The journey of healing through psychotherapy entails an unearthing of our authentic feelings that we have learned to shut down due to various reasons, including trauma and societal constructs. More and more, we recognize the importance of connection and relationships for our mental health. The space between two people, whether they are client and therapist, two friends, or lovers, may be an essential factor in healing.
On this episode, we have a conversation with professional counselor and educator Phyllis Alongi. Based in New Jersey, Phyllis brings a holistic approach to psychotherapy and healing. We explore toxic relationships, the therapeutic container, clinical inuition, Sandplay Therapy with children, and we also tackle some sensitive mental health topics like trauma, borderline personality disorder and suicidality. Phyllis is a Reiki and Healing Arts practitioner and she is currently completing her doctoral degree in Integral and Transpersonal Psychology.
Highlights:
- Therapeutic Alliance
- Navigating Toxic Relationships
- Clinical Intuition
- Using Sandplay Therapy with Children
- Trauma, Borderline Personality and Suicidality
Resources:
- Exhale-Healing Arts, Phyllis Alongi Website
- Crisis Services Canada – Suicide Prevention and Support
- Crisis Text Line (Canada)- Text HOME to 686868 to text with a trained Crisis Responder
- National Suicide Prevention Lifeline (US) – 1-800-273-8255
- A Gift of Therapy by Irvin Yalom
- Co-Dependent No More: How to Stop Controlling Others and Start Caring for Yourself by Melody Beattie
- Eyes Wide Open by Mariana Caplan
- Awakening Clinical Intuition: An Experiential Workbook for Psychotherapists by Terry Marks-Tarlow
Listen:
Poem Inspired by This Episode
Full Transcript
Thal:
Welcome Phyl to the show.
Phyllis Alongi:
Thank you. Thank you so much for having me. It’s a pleasure to be here.
Thal:
Thank you for coming on.
Adrian:
Phyl. I’d love to hear, just about the early years before psychotherapy, before you found your profession. Maybe if you can share with our listeners a bit about your history. You can go as far back as you feel is necessary to kind of bring us to date as to how you discovered the profession and why you’re doing it currently.
Phyllis Alongi:
Sure. I think that my religious background really had a lot in molding me toward the field of psychotherapy and psychology. Initially, I wanted to maybe be a psychiatrist. I was looking more in something a little more toward a medical model. I was raised a Catholic. I engaged in in 12 years of Catholic school education and it was very prominent in my upbringing and in my family, very family oriented, Italian, New York, you know, upbringing. We were Catholic, we went to Catholic school, we all went to church. It was, there was no question that that’s not how you practiced. I knew that, you know, growing up that I needed to be connected and fulfilled because church was very peaceful for me. But it was what was happening in church that didn’t settle well with me, and then throughout adolescence I really questioned and started to doubt my faith, based on some of the events that happened to me when I was 15, I was on vacation with my family, on Easter Sunday and at a restaurant in vacation in Miami, Florida. My father died and had a heart attack. My mother was 39 and widowed on spring break with her three kids and now her husband’s not here anymore.
To come back (inaudible) from that, it took many, many years. I will share with you that one of my very close family members, developed a substance abuse issue. It really put a strain on our relationship and on our family and I started to question my faith and I started to question, what is my religion and from these questions and these doubts, the yearning to be connected to something, to my belief in a higher power. I customized Christianity and Catholicism to my own spirituality, to meet my needs to connect. Psychotherapy seemed very organic in a way because it was about the human experience and it was about the things that I was gravitated towards, about people, about how interesting I think the mind is [inaudible] tried to scratch the surface and figure out why people do what it is that they do.
I think that plus my spiritual background really propelled me into the direction it was, felt very organic. Studying psychology, learning about counseling theory and technique. It never even felt like I was in school. None of that felt like a requirement to me. I’ve always been a duck to water and gravitated towards that piece of it, and as I became more and more entrenched in psychotherapy, in practice and in my life I’ve learned to take bits and pieces of what feels right to me and implement that into my practice with people.
Thal:
Amazing! So it’s the spiritual aspects, I guess, of psychotherapy that attracted you to psychotherapy as opposed to psychiatry, you think? How would you describe psychotherapy?
Phyllis Alongi:
If we look at psychotherapy through a transpersonal lens or a spiritual lens, we understand that it is what’s between the two people. That is something that we can’t taste. We can’t feel, we can’t color, we can’t touch, but we know that it exists. What is it about two human beings that we can create this space between the two of us, and be able to facilitate healing in that. Yet it’s not something tangible. If you look at Catholicism, many of the mysteries and the main focuses of what we are to believe in are not tangible. It felt very much like that, it is my faith in humanity, it is my faith in my spirituality in the essence of another person where I meet them in that area (inaudible). I know that it exists, and that is the space for healing.
Thal:
Phyl, we just want to go back a little bit and describe that space between two people, the therapeutic alliance. In your opinion, how does that process unfold? What are the elements that have to be present for healing to take place?
Phyllis Alongi:
That’s a wonderful question. When people come to therapy, oftentimes they look for the psychotherapist to not only guide them but be the first, the initial space creator. Part of what’s healing and what facilitates healing is what a client brings, what the other person brings to that space. There has to be some equality in that. What creates that therapeutic container? The elements, I feel, that are very very important to the facilitation of not only cocreating it, but also in where the healing starts is when there’s presence and a person comes to therapy willing to be in the moment, willing to delve deeper, to expand themselves so that they’re ready to shed all of what they’re afraid of to all the preconceived notions that they’ve heard, what therapy is like, or what they went on my website and they saw me first and thought, oh, she’s this or she’s that, and to shed all of that and just be in the moment of each other’s energy.
To me that essence of healing begins that therapeutic alliance. Of course, receptivity, how open we both are to being with each other. How open we are to each other’s suggestions and to the energetic flow or the direction that the therapy is going in, which is client led, but it comes from this participatory cocreated spiritual place where we’re ready and we’re receptive. We’re present and we’re in the moment of that. The alliance is built on that equal cocreated trust that what I need is inside of me and you’re going to help me move through that. You are going to help me ignite that in me so that we can discover ways only I know my limitations and only I know what’s going to work for me and you’re going to help me discover that. We can work through that together. I trust that I’m in the right space at the right time. It truly is exceptional, and when two people, that moment where there’s true healing and there’s true trust and the alliance, the rapport really starts to form, the cocreated therapeutic container gets stronger and stronger and it gets more open to what needs, what will fill it, and what needs to be addressed.
Thal:
It’s almost like this therapeutic container is a third element that’s available between the therapist and the client.
Phyllis Alongi:
Yes and it’s not only initiated by the therapist at the onset of therapy, the client needs to come to therapy already ready to do those things, ready to be present, to be receptive and to begin the alliance. When I look back at years of doing psychotherapy, what were the characteristics of clients who really made nominal therapeutic progress, like whose lives changed, who brought themselves to a space where they were feeling better, where they were higher functioning, where they were more content. I look back at those characteristics because they came to therapy ready. I’m not saying like locked and loaded where I have all the answers and I know what I have to do, but that I’ve thought about it. I’m not going to let psychotherapy happen to me. I’m going to be an active participant in it. I think coming with that mindset, seeing your work through that lens helps to shape that container.
Thal:
In many ways, this is much more empowering. A lot of people feel like psychotherapy is …is this some kind of mind control? Some of them think that or some of them might think, oh, does this really help? What’s the point of therapy? Really a large part of it is what the client brings in and their willingness to realize that the elements of their own healing is within them.
Phyllis Alongi:
Yes, what I need to heal myself, the things that I need to heal, to facilitate healing, to cultivate healing are inside of me, and in this space, we’re going to tap them out. We’re going to tease them out and we’re going to move towards healing. There’s so much in that…there’s intuition, there’s desire, there’s things like my commitment to therapy and there’s a lot of factors and sub-factors involved in that. I think willingness, receptivity, presence and the cocreation of that alliance being, you know, ready to do that are probably that my top three.
Thal:
That’s a very empowering narrative.
Adrian:
Phyllis, how do you describe to your clients your style, sort of your approach to therapy? Cause I, you know, there are many types and techniques out there, do you specialize in any particular methodology? How do you typically describe the process?
Phyllis Alongi:
It’s so interesting because when you join websites like directories and websites like psychology today, they’ll ask, what are your specialties, what techniques do you use? I always find that very interesting o r a client will call and say, you know, someone will inquire, do you do DBT? Do you do CBT? Are you this kind of therapist? Are you that kind of therapist? And I always say this, tell me what you’re looking for? My approach to therapy is that it should be client led and that based on what the information you provide to me of what your needs are, what you’re struggling with and where you want to go, then I will tailor or customize that to suit their needs. Because you know, if CBT techniques, cognitive behavioral therapy techniques, might work with one person that they might not work with someone else, someone else may not be open to just the idea of that and wants something more interactive or less inside my head and more in my behavior.
It depends. I like it to be very client led and it’s a very eclectic blend of what I’ve learned. I consider myself very intuitive so I sometimes go with my own clinical intuition of what techniques I think would work good. You know, would work well with someone, what they would be open to, how they would respond. Oftentimes I might think it’s one way, and then as I get to know someone better, it’s revealed to me that’s something else we’ll work. Usually, it’s just led by the client based on their conversation, what they’re looking for, where their level of functioning is. I think that that’s probably what I am, I’m more holistic and I come from a very spiritual place and I allow the client to tell me about spirituality before I bring it in. I let them bring it in, first, so that I know that it would be welcomed and that they’re receptive to it. I use a myriad of years of bits and pieces of what I’ve learned and what I’ve incorporated that I know is what the client is looking for in the moment.
Thal:
Before we move on to the next question, using words such as empathy and intuition nowadays, you know, it could mean so many different things. What is intuition to you? What does it mean?
Phyllis Alongi:
To me, intuition is a way of knowing without knowing how I know. When I see someone, it’s not a message or channeling, I wish I could say it was that, but it’s energy. My energy is reading your energy and I’m getting information based on your presence and your essence. This is the best way that I can describe it. I hope that it makes sense to your listeners that it’s a feeling that I get and then I take a moment to think what is this feeling? Then I get some information and I don’t know how I know to do that. For instance, I’ll give you an example. If I’m working, if I don’t know a client very well, maybe it is the first or second time that they’ve come to me for a session and we’re talking and I get this feeling like I need to ask about a specific sibling or a maternal grandparent and it is inevitably impactful, has had an impact, negative or positive on this client.
Why would that feeling come to me if we were talking about some work situation or they were explaining something else to me? It’s a way of knowing something without knowing how I know it’s not in anything the client said. It’s not in anything that any paperwork that they would do beforehand or in the intake, it’s not a conclusion that I’ve drawn. It’s a knowing that I get when I’m very connected to someone’s energy and 100% in the moment when there’s that cocreated healing environment and it’s two people present in that spiritual, exceptional transpersonal space between the two of us and we are connected is when I get the most intuitive information and it really does help guide where the sessions are going.
Adrian:
Phyllis, in your opinion, is this intuitive abilities something that can be trained? I mean we live in a society that it seems that the left brain function sort of analytical mode is highly celebrated and perhaps these sort of intuitive skills are a little bit less familiar with and perhaps often just not even an area focus in education. Is it something that can be trained?
Phyllis Alongi:
I definitely think that psychospiritual practices, Yoga, meditation, Reiki, even massage therapists, mindfulness, those are ways to increase it. We all have intuition and I think how we can train someone is how we can harness it and it would be in cultivating practices and giving some guidelines and really learning how to trust early on those intuitive moments that you have. You can ask any therapist who would tell you that they have had clinical intuitions and that they’ve gotten feelings about what to ask clients and directions to go in and have been very successful. Sometimes maybe you’re not right, but that you have to learn to trust it enough to ask.
You have to do it in a way that’s through the lens of appropriateness and respect for the profession, and for the person. To weigh whether or not it is a good question to ask and is it appropriate for me to ask at this moment? That comes with practice. I think training would come in the form of clinical supervision. Certainly a piece of that could be, let’s go through your cases. We talk about the code of ethics, we talk about dual relationships and HIPAA violations, confidentiality, you know, documentation but let’s talk about your clinical intuition. When you get those insights, how do you feel about them and is it something that you know, like any other kinds of technique that you would use?
Is it something that you feel comfortable with? Is it something that you want to cultivate, that you want to fine tune? Is it a skill you want to hone? If a supervisee says yes or a therapist or even a seasoned therapist who’s like,, I always do that, but I didn’t really know anybody else did that because it’s not very mainstream. I think it certainly can be discussed and channelled and fine-tuned and brought to a space where we could definitely come up with some techniques and more guidance on how to cultivate it and when not to use it.
Thal:
Training clinical intuition, that sounds amazing! So that means the therapist has to be working on themselves outside of that therapeutic alliance because what they bring into that therapeutic space can influence the healing process.
Phyllis Alongi:
Yes, Thal, absolutely, it’s important to note that if I’m having energy reading, or if I’m having a reaction and response, somatically, to you, maybe you are to me and I have to respect that too. So, yes, we need to have, clinical supervision outside and therapy outside of our own practice so that we can, one, unload, everybody’s energy in and all the things that we’re working on with all our clients, two, bounce cases off of someone else, but also to work on ourselves ongoing all the time. I don’t think it’s something that you do for x amount of years after licensure. I think it’s something you need to do for the rest of your life.
Thal:
You work with different modalities. One of them, you’re trained as a Sand play therapist, and maybe can you talk to us about that. Can you tell us what Sand play therapist is?
Phyllis Alongi:
Sand play therapy is an amazing modality in which there’s sand, which, you know, is the earth that we’re all very familiar with. When you feel it on the bottom of your feet, just how therapeutic something that organic can be. It was developed many years ago by a woman who trained under Carl Jung. It is a fascinating, wonderful modality to process trauma and other issues. Someone may be having anxiety or depressive symptoms, but especially for trauma without words. So there’s a specific tray that we use that’s a standard size, a regulation tray. Then we have all of these miniature symbols, these miniature objects that are really archetypal symbols. If we look at Jung and we look at what he taught us, it’s that the collective unconscious and that there are symbols and there are archetypes that we have that are based on and shaped by our own personal experience.
Then he believes that there are ones that are innately, inherently, inside of us simply because we’re human. And you know, those are amazing little miniatures and symbols that we use, and they’re so powerful. A client would come to my office either, you know, adult or child. Needless to say, children gravitate toward the sand like it’s amazing. We have to really tease out two things here. When I’m holding onto something and I’m aware of it, it’s very powerful and it’s bigger than me. The more I talk about it and the more I process it with someone and I externalize it, it’s power gets minimized. It decreases. Sand play therapy for a child, let’s just use a child as an example of you know, this situation, so we’re going to say it’s a child who comes to me who may be years and years and years before, as an infant there was some sort of abuse or something happened to them, and that was at a time before they had language or had acquired language to articulate that trauma.
So how are they going to talk about it? How is this going to happen for them? If our body remembers on a cellular level, we have memory of our trauma, of our childhoods, of our life, maybe even in the womb, so how are we going to articulate that at this time before there was words and because the sand and the miniatures are representative of our unconscious and what’s inside of us, it comes out in this narrative, in this story through these archetypal objects and these symbolic objects.
Someone, unguided, will begin to build a tray, which means this is the therapeutic container, which is myself, the office, the space between the two of us, the sand, the hands, the miniatures, the lighting. Sometimes people want to build trays to music, so they pick the music that they like and they just build and they create this extraordinary world in a sandbox on wheels that can turn around, that can spin. When they’re done, they tell you the story of what’s happening of what this world is that they created, and as each of those segments of the story unfolds, the trauma gets smaller and smaller because it’s coming from that cellular memory place. It’s coming from that primordial moment, from my ancestors, from archetypes, from the collective unconscious, and it’s coming from what’s processed and happened to me, before I could even have language to tell you.
When I do it with adults, they’ll oftentimes ask me about it and then ask me if they can do it, and then they get very emotional and tell me or go for like childhood objects and maybe things that are representative of what’s happening in their life now or in relationships. It is a beautiful experience and honestly an honor and a privilege to witness because the mind struggles with intense emotional pain and we have to process it. At some point that’s just the way our psyches work. It will force us to. It’ll keep knocking until we actually process it. This is a wonderful, imaginative, creative, therapeutic way to process what we’re dealing with, what we’re struggling with, without using any words.
Adrian:
Phyllis, I love to ask you, just considering people that might not even have experience working with a therapist. How do you understand trauma? What is trauma and how might you describe that to somebody who is approaching this for the first time?
Phyllis Alongi:
Adrian, there’s so many facets to trauma. I mean, if I saw a car accident on the corner of my block that could traumatize me and someone was injured or just the loud noise of it or holding my breath for that second when I saw two cars collide would be vicarious trauma. If someone that I love goes through something, an illness or when I care about this person, and we’re very close and I see that something is happening for them, I am affected by it, that’s traumatizing. That could impede and interfere with my everyday functioning because it’s something that’s wounded me somehow. It’s pain that I’ve held on from something that’s either happened specifically to me or I witnessed that’s impacted me negatively, and it hurts when I think about it.
When I think about this event or this relationship or this childhood that I’ve had this relationship with someone in my life when I was a child who affected me in a way that was negative. Trauma could be really ongoing. That’s why it’s important even in education, especially in education and especially with children that we…for our educators, for our psychotherapists that work with kids, social workers, school psychologists, whoever, any collateral contact that works, works with the child or an adolescent. I think especially for education though, for educators to ask instead of saying what’s wrong with you, to come from a space of what’s happened to you. We have to understand that someone’s experience brings them to where they are and we want to be able to meet people where they are, and as a psychotherapist, you have to understand when someone sits down in that space, either next to you or you know, because kids like to sit next to us, or sitting across from us.
When someone sits with us, they’re sitting down physically, it’s one person, but it’s all the people in their lives that have affected them in some way. So one person sits down, but there could be 15 people in the room and we have to be able to say instead of what’s the matter with this, what’s wrong with this client? We have to think through the lens of trauma informed psychotherapy. Where have you been? What’s happened to you? It just changes and shifts the dynamic, and it shifts the perspective of the way that you see someone. It comes from the heart. I think that’s something people have to remember. Psychotherapy is a science, psychology is a science, but it’s the science of people and people come from the heart and we have to remember that that’s where they speak from. That’s where they process from. That’s where their pain lies? We have to be able to, to remember that.
Thal:
All the elements seem to include play, spontaneity, and people, and so that has to do with relationships, which takes us to our next question. A lot of people have struggled and continue to struggle with toxic relationships. How would you define toxic relationships?
Phyllis Alongi:
A toxic relationship is a relationship and it can be a limited relationship. It doesn’t have to be an intimate relationship that has a negative impact on a person. Oftentimes toxic relationships are, we really have to change the way we look at that too, because we want to blame someone and we have to remove that from the equation because it’s not a matter of blame. It’s not a matter of whose fault it is. We have to look at, in the relationship between two people where maybe the power isn’t equal or there’s some strain on the relationship or one person is suffering from mental illness and is acting out towards this other person and doesn’t even know it. or maybe someone loved someone and wants to be with them and the other person doesn’t yet they’re together. So in toxic relationships, and I’m using air quotes, although you can’t see me.
Toxic relationships, I think what we’re looking at is unhealthy. It’s unhealthy because it doesn’t speak to my best self because when I’m in this relationship, I’m less than who I really am and what my best potential is as a person. It stifles me, it minimizes me and it makes me smaller than who I really am. People have such light and such energy to them and negative relationships really try to snuff out someone’s spiritual flame. When I think of of negative relationships, toxic relationships, unhealthy relationships, somehow or another, we managed to stay in them longer, well beyond than we should, and we have to look at why. This is why I say we one of the reasons why we need to take blame out of the equation because me being in this toxic relationship and even aware that it’s not healthy and I’m staying in it longer than I should. I’m benefiting from it in some way.
Thal:
Absolutely.
Phyllis Alongi:
By being in this relationship, there’s some benefit to me, and I may not even be aware of it.
Adrian:
Yeah, the word that’s coming to my mind is also codependent relationships. Could you share with listeners what that might mean and how that would work out as an example.
Phyllis Alongi:
Adrian, that’s a term that’s used a lot in addiction because a codependent would be like an enabler. Technically, I think, traditionally when we look at codependence, we look at that like the need to save, the need to really help someone, and because we want to love and nurture and care about this person, we allow them the space and the time to do what it is that they do that has a negative impact on us. Codependency could have many masks, many phases and we can do a whole podcast just on codependency, but I believe that that is so true. It’s so interesting because I see it in families and it’s very oftentimes not really looked at through that lens of family relationships that there is certain codependent behaviors that are evidenced in a family dynamic.
Where the one person maybe isn’t well, and then the child becomes parentified. The parentified child really cares for that parent. The role is confused, but how does that adult child benefit from parenting their parent? We have to look at that too. This relationship fulfills my need to nurture, my need to heal, and I don’t know how to move from that. I don’t know how to detach from that emotionally. I think that’s in a lot of relationships that are not healthy detachment, fear of abandonment, fear of being alone. Your own independent mental health and wellness is not really where it should be because you’ve been snuffed out or stifled, your psyche has been shaped in this negative atmosphere and so it hasn’t been able to grow properly.
Like a plant that’s not nearly in the light enough, it will twist and vine around. It’s misshapen. I think sometimes, kids that come to me with anxieties or the parentified child, they’re like that twisted vine, they’re misshapen and it takes a lot to get them to the space where they need to get, where a parent needs to back down and see, I can accept my role and try to work with kids to kind of not be afraid. That’s what I think about toxic relationships and codependency, it’s another example of a cocreated relationship because initially maybe it was facilitated by one person, but the dynamic now is cocreated. Working on moving that and shifting that kind of energy is a process and it takes time. I tell people there’s no magic wand, but if you are committed and willing, you can certainly get to where you need to get but this is going to take time.
Thal:
I just love the metaphors that you’re using to describe all these dynamics and without really being stuck with all these terminologies. I want us to also maybe touch upon the borderline personality structure. I don’t want to call it a disorder. All these personality structures are an ego defense mechanism, just like the codependency. So what can you say about the borderline, basically?
Phyllis Alongi:
Well, it depends on, like everything, the degree to which someone is in one direction. I think that personality disorders, I look at them as like autism spectrum disorder, like on a spectrum. I agree that you have it or you don’t, but somewhere in there it’s either very intense or not. I think that if we look at, let’s just say borderline personality disorder per se, there are certain characteristics to that. We can talk in extremes, that are very difficult for family members and people who are close to employers and coworkers living with someone who has a borderline personality disorder symptoms is very difficult. It is easy to get sucked into the web of histrionics and drama. The universe, in my opinion, the universe, I’m sure there’s no study on this but I do believe that the universe hears that gravitation towards emotion, high emotion to high drama, to Histrionics, to problems, to obstacles, the universe takes a little snapshot of what it is that you’re thinking and that’s why we have to really monitor our own thoughts.
If I’m always thinking the worst, the hardest, the longest, the craziest, the most dramatic, the most tumultuous relationship, the most passionate lovemaking, the most I was waiting the longest on line, those kinds of things that the universe takes a snapshot of that and so that’s what it gives you, I think, that constant state of thinking so chaotically is what the universe then provides and it perpetuates the lifestyle of someone who has a borderline personality disorder. You can really detect it, early on, although we don’t like to, but you can see features or like a borderline personality disorder flavors in adolescence. There are certain behaviors and thought processes, just the way their mind strategizes and it’s always me and this is happening to me and all of it.
It’s always a snow storm, but a blizzard, their periscope, will go up and look around the room and see where’s the heat, where’s the electricity and that’s where I’m going to gravitate towards, and it is on a very nonconscious level. It is just on an energetic level. Life is very chaotic, very sad, and relationships are navigated by control and how can I manipulate this and make this relationship everything that I need, and it’s really, in my opinion, very underlying fear of being alone, of abandonment. So I will keep my people with me for as long as I possibly can forever. You’re never going to leave me and I’ll do anything I can to see to it that you stay with me, and those relationships are very difficult. Children of parents who have had or were diagnosed or gone undiagnosed with borderline personality disorder, similar to adults who were children of alcoholics, have a whole other host of issues that they deal with going into adolescence and adulthood, emerging adulthood.
When we ask someone’s history, it’s not only biological but to see what runs in your family, only because essentially, because I want to know, where are you coming from, what’s happened to you? If you tell me that you grew up in a household with a parent that was diagnosed or is diagnosed with borderline personality disorder, then it sheds a whole new light on the situation. It’s difficult. It’s very difficult. My advice is that everybody be in therapy, that there’s family therapy that there’s in-home therapy, which would be extremely helpful because the family would get engaged and you’re seeing the dynamic in its natural habitat. Very interesting, very revealing. Every member of the family should have individual and family counseling. It would be the real way to do that and the most effective.
Adrian:
Phyllis in the psychological circles I’ve noticed that borderline personality specifically is a bit, it seems a bit stigmatized and I wanted to ask you, are there hidden gifts to people that might actually have a strong borderline tendency, that might be helpful to work with?
Phyllis Alongi:
Oh, absolutely and you know, Adrian, isn’t it true that every mental illness is just an extension of something we all are experiencing and it’s just the difference is that it’s chronic, it’s bigger than me, it’s interfering with my every day functioning. It’s interfering with relationships. That’s where the difference lies in the end of the spectrum. It’s further down the spectrum of some of our own behaviors. What are the gifts if manipulation could be a gift, if just the sense of how to navigate a situation with fine tune, heightened sensory abilities, amazing. You know, there are many gifts to that, and just like observing and assessing a situation or a person finding, being able to hone in on someone’s strengths and weaknesses, also a gift. In relationships, where even in marital relationships and intimate relationships, being able to detect what it is and anticipate what the other partner needs is very high on the gift skill I think of of someone who may be suffering with that type of disorder.
Thal:
That’s very important that you mention those things because you know, that brings in the role of empathy in difficult relationships. It seems like borderline personality disorder now is the thing that everybody’s talking about and everybody’s realizing and there is a very negative side to it. A lot of people that suffer with borderline also suffer from suicidal thoughts or people that are living with a borderline suffer from suicidal thoughts, which takes us to our next topic, which, I know that you liked her nationwide in the United States, around the topic of suicidology and its connection with youth issues. What can you say about that please?
Phyllis Alongi:
I will tell you about that in a moment but I just want to say that as far as the stigma of mental health is concerned, it’s with every diagnosis and it’s with every disorder, and people have gifts, period. We were talking about, I think we went from negative relationships to negative relationships and borderline personality disorder, but any mental health issue deserves respect and that person deserves treatment and they deserve to feel proud about that. I work really hard to diffuse and break the stigma of mental health, people are people and they are not their diagnoses, just like they’re not their mistakes. That’s something that I want to make perfectly clear and there are people, specialized psychotherapists, who have really specialized in working with that population. If you are suffering or someone you know is suffering with a borderline personality disorder, finding someone who is specializing in that area would be amazing. That would be my recommendation because it’s some, it’s a very dynamic topic and so, we’re getting more and more information about it and so it’d be someone who would be very passionate about working with that population.
When we talk about suicide we have to look at, whether it’s adults or adolescent or child, we have to look at risk factors. One of the risk factors is clinical. If you have a mental health diagnosis, any kind, you are at higher risk for suicide. If you are in a relationship with someone who is struggling and that has a health issue, not only a mental health issue but an illness or you know, you’re in a relationship that isn’t working, there’s some situation that’s causing high anxiety or depressive symptoms or you know, some turmoil in your life. It puts you at risk for suicide.
Certainly, exposure to suicide, exposure to loss will hike you right up the list of risk factors and being in a relationship with someone who has attempted and that level of exposure to suicide or loss can really be one of the biggest risk factors. Also, recently there’s been some good research coming out of I think it’s Yale actually about nonsuicidal self-injurious behavior originally was not connected to suicide at all for many years. It was like there’s suicide, self-injurious behaviors aren’t really related to suicide and Thomas Joiner and some of the other suicidologist are really looking at the connection between misbehaviors and threshold for pain and injury, self-injury and its intersection with suicidal ideation and behavior.
Adrian:
I was just going to ask you, if you can give an example, I’m just thinking of is that the same as just bad choices, like not unhealthy behaviors that’s leading to a slow death? Is it that what is considered or is that different?
Phyllis Alongi:
I think that that’s different because there are certain components. Suicide is a very complicated issue. Even when we look at suicidology in the field of psychology, it’s over like out there and in a field by itself. There are many, many, many reasons why someone would contemplate suicide or attempt suicide, and it is very multi-determinational. It’s multilayered. It’s never one reason why it’s mostly always more than one reason why. And those risk factors clinical, exposure, history, family history, access to means situations. Those come together like the perfect storm and somewhere in the middle of that, it starts to lay the groundwork. When we look at the working definition of suicide, it’s an attempt to solve a seemingly unsolvable problem with intense emotional pain and impaired problem solving skills. What it really means is that when someone wants to die by suicide, wants to hurt themselves to kill themselves, they don’t want to die, they want to end that intense emotional pain because in the moment of crisis thinking, which the characteristic of suicidal thinking, all they are doing is crisis thinking.
When someone is stuck in crisis thinking, they can’t get back up to healthful problem-solving skills. So they get stuck in unhelpful problem solving skills and then there’s some triggering event and suicide becomes an option. There’s an irrational component to it. There’s an impulse component to it. Suicidal thinking can be ambivalent or even sending a message sometimes. So when we look at all of that, we have to understand that within this complicated issue, you know what it really is and when someone is suffering from that intense emotional pain, they don’t realize at the moment in crisis thinking that it’s only temporary, that this pain isn’t going to last forever. That there are ways that I could, you know, help myself that I could, I could maybe alleviate this.
I need to ask for help. I need to reach out, externalize and reach out of that pain and ask someone for help. To know where to find the resources like the National Suicide Prevention Lifeline Number, the 74174 crisis text line. You can just text and say, I need help. I feel like I’m going to hurt myself. Talking about it is very relieving and we know that from survivors of suicide attempt that once they talk about it, they feel better about it and it actually buys you some time because there isn’t that impulsivity component to suicidal behavior. There’s a sense of not belonging. There’s a sense of burdensomeness to family and friends, not feeling connected to anyone or anything. That adds up and that’s all part of the suicidology theories, that feeling of that sense of not belonging.
It’s so important for us when we look at youth suicide. It’s so important for us to really, encourage our kids to join something in the community and schools sports to be connected to something and to find that trusted adult, that caring, trusted adult to have that connection with. Those are the two biggest protective factors for not only suicide, but other risk behaviors like substance abuse we have in our country right now and in specifically in the county that I live in the neighboring counties, we have a very big opiate epidemic going on and the same risk factors, warning signs, and protective factors for suicide are the same ones that we could apply to substance abuses and other risk behaviors.
Adrian:
I imagine people that want to direct, whether it’s friends or family members towards help, there can be resistance, often there is resistance to help. What can you offer for those who are trying to help someone who is suffering and they want to bring them to a therapist or a counselor. How do we help them get over that obstacle or that resistance?
Phyllis Alongi:
That’s a great question. Resistance is difficult and I’m going to say don’t give up, you know, don’t give up. You have to keep asking. I think we need to explain to people because they think if you tell someone that you have suicidal thoughts, you know, suicidal ideation is very common and it’s more common than we think. The Center for Disease Control did a youth risk survey, I think it’s 12.5% of a hundred thousand youth were thinking about suicide. It’s pretty common. When we tell someone, listen, I know you’re struggling, whatever you’re struggling with, you’re not the only one. We can find something that might be suited for you. Therapy doesn’t always mean, doesn’t always look like me and you, you and some old guy, sitting across from each other, or like, but they think Freud, maybe my back to you and you’re lying on a couch.
But that there’s art therapy, music therapy, drama therapy, there’s sand play therapy and all these different psychodrama, all these different modalities that work really well and that we can find one that will work for you and you’re not alone. Individual therapies. Amazing. Group therapy is amazing. There are wonderful support groups for survivors of suicide attempt and also for survivors of suicide loss. I’m sure that you can find in your Canadian resources that are amazing and not to give up, and to keep asking the person, we here in the United States we have organizations that provide in-home therapy services and that people feel more comfortable in the privacy of their own home. It could be over Skype. There are so many ways and so many different modalities and avenues that you can go to that you could explain to someone. Just because you’re thinking about suicide, doesn’t mean you’re going to end up hospitalized because that’s another myth. The number one myth surrounding suicide is if we talk to someone about suicide, we’re planting the idea of suicide in their head and that is the number one myth surrounding suicide.
Thal:
Thank you. These are very important and heavy topics really, that we touched upon today. Before closing, since we are talking about relationships, I’m thinking about couples therapy and communication. What is the role of proper communication in a healthy marriage and a healthy relationship?
Phyllis Alongi:
I’m immediately in defense mode because every conversation I have with you ends in an argument or slamming the door and sleeping alone or being in the dog house, and I don’t want that to happen so I won’t communicate or I’m not ready to talk about it right now and I don’t know how to tell you that so I’m shutting down and you’re following me around the house wanting to get out of everything you need to say. I think people need to put, you know, when we talk about communication and couples, I tried to help teach couples to argue differently and to communicate on a different level and shed those old patterns, those old habits so that they can have positive conversations that are meaningful and that respect each other, because that’s so important that a person feel heard and respected and not judged.
Whether it’s about something that happened at work or with the kids or with us isn’t minimized by your judgment. It’s so important that a person feels like what they have to say weighs more than what I’m not saying. That you are hearing what I’m saying as an insight to what I need from you emotionally. Can you meet my emotional needs or maybe maybe you don’t want to anymore? Sometimes when relationships aren’t working and it’s not what one person wants, one person really wants the relationship to sustain that communication that’s negative, it isn’t going to work so we have to look at when, when I meet with couples for the first time, the first question I ask is, does everybody want to stay together?
Do you both want to be in this relationship? If the answer is yes, then we’re going to roll our sleeves up, we’re going to get in it and we’re going to really do some homework and we’re going to make the commitment. It’s just like joining a gym first time you have to learn all the machines. You have to figure out what works for you what doesn’t work for you, what exercise is beneficial for you. Does this hurt too much? Do I feel comfortable doing this? What do I like? What do I not like? We have to rediscover each other as people, not just my wife or my husband or my partner. We have to look at who you are and how am I connected to you. If I don’t feel connected to you, how can I get reconnected to you if that’s what we both want? That’s the essence of successful couples counseling because it’s what we both want and we’re both willing and receptive to making some changes that are hard to do so that we can, our relationship can sustain all the waves of greatness and the things in our lives that happen that aren’t so great.
Thal:
Hmm. Amazing.
Adrian:
Phyllis, I’d love to leave our listeners with some resources. What’s on your list of heavily recommended books for the people that you work with.
Phyllis Alongi:
Well, Codependent No More always, that book is very old. My partner in practice and I always giggle about it because we’re like, did you write down the Bible? That is such a great book for someone who is in a relationship and wants to make changes. I think everyone should read Irvin Yalom, The Gift of Therapy. I think that that’s amazing. That’s a book that I would recommend to anyone who wanted to learn about being in the here and now and having to be in the present and maybe looking at psychotherapy from a therapist’s lens would be great and would offer some great insight. There’s Eyes Wide Open by Mariana Kaplan, which is also another wonderful book about bringing spirituality into session, which is also very beautiful.
Any clinician who wants to learn about intuition, Terry Marks Harlow. She has some really great workbooks, and some good insights into how to incorporate intuition and how to not be afraid of your own intuition. She’s done tremendous work and continues to do tremendous work in that area.
Thal:
Thank you. Is there anything else you’d like to add?
Phyllis Alongi:
I just want to say that if you or anyone you know is struggling either in a relationship or with something within themselves or you know, that therapy can be an amazing experience. It can be even just like a polishing of the skills that you already have. You don’t have to have any kind of problem. You can just want to take your life a step further. You just want to maybe gain some insight or hone your psychospiritual skills and interests that it’s a beautiful space.
There are some wonderful Reiki practitioners and that’s another great modality that I use as an adjunct to talk therapy like Sand play therapy because it’s, it gives people a great way to learn, to be in the moment of themselves, to feel their own bodies, their own energy, to learn, to breathe, to do some, wonderful mindful breathwork and understand that, and I’ll leave you with this, that everything we need to heal ourselves is inside of us, and sometimes we just have to reach out outside of us externally to figure out how to tap into that.
Thal:
Amazing. Thank you.
Phyllis Alongi:
Thank you so much for sharing. Awesome. Thank you so much for having me. This was a wonderful experience and I was so happy for you to do it and I feel very grateful and blessed to have had the opportunity. Thank you.