Anger Management Interview – Video

Hi everyone!

In this episode from MakiAlam with hosts Pelita Uy and Angelo Almonte, I discuss the recent reports about an irate employer who physically abused a housekeeper.  For all of you who have anger issues like I do, I hope you learn a few things here.

Fourteen Years of:  “Just Call Me Nathan.”

by Nathan Chua

One thing I dislike is titles.  I have always been uneasy with titles unless they were used in settings where it is necessary to set limits, respectful, honorific or makes it easier to identify the people being referred to.  The counseling room has never been a place where I thought titles were necessary.  One thing that I don’t want to impart to any of the people I see. is for them to view me as someone who’s got it all together somehow.  I don’t want them to think that I have some kind of panacea that will answer all of life’s problems.  I love the way one ACT (Acceptance and Commitment Therapy) expert put it, and I will paraphrase it here.  I often use this metaphor to describe the kind of relationship I will have with my clients.  I am not ahead of them nor am I on top of them looking down.  We are just two people climbing up our own mountains that are facing each other.  My job is to see what’s ahead of you as you climb yours and give you signals when I see what’s coming your way.  

Which brings me to the point that I want to make in this article.  What on earth are we doing counseling for?  If you have had this question come across your mind before, don’t be alarmed.  I have asked myself the same question many times before.  Through more than a decade’s work, I have hypothesized about this.  As a healer, I thought that my job was to relieve symptoms.  As a humanist, I thought that it was to find acceptance and purpose.  As a psychodynamic counselor, I thought my job was to come to terms with the past.  Today however, as a behaviorist, I have come to see that counseling is about being able to handle our difficult thoughts and feelings in a more effective way.

To date, I still find behaviorism to hold the most promise in helping alleviate human suffering and promoting successful living.  Please remember that successful living in this context is not about having the most financial success or the happiest existence.  Successful living is about helping people live up to their greatest potential.  This is not in the service of any temporary exuberant feelings nor is it about having great wealth, but about having a life that’s meaningful to the unique aspirations of every individual.  

What I find hopeful in behaviorism is the goals that it establishes that are based on scientific evidence.  A metaphor that ACT therapists use to describe the process is like learning to speak a new language.  If we spend a long enough time using a new language, we will start to get used to it and eventually not go back to using our old language.  Nonetheless, learning that new language does not mean that we completely forget the old one.  

In less metaphorical language, it simply means trying out new or different ways of behaving in the face of life’s problems.  There is an old ACT saying among therapists which goes like, I don’t have tricks to change how a client feels, but I have tricks to help a client live the life they want even with those difficult thoughts and feelings.  Here are some examples of how this can be manifest in a life:  

  • If you react to painful experiences by griping and ranting, then maybe try sitting with the pain with compassion and find out why it pains you.  Maybe it tells you that you care about something that is life-giving and loving.
  • If you react to painful experiences in relationships by running away, then maybe try to learn new ways of staying put and communicating more effectively to let the other person know how important they are to you.
  • If you react to painful experiences by distractions like drugs, alcohol, binge watching, or even working, then maybe try to see if you’re missing out on the more important goals or relationships you had in mind before the challenges came.  

I don’t know if there’s better science out there.  I would like to find out.  For now, it’s been quite the adventure of a search for what best serves the lives of those I see.   If there is one thing that I am slowly losing while learning ACT, it’s my ego.  Good riddance!  I am just your fellow sojourner my friends, and that’s why I’d appreciate it if you’d just call me, Nathan.   

Thank you for fourteen years. Your shared lives have made mine sweeter and more worthwhile.  

Pain vs. Suffering Video!

Pain vs. Suffering

by Nathan Chua

There’s an old aphorism that goes, “Pain is inevitable, suffering is optional,” credited to Japanese writer, Haruki Murakami.*  Have you seen a kid who was disappointed by a parent or primary caretaker who wasn’t as appreciative of a pyramid of blocks it created, and then proceeds to wipe out the masterpiece with one quick stroke of an arm?  I do remember myself doing so but can’t remember what my creation was.  If we look closely, we as adults sometimes revert to this way of coping with the inevitable hard feelings or the pain we get in situations at home, at work, and at random moments in our days. 

I am here borrowing a series of questions you might ask yourself when faced with a challenging moment in these situations.  This can help you see if you may be causing more pain on top of what is already an emotionally difficult moment.  I borrowed this from a book written by experts in functional analytic psychotherapy.**

  • In that situation, can you notice what it is that you do in reaction to it?  
  • If another person is involved, what do they do in response to your reaction?
  • What do you think it is that you do that aggravates or contributes to the problem?
  • Did the way you reacted show up in other places or with other people?
  • What is immediately rewarding about what you do?
  • What is it costing you in the short term?
  • What do you foresee will happen if you continue doing what you’re doing in the long run?
  • What would happen if you stopped doing what you’re doing now?  What would you have to be willing to accept?
  • Is there a purpose important enough for you to accept or face that?

In your relationships with your partner or your family:

When people in close relationships fight, there’s usually a reason for such behaviors.  Very often life’s stressors provide enough of a catalyst for differences and emotional sensitivities to be highlighted.  Couples and parents often believe that their partners or children need to be exactly just like them.  There is a tendency to believe that what is evident to one should be evident to the other.  There is nothing wrong with these thoughts for that is a typical function of our minds.  We compare and find out what should or should not be the same.  However, in your attempts to change the other, what results do you notice you get?  And if you didn’t do this, maybe you would have to accept that you and your kid or your spouse are different from you.  Now is there a purpose here for which you would be willing to accept that?        

In your relationships at work

Just like in other areas in your life, change happens at work.  Let’s take for example your boss.  We all hope that we have only one boss who happens to like us and the way we work, usually for life!  Unfortunately, that is not, most of the time, under our control.  Many decisions from within the hierarchical structure are handed down from above.  So ask yourself the questions posed above.  Let’s say you end up consuming hours contemplating how bad things have been since your company had a change of management.  You may notice that there are short term costs involved in this behavior, like procrastinating on your work tasks.  In the long term, such a habit can only lead up to you losing your job or getting bad marks on your performance.  Would you be willing to accept the fact that companies change and at times your boss will frustrate or be different from you?  What would be reason enough for you to accept this reality?  Is it the family that you love and care about who depend on your job to sustain their needs or even lifestyles?  Is it that long wished for vacation that you planned to spend with loved ones?          

At random moments    

You and I know that driving in a megapolis like Metro Manila can be rather challenging.  Anger and frustration are easy to come by when you have to contend with multiple threats to your peaceful drive home.  When you yell and scream inside your vehicle while your kids and partner are with you, what do you notice are the payoffs and both short and long term negative consequences?  Has it gotten in the way of an otherwise happy ride home?  Would you have to accept that at times driving in an overcrowded city can be challenging?  Is your drive home important enough of a reason for you to hold your peace?  

There you go my friends.  Hope these examples will give you a snippet of what you can learn from what the experts have painstakingly worked to provide us with, which is the knowledge that we are not free from life’s pains, but we are free to choose how we respond to them.  Will we follow old rules of thumb that have both long and short term costs to what otherwise are things we most cherish about our jobs and relationships?  Or will we stop and take a step back and see from a distance what we can do differently to avert the costs and live well in the moment?

*https://www.goodreads.com/quotes/613585-pain-is-inevitable-suffering-is-optional-say-you-re-running-and

**FAP Made Simple by Holman, Kanter, Tsai, Kohlenberg

Making the Hard Life-Changing Decisions

by Nathan Chua

There are a few crossroads we face in life.  Who to commit to in a long term relationship or when is it time to quit one, what course to take in tertiary education, where to live, what school to send kids to.  These are all part of what life presents to us.  Many of us can get caught up in the rigmarole of decision making.  Many clients come to therapy hoping to get an expert opinion on which path to take.  It is quite the common sight that clients come to therapy with the idea that they can consult as many therapists as they can, and come up with a logical and sensible decision.  That search for a failsafe choice can be a red herring.  Many people, and that includes me, can get really stuck for a very long time in indecision.  

Clients may find themselves weighing pros and cons with an expert in therapy.  Unfortunately, this normally ends up with what is called counterpliance or the client making a decision that goes in the opposite direction of what solution was arrived at with the expert, basically demonstrating what our minds do.  You can experiment on this by remembering how many times you have thought about how successful a decision can be.  Pretty soon, you will notice your mind reminding you about the other extreme result, which is failure.  This is why, although tempting to me, I do my best to avoid dwelling on content when a client comes to me with this kind of dilemma.  If I wasn’t conscious, I can get carried away by the back and forth in therapy.  I avoid this because it isn’t something that the client is not able to do on their own before they come.  So any kind of move in this direction will probably be nothing new for the client.  

Fundamentally, our lives can flow into these situations wherein we have to choose one way or another.  In a wonderful demonstration of how an ACT (Acceptance and Commitment Therapy) therapist would work with someone who is going through some difficult decisions, Dr. Steven Hayes shows how our minds can trick us into thinking that we can make a difficult decision and not be scared.  The thought that hard choices should not be scary can creep into this process and paralyze us into not making them to our own detriment.  

I often give my clients a perspective towards the past and the future with a question.  I would ask them if they are familiar with scenes where people are gathered for one of those momentous occasions in life that are supposed to be filled with joy and anticipation.  If these were indeed just full of positive feelings and happy thoughts, then why the heck do we see people crying in these instances?  Isn’t that strange?  Just to refresh your memory, have you been to a wedding, a graduation, a debut (an 18th birthday party)?  More often than not, you and I will see people tearing up with smiles interspersing in their faces.  Why is this?  My client will often sit with mouth agape, not finding the right word to explain such a phenomenon.  I would tell them that the body language is precisely a description of what is going on inside of them. It is a mix of feelings.  It is not just purely happiness that is going on internally.  There could be sadness, fear, anxiety, and many more.  In other words, these are the bitter sweet moments in life.  You know, the ones that are eventually etched in our memories as the most meaningful.  For in life, the best moments are not the fun moments, although they can be, but they are mostly also those that are hardest.

I can still recall some of the happiest moments I had that I spent with a friend.  Although there was nothing but fun and joy at the time, there was still something bitter about it.  It had to end.  Life is sometimes bitter sweet or has to be, bitter sweet.  Otherwise, we could be missing it.  Making hard decisions usually forms part of living richly and meaningfully.  Being brave is not about having no fear.  It is rather doing what matters to us even when there is.       

Finding Your Purpose: A Behavioral Perspective

by Nathan Chua

In a recent article about Tim Cook, the current CEO of Apple computers, he had this to say about an old saying: 

“There is a saying that if you do what you love, you will never work a day in your life,” Cook said during the speech at the Mercedes-Benz Superdome in New Orleans.

“At Apple, I learned that is a total crock,” Cook said to a laugh from the crowd.*

How many times have many of us stared at the horizon to ask ourselves what our existence is for?  There have been many cases in the counseling room wherein people ask me why they have these feelings of emptiness, a lack of purpose or direction in their lives.  Believe me, I still ask myself the same questions.  I am not exempt from life’s difficult puzzles. 

I am quite sure that most of you reading or listening or watching this have browsed through countless articles that try to answer this question of finding purpose.  In this space, I would like to share my take on how this might look like, from a behavioral perspective.  

Here’s my understanding of the subject at this point in my journey inside the world of contextual behavioral science.  We all do things for a reason.  When you pick up your toothbrush in the morning, that has a purpose.  Deciding to use your time to go to the grocery store whether by foot or by the use of a vehicle is also based on reasons.  There are three ways of explaining why we do what we do.  We either think of them as activities that we should, must, or can’t do, that we have to do, and that we want to do.  Now, let’s break each one of them down.  

Musts, Shoulds, Can’ts:

As humans who enjoy being at the top of the food chain, we occupy this spot in part because of our capacity to follow rules without having to experience something first hand.  We can just be told about a rule and not have to test it.  You can imagine how helpful this ability can be if we go back to ancient times when a rule to follow might be, “Don’t go near a lion because it can be dangerous.”   Rules like washing our hands before we eat or avoiding certain places that can pose a danger to our safety are helpful in keeping us safe and alive.

However, this rule following capacity can otherwise be detrimental when applied to threats we sense from the inside.  If we yell and scream at our child or partner, sometimes following that rule can work. 

We get what we want, like a period of less frustration from someone we live with.  The rule here is I shouldn’t be getting to this level of frustration with my child or partner.  Or, I can’t stand this feeling any longer, I must do something to stop it.  Unfortunately, this can have detrimental long term effects on your relationship with the very people that mean most to you especially when done in a harsh manner. 

This can also translate into other consequential decisions in life.  Shoulds like you should be pursuing a career in a field only because it is what others say you should do.

A good example of this is, “I must be a doctor because that is what my family wants for me,” which often leads to burnout and poor performance.

The other extreme is to follow a rule that may not be available for us to follow at the moment.  An example would be, I must be an artist regardless of the fact that I am currently without any opportunities to be one.  

Another form is when we follow rules like I must have a drink when I am stressed; I can’t sleep without a sleeping pill; or I can’t speak before a crowd until I am relaxed.

This type of rule-following can lead to unhelpful and at times unhealthy behaviors where we don’t make advances in what we are capable of achieving within the finite amount of time that we have in our existence.

Have to’s: 

These activities fall under what Tim Cook was probably referring to.  Although we would like an ideal of working in jobs that give us the most fulfillment, we nonetheless would likely end up with aspects of the work that we don’t necessarily enjoy.  This is where some of that idealism has to wear off. 

If you are one who insists on being in that dream job, but can’t find any opportunities to land one, maybe it is time to think about the have to’s.  In the meantime, and we don’t know how long that meantime will be, you might have to work other jobs and pursue your passions through other avenues.  There are people who end up doing what they love on the weekends in a different setting.  Anyway what we love to do we can do even without compensation.  You’ll never know, you might even find it in whatever current job you have that puts food on the table. In other words, there can be parts of your job that allow you to do what you love to do even if it’s less than your ideal.

Want to’s:

Here is where most of us would like to be.  Unfortunately, not even the jobs that fit our passions are purely fun.  If you wanted to play a sport for a living, there’s also the hard part of long hours of practice in a very lonely gym.  So congratulate yourself if you are able to land a job wherein you are fulfilling your want to’s.  

Want to’s can also involve what we do for rest and relaxation.  To go back to an earlier example, your musts, like I must drink to remove my stress, can be changed to, I drink when I choose to remove my stress.  This is where we see the same form of behavior functioning differently in different contexts.

Here’s a quote from Ray Owen, that I believe is a helpful guide for us to know if ingesting something to relax from heavy stress is helpful or not:

“Remembering, planning, daydreaming, imagining, and so on–matter greatly to me too and I wouldn’t give them up.  However, I’d say that they’re good things when they’re chosen,” Ray Owen

You can add having some time off of work or other commitments with a drink or two (or whatever activity it is that you do for recreation) because you choose or want to, and not because you must, is a way to see if you are doing something with your time that is helpful or unhelpful to your sense of purpose.  It is probably something that works for you if you choose to do it rather than something you must do in order to achieve something, like relieving stress. 

So next time you do something that’s like following a rule, notice the rule first, then notice why you’re doing it and see if it is something you feel like you:

  • must, should, or can’t do,
  • or something you have to do,
  • or something you want to do. 

Maybe you will find your place in the sun or what we most of the time call, your purpose for living.  Nice rule of thumb, isn’t it?

*Source: IFL Science