How To Have A Successful Therapy Experience

In the time since becoming a therapist, I have yet to have one client ask me where I received my master's degree, or where I did my training, or a word about my licenses. What clients want to know is, "Can you help me? Can you offer me anything at all that will bring me some relief from the pain I'm in?" Some also have other questions they may or may not be as likely to articulate, questions such as "Are you going to judge and reject me if you know the 'real' me? Are you going to understand me? Is this just going to be a supreme waste of my time and money?"

I always ask new clients that come to me if they've been in therapy before, and if so, how it went. If therapy is a new experience, I ask what their goals and expectations are going in of themselves, of me as their potential therapist, and of the therapy process. I like to borrow a question two of my favorite author-therapists, Terry Real, and his colleague, Lisa Merlo-Booth, have shared they ask their own clients- "If this therapy is a stunning success, what will that look like?"

Below I'd like to offer some tips that will increase the likelihood that your therapy experience will be worth your time, effort, and money.

1) Do your homework.

Ask yourself direct questions. What qualities are important to you in a therapist? Do you prefer they have a certain working style? background? Is a sense of humor important to you, or do you prefer a more reserved approach? How far are you willing to travel and how far will make it less likely you will attend regularly? Preferred gender or age range?

Equally important, what qualities don't you want in your therapist? I have a close friend who saw a therapist for several years whom she casually mentioned she felt little connection to. "How come?," I inquired. "Because," she replied," she never is willing to disclose anything about her own life. She knows everything about me but refuses to breathe a word about herself." You may be the type of client who doesn't want your therapist to disclose anything about themselves, and thats fine, just be aware of your needs going in, and why.

2) Be clear on your goals, and learn to consistently ask for what you need.

Spend some time answering for yourself what a "stunning success" will look like. How will you know that therapy is working well? What will be different? How will you feel? What will your relationships look like? Your body? Your day to day habits and ways of being and thinking in the world? What will others notice about you that is different? Most importantly, what will be different about you?

Too often I find people are sparklingly clear about what will be different about their spouse, their children, or their boss... "Oh, she won't be such a relentless nag" or "He won't be such a massively royal pain in the ass..." It gets a little...fuzzier....when asked how they, themselves, will be different, but good therapy isn't usually about changing the people around you. Usually, its about deepening and challenging the way you, yourself, have learned to operate and communicate in the world around and inside of you. A good therapist will work with you to raise your own personal standards about how you treat yourself and others, and what you are willing to tolerate in return. What therapy isn't about is getting the people around you to lower their standards and learn to tolerate disrespectful behavior from you.

Articulate your goals to your therapist, and take responsibility for staying on course with these goals. If you don't feel you are being heard, or challenged, share that directly with your therapist. Don't use therapy as another place where you don't take responsibiility for getting your needs met.

Which brings me to the next tip....

3) Your therapist is a) not a mindreader, and b) is responsible for taking care of their own feelings.

Check in with your therapist about what is and what isn't working in your work together. Don't expect him or her to know this. Along those lines, don't withhold important information from your therapist. For example, if you are having an affair or self-medicating with alcohol or food, be brave and share. What you don't share can define your relationship and sabotage your goals. And remember, your therapist is not there to judge you but to help you grow as a fellow human being (and whom has their own challenges along the way too).

If you tend to be a caretaker outside of your therapist's office, you might find yourself wanting to play this role in his or her office as well. Don't. Your therapist is responsible for taking care of their own feelings. I've heard more than once people say things like "Well, I didn't want to hurt his feelings." Even if you say something that the therapist strongly disagrees with or their feelings are wounded, you should always feel you are encouraged to have a dialogue about that without in any way feeling its your job to caretake your therapist. If your therapist becomes defensive or responds in a way that makes you feel unsafe or attacked, share that in the moment. If the dialogue isn't a respectful, productive one, you may need to assess immediately if the boundaries are safe.

However,...

4.) Be open to real feedback.

There is a difference between being criticized by your therapist, and being given feedback by him or her that might make you uncomfortable but will allow you to grow into a more relational, respectful, authentic, and mature human being.

I once worked with a couple for several weeks when one of the partners became quite angry with me for not convincing his spouse to take a sailing trip that he had planned. Her reason for not wanting to go was that he frequently berated her with belittling names. "At least when we're at home, I can get away when I want to," she explained. "But how am I going to get away when we're on a boat in the middle of an ocean?"

Good question. Unfortunately, his response to that was an explosive and abusive one. I would have been doing no one, but especially him, any favors not sharing what I was experiencing there in the room with them."

"May I offer you some feedback?" I asked him. I watched as he shifted in his seat and grabbed the cup of coffee beside him. Then he responded with more of a mutter than anything, "Go ahead."

"You might not like it," I warned. "So I want to be sure you are giving me permission."

I watch him suck a deep breath of air in through his nostrils. "Shoot."

"If how you are in this office today is even an inkling of how you behave outside of this office," I said, " then I wouldn't want to go on this trip either, any more than I'd feel safe driving home with you today."

Its not an easy thing to hear, I know, but what we were able to get to is that the very communication tactics that made him very successful as an attorney were wreaking havoc on his marriage and family life. Because he was willing to be open to this feedback, unpleasant as it might have initially felt, we were quickly able to begin working on turning him into the kind of partner that his wife not only wanted to go on a sailing trip with but whom she actually got excited again about spending the rest of her life beside.

5) Consider asking for homework between sessions and take treatment recommendations seriously.

You see your therapist for a very brief time out of all the hours in your week. Homework that provides a focus and structure for your goals, and expands on the themes you are exploring in therapy can be very beneficial. Homework can come in various forms, from book recommendations, journaling assignments, a planned date with your partner, or a specific commitment to act on something such as exercise or a therapist's recommendation to get a medical or psychiatric evaluation.

Consider that when you don't follow professional recommendations your therapist believes may truly help that you may be undermining your goals, and self-sabotaging the therapy process.

6) Expect that things may feel worse before they feel better.

As the old motto goes, "No pain, no gain." In relationships, ignorance can only be bliss for so long. There is nothing more rewarding than seeing your relationships with yourself and those you love blossom and transform out of old, paralyzing paradigms. Put in the honest, dedicated effort, and the short-term pain will be well worth it.

**Please note that where clients have been mentioned, details have been slightly changed so that their information could not be recognizable to anyone who might be reading this.**

-

"Gate 22" & Miscellaneous Thoughts on Therapy...

Gate C22
by Ellen Bass

At gate C22 in the Portland airport
a man in a broad-band leather hat kissed
a woman arriving from Orange County.
They kissed and kissed and kissed. Long after
the other passengers clicked the handles of their carry-ons
and wheeled briskly toward short-term parking,
the couple stood there, arms wrapped around each other
like he'd just staggered off the boat at Ellis Island,
like she'd been released at last from ICU, snapped
out of a coma, survived bone cancer, made it down
from Annapurna in only the clothes she was wearing.

Neither of them was young. His beard was gray.
She carried a few extra pounds you could imagine
her saying she had to lose. But they kissed lavish
kisses like the ocean in the early morning,
the way it gathers and swells, sucking
each rock under, swallowing it
again and again. We were all watching--
passengers waiting for the delayed flight
to San Jose, the stewardesses, the pilots,
the aproned woman icing Cinnabons, the man selling
sunglasses. We couldn't look away. We could
taste the kisses crushed in our mouths.

But the best part was his face. When he drew back
and looked at her, his smile soft with wonder, almost
as though he were a mother still open from giving birth,
as your mother must have looked at you, no matter
what happened after--if she beat you or left you or
you're lonely now--you once lay there, the vernix
not yet wiped off, and someone gazed at you
as if you were the first sunrise seen from the Earth.
The whole wing of the airport hushed,
all of us trying to slip into that woman's middle-aged body,
her plaid Bermuda shorts, sleeveless blouse, glasses,
little gold hoop earrings, tilting our heads up.

---

Ellen Bass is well known for her work on helping others recover from sexual abuse, and unfortunately, not as well known for her equally beautiful work as a poet. Personally, I find myself referring to lines from poems often as I seek to more deeply understand and imagine the possibilities and challenges in my own life, and those of family, friends, and clients. Poets such as Hafiz, Rumi, Kabir, Mary Oliver, and David Whyte may have been our original therapists without knowing it.

One poem I find meaningful to many couples has been "The Third Body" by Robert Bly. The idea behind it is that in any relationship there are three bodies- there is your own that you solely are responsible for physically, spiritually, mentally, and emotionally. Then there is your partner's body and they are responsible to do the same, not asking the other to do what we must do for ourselves. This means caretaking ourselves the way a gardener would tend to their own garden- pulling out the weeds as they rise without blame, denial or too much delay, and taking personal responsibility for the direction and quality of our lives. And then there is this "third body" that you are both responsible for nurturing and nourishing together. This image is one that many people like and intuitively grasp easily, and often allows for people to create a new, more inspiring image for the health of their relationship. When any of these three bodies aren't being respected and well cared for, the health of the other two often are impacted for the worst.

Two very common examples of self neglect are ignoring our own cherished dreams for what we want most in life and/or denial of addictions. Addictions can range from substance abuse to pornography to video games. Both often play an insidious and destructive role, and the more either is minimized or denied, the longer the relationship might suffer. How many times have I seen relationships seem to magically improve as one spouse reclaimed a buried dream such as writing or painting, lost weight they had been carrying for years, or left a soul-sucking job? Sometimes, the sense of unfulfillment in our lives can be misplaced onto the relationship. Rather than take a gentle but firm critical look at ourselves, we will take a blatant and scathing critical look at our partners instead. This is a particular danger as we enter mid-life, and feel compelled to evaluate the decisions we have made. By mid-life, the emergence of our wrinkles in the mirror no longer allow us to pretend that we are exempt from the passage of time and the consequences of our actions. This can be an incredible time of rebirth and opportunity depending on our attitudes and responsibility we are willing to take into this next chapter of our lives.

In a wedding I attended there was a table placed at the foot of the podium. Three candles were lit. As part of the tradition, the bride and groom each took one candle and then together, lit the third. Then, they blew out their own candles. I found myself wishing that they had each kept their own candles lit, and allowed for all three candles to be aflame side by side- a perfect metaphor to me for the message of "The Third Body."

To close, I recommend spending some time, if you don't already, with the poetry of writers such as Rainer Maria Rilke, Rumi, or Mary Oliver, for starters. You may find, as I and others have, that they allow us to reimagine our lives in fantastic new ways. Recently, I redesigned my entire living space from the paint color to nearly everything else. You wouldn't recognize it from before, but my favorite thing I did was blow up favorite lines of poets that inspire me. A few examples that have continued to create profound inner shifts for me are:

“This sky where we live is no place to lose your wings so love, love, love.” (Hafiz)


"Tell me, what do you plan to do with your one wild and precious life?" (Mary Oliver)


“If you don't break your ropes while you're alive do you think ghosts will do it after?” (Kabir)

I decided to start off this new year by reading this poem in the mornings. Hope you might like it too...

A Morning Offering

I bless the night that nourished my heart
To set the ghosts of longing free
Into the flow and figure of dream
That went to harvest from the dark
Bread for the hunger no one sees.

All that is eternal in me
Welcome the wonder of this day,
The field of brightness it creates
Offering time for each thing
To arise and illuminate.

I place on the altar of dawn:
The quiet loyalty of breath,
The tent of thought where I shelter,
Wave of desire I am shore to
And all beauty drawn to the eye.

May my mind come alive today
To the invisible geography
That invites me to new frontiers,
To break the dead shell of yesterdays,
To risk being disturbed and changed.

May I have the courage today
To live the life that I would love,
To postpone my dream no longer
But do at last what I came here for
And waste my heart on fear no more.

~ John O'Donohue ~

Three Traits of Exceptional Partners

In the years since becoming a therapist, and especially in my work with couples as an Advanced Trained Gottman Couples therapist here in Portland, Oregon, I've noticed a number of traits that genuinely happy and fulfilled couples seem to have in common. If you are looking to take your relationship to the next level, consider raising your personal standards in any of the following ways below, remembering that if you want a better relationship, it begins with looking at one's own self first and foremost.

1. Exceptional partners have a good idea about what makes it difficult to have themselves for a partner, and they feel a sense of appreciation and respect for the challenges their own personality presents for their partner at times. It is easy enough for most people to list off a handful of traits that make it difficult to have their significant other for a partner, but when the question is turned back on oneself- "What makes it difficult to have MYSELF for a partner?"- the exceptional partner demonstrates a rare willingness to identify their own shortcomings, and  backs this up with a steady commitment to managing and keeping their own difficult traits and imperfections in check so that they don't impact their partner in unfair ways.

2. Exceptional partners understand that while they are not responsible for their partner's happiness, contributing to their  partner's happiness is nonetheless a top priority. Several years ago, I placed a bed frame up for sale. A couple arrived to purchase it. As they dismantled the bed piece by piece, there was an attitude of playfulness and a sense of mutual joy they took in one another that was striking in its rarity. "What's your secret?" I asked them. They shared that the secret of their successful marriage was that every morning they ask themselves, "What might I do today to let my partner feel loved?" Exceptional partners make it a habit to be exceptionally thoughtful. They seem to recognize that life is short and seek out ways on a regular basis to express their love. For these couples, love is indeed not just a feeling but an active verb.

3. Exceptional partners ask a lot of themselves, and not more nor less of their partners. It is often said that we should ask more from ourselves than others because this is the one thing that is in our control. However, this advice has its limits when it comes to the person we spend our lifetime beside day in and day out. Exceptional partners consider themselves a work-in-progress, and make a habit of expressing their needs and desires  in a direct yet respectful way. They insist on both treating their partner well while also being treated well in return. In other words, they invest heavily in the success of the relationship and expect their partner to bring this same level of consideration and commitment.

Five Silent But Deadly Relationship Killers

We always hear about the foods and chemicals that quietly erode our health. But, while we don't hear about them as frequently, there are similarly dangerous threats to our relationships. The sooner you identify any of these five things in your relationship, the better your chances are of saving it. 

1. You criticize your partner more than you express appreciation. Think for a moment about how you have felt when your partner, your parent, friend or boss has made it a personal habit to hone in on everything you aren't doing, rather than appreciate all the positive and thoughtful steps and efforts you are taking. It feels awful, right? Don't you want to be around this person less and less? Perhaps your partner does, too ...

2. You cling to mistakes your partner made in the past, even though he/she is working hard not to repeat them. I often share this quote with clients as it sums up perfectly the futility of clinging to grudges and old grievances: "Resentment is like taking poison and waiting for the other person to die.

It's one thing for your significant other to keep making the same, disrespectful mistake over and over. However, if genuine and consistent steps to change following a sincere apology have taken place, take your hands off the wheel of grievances that will only spin you both into a ditch.

When you pin your partner to their past mistakes and don't honor their efforts to grow, you punish them unfairly and may be dooming your relationship in the process. 

3. You or your partner shows signs of depression but aren't seeking help. During my career as a therapist, I have seen more relationships destroyed for this reason alone than perhaps any other. We wouldn't think twice about going to the E.R. for a broken arm and yet, because many of depression's symptoms are invisible — sleep difficulties, lack of energy, sadness, feelings of worthlessness/hopelessness, and anger — we dismiss, neglect, and/or deny them.

Stress from work, the loss of a job or loved one, illness and past traumas can all take a heavy toll. Don't fool yourself. Untreated depression distorts our perception, our sense of hope and possibilities and causes us to act and react in ways that can be profoundly destructive.

If you or your partner have been showing signs of depression for more than one month, seek support now in your local community. Find a therapist, talk to a trusted doctor and don't rule out a medication evaluation if symptoms persist.

4. You're defensive and stubborn when your partner gives you constructive criticism. Unless the space is filled with mirrors, you can see everyone but yourself when you walk into a room. When your partner points out something to you that is irritating or hurtful, do you typically take it seriously or respond like a kindergartner might? Do you find yourself saying things like, "Well, you do that too!" or "No, I don’t!" If yes, cut it out.

Instead, take a deep breath, consider if there is truth in any aspect of what your partner is saying and accept responsibility. Stop giving feedback if you aren't willing to hear it in return and make real changes.

5. You expect perfection from your partner rather than remembering we are all perfectly imperfect. Learn to pick your battles wisely. We can't get everything from one person nor can they from us. We've all been on the receiving end of being around someone with whom it feels you can do nothing good nor fast enough. Lighten up where you can, both with yourself and your partner and this alone will create fresh air in a relationship that is feeling smothered under the weight of unrealistic expectations. 

Alexandra Saperstein is a Licensed Professional Counselor, Advanced Trained Gottman Couples Counselor, and Marriage and Family Therapist in Portland, Oregon. For a free phone consultation, please feel free to call me at (503) 450-9902. You may also learn much more about services at my website at http://www.alexandrasaperstein.com .

“When you plant lettuce, if it does not grow well, you
don't blame the lettuce. You look for reasons it is not
doing well. It may need fertilizer, or more water, or
less sun. You never blame the lettuce. Yet if we have
problems with our friends or family, we blame the other
person. But if we know how to take care of them, they will
grow well, like the lettuce. Blaming has no positive
effect at all, nor does trying to persuade using reason
and argument. That is my experience. No blame, no
reasoning, no argument, just understanding. If you
understand, and you show that you understand, you can
love, and the situation will change”
― Thích Nhất Hạnh

Five Tips to Improve Your Relationship Today

It can be so very easy to focus on what isn’t working in our relationships rather than what is actually in our control. We all get stuck in the trap of keeping score, holding on ferociously to past hurts as if we have claws, and forgetting that as partners if we want a more loving relationship, we must first make sure we aren’t standing in our own way. Fortunately, what we focus on tends to grow. Once we remember this fact, it makes sense to zone in on what we can do this very moment to nudge our relationships back on track. Below are five tips and thoughts to consider for the health of your own partnership.

• Remember you can see everyone but yourself when you walk into a room.

 It is human nature to underestimate the toll we can take on others with our opinions, moods and habits. Indeed, it is the rare soul who pauses to consider what makes it difficult to have themselves for a partner rather than the other way around. It is a good thing to get curious and focus on our own rough edges, sand them down, and remember that it may be more natural to focus on the flaws of others, especially our spouse’s, because our own are so engrained often so as to seem nonexistent. Focusing on our own blind spots rather than our partner’s flaws helps us both.

• Growing up is a lifelong process for everyone.

When I was a child I couldn’t wait to turn eighteen years old. After all, eighteen meant I would be a legal adult with all the freedom and possibilities I imagined that came with this magical age. It is only now, more than twenty years later, that I understand we are all simultaneously works-of-art and works-in-progress for the rest of our lives. Zen master Shunryu Suzuki expressed this sentiment beautifully when he told his disciple, “You are perfect just the way you are.  And...there is plenty of room for improvement!”

• Don't be stingy with your love.
• This means don’t withhold love from your partner nor from your own self.  Last year, I had quite a health scare. Fortunately, everything turned out fine but as I lay in the basement of the hospital’s emergency unit waiting for an x-ray, all I could think over and over again was “Why are we as human beings often so stingy with our love?” What are we waiting for? Has anyone ever dropped dead from their partner going out of their way on a regular basis to be more exceptionally loving and thoughtful? Why hold back? I made a vow to myself in the wee morning hours of that scary night to go all out and make sure my beloved never had to wonder again whether or not I loved and cherished him. Equally, I found myself remembering all the extraordinary things he does each and every day to make me feel loved and cherished. 

Consider the ways you may withhold or withdrawn from opportunities to infuse your own relationships with bold acts of love and generosity. Is there one step or act you could take today that would demonstrate love, affection, and/or renewed goodwill efforts towards your partner?

• Throw away your score cards.

While we don’t literally write down every time our partner makes a mistake or hurts us, more often than not we are keeping a mental score card or list. This is why I’ll often ask my clients if they are ready to turn over their score cards because it is human nature to react when we are hurt. Unfortunately, what quickly becomes the norm is to recoil into ourselves, taking all our hurt and grievances with us and refusing to let go. Sometimes, we will cling to old grievances for months and/or years. Have you ever heard the phrase, “Resentment is like taking a poison pill and waiting for the other person to die.”

Instead, deal directly in the here and now with whatever the upset is.  If you are the one who has acted disrespectfully, apologize as quickly as you can, and move into repair mode. Do the same when your partner screws up. State your truth calmly, directly, and set a clear limit on what you will and will not tolerate in the future.  As you communicate your needs, treat your partner like a teammate who is on your side to win, and not an enemy who is out to get you. If this doesn’t work and you keep getting stuck, seek out professional help with a licensed couples counselor. A well-trained couples counselor can move you both from gridlock to dialogue, and from misery back to joy. As an Advanced Trained Gottman Couples Counselor who has been working with couples for over a decade now, I can tell you firsthand that I have seen many couples who had nearly given up all hope make profound, brave, and radical changes together. First, score cards must be thrown out so that your minds are free to learn new skills and ways of reconnecting and communicating.

• Vow that your partner's "bad behavior" won't be allowed to be a green light for your own.

At my relational worst, I have felt like I might as well be back in kindergarten. In past relationships,  I'd use my partner’s worst  moments as an excuse to be reactive right back. Then, I read something by colleague and author, Terry Real, that really struck me. In his book, The New Rules of Marriage, he described the concept of “full respect living.” Full respect living means that no matter what your partner does, and no matter what you do or have done, both of you are always entitled to unconditional respect. When you see respect as a relational birthright, the lens through which you see your own behavior must shape up and evolve. Full respect living is about immediately raising the standards by which you allow yourself to treat your partner, and vice versa. It means that one partner’s nasty or inappropriate behavior cannot be the green light for our own. Otherwise, we find ourselves in the sandbox all too quickly flinging the equivalent of sand with our words, and gradually, feeling less and less connected, protected, and invested in our relationship. 

When we feel that pull to lash out in response, we can instead learn new coping skills and responses that will help to ensure a much happier outcome. Often, clients have said to me, “Alex, that ‘s just too hard. I go on auto pilot.” While it feels like auto pilot, the more honest truth may be that we have more control than we want to admit to ourselves. For example, we often exhibit much more control when our bosses, customers, or patients trigger us than when our own partners do.  Similarly, if we are in public and know others are watching, we do in fact tone our anger and frustration down. It can take work and practice to become proactive rather than reactive if this habit is deeply engrained in us, but remembering each of us alone is responsible for our own behavior can help next time your partner steps on one of your buttons. Responding respectfully doesn’t mean caving in to another’s crummy behavior. It means staying calm, setting a clear limit, and remembering we are in the driver’s seat of our relationships, and not sitting helpless in the back seat.

It would be nice if we had classes beginning as early as elementary school on how to create great relationships. Instead, we usually learn the hard way through agonizing trial and error. We can’t go back, of course, but we can start right now to take active accountability and brave new steps to sculpt the kind of relationship we’ve always longed to be in.

Alexandra Saperstein is a Licensed Professional Counselor, Advanced Trained Gottman Couples Counselor, and Marriage and Family Therapist in Portland, Oregon. For a free phone consultation, please call (503) 450-9902. You can learn more about her couples and individual counseling options at http://www.alexandrasaperstein.com .

Hope for Bulgaria's Children Struggling With Mental Illness

Earlier this fall, an article in the New York Times caught my eye. It was about the Bulgarian Helsinki Committee, an international human rights organization based in Sofia, Bulgaria, and their ongoing attempts to bring landmark charges against those whom have fatally neglected the rights and access to care of mentally ill children across Bulgaria.

Since 2000, it is reported that 238 children in Bulgaria’s mental health homes have died. As quoted in the NY Times, “More than three-fourths of the deaths were found to have been avoidable: 84 from physical deterioration caused by neglect; 36 from exposure to cold or long-term immobility; 31 from malnutrition; 13 from infections caused by poor hygiene; 6 from accidents; 15 were unexplained.”

I would have been a lot more likely to bypass this article had I not served as a Peace Corps Volunteer in Bulgaria from 1998 to 2000. While living in a small town tucked away in the central Balkan mountains, I experienced firsthand the legacy that continues from the Soviet era well into 2010. The next train stop over from my town, Dryanovo, was Tsareva Levada, a small village with a population of no more than two thousand people. Every building in Tsareva Levada, like the majority across Bulgaria, let you know by their horrid condition tthat they had endured against all odds. They stood stoically in their often gray and peeling paint, plaster chips dangling like dead leaves, burnt out lights and insufficient heating the norm.

The people living inside these buildings endured as well. Inside some units lived grandmothers who rationed their daily beans to make sure they’d have enough to make their meager pensions stretch to month’s end. In Tsareva Levada stood a large two story concrete structure that housed a number of children and teenagers. I had been told this structure was an orphanage and over the two years I lived in Bulgaria, I took my students there to visit them from time to time and as part of a community service project led by two students I was supervising. I can remember one occasion when we had a spring picnic and had brought bananas. A number of the children were biting right into the peel or scratching at it, unsure of what to do with this odd-shaped yellow object. This was a reflection of the limited budget granted to these institutions to ensure a proper nutritious diet as well as meet other basic needs.

It wasn’t until I was close to completing my time as a Peace Corps Volunteer that I learned this wasn’t an orphanage at all. Many of these children, as it turned out, did have parents and families,and many would only go home only at the holidays. The majority of these children struggled with various mental health conditions and it was for this reason that they were living in Tsareva Levada, and not because they didn’t have homes and families somewhere in Bulgaria. Looking back, I shudder when I wonder how many of their mental health conditions may have been created or further exacerbated by possible lifelong neglect and abuse on so many levels.

Why weren’t they with their families all along? Unfortunately, they were part of a long tradition during the Soviet era where the mentally ill- children and adults alike- were banished to institutions in villages and countrysides where they could be more easily forgotten. As quoted in an article by Oksana Yakushko in the Mental Health Counseling Journal, “Mental illness was typically associated with prison-like mental institutions.” Though there had once actually been a rich tradition of psychotherapy practice in imperial Russia, under Communism there would be no welcome shelter to protect the human rights of the mentally ill.

When the Iron Curtain crumpled to the ground in the early nineties , the neglected plight of many of the region’s mentally ill continued under the crushing weight of historic changes and increasing poverty for many. The Bulgarian Helsinki Committee seems determined to terminate this chapter of their history and to restore accountability of governments and caregivers across Bulgaria. “It’s about ending impunity,” said Margarita Ilieva, legal director at the Bulgarian Helsinki Committee. “This will instill a fear of criminal liability, and that will change the behavior of the executive branch of government.” For its part, the Bulgarian government has announced it will close all mental health institutions housing children within fifteen years.

Fifteen years is a long time away though if you are a Bulgarian child struggling as you and I sit here in Oregon. As the investigations continue, the most crucial impact will only occur with a national awareness campaign that truly educates Bulgarians about the nature and special needs of the mentally ill. Once these institutions finally do close, little will change if these children’s local communities and the families with whom they will permanently reside still do not understand their needs nor embrace their equal rights as fellow human beings. It is the mentality that created and sustained these institutions that will still need to be dismantled long after the last institution’s front gates have been closed for the last time.

For more information, you can visit the Bulgarian Helsinki Committee’s website at www.bghelsinki.org.
(This is a piece to be published in ORCA's (Oregon Counseling Association) next newsletter but may be of interest to others following the human rights issues of those struggling with mental illness worldwide.)