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Psychotherapy
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Phoenix psychologist Lisa Colangelo Fischer, Ph.D.: Posted on Monday, January 16, 2012 7:40 AM
The secret access password to this club is, “Heart pounding, shallow breathing, and sweaty palms.” My initiation to this club was in one of the most exotic locations in the world which was inside the pyramids in Giza, Eygpt. It was summer 1985 and I was a teenager at the time. My sister and I were standing in a chamber inside the pyramid. It was quite a trek to reach the chamber through walking hunched over in the tunnel passage and then crawling on fours. The chamber was dimly lit by a wall torch. It was hot and humid. More and more people entered the room, making the place more humid. All of a sudden I had trouble breathing. At the same time, I was very aware that I was underneath tons and tons of stones that composed the pyramid. It was a heavy weight feeling. Needing to leave immediately, I proceeded to the single entrance/exit. One of the Egyptian tour guides blocked my escape, indicating I should pay him before leaving. That made my panic worse. I pushed him aside and somehow managed to get out.  I have treated many patients with anxiety and panic attacks. What I have found that is common among us is our mindful awareness of what is going on within our bodies and outside of our bodies especially during the attack. That mindfulness unfortunately exacerbates the panic attack. I teach my patients to tune out that awareness during the attack and focus on something else. Treating anxiety and panic attacks are one of my favorite ailments to work with. Patients are able to significantly reduce the troublesome feeling which, in turn, is rewarding for me. |
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Phoenix Psychologist Lisa Colangelo Fischer, Ph.D.: Posted on Wednesday, January 11, 2012 11:09 AM
 In his 1949 paper, “Hate in the Counter-Transference” D.W. Winnicott, a British pediatrician and psychoanalyst describes the love-hate relationship a mother has for her infant baby. He outlined several reasons why a mother would harbor such harsh feelings towards her baby and some of his reasons are highlighted as follows: “The baby is an interference with her private life, a challenge to preoccupation.” “He is ruthless, treats her as scum, an unpaid servant, a slave.” “She has to love him, excretions and all, at any rate at the beginning, till he has doubts about himself.” “He tries to hurt her, periodically bites her, all in love.” “He shows disillusionment about her.” “His excited love is cupboard love, so that having got what he wants he throws her away like orange peel.” “At first he does not know at all what she does or what she sacrifices for him.” “He is suspicious, refuses her good food, and makes her doubt herself, but eats well with his aunt.” “After an awful morning with him she goes out, and he smiles at a stranger, who says ‘Isn’t he sweet!’” When I first read Winnicott’s paper for a psychoanalytic study group, I thought that this guy must be joking or off his rocker. Although I thought his reasons why a mother would hate her baby were hilarious and disturbing, I as a mother, reluctantly admit there was a grain of truth in them. I commented to my study group that Winnicott has accurately described 50 years early, a cartoon character called Stewie on the TV show Family Guy. Stewie is the sophisticated, intelligent, and mischievous to a sociopathic extent two-year old infant son of Peter and Lois Griffin and who was for a time being, preoccupied with matricide. Few episodes show him fantasizing of killing his mother and vice-versa, and his anger at his mother for deciding to wean him off from breastfeeding. He makes many derogatory comments about his family in their presence, especially to his mother.  Let’s imagine Winnicott is still alive today and that Stewie is a real live person. His mother, Lois is frustrated and has had it with Stewie, and decides to take him for professional mental help. Winnicott accepts to treat Stewie. Winnicott is no stranger to children like Stewie. In fact, he altruistically on his wife’s behest, took in a young orphan boy in his home for three months, “three months of hell” as he said. Winnicott described the boy as “the most loveable and most maddening of children.” On several occasions when the boy misbehaved, Winnicott went as far as to shut the boy out of the house and at the same time telling the boy what happened made Winnicott hate him. Winnicott learned from fathering the boy to be able to tolerate his own hatred towards the boy without losing his temper and murdering him. The boy ended up doing well, attended a prestigious school. Winnicott’s goal when working with a child like Stewie is not to make him well behaved and loveable, but to help Lois tolerate her hate towards Stewie, not express her hate to him as harm, and to be patient with hers and his hate towards each other. As a result of better tolerating and understanding her hate towards her baby, Lois would then be free to love Stewie. Stewie, in return would then feel loved by Lois. |
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Phoenix Psychologist Lisa Colangelo Fischer, Ph.D.: Posted on Saturday, August 06, 2011 3:13 PM
The psychotherapy room with its furnishings, colors, lighting, framed pictures, and so on provides an ambient environment for the patient as well as the therapist. The room may, based on the patient’s determination, become a safe haven to explore uncharted mental territory. For many patients, the psychotherapy room as a whole and objects within the room is an extension of the therapist and his/her personality style. The room space as well as the relationship developed with the therapist is what compose healing (Gerald, Psychoanalytic Psychology, 2011). I was mindful of these influential elements when I moved into my current office room pictured above a few years ago. The position and placement of furniture, the colors chosen, the brightness of lighting, framed prints, etc. were among the many objects I considered based on my preference of style and taste. I carefully considered how the objects in the room as well as the ambient environment would be perceived by whoever steps into the office. I wanted to ensure that this room becomes a mental home for many of my patients. Few times when patients come to my office room for the first time and when they see the couch, I hear a chuckle coming from them. The Freudian couch has become synonymous, a symbol of psychotherapy. Objects in the psychotherapy room have come and gone over the years and yet the couch was noted to have almost always remained in place since Freud introduced this piece of furniture in the 19th century (Lingiardi & De Bei, Psychoanalytic Psychology, 2011). I don’t use the couch in the manner conducted by a classical psychoanalyst. To me, the couch represents those placed in family rooms where many sit down to relax, and this is why I have it in the office room. I have already spent countless hours with patients in that room and it always has been a place where I enjoy spending time in. I find that the room I created is not only conductive to patients’ growth, but of mine as well. Mi habitacion es su habitacion! My room is your room! |
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Phoenix psychologist Lisa Colangelo Fischer, Ph.D.: Posted on Friday, May 20, 2011 4:01 PM
At one of my supervision sessions during my internship at Northwestern University, I discussed with my supervisor about a patient with whom I worked intensively for nearly a year. This patient was back home across the country for the summer and I hadn’t seen her in two months. I remarked to the supervisor that I hoped this patient is doing okay. Then I walked back to my desk to check on my emails. Lo and behold, there was an email from this very patient I had been talking about! She wrote to let me know that she is doing well. Most recently I received contacts from two former patients within days after my thinking about them. Most people have experienced thinking about a friend whom they haven’t seen or thought in a while and then to either run into them, receive a telephone call from the friend, etc. What is this seemingly common and also yet uncommon phenomenon? Some call it uncanny coincidence, some call it telepathy, and others call it intuition or serendipity. Scientists theorize this phenomenon through quantum physics and chaos theory. Carl Jung describes this as “synchronicity” which is a part of the collective unconscious. He said this underlying connectedness manifests itself as a meaningful coincidence that cannot be explained by cause and effect. According to most analysts including Jung, communication is relayed not only at the conscious level, but unconsciously between individuals as well. I believe the groundwork for synchronicity is the two different but related types of connectedness. These two types of connection can be defined as intersubjectivity. First, a strong bond is formed between two people as part of their relationship with one another. I call this interconnectedness. In addition to the strong relationship, the individual is well attuned to his/her own emotions and that of others, and has awareness of his/her unconscious emotions. I call this intraconnectedness. As a result of both inter- and intraconnectedness, it becomes possible for the individual to sense or pick up emotional vibes from one another and from within. Synchronicity, when it occurs, is a fascinating event that pays tribute to the close relationships we have with one another. |
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Phoenix Psychologist Lisa Colangelo Fischer, Ph.D.: Posted on Saturday, September 11, 2010 10:39 AM
 It is ironical that while I open this first blog with a hello and welcome, I am writing about saying goodbye. Earlier this week I said goodbye to a patient whom I have been treating twice a week for three years. It was a bittersweet moment for both of us. He has gone on to follow his budding career out of state. When he first came to me in therapy, he was very uncomfortable despite my efforts and his glances kept shifting to the door as if he wanted to spring out of his chair and leave. I was pretty sure he would never come back. But he came back and kept returning. He was uncomfortable with talking and would mumble few words here and there. For about a year I would do most of the talking while he listened. I thought to myself (and shared with him later), I wasn't trained to talk, but to listen. Just about everything I learned didn't apply here. I had to go by my gut instinct. While he challenged himself to keep coming back and eventually opening up to share, I was challenged to be a better therapist for him. What happens to therapists when a patient leaves? Do we remember all of our patients? We remember the ones who are invested in therapy and therefore brings us to invest ourselves professionally. We remember the ones who take risks and therefore experience tremendous growth as a result. We remember the ones who open up and invites us into their lives. With this blog and ones following thereafter, I invite you to read and share with my experiences and thoughts regarding my profession. I invite you to take that next step in challenging yourself despite some discomfort for personal growth like this man did in therapy with me. |
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