The Healthy Management of Reality - Stanford University

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past that we remember (that is our mental or internal representation of the past),and the objective past that is yet to be.Changing the Past We RememberI became acutely aware of the importance of changing the past we rememberwhile working with a Central American woman whose teenage son had beentortured and killed by one of the many factions in an ongoing struggle in hercountry. His body had been found with many cigarette burns. Although this eventhad taken place several years before, our patient still suffered from a severedepression which had been disrupting her work and family life, and which made itdifficult for her to care for her remaining children. One of the most disturbing ofher symptoms was that when she remembered her son, her mind filled with imagesof his lifeless body and the evidence of torture.One of the things a psychologist learns when working with individuals withreal problems, such as victims of extreme cruelty, is not to trivialize the person'spain, or, in this case, the fact that an unspeakable tragedy had occurred.Acknowledgment of the enormity of the event, the excruciating pain that wasinvolved, and the fact that her inability to shake off the pain is understandable mustbe made before attempts to intervene begin.HMOR.July2005.Muñoz.doc 46
When a patient appears to be drowning with the weight of his or hersubjective or objective burdens, the therapist must first dive into the water with thepatient, experience as much as one can the desperate feeling of imminentasphyxiation the patient is undergoing, and only then attempt to guide the patientto the surface. One does this by listening to the patient, trying to obtain not onlythe facts, but also the meaning these facts have for the patient. And then one mustsay these things back to the patient, so the patient can hear that someone else hasunderstood not just what happened, but the impact of what happened on his or herbeing.But it is also important not to stay underwater too long. Once the patient hasseen that we have followed them to the depths, they must also see that we can showthem a way out. We must help them swim to the surface and help them get thatgulp of air that tells them that there is hope still. Only then will they be able tobegin swimming to shore.The treatment of the patient involved many interventions. But changinghow she remembered her son was a very important one. What we did was to haveher imagine her son's life as though it were a line, from his birth to his death. Theline was 17 years long, and it did end in tragedy. But, as she remembered her son,she had gotten used to looking at his lifeline as though looking through a telescope.And, because his death had shocked her so much, it was this horrifying eyepiecethat filled her field of vision, blocking out the bulk of his life. We asked her tovisualize turning the telescope, so she could see it from the side, to notice how longit was, and how many things had happened throughout the son's life, and to be ableto remember those things without filtering them through his death. She was able toremember that he was a prankster, a kid with a good sense of humor, with a heartylaugh. The memories triggered a smile in her, for the first time in therapy.HMOR.July2005.Muñoz.doc 47
Page 1 and 2: The HealthyManagementof RealityRica
Page 3 and 4: The Healthy Management of RealityCo
Page 5 and 6: Preface: The Origins of This BookEv
Page 7 and 8: serious depression. The course was
Page 9 and 10: Introduction: Sculpting RealityIn m
Page 11 and 12: The people of the Andes found thems
Page 13 and 14: Chapter 1On Managing RealityThe uni
Page 15 and 16: To continue with the example: If ou
Page 17 and 18: But, given that we are finite and l
Page 19 and 20: The objective environment refers to
Page 21 and 22: Throughout the book, we will addres
Page 23 and 24: Chapter 2Choosing a Direction"If yo
Page 25 and 26: Choosing a direction for one's life
Page 27 and 28: Few Christians would support the re
Page 30 and 31: The "healthy" aspect of "the health
Page 32 and 33: It appears, then, that there is a r
Page 34 and 35: Once one becomes aware of oneself a
Page 36 and 37: HMOR.July2005.Muñoz.doc 36
Page 38 and 39: are what I mean by necessary suffer
Page 40 and 41: unnecessary and can be prevented.Th
Page 42 and 43: the things that cause human sufferi
Page 44 and 45: HMOR.July2005.Muñoz.doc 44
Page 48 and 49: The objective past had not changed,
Page 50 and 51: The fact is that five years hence,
Page 52 and 53: - The meanings we have accepted or
Page 54 and 55: Molding the past of our childrenThe
Page 56 and 57: - The child's core beliefs. Though
Page 58 and 59: your favorite book afterwards") the
Page 60 and 61: making sure that one's daily realit
Page 62 and 63: Change can move us toward a healthi
Page 64 and 65: Similarly, behaving in an exemplary
Page 66 and 67: Similarly, it is true that certain
Page 68 and 69: Learning which thoughts and actions
Page 70 and 71: do what you wish. If you are able,
Page 72 and 73: Tips on increasing the probability
Page 74 and 75: influence on us on one side and tho
Page 76 and 77: Being your own coach involves decid
Page 78 and 79: Beliefs and ConsequencesThe third l
Page 80 and 81: Aaron Beck, a psychiatrist who deve
Page 82 and 83: We Are Meaning-MakersThe fourth lev
Page 84 and 85: Closing the Loop: The four levels a
Page 86 and 87: To manage our reality optimally, we
Page 88 and 89: If you are feeling down or depresse
Page 90 and 91: PeopleThe social environment is at
Page 92 and 93: stimulation just as they need their
Page 94 and 95: In Chapter 2, I talked about choosi
Page 96 and 97:
As we enter the twenty-first centur
Page 98 and 99:
years. As I trace back my thinking
Page 100 and 101:
what we both want.If we have a stro
Page 102 and 103:
we will have progressed in terms of
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