Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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Labor Day

By Lynne Gots, posted on September 5th, 2011.

Nobody would call what I do for a living labor, but it is hard work. Sometimes I leave the office feeling as beat as if I’d been on my feet all day swinging a pickaxe instead of sitting in a chair.

Friends, family, and even patients say they envy me. “You’re so lucky,” they tell me. “You don’t have projects hanging over your head. When you’re done for the day, you’re done.”

Seriously? I’m grateful to have a job I love. It’s stimulating and challenging. I get to work with interesting people, and I’m my own boss. There are many enviable aspects of my job, but being able to leave it at the office isn’t one of them.

Doing therapy isn’t as easy as the TV shows and movies make it seem. Or as tedious. (I know a lot of people who are devoted followers of In Treatment, but I couldn’t get through a single episode.) I spend a lot of time after hours thinking about my patients, reading up on treatment techniques, figuring out the best approach for a particular problem, and reviewing what worked and what didn’t. And when I realize I’ve made a blunder, I get really upset. After all, when you’re dealing with the human psyche, the stakes can be quite high.

In my business, mistakes aren’t nearly as clear-cut as, say, in surgery, when you know instantly and with dramatic effect that you’ve nicked an artery. As schooled as I am in reading people, I’m not clairvoyant. I may make a remark that is misinterpreted or push harder than someone is ready to be pushed. I may not discover a misstep until it’s brought up weeks later– or, worse, when a patient abruptly, with no explanation, stops coming to see me.

Sigmund Freud used to sit behind the couch where his patients reclined to pour out their deepest secrets. He claimed that this hidden vantage point, by eliminating the discomfort of eye contact, encouraged the flow of free associations. But, really, according to psychology lore, he liked not being seen in case he fell asleep.

Drifting off during a session is every therapist’s worst nightmare, the equivalent of suturing up a surgical incision with a sponge still inside. It might never get noticed or, if it does, might not have any serious consequences. But sometimes it can cause major, even irreparable, harm.

It happened to me once, to my knowledge. I was tired that day, having been awakened frequently during the night by my new puppy whining in his crate. I was with a patient I’d known for a while and liked very much. We had been doing good work together. His was the first appointment after lunch, and the combined soporific effects of the L-tryptophan in my turkey sandwich and the previous night’s sleep deprivation finally overwhelmed me. My eyelids decided to stage a mutiny, and I succumbed to the overpowering urge to shut them. I instantly jerked to attention, but the damage had been done.

Later that evening I got an email from the unfortunate person who had been at the receiving end of my narcoleptic lapse. To my horror, he told me he had seen my eyes close and informed me that, despite having benefitted a great deal from his treatment with me, he wouldn’t be returning.

Mortified, I sent him a note of profuse apology for my unprofessional behavior and urged him to come back at least once so we could talk. He did, and he was gracious enough to forgive me (much more quickly than I forgave myself, I might add). He decided, after all, to finish out his therapy with me, and my fade-out even became a running joke between us, though it took some time before I could laugh about it without feeling my cheeks redden.

I realize I’m taking a big risk by posting this story and laying bare a mistake that tarnishes my professionalism. That’s why I decided to do it. If I expect to have any credibility when I counsel others to accept their imperfections, I have to come to terms with my own.

In the words of martial artist and Eastern philosopher, Bruce Lee, “Mistakes are always forgivable, if one has the courage to admit them.” And, I would add, to make peace with them.

I’ve been doing an informal survey of workplace errors and will share some of them in my next post. Stay tuned.





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Posted in Acceptance and Mindfulness, Perfectionism |

Scaredy Dog

By Lynne Gots, posted on August 31st, 2011.

Like I’ve said before, dogs can teach us a lot about behavior if we bother to pay attention.

My Australian Shepherd, Freddie, is very high strung. He’s what’s known in training circles as a “reactive” dog. This means he barks at pretty much everything– bad guys on TV, garbage cans, the vacuum cleaner, motor cycles, Dr. Hambright (his vet), German Shepherds. These are just some of the many things that frighten him. We know this because, according to animal behaviorists, dogs barking out of fear sound and look different from dogs barking out of excitement or joy.

Freddie goes into a vocal frenzy whenever new people enter the house. He comes from a long line of sheep dogs, and it’s an occupational plus for his breed to be suspicious of interlopers. But Freddie takes the job of protecting his flock a little too seriously.

I’ve worked hard to get him to associate visitors with good things, like marrow bones and juicy steak tidbits. And, in much the same way I teach my human patients to face their fears gradually, I try not to put him in situations that would be too much for him to handle, keeping his fear level at around a 5 on a scale of 1 to 10. But sometimes I forget to follow my own expert advice.

Last week my son’s college roommate, Bryan, was staying with us for a few days before the guys drove back to school. Whenever Bryan entered or left a room, Freddie barked at him. I usually hold Freddie on a short leash if strangers are in the house so I can control the distance between him and them until he gets more comfortable—“habituates,” in behavior therapy parlance.

For some reason, though, this time I got lax. Maybe I was hoping he’d suddenly act like our late Golden Retriever, Calvin— a dog who gladly would befriend any person who extended a hand for him to lick. I let Freddie get close enough to Bryan for a head pat. Bad idea. Freddie let us know loud and clear, with snarling and baring of teeth, that we’d gone too far. This was maybe an 8 or 9 for him, and it was too much.

Lesson learned. Two lessons, actually: 1) Freddie is his own dog, and I need to accept him as he is, and 2) Slow and steady works best when doing exposure therapy.

By the time the loaded car pulled out of the driveway, Freddie had worked up the courage to nuzzle Bryan and lick his hand. Not like Calvin, exactly, but good enough for me.





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Posted in Behavior Change, Dogs, Phobias, Techniques |

School Daze

By Lynne Gots, posted on August 29th, 2011.

It’s been decades since I last boarded a school bus as a student, but seeing those behemoths swarming down my street today like giant yellow jackets still made my stomach knot up. I no longer have homework or new teachers to worry about, or even my kids’ homework or teachers to concern me. Yet that old, familiar mix of melancholy and dread returns every August as soon as the lunchboxes and thermoses show up in the supermarket.

September has always gotten to me. It must have something to do, I guess, with being reminded of the inexorable march of time. Unlike many of the moms I know, I never counted the days until summer ended or kicked up my heels in unfettered joy at the prospect of “me” time. Not that there’s anything wrong with that; I was just too caught up in the sadness of letting go to feel excited. While the other PTA parents were toasting their freedom with Mimosas at a neighbor’s annual, first-day-of-school brunch after dropping their kids off at the bus stop, I was holding back the tears.

I often think about a conversation I had with a friend when my oldest daughter was two and his only child was about to graduate from high school. Looking wistfully at my curly-haired toddler, he said: “Enjoy it now. It goes so fast.” At the time, caught up as I was in the bedtime battles, temper tantrums, and endless viewings of Disney’s Cinderella, I brushed off his advice. But he was so right. That strong-willed two-year-old has, herself, long since graduated from high school, and she went back to school today—as a second-year law student.

Don’t get me wrong. I’m not always wallowing in nostalgia. When I’m not sniffing my kids’ pillows like a rooting sow,  trying to catch  lingering whiffs of their scents, I do see some advantages to an empty nest. I don’t have to pack lunches. I can relax at the end of a long working day without having to start fashioning igloos out of marshmallows and decorator’s icing (yes, I really did this). And my husband and I can eat dinner together at 9:00 pm without hearing any complaints. Besides, the dogs make great child surrogates—superior, even, to their real counterparts in some ways.  They rarely talk back, don’t leave their clothes all over the floor, and never keep me awake into the early morning hours, unable to fall asleep until I hear a key in the front door.

And, best of all, they won’t ever grow up and leave home.





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Posted in General |

This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.

Contact Dr. Gots

202-331-1566

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If you don't receive a response to an email from Dr. Gots in 48 hours, please call the office and leave a voicemail message.

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