Internship Class Reflections

Evening in M 1

Due to my poor time management skills, I ran out of time for comments during my Tuesday internship class. This error provided a sudden inspiration to continue making comments to my students via email. I asked their permission and they seemed interested. It reminded me of a technique Rita used to use when running groups. Following every group, she would write her own insightful reflective comments and send them out to the group members.

Here’s what I shared with me students . . . with . . . of course . . . all identifying information removed.

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In class I mentioned that I wanted to email you some ideas I didn’t have time to share . . . so here we go.

Based on the small amount of recording we listened to together, it sounded like our rock star counselor-in-training (aka “Rocky”) has established an excellent “relationship” or working alliance with her client. That being the case, many things are possible.

The first thing is what I already mentioned at the very end of class. Using her relational connection as a foundation, Rocky can use any of a number of strategies to open up a discussion about her changing her approach to less listening and more engagement. This doesn’t mean I think Rocky “should” be more active, but because Rocky feels it to some degree and brought it up with us, it’s a signal to me that it might be an issue worth exploring. Here’s an example:

“I’ve been thinking about how I act during our counseling sessions. Sometimes I notice myself sitting back and listening as you tell me a story about your life. I think the stories are important, so I mostly just stay quiet and listen. But I’m also wondering if, because the stories are important parts of your life, if maybe I should be more active and engaged with you as you share your stories with me. It might be better for me to ask questions, make comments, or try to identify patterns. If it’s okay with you, I’d like to talk a bit more. Would you be okay with that? If I try it and you don’t like it, we can always switch back.”

This way of bringing up the issue places the focus on Rocky’s behavior and it models how part of counseling involves self-reflection/analysis. It also introduces the idea as an experiment that both Rocky and her client can comment on.

The second issue I wanted to discuss more is the client’s reluctance to “get into her emotions.” Of course, this is a very common reluctance. If we look at it through a motivational interviewing lens, it’s very possible for her to be ambivalent about getting emotional. Part of her can see the value and part of her is afraid or reluctant.

One possible strategy, among many, is for Rocky to affirm that it’s okay to avoid talking about emotions (at least for now), but that in the meantime, it might be helpful to explore what makes talking about emotions feel so challenging. The point is to focus on “what gets in the way” of talking about the emotions directly first, and only then, after greater understanding is obtained, possibly move forward and experience the emotions.

Using this strategy, the assumption is that there are negative expectations (cognitions) linked to directly feeling/experiencing emotion. One of the following could be possible: (a) “I’m afraid once I open the emotional box, I won’t be able to stop” (then you explore if this has happened and examples of how she has recovered after being emotional in the past); (b) “I’m worried that you’ll judge me” (then you explore the possibility of that happening; (c) “I feel weak when I get emotional” (this might inspire a discussion about whether facing emotions directly is an example of being weak or being strong, or something else).

These are just some examples of the thoughts/expectations that can interfere with emotional processing. Many other unique scenarios are possible. In my experience, if you use collaborative empiricism to explore negative expectations, sometimes the expectations can be managed . . . and sometimes clients will spontaneously start talking about the benefits of emotional expression.

My last idea is related to a component part of EMDR. When clients have an image or situation linked to a specific trauma, EMDR practitioners employ two questions that are IMHO quite powerful. Here they are, using a made up scenario:

  1. “When you imagine the scene at your mother’s funeral, what negative belief about yourself comes into your mind?”

You might have to repeat that question because it’s complicated. The assumption here is that the trauma memory is linked to a core negative belief about the self.

Then you move to the opposite question:

  1. “When you imagine the scene at your mother’s funeral, what positive belief about yourself would you rather have come into your mind?”

You don’t have to be using EMDR to find your client’s answers to these questions very useful. The first answer is the disturbing or dysregulating belief. It needs desensitizing or disputing or something. The second answer is a new belief about the self that may constitute a major therapeutic goal. It needs supporting; it needs to become a possibility.

So . . . how do you get there? Well, I’d go on, but we need to have something to talk about next week:).

Have a great evening.

John

 

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Aotearoa New Zealand Conference Keynote

NZ Tree and John

Kia ora.

Today is the future in New Zealand where I have the distinguished and humbling honor to present the closing keynote speech at the New Zealand Psychological Society’s Jubilee Conference.

Attached here are two things:

  1. The Brainstormed powerpoint slides from my workshop last Wednesday. These include a list of resources that New Zealand professionals and students have found useful in their suicide assessment, intervention, and prevention work. NZ 2018 Workshop Brainstorming
  2. The powerpoint slides for today’s keynote:NZ 2018 Suicide Keynote Final

New Zealand Jubilee Resources!

Kia ora.

I’m in New Zealand to present at their 50th Anniversary Jubilee Psychology Society Conference. . . which is way cool. Below are two resource links.

First, the Powerpoint Slides: NZ 2018 Suicide Workshop

Second, a link to my 2018 Journal of Health Service Psychology article on suicide assessment and intervention: https://www.nationalregister.org/pub/the-national-register-report-pub/journal-of-health-service-psychology-winter-2018/conversations-about-suicide-strategies-for-detecting-and-assessing-suicide-risk/

Have a fabulous week!

John

The Long Version of the Trump Personality Slate Magazine Article

 

Publishing a piece in Slate Magazine was fun and interesting. The editor did a nice job reining me in and trimming the piece to an appropriate length. However, for anyone interested in the long-winded JSF version of the article, here it is. As you’ll notice, I included the examples of Trump’s behavior that fit the Millon personality descriptors.

My dad helped inspire the Slate article with his clear and concise comments about DJT’s “con man” skills. Here we are NOT talking about DJT.

John and Max Seattle

Preparing for and Containing a Trumpian Endgame

Pundits and professionals regularly express concerns about Donald Trump’s mental health. Most speculations focus on Narcissistic Personality Disorder (NPD). It’s easy to see why. If you look at the DSM-5 criteria for NPD, Trump’s public behaviors are obviously consistent with all nine diagnostic criteria. Even further, because only five of nine criteria are needed for an NPD diagnosis, Trump getting nine of nine is huge; perhaps no one has ever seen a narcissism quite so beautiful. Nevertheless, we still can’t diagnose Trump with NPD. That’s because it’s unethical to diagnose anyone without first conducting a professional evaluation. Also, Trump doesn’t meet the distress or impairment criteria required for a mental disorder diagnosis.

As disturbing as observations of Trump’s narcissism may be, what’s frightening about his personality isn’t narcissism. Narcissistic traits among politicians and presidential candidates—who often have big personalities—are common. Far more worrisome and dangerous is that his statements and behaviors fit so well with a different personality style. This style is what the renowned psychologist, Theodore Millon, called “The Aggrandizing-Devious-Antisocial Personality” (aka antisocial personality).

Millon summarized these personalities as “driven by a need to . . . achieve superiority.” They act “to counter expectation of derogation and disloyalty at the hands of others,” and do this by “actively engaging in clever, duplicitous, or illegal behaviors in which they seek to exploit others for self-gain.” Sound familiar?

What follows are summary descriptions of Millon’s antisocial personality style. Keep in mind that Millon’s statements are not diagnostic criteria for a mental disorder. The purpose here is not psychiatric diagnosis. Instead, my goal is to describe Trump’s personality, speculate on his future behaviors, and discuss strategies for how antisocial behaviors can be contained. To invoke a cliché, knowledge confers power; the more we understand Trump’s personality, the better prepared we can be for the directions his behaviors may take us.

Impulsive Imprudence. Millon described antisocial personalities as “. . . shortsighted, incautious, and imprudent. There is minimal planning, limited consideration of alternative actions, and consequences are rarely examined.”

Reading this, you may immediately think of Trump’s impetuous meetings with Kim Jong Un and Vladimir Putin, his sudden decision to impose international tariffs, or a different example. Whatever the case, it’s easy to spot incautious patterns in Trump’s behavioral repertoire. Now, and going forward, Trump needs continuous supervision and monitoring. This is especially the case when he meets with authoritarian leaders. Millon further described this impulsive style, “There is a tendency to jump from one exciting and momentarily gratifying escapade to another, with little or no care for potentially detrimental consequences.” Trump will probably need a clean-up team to finish his work or conduct damage control following his various escapades.

Blaming Others for Shirked Obligations. Antisocial personalities “frequently fail to meet or intentionally negate obligations of a marital, parental, employment, or financial nature.” When negative outcomes arise, Trump will be inclined to blame external forces or subordinates. This is the equivalent of a personal philosophy in direct opposition to President Harry Truman’s, “The buck stops here.” Holding Trump responsible for his behaviors has been, is, and will be extremely challenging.

Pathological Lying. Millon wrote, “Untroubled by guilt and loyalty, they develop a talent for pathological lying. Unconstrained by honesty and truth, they weave impressive talks of competency and reliability. Many . . . become skillful swindlers and imposters.”

Trump’s disregard for truth and fact is already legendary, with over 4,200 Trump lies since his inauguration. Millon also noted that antisocial personalities “play their games of deception with considerable skill” and “experience a degree of pleasure” from their deceptions, gaining “special joy in . . . taking from others.” These descriptions underline the need for the press and Congress to continually monitor and report the accuracy of Trump’s statements.

Declarations of Innocence. During times of trouble, antisocial personality types employ an innocence strategy. “When . . . caught in obvious and repeated lies and dishonesties, many will affect an air of total innocence, claiming without a trace of shame that they have been unfairly accused.”

Trump has repeatedly proclaimed his innocence, calling the Mueller investigation a “witch hunt” and frequently tweeting, “No collusion!” As he feels increasingly threatened, Trump’s claims of innocence will likely escalate, along with spirited efforts to arouse support by pinning the blame on individuals who are well-hated by his populist base—like President Obama or Hillary Clinton.

Empathy Deficits. Antisocial personalities are devoid of empathy and compassion. Millon called this “A wide-ranging deficit in social charitability, in human compassion, and in personal remorse and sensitivity.” He added that “many have a seeming disdain for human compassion.” Going forward, Trump’s efforts to display empathy or sustain charitable behaviors will sound and feel much less genuine than his glowing statements about himself or his aggressive attacks on his detractors.

Counterattacks. Millon noted that antisocial personalities are hyper-alert to criticism. He “sees himself as the victim, an indignant bystander subjected to unjust persecution and hostility” feeling “free to counterattack and gain restitution and vindication.” For Trump, the urge to counterattack appears irresistible. He often uses a favorite attack or counterattack strategy among antisocials—projecting their own malicious ideas and behaviors onto others through name-calling and accusations of illegal (or crooked) behavior. Trump’s pattern of lashing out at others will only continue to escalate.

Moral Emptiness. Antisocial personalities have no ethical or moral compass. As Millon described, they “are contemptuous of conventional ethics and values” and “right and wrong are irrelevant abstractions.” Antisocials may feign religiosity—when it suits their purpose. But the moral litmus test will always involve whether they stand to gain from a particular behavior, policy, or government action. For instance, adopting an anti-abortion stance could serve as a calculated strategy, despite having a history of being “very pro-choice.” In all likelihood, no method for Trump to achieve his ends—including separating children from parents—will be morally beneath him.

Clinicians have observed that some individuals with antisocial personalities burn out. Over time, negative family and legal consequences take a toll, prompting antisocials to conform to social and legal expectations. However, as in Trump’s case, when antisocial personalities wield power, burning out is unlikely. Power provides leverage to evade personal responsibility for financial maleficence and sexual indiscretions. Antisocial personalities who have the upper hand will increase their reckless, impulsive, and self-aggrandizing behaviors in an effort to extend their ever-expanding need for power and control. Trump will continue to be drawn toward authoritarian leaders, because they symbolize his interpersonal goal of gaining power and authority over everyone.

Because antisocial personalities don’t change on their own and don’t respond well to interventions, containment is the default management strategy. Without firm, unwavering limits, deception, law-breaking, greed, manipulation, and malevolent behaviors will increase. An antisocial person in a position to self-pardon or self-regulate is a recipe for disaster. Containment must be forceful and uncompromising, because if an antisocial personality locates a crack or loophole, he will exploit it. Staff interventions, comprehensive law enforcement, and judicial systems that mandate accountability must be in place.

Three main containment strategies remain in play: Republican control; the Mueller investigation, and a November blue wave.

Unfortunately, although many Republicans are concerned about Trump’s behaviors, they’re no match for Trump’s populist charisma. Defying Trump is too costly; he can make Republicans pay with electoral consequences and his populist base will pelt defectors with threatening hate mail. Like him or not, Republicans have little motivation for clashing with a powerful leader who promises them judicial appointments and legislative opportunities, the likes of which they’ve not seen in their lifetimes.

Recruiting independent actors to resist Trump is also difficult. Trump skillfully uses intimidation, direct and indirect threats, and offers of power to recruit new supporters who will walk to the microphone, as Brett Kavanaugh did, and speak to the world of Trump’s unprecedented greatness. Exhibiting a glaring lack of judicial independence, Kavanaugh opened his nomination speech with a no holds barred endorsement of Trump’s character, stating, “No president has ever consulted more widely, or talked with more people from more backgrounds, to seek input about a Supreme Court nomination.” Never mind that reflective consultation is anathema to antisocial personalities or that Kavanaugh would have had to review 230 years of Supreme Court nominations to support his statement. Soliciting others to lie for them is a common antisocial strategy. Kavanaugh‘s genuflection to Trump is a foreboding example of how far and deep Trump’s power and influence run.

The Mueller investigation and November blue wave are in danger of being outpaced by Trump’s unmatched speed and skill for playing “games of deception.” Trump’s talent for quickly tweeting divisive messages and propaganda is well-established. Without organized political opposition and a massive public movement for truth, justice, and integrity, Trump will continue winning and most Americans will continue losing.

Even if one or more of these containment strategies succeeds, it’s difficult to envision the American public emerging unscathed. Trump and his followers have shredded civil discourse and elevated division, distrust, and hatred. If he is dethroned, Trump has all but ensured that public conflict over his fall from grace will be painful and violent. Preparation for a Trumpian “call to arms” is necessary.

Coming together to contain a common threat is the best path forward. Trump’s personality and probable future behaviors are inconsistent with American virtues and values and the rule of law. Our youth don’t need a presidential role model who pays off porn stars, locks up children, and locks out the press if they ask him hard questions. For all Americans who crave integrity, honesty, and civil discourse, it’s time to gather together under a large (metaphorical) tent, where all are welcome and respected. We can sort out our differences on climate change, guns, and abortion later. If we don’t come together now—as Mr. Trump himself might say—we’ll soon be facing a huge national and global crisis like no one has ever seen before.

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John Sommers-Flanagan (johnsommersflanagan.com) is a clinical psychologist, professor of counselor education at the University of Montana, and author of eight books, including Clinical Interviewing (6th edition, John Wiley & Sons). The views expressed here are not representative of the University of Montana or the Montana University System.

 

My Slate Article on Donald Trump’s Dangerous Personality Dimensions

Hi All.

The Slate Magazine article where I use Theodore Millon’s personality descriptions to articulate possible challenges linked to Trump and the U.S. Presidency is out. Here’s the link: https://slate.com/technology/2018/08/no-matter-how-bad-it-gets-trump-will-never-give-up.html

As always, feel free to comment. You can do that here or on the Slate article itself.

John SF

The Rest of the Story on Trump’s Personality

AOIP6519

The Slate article on Donald Trump and his personality is coming out tomorrow morning. Of course, as with all things writing, it was wonderful and challenging. Writing for a popular online magazine like Slate is a new venue for me, so I learned plenty, and was honored to work with Slate’s Health and Science editor, Susan Matthews. She helped me be more focused and more articulate.

I’ll post a link to the article here tomorrow.

The main focus of the article was to look at Donald Trump’s personality through the lens of Theodore Millon’s antisocial personality formulations. Millon’s perspective is fascinating and I think some of his descriptive phrases fit Trump “beautifully,” but one of the  points of the article is for you to be the judge.

In the meantime, I want to share a paragraph that got cut. As we made revisions, it fell slightly outside the focus, but it was one of my favorite paragraphs. . . so here it is:

Recruiting independent actors to resist Trump is difficult. Trump skillfully uses intimidation, direct and indirect threats, and offers of power to recruit new supporters who will walk to the microphone, as Brett Kavanaugh did, and speak to the world of Trump’s unprecedented greatness. Exhibiting a glaring lack of judicial independence, Kavanaugh opened his nomination speech with a no holds barred endorsement of Trump’s character, stating, “No president has ever consulted more widely, or talked with more people from more backgrounds, to seek input about a Supreme Court nomination.” Never mind that reflective consultation is anathema to antisocial personalities or that Kavanaugh would have had to review 230 years of Supreme Court nominations to support his statement. Soliciting others to lie for them is a common antisocial strategy. Kavanaugh‘s genuflection to Trump is a foreboding example of how far and deep Trump’s power and influence run.

After the article is out, I’ll be posting more content that wasn’t quite ready for prime time.

 

The place to click if you want to learn about psychotherapy, counseling, or whatever John SF is thinking about.