Janis
                  Rosenberg, Ph.D., Clinical Psychologist

Janis Rosenberg, Ph.D.

Clinical Psychologist

9696 Culver Boulevard, Suite 303
Culver City, CA 90232
310-841-0302
Lic # PSY 15452

Services
                        Offered
  • Weekly or Biweekly Individual Psychotherapy Sessions for Personal Growth
  • Couples, Marriage and Family Counseling
  • Telephone consultation sessions
  • Half hour supportive or educational sessions
  • One and one-half hour sessions for couples

Areas of Specialization

  • Fear of intimacy and relationship ambivalence
  • Divorce and infidelity
  • Trauma and DEPRESSION
  • Parenting and Step-parenting
  • Shyness and Self-esteem Issues
  • Finding or building a healthy passionate relationship
  • Adjusting to loss, separation and divorce
  • Underachieving or creative blocks
  • EMDR Therapy (Level 2 Certification)
  • Eating disorders, weight loss, body image
  • Anxiety and panic
  • Motivation and tools for CHANGE

CHANGE

Clients come to therapists feeling that something in their life doesn't work. Either they want someone or something else to change, or they want to change how their beliefs, low self-esteem, tendency toward bad relationships, lack of confidence, or lifestyle is causing depression, anxiety, or just isn't working for them.

For clients who have been mistreated or hurt by families, others, or negative life events, they want to be able to deal with life's blows with equanimity, and release fear and shame.

My first supervisor in graduate school told me, a total neophyte therapist, that by the end of the year, she wanted me to be able to tell her how therapy works to help people change. What a tall order. I've been pondering it ever since.

If you ask clients who have been in therapy-what brought on change? What happened? Was it the relationship with someone you could trust? Was it learning new more adaptive ways of thinking and feeling from the therapist?

Jim Johnson talks about steps to motivate change in his book The Sixty-Second Motivator. Two factors are needed to have good motivation to change. One is finding an important reason to change behaviors. If there is high importance that is personally meaningful to you to give you something you really want, you are more prone to change the behavior. Second,  you have to have confidence that you have the tools, skills and knowledge to change. Someone who wants to stop smoking has to be very motivated, and then the appropriate tools, whether it's medication, hypnosis, group support, can help you change.

If you ask clients about motivation to change, they may say they really want to change, but feel stuck in negative patterns of shame, self-doubt, and feeling hopeless. How does the belief that you can't change deter the therapeutic process? If the therapist tries too hard to motivate the client, the client doesn't feel accepted for being where s/he is.

I have had the experience of urging clients to reach out, attend support meetings, get medical help, consider antidepressant medication, only to have the clients leave therapy because they needed for me be in the dark place with them, while still complaining about how terrible it was.

I have also had the opposite happen, but this happens when the client is more open to change. So the question is, how does a person open to change?

Clients who make significant life changes often start not knowing what their goals are or what path they want to take to change. Let's say Jim starts therapy because his significant other has many complaints about his depressed, unmotivated mood and lifestyle. At the time he starts, he might just want his partner to be less critical and more satisfied with him. As it turns out, he is able to gain the confidence in himself to make significant changes in his life and relationship in therapy. But how does this happen, when at the start the waters are so murky and motivation and goals aren't clear?

Is it our caring for the clients, convincing them, plying out the resistant parts and reworking them that creates change? What happens in the brain and from trauma to bring people to the hopeless, devastated place where they don't feel capable of change? They are coming to us begging for us to change them, yet telling us all the reasons they aren't capable, it's too hard, they are not good enough, smart enough, etc. Feelings of being unworthy are the most common negative beliefs clients have when beginning therapy.

In his article, "Change or Die" in Fast Company Magazine, Alan Deutshman talks ab how we fight change, even in a health crisis. " Severe heart disease is among the most serious of personal crises, and it doesn't motivate-at least not nearly enough. Nor does giving people accurate analysis and factual information about their situations. What works? Why, in general, is change so incredibly difficult for people? What is it about how our brains are wired that resists change so tenaciously? Why do we fight even what we know to be in our own vital interests?"

Dr. Dean Ornish, who motivates heart patients to make radical change, believes you have to appeal to people's emotions, to reframe their ideas of themselves to believe that they can have joy, not through fear of death. Fear isn't a good motivator,  but joy is. He also found that radical, sweeping, comprehensive changes are often easier for people than small, incremental ones. "People need to make big changes to get immediate rewards, whether in health, weight loss or gains in physical ability. Then they see that the changes are worth it. It's a paradox, that big changes are eaiser for people to make than small ones." For example, patients often stop taking a cholesterol-lowering drug, he says, because they don't actually see the changes or feel better.

While this may be true for physical changes, many clients are too fearful to embrace sweeping emotional or relationship changes. They need to take it a step at a time.

One area where we can see big movement toward change is the recovery movement. People may have to "hit bottom", but Anonymous groups using the Twelve Step model of recovery support groups has helped many people let go of various addictions, from drinking and drugs, to food, sex, gambling, debt, and even cluttering. Something about not being alone, seeing others who have recovered, sharing publicly and coming out of the shameful secret places of dysfunction can bring about change. Others may use faith in religion or God to change to become better people.

What I came to realize in graduate school, was that there is something about the relationship with a safe, trustworthy, understanding therapist that helps promote change. Psychoanalysts call it transference and focus on interpreting the patient's reactions to the therapist, which sometimes seems too much for some clients. 

So how do clients change in therapy?

Clients also learn to be more accepting of who they are in the present, when they explore the past with the therapist explaining why they turned out like they are. Negative parents shame and blame the child, who then internalizes the inner badness and carries it forever. "It is better to be a sinner in a world full of saints that a saint in a world full of sinners." Ronald Fairbairn, famous Object Relations Theorist, stated this explanation that the child takes on the badness, thus protecting the parents' goodness, since s/he needs to believe the parent is good for her survival. Often this is carried through life, with clients fearing saying anything negative about their parents. 

People change when they learn from a credible source that conflicts with others can be worked through, needs can be expressed and often met, concerns about personal image can be less pervasive, and feelings can be tolerated and understood.

There is something more that happens in therapy. We can see that therapy creates a safe relationship with a trusted expert, fosters self-acceptance and self-awareness, and offers tools for changing beliefs, habits, and patterns.

But maybe there is something that happens when "two or more are gathered." There is genuine caring, cheerleading, enthusiasm, pride, nurturance and even love. 

Questions for Dr. Rosenberg? Send her e-mail or call her at 310-841-0302