Cognitiva. Entre Descartes y Spinoza


     

 La Terapia Cognitiva se inició en la década de 1960 en la costa este de los Estados Unidos. Beck y Ellis fueron sus pioneros y en sus inicios estuvo asociada con las técnicas de modificación de conducta. Cuarenta años más tarde, el campo de la T.C. es un vasto y heterogéneo conjunto de procedimientos. Dicha heterogeneidad no es reciente. Tiene no menos de 20 años. Durante cierto tiempo, las diferentes modalidades estuvieron más enfrentadas que asociadas como parte de un territorio común. Los polos de esa diversidad se identificaron con el enfoque cognitivo-comportamental en un extremo y el enfoque pos-racionalista en el extremo opuesto. Para diversos autores (Mahoney por ejemplo) la primera de esas modalidades se corresponde con el pensamiento moderno y la segunda forma con el pensamiento pos-moderno. El arco epistemológico que abarca esa dispersión también suele representarse con las polaridades del racionalismo y el realismo objetivista por un lado y el posracionalismo y el constructivismo radical por el otro.
El surgimiento de la T.C. fue consecutivo, por pocos años, a la revolucionaria aparición de la psicología cognitiva, de manos de teóricos brillantes y profundamente innovadores como Bruner, Miller, Osgood y otros. Desde entonces, una pregunta recurrente que ha atravesado este campo estuvo dirigida a establecer qué conexiones existían entre esa psicología y esta terapia. ¿Cuáles son los fundamentos teóricos que la psicología cognitiva le provee a la terapia cognitiva? Como sabemos, esa pregunta no ha encontrado una respuesta unívoca y coherente. Existen ciertos lazos pero no están claros ni es muy fácil precisar cuáles son y de qué manera los programas terapéuticos se ajustan a ello. La contracara de este fenómeno es que, de la mano del éxito relativo obtenido, la terapia cognitiva ha visto surgir una miríada de propuestas terapéuticas no solamente disímiles sino que, por momentos, se presentan como contrapuestas en aspectos teóricos centrales. Las divergencias son, en principio, epistemológicas, pero se traducen consecuentemente en diferencias de enfoque y en el modo de brindar asistencia a quienes reclaman ayuda.

 El movimiento internacional de las T.C. ha sido testigo en los últimos 15 años de varias idas y venidas que se tradujeron en actitudes de diálogo y de confrontación respectivamente. La puja tuvo por momentos una violencia tal que el campo pareció fracturarse irreversiblemente. Sin embargo, a esos momentos de gran tensión le siguieron otros donde primó el interés por promover el acercamiento entre ambas posiciones. El Congreso Internacional de Terapia Cognitiva realizado en 1995 en Copenhagen fue un claro ejemplo de esto último y las palabras de bienvenidas de la presidente del evento, Irene Oistrich estuvieron centradas en invitar al acercamiento entre los distintos grupos para favorecer la unidad del campo. Los años intermedios siguieron mostrando momentos de acercamiento y de distancia y el último evento de la organización, celebrado en Göteborg mostró una fuerte vocación de integración. Sin embargo, más allá del alcance político que esas decisiones muestran y más allá también de lo que esto puede fomentar en la cultura de nuestra sociedad, existe una convicción clara de que todo lo que ponemos bajo el nombre de terapia cognitiva no es algo homogéneo.
 ¿En qué punto estamos situados y cómo nos encuentra posicionados a los terapeutas de Latinoamérica? Varias preguntas surgen y a cada una de ellas le daremos una respuesta tentativa
1. ¿Cuán cognitiva es la T.C. O, más aún, ¿En qué medida son “cognitivas” las terapias que reciben esa denominación? Otra manera de hacer esa pregunta es la siguiente: ¿Qué tienen en común todas las T.C.?
2. ¿Cuáles son los puntos fuertes de nuestra terapia? ¿Estamos en condiciones de identificar puntos débiles en ella?
3. ¿Cómo pueden incidir sobre nuestras prácticas los cambios que se están operando en el campo de la psicopatología y de la clínica psicológica en general?
4. ¿Podemos avizorar alguna dirección en el futuro próximo para la T.C.? ¿Cuál y hacia dónde?
5. ¿Qué aportes hemos hecho en nuestra región? ¿Cuál es el balance de nuestro desarrollo y qué propuestas pueden ser de interés de aquí en más?

¿Qué tienen de común todas las T.C.?
 ¿Es posible, pese a la gran diversidad, encontrar notas comunes entre todos esos procedimientos?
Las T.C. priorizan el abordaje del paciente como un sujeto procesador de conocimientos, donde el conocimiento es concebido como una forma de organización (autoorganización) de la experiencia. Por lo tanto, apuntan a la mente y sus distintos procesos.
 Ser un terapeuta cognitivo supone afirmar que la probabilidad de brindar ayuda a quienes sufren depende de contar con un método que propicie un desarrollo emergente del individuo, capaz de propiciar un incremento de la agencia personal y, consecuentemente, alguna forma singular de expansión de la conciencia.
La primacía de los fenómenos mentales y el papel relevante del significado en la organización de la experiencia personal constituyen algunas de las notas centrales que se hallan presentes en todos los modelos de terapia cognitiva. De allí que, más allá de las diferencias epistemológicas existentes entre los diferentes enfoques podemos reconocer en cualquier terapeuta cognitivo a un experto cuya tarea está anclada en una teoría representacional de la mente y en una perspectiva intencional de los actos humanos.
Como síntesis podemos decir que todas las T.C. comparten un enfoque de la psicoterapia que está centrado, principalmente, sobre el modo en que operan las denominadas variables mediadoras. Es decir, aquellos factores subjetivos (intersubjetivos) que median entre la circulación de los fenómenos que pueblan el mundo exterior y las acciones realizadas por el individuo.
Si buscáramos una imagen para representar el cometido principal que un psicoanalista debe cumplir en su tarea, siguiendo los preceptos de su teoría, veríamos la figura de alguien preguntando e intentado descifrar el mensaje de una esfinge. En un terapeuta orientado a modificar la conducta tendríamos una buena imagen en la figura de alguien que opera sobre el control de las contingencias de refuerzo en un laboratorio. ¿Cuál es la mejor imagen que podemos hacernos de un terapeuta cognitivo? Creo que la más adecuada es la de una persona común que, en la vida cotidiana intenta elaborar teorías consistentes de la mente.
Todos los terapeutas cognitivos compartimos un techo, el que abriga a los terapeutas que acuerdan en que las creencias cumplen un papel decisivo en la organización de nuestra experiencia y que en torno a ellas debemos bucear para conocer cómo se generan las situaciones disfuncionales y también para encontrar el medio que haga propicios los cambios para mejorar nuestra condición vital.
La diversidad que rige en nuestro territorio es notoria y se expresa tanto en el campo de la teoría como en el de las aplicaciones y las estrategias terapéuticas específicas utilizadas. Actualmente existen numerosos enfoques que se identifican como T.C. Podemos mencionar los siguientes modelos de terapia:
- cognitivo-comportamental
- cognitivo-narrativa
- cognitiva-posracionalista
- cognitivo-social
- cognitivo-analítica
- racional-emotiva
- centrada en esquemas
- lingüística de evaluación
- constructivista-relacional
- de resolución de problemas
 Las diferentes variantes tienen algo importante para ofrecer y que ninguna ha reunido pruebas de superioridad que la convierta en una opción excluyente. Sabemos que el tema de la constatación de resultados en psicoterapia es uno de los puntos más controvertidos. Difícil estimar con precisión cuál es el grado de beneficio comparativo que puede obtenerse entre diferentes abordajes. Tanto si se compara un enfoque de terapia cognitivo con otro como si se compara la terapia cognitiva con otro tipo de psicoterapia. Todavía estamos en la etapa de contrastar los efectos con el ánimo de sumar y de encontrar mejorar nuestras ofertas para beneficio de la comunidad.
Puntos fuertes y débiles de la T.C.
Solemos decir que los puntos fuertes de nuestra terapia radican en las pruebas de eficacia y efectividad encontradas. Esto ha quedado asentado hace casi una década atrás en el catálogo de Nathan & Gorman (1998, 2002) y en la mayoría de los estudios metanalíticos vigentes. Un ejemplo cabal de esto último es el reciente trabajo publicado por Mitte (2005) en relación con el TAG. Esta investigadora de la Universidad de Jena ha presentado datos imponentes que prueban la elevada potencia de la T.C. en ese capítulo.

 La literatura es abundante en referencias sobre la superioridad de nuestros procedimientos. Esto es aceptado, incluso, por autores claramente identificados con otras líneas teóricas. Roth & Fonagy (2005), enrolados dentro de la tradición psicoanalítica, reconocen la superioridad de la T.C. para gran cantidad de situaciones clínicas, en particular en las disfunciones de la ansiedad y del estado de ánimo.
 Esas presentaciones tienen, obviamente, mucho peso. Pero, más allá de ello, la potencia de la T.C. se pone de manifiesto hoy en día, por algunos indicadores que observamos en la experiencia clínica de todos los días. Existen cuatro dimensiones que, a mi juicio, son el mejor testimonio de ese hecho:
a) el enlace con las neurociencias
b) a proximidad entre las hipótesis científicas y la psicología cotidiana
c) la posibilidad de contar con un sistema amplio de evaluación
d) la organización formal de los diseños que permite el intercambio de dispositivos

El enlace con las neurociencias
 Las relaciones entre la psicoterapia y las neurociencias han experimentado grandes transformaciones en los últimos años. Por un lado, como consecuencia de los enormes avances registrados en el conocimiento del funcionamiento del sistema nervioso en la génesis y el mantenimiento de los procesos disfuncionales. Las hipótesis etiológicas que manejamos en la mayoría de las situaciones clínicas operan basándose en esquemas de vulnerabilidad que combinan factores biológicos y psicológicos.
Por otro lado, en los últimos años se vienen publicando numerosos hallazgos sobre la poderosa influencia que la psicoterapia puede ejercer sobre la actividad nerviosa superior merced a la extraordinaria plasticidad que caracteriza al funcionamiento cerebral. Ambos fenómenos convergen en el diseño de un nuevo paisaje en la necesaria relación entre la actividad biológica y psicológica. Un nuevo modelo capaz de interpretar adecuadamente esa relación se impone en la práctica clínica. Un modelo que seguramente mostrará transformaciones no sólo en el cuerpo teórico sino incluso en las cuestiones disciplinares de nuestra pertinencia. Un diálogo cada vez más activo entre psicología y neurología, probablemente ocupe un primer lugar en el escenario.
 El pensamiento cognitivo tiene allí uno de sus puntos más fuertes, en la medida en que su estructura permite establecer reglas de correspondencia directa entre los fenómenos mentales y la actividad del sistema nervioso. La ciencia cognitiva es una confederación de disciplinas que se ocupa de los sistemas procesadores en general (tanto biológicos, como psicológicos y sociales). Sus principios establecen que todos los sistemas procesadores comparten un modelo funcional, permitiendo el traslado de las operaciones merced a reglas de correspondencia estrictas. Esto permitió reconceptualizar fenómenos disfuncionales como en el caso de la crítica a la distinción entre endogeneidad y exogeneidad antes citada.
 Entre las muchas consecuencias que esto produjo en nuestro territorio uno de los fenómenos de mayor impacto sobre los tratamientos ha sido la consideración de los tratamientos biológicos y psicológicos como herramientas potencialmente complementarias. Los llamados tratamientos combinados han sido una indicación frecuente en los últimos años, lo que contribuyó en gran medida a realizar estudios comparativos de resultados a gran escala.

El diálogo entre el pensamiento científico y la psicología cotidiana
Nunca como hasta el arribo de la psicología cognitiva, se contó con un modelo del funcionamiento de la mente que permitiera tanto acercamiento entre las hipótesis de la ciencia y la psicología del sentido común, como el que disponemos en la actualidad. La psicología cognitiva encontró una buena manera de explorar las hipótesis explicativas de la psicología en la vida cotidiana, facilitando que los terapeutas pudieran desarrollar modos de operar significativamente más inteligibles para los pacientes. Esto marcó un estímulo y un incremento de la credibilidad en la terapia.
Lo procedimientos terapéuticos aprovecharon, además, esa situación en varios aspectos. Por un lado, sirvió para comprender mejor la importancia de la psicoeducación como función preparatoria del sistema de cambios. En segundo lugar, condujo a una concepción de la terapia como un fenómeno continuo (no restringido a la hora de la sesión de trabajo con el terapeuta). Las tareas intersesión pasaron a incorporarse como un hecho regular de la terapia. Finamente, permitió estimar mejor los límites de los cambios que el paciente puede lograr, ya que las hipótesis del sentido común contienen las barreras potenciales de las transformaciones que pueden intentarse.

El poder de la evaluación
 Evaluar la acción de la psicoterapia ha sido un recurso empleado con múltiples finalidades. Por un lado ha servido a los fines de diagnóstico, luego se lo empleó para estimar los resultados de un proceso terapéutico. Hoy en día también es frecuentemente empleado como ponderación de los cambios ocurridos a lo largo de un proceso de psicoterapia. La evaluación terminó por constituirse como una de las habilidades fundamentales que debe manejar cualquier terapeuta. Aunque siguen existiendo expertos especializados en esa área, cada día existen más exigencias para que los terapeutas tengan una buena formación en relación a los criterios y herramientas de evaluación de utilidad en psicoterapia. En esta evolución, el enfoque cognitivo ha tenido una notable influencia. ¿Por qué ocurrió esto?
 La evaluación no ha sido algo privativo del pensamiento cognitivo. De hecho, las teorías clásicas del aprendizaje y el movimiento funcionalista dieron un lugar preponderante a la evaluación. Los instrumentos clásicos que hemos utilizado, los inventarios y cuestionarios aparecieron con mucha anterioridad a la aparición del cognitivismo. Pero la terapia cognitiva generó un cambio decisivo que promovió este recurso a partir de definirse como una terapia centrada en objetivos y al favorecer la disección de los microprocesos de que se componen los actos de la psicoterapia.
 El empleo sistemático de la evaluación ha permitido, de manera simultánea, el desarrollo de una potente corriente orientada a la investigación empírica. Esto finalmente ha tenido sus frutos en favorecer que los éxitos obtenidos con la T.C. pudieran ser registrados y documentados suficientemente como para avalar el prestigio de esta corriente.

Organización formal del dispositivo
 A medida que la terapia evolucionó, quedó claro que el modelo psicosocial tenía claras chances de sustituir exitosamente el modelo médico, centrado en una explicación organísmica. El modelo psicosocial abrió las puertas para la consolidación de formas de intervención no-individuales. Es decir, dispositivos vinculares, grupales, familiares, comunitarios inclusive. La terapia cognitiva define la estructura formal como un intercambio sistémico para favorecer la movilización de alternativas.
 Las representaciones de que se ocupa el pensamiento cognitivo son tanto individuales como sociales, y los procesos mentales son el resultado de una operación que no tiene su sede en una persona sino en un generador significativo.

Sin embargo, aunque hemos hecho muchos progresos (o tal vez precisamente por eso), existen varios puntos débiles en el abordaje de un gran número de situaciones clínicas. Todavía tenemos un instrumento que tiene mucho que mejorar. Y en ese camino, deberá estar lo más abierto posible para reunir todos los aportes que puedan enriquecerlo. Y aunque la palabra integración ha sido motivo de críticas y controversias, cada vez se la siente como algo más necesario en nuestro campo de trabajo. Esta necesidad adopta algunas órmulas dentro de nuestro propio campo. Por ejemplo: la existencia de diversos enfoques refleja diferentes posiciones teórico-clínicas y todas ellas pueden reclamar su legitimidad. Pero, ¿Es posible ser un T.C. eludiendo por completo la perspectiva constructivista? O, en otra dirección ¿Es posible desconocer el peso que aportan las pruebas empíricas sobre los efectos de la exposición?
 Siempre es difícil observar los puntos débiles de una práctica que uno realiza. Y más aún cuando nos encontramos en un momento de expansión y prestigio creciente en la comunidad. Sin embargo, tal vez esa debilidad puede filtrarse a través de la desatención en que podemos incurrir respecto de ciertos fenómenos concurrentes.
 En Enero de este año, dos de los teóricos más relevantes en el campo de la etiología de los trastornos de ansiedad, los profesores de la Northwestern University en Illinois, Susan Mineka y Richard Zinbarg, presentaron en el American Psychologist una síntesis de sus propuestas. Allí sostienen que el papel del condicionamiento en la generación y el mantenimiento de los procesos ansiosos es más relevante de lo que hemos estado considerando en los últimos años, lo que sirve para entender mejor el papel de los factores desencadenantes y por qué, por ejemplo, algunas de las personas que tienen crisis de pánico estructuran un trastorno y otras no. Según estos autores las modernas teorías del aprendizaje, superadoras de los esquemas simplistas presentes en los enfoques clásicos permiten identificar esas funciones, aumentando la visión que podemos lograr del problema si nos basamos en un modelo explicativo puramente cognitivo de las reacciones de ansiedad.
 ¿Significa esto volver sobre nuestros pasos en dirección a una interpretación positivista? De ninguna manera. Pero es una llamado de atención sobre el solipsismo que puede estar agazapado debajo de  los logros de un modelo. Esto no es nuevo. Algunas experiencias ocurridas años atrás son muy ilustrativas. Veamos un par de situaciones.
 Cuando Guidano y Liotti advirtieron sobre la necesidad de relevar el papel de los procesos emocionales en el desarrollo de las perturbaciones se suscitó un arduo debate en el campo cognitivo. Algunos autores como Ellis, por ejemplo, reaccionaron muy críticamente, aunque tiempo después la controversia se suavizó. En medio de esos acontecimientos, dos profesores del Instituto Clark de T.C. en la Universidad de Toronto, Safran y Greenberg lanzaron un ambicioso programa de investigación sobre la relación entre emoción y psicoterapia.
 Cuando Marcia Linehan recurrió a la meditación como un recurso central en la terapia con pacientes límites, introdujo la conveniencia de incorporar los procesos de mindfullness (conciencia plena) como estrategia destinada a colaborar en la regulación emocional. Ello convergía con los desarrollos de un teórico como Varela dando así empuje a una línea de trabajo que se fue afirmando con los datos y que hoy tiene mucha presencia en nuestro territorio. No en vano, en el último congreso celebrado en Suecia el año último, la reunión plenaria inaugural consistió en un diálogo entre Beck y el Dalai Lama.
 Tal vez el punto débil más importante que presenta hoy nuestra disciplina es cierto retraso en la consideración de los factores contextuales y culturales. Aunque seguramente el aspecto más frágil radique en la pretensión de absoluto que a veces parece emanar de algunas de nuestras presentaciones.

Los desarrollos de la T.C. y el pensamiento clínico y psicopatológico
 La psicoterapia es una disciplina que se nutre de varias fuentes. La psicopatología es una de las más importantes pues en ella se afincan los modelos explicativos que utilizamos para entender los fenómenos que aquejan a nuestros pacientes y es la base sobre la que bosquejan los diseños terapéuticos. Esta relación es dialéctica y la influencia entre psicopatología y psicoterapia bien puede describirse como un fenómeno de interacción recíproca.
De hecho, la T.C. ha influido muchísimo sobre la psicopatología en particular. Cuando a raíz de la investigación del N.I.M.H. a fines de los 70, la T.C. obtuvo resultados sorprendentemente positivos, el modelo psicodinámico clásico de abordaje para la depresión entró en crisis. Y junto con él, el modelo de clasificación psicopatológica vigente. Desde entonces, dejamos de distinguir entre depresiones endógenas y reactivas y encontramos en toda depresión la presencia de ambos componentes. Distinguimos en cambio entre trastornos unipolares y bipolares. Otro ejemplo notable es que la T.C. fue responsable también de reemplazar la vieja noción de neurosis de angustia por el de trastorno de ansiedad, distinguiendo dentro de ese grupo un variado conjunto de fenómenos.
 Hoy estamos asistiendo a lo que Brown y Barlow denominan la segunda revolución nosológica de nuestro tiempo. La primera, como sabemos, ocurrió precisamente a fines de la década del 70 y tomó la forma del modelo descriptivo y ateórico que recogió el DSM-III. En el momento actual, cuando los investigadores trabajan para elaborar el DSM-V, existe consenso de que deberíamos ir más allá de ese modelo meramente descriptivo y deberíamos reposicionar un modelo de teoría etiológica, pero tal enfoque es tan radicalmente nuevo que difícilmente tengamos consenso para la próxima edición. Dados los avances registrados tanto en el terreno de las neurociencias como en el campo de la investigación sobre aspectos psicopatológicos ligados al temperamento, parece evidente que un sistema de dimensiones que se integre (y supere) al sistema categorial actualmente vigente es la mejor opción. Un sistema dimensional basado en constructos sobre temperamento, personalidad y genética. Eso probablemente será el sistema del DSM-VI, sobre el cual ya comenzamos a hablar, mucho antes que la edición V esté definida.
 Una sección especial del Journal of Abnormal Psychology contiene un conjunto de trabajos que exploran muchos de los puntos más críticos referidos a este problema. Watson, por ejemplo, expone diversas inconsistencias presentes en las clases diagnósticas tal como estamos considerándolas actualmente. Un ejemplo paradigmático es el del T.A.G. Hoy existen pruebas consistentes de que el TAG está fuertemente relacionado con el trastorno del estado de ánimo unipolar, tanto fenotípica como genotípicamente (Kendler, 2003). Existen pruebas de que la depresión mayor y el TAG tienen una diátesis genética común. Al nivel fenotípico, distintos estudios tanto en Australia como en Holanda y en los Estados Unidos muestran que el diagnóstico de TAG a lo largo de la vida correlaciona de manera significativa con la distimia y la depresión mayor (O.64 y 0.59 respectivamente en Australia) (0.68 y 0.67 en Estados Unidos). Brown y Di Nardo concluyen que las fronteras entre el TAG y los trastornos del estado de ánimo son mucho más borrosas que con cualquier otro trastorno de ansiedad. Más aún, parece claro que el TAG está más cerca del trastorno unipolar que de cualquier trastorno de ansiedad.
 Datos igualmente críticos se van presentando en torno a otras entidades como el T.O.C., el T.E.P.T. y la Hipocondría. En algunos casos, las dimensiones encontradas muestran que determinada entidad lejos de ser una unidad clínica es un conglomerado de fenómenos (como en el caso del T.O.C.). En otros casos, hay buenas pruebas de que el fenómeno psicopatológico localizado en el Eje I da muestras de ser, en realidad, un trastorno de personalidad (como en el caso de la hipocondría).
 Distintos análisis confirmatorios sobre las correlaciones halladas entre las diferentes entidades (Por ejemplo por Brown et.al.) permiten construir un esquema estructural como el que expone Kendler: Figura 3).
 La T.C. se desarrolló al amparo de esos modelos de clasificación. Influyó para precisar la descripción de algunas entidades y para refinar los límites que el diagnóstico diferencial correspondiente exigía. Pero no cuestionó el modelo categorial que ahora se encuentra en estado crítico. Teniendo en cuenta las características intrínsecas del enfoque cognitivo no existirán mayores dificultades en adecuarlo a sistemas de diagnóstico dimensionales. Más aún, probablemente se produzca una correspondencia fluida. Pero, sin duda, será necesario realizar diversos ajustes en los programas terapéuticos. Necesitaremos programas de tratamiento más flexibles, capaces de ajustarse de manera más singularizada a las condiciones de cada paciente. Los programas manualizados, para los que la T.C. realizó grandes contribuciones deberán enfrentar cambios importantes.

La dirección de la T.C.
Siempre es difícil anticipar lo que vendrá. Suele ser algo pretencioso y muchas veces expresa más nuestros deseos que otra cosa. Por ello quiero comentar lo que me parece que puede observarse sólo en el futuro inmediato, a corto plazo. Es decir, lo que parece difícil detener a partir de lo que hoy está ocurriendo.
 En primer lugar parece claro que se intensificará el proceso por el cual la T.C. va viéndose penetrada por otros enfoques, precisamente a partir del reconocimiento sostenido de su potencia. Hoy tenemos formatos de diversas procedencias (sistémica, psicodinámica, humanística, etc.) que se han integrado a su tronco. Como ocurre con otras disciplinas científicas, los saberes prevalentes generan un fenómeno de atracción sobre los modelos anteriores. Una manera sintética de expresarlo es que así como años atrás los terapeutas eran básicamente psicoanalistas, en los próximos años, los terapeutas serán en gran medida cognitivistas. 
En segundo lugar resulta evidente que los diversos procedimientos originados en nuestro campo se han ido abriendo en un amplio abanico de formatos y dispositivos. La longitud de los tratamientos entró en una zona de discusión que probablemente se verá intensificada. La propuesta de que la T.C. opere en base a programas breves y focalizados (como enunciaba Beck años atrás) ha sufrido importantes modificaciones. Hoy en día, la extensión de los tratamientos que realizamos varía en gran medida de acuerdo con la situación clínica de que nos ocupamos.
Lo que decimos respecto de la extensión es aplicable a otras instancias del formato y a las técnicas utilizadas. En la medida en que el campo se amplió, reconocemos menos al terapeuta cognitivo por lo que hace, por las operaciones específicas que realiza. En su lugar lo identificamos con una concepción acerca del funcionamiento mental en general y la evolución de los procesos disfuncionales en particular.
En tercer lugar parece evidente que, pese a las diferentes teóricas dentro del campo de la T.C. existe un consenso creciente para enfocar el carácter representacional de la mente como un fenómeno constructivo, en el sentido de un sistema productor de lo que Bruner denominó actos de significado.
Finalmente dos temas poblarán el paisaje de la T.C. (y de toda la psicoterapia) en el futuro próximo: la investigación sobre el terapeuta y la construcción de modelos sobre entrenamiento para supervisores.

El Aporte de nuestra región
 La T.C. en Latinoamérica está viva.
 Adolecemos de información sobre lo que se produce en nuestros propias países y, con frecuencia, sabemos más cosas sobre la obra de los autores extranjeros. En ese sentido conviene que reflexiones sobre nuestra fuerte inclinación a fomentar el colonialismo científico en nuestro territorio.
Sin embargo, los desarrollos de la T.C. en nuestro continente son muy importantes. Voy a ilustrarlos reseñando la situación de mi país (Argentina), debido a que es la mejor conozco.
 He participado de este movimiento desde sus comienzos. En un libro reciente, Marvin Goldfried recogió los testimonios de varios terapeutas sobre su evolución científica y profesional. Muchos terapeutas cambian mucho su enfoque a través de los años. A mí también me ocurrió y mi acercamiento a este enfoque ocurrió después de incursionar por varios modelos, entre ellos después de experimentar un profundo interés por el pensamiento humanista y existencial. Los primeros pasos como T.C. los dimos a comienzos de la década del 80. Hablo en plural porque tuve una compañera de ruta en ese entonces que fue Sara Baringoltz. Investigábamos en torno nuestro con el afán de expandir el esquema clásico en boga en ese momento. La modificación de conducta fue una las fuentes que consultamos. Por eso decidimos invitar a personajes como Hans Eysenck y Rubén Ardila a Buenos Aires. Con ellos trazamos una relación nutritiva que tuvo  acuerdos y diferencias.
 No éramos los primeros en ese intento. A Herbert Chappa le corresponde ese sitial, pues, estando cercano a Córsico en la Plata, se había constituido en un puntal de la terapia comportamental en estas latitudes. Considero que es muy encomiable el desarrollo que ha tenido la obra de Herbert en estos años. Basta con mirar su reciente obra sobre Distimia para darse cuenta de la magnitud de la evolución que tuvo su pensamiento. Además, a Herbert y su grupo le corresponde, entre otras cosas, el mérito de haber adaptado algunos de los instrumentos más útiles para investigar dimensiones específicas.
 Volviendo a Sara, en estos 25 años no solamente contribuyó en el campo de la clínica y en sus reflexiones sobre el papel del terapeuta, sino que impulsó la creación del Centro de Terapia Cognitiva, la institución que promovió la formación y entrenamiento del mayor número de terapeutas cognitivos en nuestro país. No solamente en Buenos Aires, sino también en el interior del país
 El interior del país ha contribuido con la constitución de importantes núcleos. En Rosario, Cristina Goytía ha sido pionera en acercar los desarrollos de Beck en nuestro país. Otros centros se han ido constituyendo en lugares tan variados como Mendoza, Neuquén, Entre Ríos, Santiago del Estero y Córdoba, Tucuman, Paraná, Santa Fé, Comodoro Rivadavia, Bahía Blanca.
 Dijimos al comienzo que Beck y Ellis fueron los creadores de esta disciplina. También Ellis está bien representado en nuestro país. Ha habido varios grupos, entre los cuales se destaca el que fundó Julio Obst, quien también cumple una activa tarea de difusión en el resto del continente.
 La Universidad ha cumplido un papel relevante, especialmente en los últimos años, después de despejar el exceso de influencia psicodinámica que la caracterizó por muchos años. Eduardo Keegan viene llevando a cabo una tarea muy significativa en la U.B.A., colaborando con la docencia de grado y posgrado a favorecer una imagen más positiva de la T.C. en el ambiente académico. Además, impulsó la creación de un activo grupo de investigación en nuestra disciplina.
 Como todos saben, mi tarea se distribuye en varios ámbitos, dentro y fuera del país. Pero Aiglé es, sin dudas, el recinto donde se alojó mi producción más personal. No lo dejo para el final con el ánimo de resaltar su obra. Nuestra labor ha sido una dentro de un colectivo que crece. En el trabajo de todos los días compartí nuestro interés por la T.C. con muchos amigos y colegas. Cualquier mención es injusta para los demás, pero quiero destacar hoy a Edith Vega y a Fernando García que acaban de presentar sendos libros que recogen algunos de sus trabajos en estos últimos años.
Encuentro importante propiciar la creación de redes entre grupos e instituciones de diversos países. No es que no existan. Por ejemplo, y como resultado de un poderoso estímulo que sembró Vittorio Guidano, existe una red en torno al posracionalismo que tiene sedes en diversos países. Tito Zagmutt en Chile y Juan Balbi en nuestro país, entre muchos otros, han emprendido una poderosa tarea de difusión de ese movimiento. Roberto Opazo ha sido muy activo en invitar a representantes de otros países como Uruguay, Brasil y Argentina a participar de las actividades de su programa de postítulo en Santiago de Chile.
 Una vez más, estos son sólo ejemplos. Pero, aunque existen muchos otros, todavía estamos en una etapa embrionaria. Sería muy interesante considerar la posibilidad de constituir programas de formación continentales, capaces de favorecer el intercambio académico y profesional entre diversos países, lo que contribuiría al enriquecimiento intelectual respectivo y favorecería el estudio de las condiciones culturales que atraviesan nuestra práctica. Un Centro de Posgrado para la formación de Terapeutas Cognitivas con múltiples sedes y un título común sería un gran aporte para nuestra disciplina.
 Acorde con ello, también creo conveniente preparar programas de investigación multicéntricos, que tengan chance de aspirar a lograr fondos para el desarrollo de los  organismos internacionales que los estudios aislados rara vez consiguen.
 
 http://www.depsicoterapias.com/articulo.asp?IdSeccion=16&IdArticulo=146

7 ago 2012

Stop Escalating Conflict!

By Dr. Margaret Paul August 06, 2012

A participant in one of my webinars asked: "Is there any way to resolve conflict if you have two 'escalating' personalities trying to solve a problem? In other words, how do you resolve conflict between two very strong willed, always-right personalities, who tend to escalate with every attempt at solving conflict?"
There is a hard and fast rule about resolving conflict that most people find hard to remember: You cannot resolve conflict unless both people are open to learning.
As long as each person is trying to be right, win, or at least not lose, no new learning can take place. Conflict resolves when new learning occurs due to both people being open to learning about themselves and each other.
What to do When the Conflict is Escalating
It is actually not hard to stop conflicts from escalating;  the challenge is remembering to do it. This is hard to remember because, in conflict, often the fight or flight mechanism is activated. If both people involved tend to fight rather than flee, they will generally go on automatic pilot to win.
When the stress response - the fight or flight mechanism - is activated, blood leaves the brain and goes into the arms and legs to enhance the ability to fight or flee You stop thinking well when your focus is on winning the fight. You are likely to say and do things that you would not ordinarily say or do - which, of course, escalates the fight.
What to do?
What you need to remember to do is to disengage the moment the fight starts to escalate. If you wait too long, you will be in the throes of the stress response. Once your amygdala - the survival part of the brain that activates fight or flight - takes over, it is VERY hard to stop. You both are like runaway trains, trying everything you can to win or not lose. That’s when things can get very ugly.
If you disengage the moment the fight starts to escalate, then you can cool off, get your brain back online, and do an Inner Bonding process to see what has gotten triggered in you. You can move into compassion for yourself, make sure you are not taking the other person's words and behavior personally, allow your sadness, loneliness, heartache and helplessness over the other person's behavior to move through you, and then address what is really going on with you. Why do you need to win? What are you trying to control? What are you afraid of? What are you trying to avoid? These are some of the questions you can ask yourself during your Inner Bonding process.
When to Resolve the Conflict
Once you understand your part of the conflict and you feel open hearted and open to learning, you can approach the other person to see if he or she is also ready to learn. If not, then wait. If he or she is open, then the two of you can each share what you've learned in your Inner Bonding process and explore what needs to happen for each of you to feel resolved. This is a wonderful, intimate process that can happen only when both people are open to learning.
If the other person does not open to learning, then you need to let go of trying to resolve the issue between you. You can then do an Inner Bonding process to understand what is in your highest good, given that the other person is not available to resolve the issue. In order to do this, you need to completely accept that you are helpless over getting the other person to open, which is a big challenge for many people.
Even though resolving the issue for yourself is not always ideal, it is far better than the ugliness that often occurs when two people escalate a conflict.

6 ago 2012

You have an intuitive sense of the wonder that you will experience


August promises to be an exhilarating month for you as the essential changes leading up to your awakening come into effect, or occur more and more rapidly. It will be like a chain reaction as each change leads inevitably to the next, and they become closer and closer together in time.  And all of these changes are due to you, the Light-holders, doing such a marvelous job of raising your own level of awareness by addressing and releasing the issues of conflict and abuse that have lain buried deep within you.  They have been waiting for this moment, when you have so much help from the spiritual realms, to demand your attention so that you could deal with them quickly and effectively in the minimum amount of time.
All over the world there is a great air of optimism and excitement, which is in itself a very powerful energetic field, and this energy field is further intensified by the worldwide enthusiasm for sporting events as nearly every nation in the world takes part in the Olympic Games in London.  Friendship and respect for one anothers’ nations and cultures has never before been shown on such a large scale as is occurring during these sporting events which, due to the enormous mainstream broadcasting media attention, are able to be seen by many hundreds of millions planetwide.
The sudden intensifying of the divine energy field enveloping Earth at this time, due to humanity’s interest in and friendly enthusiasm for these international sporting events, is helping to release great quantities of the negative and unloving energies that wars in various fields – military, economic, religious, political, scientific, family, etc. – give rise to and the judgment and blame that goes with them.  The planet is now beginning to shine very brightly indeed as these old energies, filled with suspicion and mistrust, dissolve into the ocean of Love that you are all helping to enlarge and amplify, and there they become totally transformed so that they become one with and can be added to the bright light of the divine Love field.
Your spiritual progress is proceeding apace, and is indeed accelerating as you cruise down the home straight to the finishing line.  There is great joy in the spiritual realms as we watch and observe the amazing flowering of the Love that God implanted within you at the moment of your creation, and which, until very recently, was hidden under the clouds of emotional pain and suffering that you had been undergoing since the dawn of time.  Your intent to awaken, strengthened and intensified by our Father’s Will that you do so, has reached a momentum that is self-sustaining and that will not be thwarted.  You know and recognize your divine destination, and you have an intuitive sense of the wonder and gratification that you will experience on your arrival.  And the closer you get to this moment the stronger becomes your intuitive sense of it.
Whenever you find yourselves swayed by doubts and anxieties – by news items, personal confrontations or attacks, depression, disbelief in the truth of God’s infinite Love for you, or any other unhappy or disturbing moods – make a point of reminding yourselves of the fact that you are always divinely guided and that you have progressed well beyond the “point of no return,” and consequently, the only place at which you can arrive is your divine destination.
Deep within yourselves you do know this, but you are often distracted by the derisory and disparaging comments that you hear from family, friends, work associates, and the media when they address the intolerable state of world affairs and the massive corruption apparent everywhere in politics, global corporations, and religious institutions that is being exposed and reported on as never before. They then use this information as arguments to persuade you that not only are honesty and integrity seriously lacking, but even if they were not, there is little chance that those ethical attitudes would make any difference because unconscionable corruption is obviously endemic all across the world.
Do not allow yourselves to be discouraged.  You know that all is divinely taken care of and that you will awaken into the Reality that is your eternal Home. Whenever the apparent reality of the breakdown and collapse of the global system unnerves or depresses you, just remind yourselves once more that what you are seeing is a vast illusion that is indeed collapsing, and thus making way for the grand awakening.
Your loving brother, Jesus.

1 ago 2012

Eliminating Overdependence

What is overdependency?
Overdependency is the:
Holding on desperately to other people, places or things to give your life meaning and direction.

Allowing others to "do for'' you so much so that you haven't developed a sense of personal autonomy, independence and personal responsibility for your own actions.

Unwillingness to let go of others so that you can get on with your own life.

Unwillingness to set out your own goals, aspirations and dreams for your life for fear that they won't coincide with those of the people, places and things on which you have become dependent.

Sense of worthlessness since the "need to be needed'' and "need to be loved'' have gone out of control where you need the dependency of another on you in order to believe that your life has meaning and value.

Confusing sympathy and pity for love which is a result of feeling sorry and compassionate for someone so much that you have smothered and coddled them until they cannot do for themselves and have become completely dependent on you.

Inability to take self-initiated steps to get your life into control, order and direction because you have overly identified and submitted yourself to the will, power and control of another person even if that person did not intentionally set you up to be so dependent.

Immobilized since need for approval, fear of rejection and feeling of insecurity gone so out of control that you become immobilized without the direction, support and nurturing of the person, place or thing on whose approval you have become dependent.

Directionless which is result of the lack of belief in your own competency, skills or abilities to handle things on your own and the fear to set out on a course of self-direction and independence.

Irresponsibility due to lack of training in knowing what normal personal responsibility taking is and the resultant handing over to other persons, places and things the responsibility to take care of you.

Feeling stuck due to fear of failure, fear of making a bad decision and the fear of success gone out of control until you have become immobilized and incapable of taking care of your own life.

Clingy due to fear of abandonment and fear of loss of value to other people, places and things gone out of control so much so that you become over-clingy and grasp on to any last straw to ensure your dependent relationship is not changed or ended.

Fear of loss of identity, making you frantic in pursuit of maintaining a relationship with a person, place or thing, which is in reality unhealthy for you.

Fear of loneliness, being alone or isolation making you desperate to hold onto a dying relationship with a person, place or thing, well beyond the time that it is reasonable to do so.

Fear of being independent which is due to the fear of the negative consequences of becoming independent keeping you weak and frail, thus needing the support and nurture of those people, places and things, on which you are dependent.


What are the effects of overdependency?
If you continue to be overdependent in your relationships with people, places or things, then you could:
* Lose a sense of personal identity, uniqueness or independence.
* Never gain personal mastery or control over your own life.
* Not allow those who are dependent on you to become fully functional and independent.
* Lack the social, emotional or physical skills to enable you to be a fully functional human being.
* Begin to become resentful of those upon whom you are dependent for keeping you back from becoming all that you are capable of being.
* Become so "smothered'' and "coddled'' that you drown in this sea of love, concern and support, losing focus on yourself as the creation which is in your own hands to shape and mold.
* Fear the possibility of separation, abandonment or individuation from those upon whom you are dependent and thus sabotage all efforts to grow and heal as a fully independent and self-confident person.
* Become disabled, handicapped and incapable of caring for yourself in a mature, healthy way.
* Become sick from the toxic effects of the overdependency especially if the dependency is on substances which have harmful effects such as alcohol, drugs, sex, gambling, shopping, relationships, crises, etc.
* Run the risk of being left by people who get healthy and no longer are willing to be caretakers or fixers in your life.
* Not only give the appearance of being helpless but begin to believe that you are helpless and incapable of taking care of yourself and resist all efforts to help you break the over-bondedness you have with others.
* Increase your manipulation to keep those whom you are "hooked'' on to remain hooked in the relationship with you.
* Suffer from worsened low self-esteem because you are convinced of your lack of competence to be a fully independent individual or conversely incapable of helping others to become independent.
* Run the risk of dying from negative health aspects of the overdependency on things which are deadly.


How is overdependency a control issue?
Overdependency is a control issue because:
* It is an act of transferring the "locus of control'' out of your hands into the hands of others.
* When you become too dependent on a person, place or thing, you give it power to control you.
* It is an act of controlling others to take care of you so you don't have to do it yourself.
* By use of manipulation, conning and other subversive control techniques, you "hook'' people into allowing you to be dependent on them so that they can "fix,'' save, rescue or be a caretaker for you.
* You use your "hooks'' to prevent others from detaching from you so that you can continue to be dependent on their resources, energy, knowledge, care, concern and support.
* You use intimidation, coercion and threats oftentimes when you become disgruntled because others no longer want to allow you to be dependent on them.
* You have learned to use the mask of "helplessness'' to get others to allow you to be dependent on them and they likewise get hooked on being depended on.
* Your style is to seek out people whom you can control to do for you what you need to do for yourself, so you succeed in finding "fixers,'' "caretakers'' and "rescuers'' ready to take over your responsibility for you.
* It blinds you to your own inner strength, resources and power to take care of yourself and lessens your belief in your own ability to maintain self-control of your life.
* It hands power and control of your life over to others whom you are willing to rely on in order to avoid taking personal responsibility for your own life.
* When it is an act of dependency on such things as alcohol, drugs, food, sex, relationships, gambling or shopping, it gives these things the power to control you even to the point of willingness to risk your physical life to have them.
* When it is a compulsive dependency on a person, place or thing, you have become powerless to control it.
* When it takes on an addictive quality, you appear to lose power and control over it.


What irrational thinking leads to overdependency?
* I could never survive without them.
* I need them as much as they need me.
* They would never survive without me.
* I should be taking care of them since it is my responsibility, obligation and duty.
* I could never envision my life without it (thing you are dependent on).
* What would I do if no one needed me?
* I am afraid to let go of them since I'd be so lonely.
* I'd rather be used than ignored by people.
* The only meaning I have in life is to do for others.
* I would have no idea what to do if I were on my own.
* I am happiest when I am serving others.
* They are crazy if they think I'd give up my warm, comfortable, safe state of being cared for by others.
* As long as they are offering to help me out, I'll continue to accept their help.
* I am entitled to what they do for me.
* They owe it to me. After all, I am their child.
* They made my life as a child so miserable it is OK that they take care of me now as an adult.
* I am afraid that I won't do or say it right so I need help to keep me correct.
* I am not dependent on anybody. I am only accepting their gifts, offers of help and support because it makes them feel good.
* I can take care of my own life as long as I don't have to pay for food, shelter, school and transportation.
* Accepting gifts of money and other physical support is not being overly dependent on others.
* I am not dependent on anything but I do enjoy these things a lot (e.g., alcohol, drugs, sex, etc.).
* Being dependent is not a bad thing if it gives meaning to the lives of the people you live with.
* I'd rather be dependent on a person than on myself because I am so afraid of being by myself.
* Telling me that the person who needs to love me is me doesn't quite make it. I don't feel complete unless someone else needs, wants and loves me.


How You can Help Someone Overdependent on You to Become More Independent
In order to help a person become independent of you, you need to follow these steps.
First: You first need to determine if the person is in reality overdependent on you and then identify for what the dependency is.

* Financial support
* Physical support
* Companionship/friendship
* Emotional support
* Problem solving/decision making
* Knowledge and insight
* Skills and abilities
* Sexual outlet
* Affirmation, recognition and approval
* Advice, direction and information on how to live life
* Something else. Name it ____________.

Second: Once you have identified for what a person is overly dependent on you, you then need to determine if you are dependent on this person needing you.
You need to identify if you are a person who:
* Needs to be needed.
* Needs to be the source of financial stability in the family or workplace.
* Needs to be recognized for your generosity.
* Needs approval for your good deeds.
* Has a martyr's role in your family, workplace or relationship.
* Loves others too much to your own detriment.
* Likes to fix, correct and make things right.
* Is a compulsive caretaker.
* Has a hard time "letting go'' of people in your life.
* Finds it difficult to be emotionally detached when you see someone you love getting into trouble.
* Any other reason why you are a person who allows others to become overly dependent on you. Name it___________.

Third: Once you have identified why you allow this person to become overdependent on you, then you need to identify a healthier way to think about the other people in your life and your relationships with them, such as:
* It is OK for people to fail.
* It is better for people to become responsible for all aspects of their own lives.
* People need to be independent if they are to experience a full productive life.
* People won't initially like being cut off from their "dependency'' on you but they will benefit from it in the long run.
* It is healthier for a person to refuse your offer of help if it means they are overcoming their dependency on you.
* I am a good person and it is OK if people don't need me.
* I don't have to fix, rescue or make correct anybody else but me.
* I am a better person by freeing people from being dependent on me.
* don't need to buy my relationships with people by all of the ways they can become dependent on me.
* I can love someone and still set them free to become who they really are.
* Any other rational, reality-based, healthy ideas can be added here.

Fourth: Once you have identified new ways of thinking about the overdependent people in your life, you then need to establish a new set of guidelines to help them to become more personally responsible for their own lives.

Some new strategies to help you set the guidelines are:

Strategies for Helping Others to Become Independent of You
1. Natural Consequences
Letting people accept the natural consequences for their own actions so that they can learn what is good or bad in their own actions, decisions and behaviors.
2. Freedom to Fail
Letting people have the freedom to fail, make mistakes or experience personal disasters so that they can learn from their mistakes and recognize new strategies to prevent them on their own in the future.
3. Shared Responsibility
Letting people share with you the responsibility to do the things which in the past you were totally responsible for. This approximates or shapes them into the ability to be self caretakers and independent beings.
4. Win-Win Solution of Problem Solving
Rather than solving problems between two people where you are the winner and the other is the loser or where the other wins and you lose or where you both lose, this solution allows you both a chance to win. Overdependence is often a result of the win-lose solution where you get your way and the other becomes dependent on you to follow through on a solution which is not fully self-owned or self-generated. In the long run, if you always win in solving problems, you probably lose more since the other people choose to be dependent on your decisions and direction rather than think and act for themselves so as not to cause any conflict or problem with you.

5. Compromise
In relationships the way to ensure the independence of the other person is to reach compromises between your wants and needs and the other's wants and needs. This ensures you both are winners in your interactions with one another and there is less chance of dependence on one another.

6. Mutual Respect
This involves you and the other person respecting one another's competency, skills and abilities without undermining either's independence of thinking, emotions or actions. Respecting each other as deserving people creates an atmosphere which encourages individuality.

7. Acceptance of Uniqueness
This allows the other person to be unique and different from you as a free standing and independent being so that there is no need for the other to be "just like you'' and vice versa. "Free to be who you are'' is a healthy consequence of acceptance of uniqueness by one another.

8. Limit Setting
This is setting a line over which other people cannot step so as to allow you to be free of their overdependence on you and allows them to remain free and independent from you. Once the limits are set the other person then has the freedom to think, feel and act uniquely with your "unconditional'' acceptance and love.

9. Logical Consequences
When allowing another to be free to fail and experience the natural consequences of an action is life threatening or too damaging, you can establish a consequence of your own which approximates or simulates the more disastrous consequence. This is a form of setting limits for the other's behaviors which you will or will not tolerate from them.

10. Mutual Protection of Rights
This involves the encouragement of open, honest and assertive communication between you and the other person to give feedback when either of you feels your rights to be independent and free are being violated. This type of communication is encouraged by giving the other person permission to "call you on it'' if you are ignoring their rights.

11. Enmeshment Elimination
When you recognize that you and the other person have become enmeshed in a mutually dependent relationship, it is important to openly communicate your recognition of the lack of health in this. You then need to admit openly that it is better for you both to be independent, unique individuals who are neither clones or enmeshed in a symbiotic, unhealthy relationship.

12. Fantasy and Myth Debunking
Often when you hold on too tightly to a dream, fantasy or myth of the way things are supposed to be, you control relationships too tightly and force the other into an overly dependent relationship with you. It is important to keep your focus in the relationship rational, realistic and based on "what is'' rather than on "what I want or wish it to be.''

13. Elimination of Entitlement
Entitlement is the belief that you are owed something because of circumstances of birth, rank, position, title, tradition or status. By de-powering the concept of entitlement, people then need to earn on their own merits what they are getting out of life. This eliminates the dependency which makes the entitled person lack ambition, motivation or drive to be independent, successful or accomplished.

14. Individuation
Individuation is the encouragement of people dependent on you to become unique individuals with an accent on their own interests, values, attitudes, skills, abilities, knowledge and competencies. This encourages each person to become a free-standing, independent, self-sufficient, self-confident and self-responsible individual.

15. Establishing Emotional Boundaries
Oftentimes there is a need to establish emotional boundaries between you and other people in your life so that you can identify where you begin and end in comparison to where they begin and end emotionally. This breaks emotional ties which link you into overly enmeshed and overdependent emotional relationships.

16. Disarming the "Hooks''
It is imperative to be on the watch for the "hooks'' that keep you dependent on dependent people, such as manipulation, helplessness, threats of suicide, self-destruction, intimidation or con jobs. Also the people who are dependent on you need to be encouraged to unhook the bait of money, physical help, companionship, knowledge, help, aid, fixing, rescuing and enabling that you offer them.

Fifth: Once you set guidelines for your relationships with people to help them to become independent from you, then you need to put the new non-controlling, independence encouraging beliefs and behaviors into practice.
Sixth: Monitor your progress. If you find others becoming overdependent on you or you overdependent on them, then return to first step and being again.


Steps to Eliminating Overdependency

Step 1: In order to eliminate overdependency in your relationship, you first need to identify where overdependency exists in your relationship. Use the guidelines given in How you can help someone overdependent on you to become more independent to help you with this process. In your journal do the following.
A. List all of the people you have significant relationships with in:
* Marriage.
* Family.
* Family of origin.
* Friendship.
* Work or school.
* Community.
B. Identify which people:
* Are overdependent on you.
* You are overdependent on.
* Are independently unique from you and you are independently unique from them.
C. For all overdependent relationships, identify for what they are overdependent on you.
D. For all relationships in which you are overdependent, identify for what you are overdependent.
E. What are the reasons you allow these people to become overdependent on you?
F. What are the reasons you allow yourself to become overdependent on others?

Step 2: Once you identify the scope of your overdependency, you then need to identify healthy scripts for each person with whom you desire to change the relationship's level of overdependency. In your journal for each person listed as overdependent on you or you are overdependent on them, identify new behavioral strategies to use to establish guidelines to encourage independent thinking, emotions and actions between you and them.

Step 3: Once you have written out guidelines for how you intend to relate to each relationship listed in Step 1, then share your proposed guidelines and work with each person to come up with a mutually agreed upon plan of action to eliminate overdependency in your relationship.

Step 4: Implement the plan of action which could be recorded as a contract with each person.

Step 5: Monitor your progress. If you have problems with over

How to Transform Anger Into Love

Jafree Ozwald | July 31 2012

“When the power of love overcomes the love of power, the world will finally know peace.” ~Jimi Hendrix

One of the most destructive and constructive forces in the Universe is found inside the fiery energy of anger. This amazing energy is so powerful that it can melt through your personal fears, blocks, and insecurities and transform you into a truly passionate alive loving being. As you know, if this intense inner fire is not harnessed correctly, it can destroy the sacred love, joy and real power that is possible with your life. The key to this alchemical process is understanding the power of anger is found in its greatest weakness. Throughout this article we will explore this weakness and how to enter the fiery passionate anger energy on a deeper spiritual level so that you can discover how to use it as a gateway to enter the Divine.
In its purest form anger is simply raw potential energy. It’s like a tremendous fireball breathing inside you, that can fuel the manifestation of all your desires if you learn how not to be afraid of it and meet it intimately. To transform your anger into love you must be willing to surrender to a process that will take you on what may be the greatest spiritual journey of your life. You must be strong enough to be a channel for this potentially destructive energy and understand how to use it and not abuse it. Welcoming the fire in this passionate energy will open many doors to you which you once thought were closed. When you can truly awaken, befriend and tame this wild fire inside, you’ll become unstoppable and able to manifest massive positive outcomes all over your life.
Here’s a simple trick that may help you to find a healthy way to relate to anger. The next time you are overcome by the dramatic urgency to express or suppress your anger, imagine that a very hungry wild tiger has just entered the room. A very large ferocious beast is now circling you and about to pounce and kill you, and so what are you going to do? If you run it will chase you and eat you alive, and if you try to attack it the tiger will surely win. The best option is to be very very still, unmoving like a statue and soon it will stop moving too. Do not move a single muscle until a deeper conscious stillness enters your entire body and brain. Keep one eye on this ravenous feline as this crazy animal could turn on you in any moment thinking that you are its food. Until you feel this beast has totally left the room, be very conscious of the conversation going on in your head. The tiger may be nearby and could sniff you out again. Continue being very still and silent inside until you feel the crazy energy has relaxed enough for you to sit on its back and ride it, or has no interest into you and has walked away.
To master anything in this world, it’s important to understand it. The first thing to know about anger is that it stems from unmet desires formed by your ego. When the ego doesn’t get exactly what it wants when it wants it, it may thrash out at the world in a fit of fiery expression. What’s really going on underneath the surface is that the ego feels powerless and unable to manifest its desires. It’s even more accurate to say that the ego is powerlessness itself, and any attempt to operate your life from this helpless energy will only manifest into life experiences that are hard and challenging. The essential secret here is learning to be aware of when you are coming from ego, and when you are coming from your true peaceful power which is the God Source itself.
The ego is an identity you formed around who you think you are. It doesn’t have anything to do with the true spiritual source you truly are. When you can let go of the ideas and beliefs the ego has you imprisoned in, you can dive into finding the root cause of your anger. All anger stems from a lack of connection to your true spiritual source and power. When you find this connection you can heal the core wound inside you which is this powerlessness. The healing spiritual source naturally comes flooding through as you embrace your deepest wound. The moment you do this you’ll find your anger transforms into passion and your real spiritual journey in life begins.
One of the most important first steps towards emotional mastery comes through consciously approaching any feeling of being powerless. This means dropping through your anger and into the deepest core wound that is creating your anger in the first place. The powerless ego will try to avoid being seen and healed at all costs, so you must be a healing warrior here. When you dive inside yourself and reach that deeper emotional belief that says “I am powerless” notice who (or what) is it that is identifying with this experience. Investigate this idea that you are powerless over anything or anyone in your life, including your anger. Is it true? To find peace with these deep powerless feelings simply takes a willingness to let in the healing energy, and this is the only way you will find true freedom in this lifetime.
The consequence of not diving into anger and feeling your powerless disconnection to Source is enormous. If you cannot allow yourself to drop into your deepest helpless feeling and have the need to be “strong” in that moment, the ego has to resort to anger as a close replacement. By expressing anger at someone (or yourself) there’s this false sense of feeling powerful, which is then followed by feeling sad, guilty or ashamed at the uncentered demon you just became. Then a vicious downward self-hating spiral begins, and expands the more you tend to suppress or express your anger, making you feel even more powerless and frustrated than before.
In your practical daily life, having a truly conscious and healthy relationship with anger may seem like a huge impossible feat, yet think of it as a simple balancing act on the inner world. There are three basic ways to deal with anger to find your path to your balance and freedom with it. You have the choice to express it, suppress it, or transcend it. When you express it at a person, that dark violent energy will release from your body momentarily, then later take over your heart and your mind. If you suppress it, a rigid control structure is formed to stop this erupting volcano, which requires tons of your precious energy to keep you from exploding. When you choose to transcend anger, you are neither expressing nor repressing it. The passionate fiery energy rises from the forbidden gallows and you choose to dive into the core of it, until you reach your powerlessness and sit with your helpless wound. Then anger becomes this secret agent on your side empowering you with more focus, clarity, strength and the courage you need to heal your past, burn through the ego-mind and find the true peaceful divine infinite spirit you really are.

“There are only two ways to live your life. One, is as though there are no miracles and the other is as though everything is a miracle.” ~Albert Einstein

This transcendent approach to anger has many layers and steps to it. It often starts with feeling whatever you’re truly upset about, yet going deeper than the powerless story that tries to hook you in. Use your angry victim story to push you deeper inside, and go beyond the identity you’ve created around yourself in your story. The fire of anger will help you to burn through the ego on its own accord. Let it burn “you” away until there is nothing left of you. Notice that this story is the same powerless story you’ve been repeating to yourself your entire life. When your story takes on a slightly new flavor and color, the anger will loosen its grip on you. You will start to move beyond the reaction mode and move into more of a conscious response to it. The day you stop buying into your victim story is the day you arrive in the land of transcendence. It takes practice to be open to feeling the anger energy without getting caught in it. The more you meditate on the awareness that is aware of the anger, the easier it is to naturally transcend it without trying to control your expression or suppression of it.
On a practical level, I invite you to use complete stillness of the body to drill through that moment when anger would take over your mouth and mind. Just stop all movement anytime you feel anger arising and watch! Don’t express, don’t suppress, just observe. Wait to speak until the words you want to say are truly loving, compassionate and heart felt. Anger like any emotion is a natural energy that can be used to make life more juicy and powerful. To get authentically into this higher vibe place you must dive deeper than the angry victim story buried inside you. This is the key to unraveling the wound that is creating the anger in the first place. By using your hot fiery feelings as fuel they will push you deeper until you arrive at the source of your powerlessness and discover a well spring of healing that is inside the most wounded part of your being. This may not seem like something to get excited about yet it is by far the greatest discovery mankind has yet to find. It’s within your deepest most helpless feelings that you find the key to happiness. When you mix and merge your frozen powerlessness with this fiery anger, every fear, insecurity and hard feeling inside you will slowly start to dissolve.
It’s good to be aware that all the wounds you’ve never healed through your childhood and any broken relationships you’ve had will show up inside this healing process. The feeling of powerlessness is powerful and it can be very dark and very deep in there, so be sure to take the flashlight of pure awareness with you! Take the risk to peer through this darkness and be a friend to your deepest pain. This is the key to true life mastery. When you can sit with your illusion of powerlessness, knowing it is just a limiting belief keeping you stuck in life, you’ve started the path to becoming a truly healed human being and your anger will naturally turn into a beautiful passion for being alive. The real work here is in remaining curious about the gift that you get by diving through your anger and surrendering to the core of your powerlessness. At the very center of powerlessness is always the greatest peace. This is the sacred guidance that you need to find your way through this life.
When you have access to the source of love, you have found the ultimate flashlight that will bring you through any darkness. There is no need to vent your anger on anyone as long as you know and feel your connection to this source. The secret to finding it comes in many forms, one is exploring the qualities of infinite patience and unconditional love. By simply inviting in a feeling of infinite patience with everything you do in your daily life, getting caught in anger is truly impossible. You’ll soon find that you’re naturally relaxed with those people whom you once felt rushed with, or full of judgment, criticism and deep misunderstanding.
When you can sit with your helplessness and relax into it as if for an eternity, something truly miraculous happens. A gentle calming healing energy naturally trickles in and God’s love for you takes over. Our healing in life is so natural and effortless and happens on its own. When you stop picking at a scab and give it a loving bandage, you’re giving your wound the opportunity to heal. Emotional wounds naturally heal when you stop picking at them and give them love the moment they arise. When you are able to truly sit and be with your wounded feelings, not trying to fix them in any way, just being loving and gentle with them, they will all heal. It often only takes 10 seconds of courage and a few minutes of patience before you can feel the gentle energy inching its way into the wounded feeling.
Some people need to suffer greatly before they change their life course and start their healing process. It takes tremendous courage and a willingness to feel your powerlessness without covering it up with addictive substances or behaviors. Most people avoid feeling their core wound because its easier to be distracted by something that gives instant gratification. Yet, in the long run this just creates a bigger festering wound. What’s interesting is that our addictions naturally let go when the wound is dealt with and healed. The addictions are there to cover up the wound, and when your wound is met consistently with a soft sweet gentleness, the love moves through you healing everything inside you.
Our deepest wounds are our greatest teachers. It would be a travesty to ignore the most amazing teacher that shows up on your path. So dive through your anger, find your powerlessness, surrender to the stillness it’s offering, and embrace this entire process with warm tender caring energy every time. Do this ritual every day and practice it consciously. A powerful love will naturally sprout from your being and you’ll become a truly passionate alive being in your world. This is how you transform anger into love. You’ll know the shift happens when the situations where you normally would have been angry or frustrated at a friend or family member, you instead find a true healthy compassion rising naturally on its own accord.
With love all things are possible and nothing is impossible. With love, there’s this sensation that eternity is coursing through your every breath, and you could wait for ten thousand years for things to change. With love, your life is an unstoppable glorious adventure! Love is soooo powerful and because it feels so good, it instantly heals all the hard sabotaging energies that would have ruled your entire life. When you devote your life to love, you’ll find that light you need to find your way to true peace within your powerlessness. So let yourself bathe in unconditional love for yourself as much as possible. Love yourself as you are, no matter how messed up you think you are. Let love in. Let love be your guide. It will naturally transform your life into a profound healing experience that touches your very soul. Who you really are is the source of love, so surrender to that! There is nothing that can throw you off track when you know that love is your one and only guide.

Something of enormous significance is shortly to come into view


Excitement mounts as the most pivotal moment in all of human history draws ever closer.  Examples of previous pivotal moments in your more recent history have been: the telephone; the establishment of an electricity grid; the assassination of Archduke Franz Ferdinand of Austria leading to the first world war; radio broadcasting; the nuclear bomb; worldwide travel for all; computers; the Internet. And all of these are as nothing compared to what is about to occur.
Many of you are spending a lot of time attempting to imagine what will happen to humanity and the planet as you all awaken from the illusion.  If it excites and encourages your optimism about your future, then that is very appropriate because optimism is an essential frame of mind with which to embrace and move forwards towards awakening.  Your most creative imaginings of what is about to come into being are but the palest shadows of what is actually to occur.
Optimism is a very powerful energy that includes enthusiasm, cooperation, and harmony, and which brings with it happiness as an added benefit.  You all have every reason to be extremely optimistic as the changes and developments leading to awakening unfold all across the planet.  Make a point of focusing on the marvelous events that are bringing people together in friendship and love on a scale never before been seen on Earth.  It is most definitely going to be a defining moment in humanity’s ongoing evolution as you awaken into the boundless Reality that is your eternal Home.
As you get ever closer to this exhilarating event, your momentum is increasing. No longer is there the least chance of you arresting your progress, let alone of turning back.  Your arrival is inevitable, as divinely promised ever since the separation from God apparently occurred.  Your intent to awaken continues to intensify as more and more of the human inhabitants of Planet Earth start getting intuitive feelings, telling them that something of enormous importance and significance is shortly to come into view, beyond the horizon that presently encloses the world that you see and in which all your activities currently take place.
Many are feeling on edge, unsettled, unsure, as the energies that are carrying you forwards strengthen and intensify even further in order to whisk you firmly and directly on your way.  There will be no more deviations or detours as you follow the divine super-highway to your heavenly destination – your tanks are full and will remain so – and there is no need to stop en route for provisions of any kind. It is as though you had been catapulted into space with your ship fully victualed for the journey, and your course precisely calculated to ensure that you capture the added impetus to your trajectory that is available as you pass through the orbits of various other planets to speed you securely on your way.
You have been doing extremely well in your efforts to let go of attitudes and behaviors that restrain or restrict you from being open and honest in your dealings and communications with others.  Now is the time for you to engage fully with the divine energies that are enveloping the planet, and to release whatever else is holding you back from doing so – any beliefs that are in any way unloving, and the grievances, resentments, lack of ability to forgive, or judgments that are entangled with them.
You are being offered limitless assistance with your closing tasks so that your Light may burn ever more brightly, demonstrating to all that Love is the answer to every issue, problem, disagreement, or conflict that is engaging the minds and hearts of humanity.  The upswell in Love enveloping the planet is quite astounding as the meditative intents of enormous numbers of you combine together to further assist you all in releasing the remaining chains of chaos and confusion that are still binding you to the illusion.  You are most definitely firmly established on your way, and nothing can prevent your arrival at your heavenly destination.
Your loving brother, Jesus.

Your awakening will allow you to interact fully with all of creation

Your awakening will allow you to interact fully with all of creation

We are all one – there is no separation.  Your human perception of individuality is caused by the severely limited state of consciousness that you experience, and this makes it extremely difficult for you to perceive very much at all.  As individuals, you engage in apparently separate disciplines, areas of interest, of study, of entertainment, of activity, etc. which further emphasize your sense of separation and hide from you the all-encompassing oneness that is your original and eternal state of existence.  Your awakening will remove those severe limitations, allowing you to interact fully with all of creation and to offer all your diverse skills and talents to enhance God’s ongoing creative enterprise, in which all participate gloriously and harmoniously.
Because of your presently limited state of consciousness, you have only a very slight awareness of your skills and talents as you use them to earn your living or to entertain yourselves, but you are all extremely talented and creative beings, and this will become apparent and will delight you when the illusion dissolves and you are once more able to access the infinite knowledge of the divine realms.  To fully partner with God in your creative endeavors is, and always has been, your destiny, and you are shortly to engage with it.
Your destiny is your natural state, the state in which God created you as eternal beings always at one with Him.  You have never left it; it just seems that you have, and your present ongoing life experience is a distraction – an extremely powerful and enticing one – with which you engage continuously through your bodies and all their senses.  Yes, your bodies are powerful, distracting attention-grabbers, and that includes your thought processes and emotions; and it is very difficult for you to withdraw your focus from them for very long because they always seem to have needs requiring your attention – food, drink, exercise, sleep, entertainment, worry, competing, winning, etc.
Meditation, quiet relaxation, feeling the earth, the trees, enjoying the beauty of a view or the sunset can help you reach a “non-ordinary” state of consciousness, where the pressures of living in a body can be greatly reduced to the extent that you can become momentarily unaware of it.  When that happens, you experience a sense of sublime peace.  Most of you have at some time had an experience like this, and you never forget it.  For some it is very intense, for others just an extremely peaceful release from the stress of daily living, but it is unforgettable. It is a veiled glimpse of Reality that you would love to experience more frequently and easily, and yet it seems to elude you no matter how hard you try to re-experience it.  And of course the trick is not to try, and that too is very difficult.  Once experienced, you cannot help yearning for it and looking for it whenever you think that you are close to that inner place in which it occurred.
But of course a non-ordinary state of consciousness is really an extremely ordinary state!  It is just that because of the distractions of the illusion it is very rarely experienced.  The illusion is an all-encompassing environment that demands your constant attention.  The thing is that you do not have to respond to those demands.  It is incumbent on you to be aware of them, but then you must decide whether or not to comply with them.  That is what free will is all about.
Far too frequently your ego succeeds in convincing you that as you live in this world it would be foolish, even insane, not to cooperate with it fully – you need to earn your living, sort out your relationships, attend to your children, keep your body in good shape, take out health insurance, not make yourself look a total idiot by trying to be honest in a dishonest world – and its reasoning seems so reasonable.  But, deep within yourselves you sense that something about this reasoning is seriously amiss — and you are correct.
Everyone experiences dissatisfaction with human existence, and yet you often reason that that is the human condition.  But that does not ease your dissatisfaction. You may bury it as you actively work very hard at playing out the hand that you have been dealt.  Nevertheless, deep within you there is a sense of anxiety, a sense that you are missing out on something, that there must “please God!” be more to life than this endless struggle to survive.  Others do not seem to suffer from this angst, so you dare not discuss it with anyone, and you just soldier on.
That inner yearning is your divine wake-up call.  It is not a psychotic threat to your sanity.  But because you all experience life as separated, individual, you cannot see how others feel, and you worry that you are horribly different from all those basically normal people you see all around you.  And when you see someone trapped in some sort of addiction, or homeless on the streets, it confirms for you that the world is a very dangerous place and that you must conform or sink.  So you keep your angst to yourselves, as a closely guarded secret.
Yes, some of you may enter psychotherapy in the hope of achieving some kind of relief, but you are also aware of people who have spent years in therapy with no obviously beneficial results – they just keep changing therapists – unless they are lucky enough to find someone who is open to deeper discussions of their issues and who will look at them from a spiritual standpoint.
So that angst, that dissatisfaction, is your intuition attempting to make contact with you by distracting you from the distractions of the illusion.  It feels like an inner conflict between “shoulds,” as part of you feels honor bound to do them and part of you wants freedom from doing them.  It is very confusing for you.
Keep reminding yourselves that these feelings are to encourage you to spend time quietly, alone, without distractions (phone, TV, children, spouses), when you make a point of not focusing on the anxieties and worries of daily life (it can help to play some soothing music quietly in the background), and just let go!  Maybe you will weep, maybe you will laugh, or maybe nothing will apparently occur, but by allowing yourself that time, and by thus honoring yourself, even if only for five minutes during the day, you will strengthen your self-esteem, your God-given right to be yourself (after all, who else can you be?), and in those minutes your heart will open to accept the constantly offered gift of God’s Love for you – and you will feel it as a moment of peace or of self-validation.
You owe yourself that personal, private space every day, because it is where you can find the peace and the stillness you need to strengthen your ability to hold the Light and allow it to burn ever more brightly within you.  You are all bright jewels, piercing through the gloom and despondency of the illusion, and showing the way towards awakening.  This is your duty and your joy as the divine way-showers that you are, and by making time for yourselves daily, you will experience that joy and know you are on your path doing precisely what you incarnated to do.
Others may well try to dissuade you from offering love, compassion, and honesty indiscriminately in every situation.   But you know, deep within yourselves, that this is your path, and that just by living it and demonstrating it you are changing the whole world!
With so very much love, Saul.