Ask someone about what makes a relationship strong, and you'll get responses that include trust, honesty, communication or a mix of all three. Trust is a requirement for a healthy relationship. But what happens when that trust is broken? Here are some tips to consider to rebuild the trust in your relationship,

Acknowledge the process will be difficult. Rebuilding trust is a complex and difficult task. Accept that there will be progress and setbacks, it will be time-consuming, and that the relationship may not survive. 
 
Reflect on how trust was broken. In order to fix something, you have to know why and how it broke. Every relationship is different, but usually there are signs of trouble in the relationship. 

What was each person's role? It takes two to tango. It's important to be accountable for your behavior, however, it's equally important to understand how the distrusting behavior came about. I've written more about this process in a post about infidelity. 

Express your pain and uncertainty. People aren't computers. You can't just reboot and wipe out a virus from your system. Share your feelings with the person. Acknowledge that there is pain, confusion, anger, and sadness. You have to purge your emotional world. 

Let go. Letting go is not about forgiving the other person, it's about forgiving yourself and moving forward. In order to move forward in a relationship, you have to come to peace with the past. Letting go can be difficult but it doesn't have to hold you back from happiness. 

Mutual recommitment. Both people have to recommit to the relationship. If there has been infidelity, all communication has to be severed with the person, all communication. You can't recommit when your mind and emotions are somewhere else. 

Communicate. Start from the basics. Seek counseling. If trust was violated, it almost always means the communication was lacking or artificial. Learn how to communicate respectfully and effectively. 

Express what you need from one another. Part of the recommitment process is being clear and direct about not only what was lacking, but also what each person needs moving forward. 

Set goals together. A therapist may be helpful here to provide balance and a realistic expectation. Setting goals together provides two things: 1) both people are on the same page about the direction of the relationship, 2) it's a healthy exercise of communication and connection, which was probably lacking in the relationship. 

Check in regularly. Again, weekly therapy sessions can be helpful here. Or set aside time each week to check in and reflect on progress, difficulties, or changes in the trust rebuilding process. Weekly discussions also keep you invested and mindful of your relationship. Another thing that was lacking that lead to the trust fissure. 

Praise and show gratitude. Praise one another for effort and positive growth, even if it's minuscule. Just like letting go, the process of praising can be beneficial not only for the other person, but also for you. 


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

I rarely go to movies, maybe once a year. Inception (2010) was an exception largely in part of the fantastic reviews and I'm a DiCaprio fan. However, I was also curious as a psychologist. The movie was about levels of consciousness and memories. Memory formation has been a controversial area of research for decades with implications from the law to abuse to your own memory (check out the TED Talk "The  fiction of memory").

As I reflected on the movie, my mind kept returning to the therapy process. There were many themes in the movie that I experience in the therapy room. Initially I thought my narcissism was kicking in. Is it a bit much to compare working with a patient to a blockbuster mind bender? Set aside the process of inception or extraction. Reflect more on the underlying process of entering someone's mind, circumnavigating their and your own defenses, and uncovering raw, genuine experiences. Read below and you be the judge.

A major theme of therapy is the patient protecting the unconscious. Dom Cobb (DiCaprio) offers a service to Saito (Ken Watanabe) of training his mind to protect its secrets from extractors when in a vulnerable mental state. In Saito's case, the vulnerable state of dreaming.  People protect their emotional world by gaining distance from real feelings by utilizing defense mechanisms such as repression, rationalization, and humor. These mechanisms offer protection from the power of our emotional world. 

Therapy is the process of extracting. Extracting that memory or experience that lies deep within the psyche. An emotional experience that's difficult to reach. In the real world, we present differently than we do in the privacy of our home or a therapy room. We work to maintain our composure in public, counting down the minutes until you can finally be yourself. Our public and private experiences are different levels of consciousness. Therapy is the plot of Inception, gaining the combination to a personal safe.

Enter the character of Robert Fischer (Cillian Murphy). Saito has asked Cobb and his associates to enter Fischer's subconscious. This is mantra the role of psychoanalytically informed therapy; bringing the unconscious to conscious. Freud posited that people have developed simple and complex mechanisms to keep unconscious thoughts, feelings, and experiences from entering consciousness. Freud utilized a number of strategies to bring the unconscious to the conscious including hypnosis, free association...and dreams. 

The process of entering deeper into the mind has a sinister feel in the movie. For therapy, the belief is the opposite: if emotions are brought from the unconscious to consciousness, experiences can finally be resolved, leading to psychological relief and growth. During the process of exploring the unconscious, the therapist will regularly encounter resistance in the form of the patient's defense mechanisms. 

The projections in the movie are the defense mechanisms that are present in therapy. The role of projections were to block Cobb's team from completing their extraction mission, much like a defense mechanism blocks a therapist or even you from accessing experiences and feelings in the unconscious. 

To illustrate, let's use a therapy example. A patient conveys a story where a family member forgets the patient's birthday. The patient dismisses the forgetfulness as a non-issue because the family member has a busy life. The patient may then state birthdays are blown out or proportion, and actually express relief that their birthday was forgotten. 

However, at a deeper level the patient may actually feel hurt and disappointed. At an even deeper level, the patient may feel dismissed and unloved by family. The deep, core issue here is feeling dismissed and unloved. However, the rationalization (e.g., busy family member) and intellectualization (e.g., debate of birthday value) of the situation  serves as a defense against the realization of deeper, more profound emotions. 

Each "kick" represented a different level in the dream state, with its own world and sense of time. The same applies to the different levels of consciousness for each person. In the birthday example, each level of consciousness came equipped with it's own defense mechanism as well as a unique sense of time. Just as in the movie, as you move to deeper levels, the laws of time are compromised, and more signals or markings are needed to keep perspective. 

Yusuf kept a sense of time by playing music in the van. In therapy, a sense of time may occur by recognizing the context of the memory (e.g. the physical location of the experience, who you were with, etc.). Just like the kicks, moving from one conscious state to another with a patient can be smooth or violently jarring. Just like a kick, therapy is finite, each session is limited to 50 minutes. 

With each "kick" into a deeper dream state, stability and predictability were compromised. Cobb's team experienced a loss of control as they descended into deeper levels of the dream state. In therapy, as you venture deeper into a patient's psyche, there is the risk of destabilizing the patient. It's one thing to process a family member missing your birthday, it's an entirely different thing to process feeling unloved and forgotten by family. 

It's a very delicate process to venture deeper into someone's mind. Now add the time constraint of 50 minutes. It's not often talked about but there is a psychic pressure similar to the experience of deep sea diving or climbing a mountain. If you ascend from a sea depth or ascent a mountain too quickly, the body and mind sometimes have difficulty transitioning which can result in a sickness, shock, or even death. If you move quickly in and out of the unconscious, the patient can suffer a similar experience of sickness, shock, or even psychosis. It's imperative to bring a patient out of a deeper psychological state, and help them recover toward the end of the session. When the session is finished, that's the "kick" back to reality, the return to the world outside the therapy room. 

The underlying subplot of Inception is Cobb's unresolved trauma of his wife's, Mal, psychosis and subsequent suicide. Cobb feels responsible for her death, and his own psyche proves to be a complex web for the inception team. Ariadne, the dream architect, repeatedly questions whether Cobb can keep his own projections contained during the dream extraction and inception. 

This subplot is quintessential countertransference. Countertransference is the therapist's feelings that are stirred and brought to consciousness by the patient's experience. Entering Fischer's dream state stirs Cobb's own dream experience with his wife. A patient talking about abuse, loss, or fear can stir the same emotions in a therapist. Like Cobb, the therapist has to be vigilant and set aside their own experiences to work with the patient and their psyche. Countertransference is a powerful experience and should be addressed whether in a therapist's own therapy or in peer consultation. 

Inception concludes with Cobb returning home to his children. He spins his totem, his reality check mechanism, and the screen goes black leaving the viewer wondering if this last image is in fact reality, a dream state, limbo, or all of the above. 

Memory and the patient's reality (whether accurate or not) is the foundation of therapy. I often encourage patients to journal or talk to their parents, if possible, about early childhood experiences that we process in therapy (I encourage you as well). Sometimes we are sure of a memory, then are surprised by how we are our own inception team. Each person decides how they are going to encode an experience into a memory, without the guarantee of accuracy.

For example, I was sure of a decades old memory until a year ago. I remember riding my bike home as a kid and seeing my mom pull out of the driveway with a child in the passenger seat writhing in pain. I remember feeling confused and wondering what happened. According to my memory bank, I found out the injury details hours later when everyone returned from the hospital. 

I revisited this memory with my mom last year and her recollection floored me. She recalled sending me out to find this child as she feared something bad had happened. I found him injured in the woods, carried him from there into the house, and my mother took him to the hospital. 

Two incredibly different stories for the same experience. Only one of us can be right. So if my mom and I both spin are totems, which spinner will continue to spin?

Take a moment and ask someone about one of your memories. Ask them their experience and compare notes. You might learn something about yourself.


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!