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Wednesday, November 17, 2010

The Untold Story Bina 2010

The Untold Story
Meet Rabbi and Mrs. Cornfeld
By Debbie Shapiro

Several years ago, when a close friend confided in me that she and her husband were studying Narrative Therapy, my immediate reaction was, "What in the world is THAT?" Then, a few years later, I met a young woman who was doing her field work in Narrative Therapy as part of her internship at Yeshivah University's Wurzweiller School of Social Work. When I asked her about it, she enthusiastically began telling me how she guides people in discovering their personal stories. "We define ourselves through how we view our stories. Through discovering our stories we discover our strengths." I still didn't get it; so she put me in touch with Rabbi Cornfeld, MSW, a therapist specializing in Narrative Therapy and supervisor of the student interns at the Jerusalem Narrative Therapy Institute.

Rabbi Cornfeld, and his lovely wife, Ellen, invited me to visit them in their home. Located on a hill facing the city and overlooking the Jerusalem forest, the view was spectacular. With its mahogany highlights and auburn stone floor, the house felt warm and inviting.

@Rabbi Cornfeld, could you tell our readers a bit about your background?

Rabbi Cornfeld: "I'm originally from St. Louis, Missouri. At age twenty-one I came to Israel to see the sights and ended up studying Torah at the Diaspora Yeshiva on Har Tzion, just outside the Old City of Jerusalem. Eventually I married, earned my rabbinical degree and continued learning in kollel. Then, twenty something years and eight children later, that marriage dissolved."

I glanced at the very gentle and empathic woman sitting on the sofa opposite me. "We've been married for eight years now," Rabbi Cornfeld answered in response to my unasked question. "Each of us brought eight children into the marriage. When we were first married, we had twelve kids living at home!"

"That must've been some shanah rishonah!" I couldn't help but blurt out. 

Ellen's face crinkled into a smile. "It certainly wasn't easy. We learned a tremendous amount that year. As a matter of fact, we're giving a workshop on blended families ("Actually," Rabbi Cornfeld jokingly commented, "I'd prefer to call it meat-grinded families") at an upcoming national conference on Narrative Therapy."

Rabbi Cornfeld continued, "My divorce is what compelled me to enter the mental health profession. In attempting to save our marriage, my first wife and I went for lots of marriage counseling, but it wasn't taking us where we wanted to go. I came to the conclusion that there was a real need for proficient therapists and decided to enter the field. So I enrolled at Wurzweiller School of Social Work's block program. For three year I traveled every summer to New York to attend graduate school and spent the other nine months of the year doing supervised field work here in Israel. 

"After completing my masters in social work, I worked as a community social worker in the Bucharim neighborhood and a family social worker in Beitar Illit. I dealt with a wide array of issues gained tremendous experience. On a personal level, however, my marriage disintegrated completely and we got divorced.

"A few years down the road, when I was already married to Ellen, I noticed a post in a professional journal announcing the formation of a course in Narrative Therapy. I was interested enough to make an appointment with Channa Rochel Frumin, head of the Narrative Institute in Jerusalem to learn more. She explained that people define themselves through how they interpret their life story. By asking the right questions, the therapist enables the client to discover his strengths that already exist within that story, and then use those strengths to create a stronger story, until eventually he comes to see himself in a totally different light.

"In my work as a narrative therapist, one of the things that I specialize in is addiction problems – narcotics, alcohol, gambling and, what we're seeing a lot of today, internet. I'll ask the client to talk about what is drawing him to this destructive behavior; what problem he's trying to solve in a negative way. Then we'll search for other times in the client's life when he solved that same problem positively. A person addicted to gambling, for example, may have a real need for the excitement — that rush of adrenaline – that comes with making a bet.  So we search for times that he did something positive to attain that same feeling. Then we transpose that picture to his present behavior.

"What we tell ourselves impacts how we live our own, personal story. So, for example, if a person with a problem with alcohol constantly tells himself that he's an alcoholic, and that if he takes one drink he will completely lose control and go on a drinking binge, that is exactly what will happen. He fulfills his own expectations.

"Usually, a person who comes to therapy is so totally immersed in his problem that it defines him as a person. In Narrative Therapy, we try to disassociate the person from the problem by externalizing the problem. So if, for example, if someone's a perfectionist to the point that it negatively impacts his life, rather than talk about how his being a perfectionist is problematic, we'll talk about a problem called "the Perfection" and its impact on him."

Ellen: "I specialize in eating disorders such as bulimia and anorexia. We help the client understand the root of her problem – why she's resorting to self-destructive behavior – and then guide her in discovering the glimmers of hope, the times when she dealt with her problem in a positive way. Once she's discovered that she possesses the inner strength to deal with her problem, I assist her in finding the tools for accessing that strength."

Rabbi Cornfeld: "In the addiction world it's common to say that a person must hit bottom before he can get up. But the problem with that is that a person might, chas v'chalila, drop so low that he will never be able to get up. On the other hand, it's possible to define 'bottom" as a red line that the person will never cross. A person struggling with a narcotic addiction might say, 'I'll never shoot heroin,' whereas for someone dealing with explosive anger the red line might be getting physically violent. Although a conventional therapist might ignore that one point of strength, a therapist trained in Narrative Therapy will build on it, find out what tools the client uses to keep from crossing that red line and then use those same tools for dealing with the greater problem."

@Could you give me some actual examples of how narrative therapy has helped?

Rabbi Cornfeld: "Sure. One of my clients, let's call him Moshe, came for therapy because he felt a general lack of motivation and direction in his life. In his late thirties, he was married, with a family and had recently started a job as a bookkeeper. Before that, he had been unemployed and deeply depressed. Moshe wanted to make something of himself, but he felt powerless and viewed himself as a failure.

"During our first few sessions, we talked about what types of things he could do to 'make something of himself.' Moshe had a wide range of interests and talents, including playing a musical instrument, writing, photography, computers, ceramics, and drama.  Although he had done all of these things in the past, recently he hadn't done any of them. Moshe recalled that his teachers often wrote on his report card that he had a lot of potential and could go far.'

"One session we had the following conversation:

"Moshe: 'My wife tells me that when I finally do something, people love it.  But somehow I can’t get myself to follow through with anything.'

"Me: What's holding you back?

"Moshe: 'I get easily distracted with nonsense, such as computer games or reading magazines.

"Me: 'And anything else?'

"Moshe: 'I fear failure. Sometimes, to cover up this fear, I'll research the subject so extensively that I'll never do anything about it.'

"Me: 'Could you tell me a story about that?'

"Moshe: 'I would like to begin a physical fitness regime, so I looked into the pros and cons of different types of exercise. I finally came to the conclusion that I want to purchase a bike, and now I'm researching the many different types of bikes on the market. But I haven't actually started exercising.

"Me:  “If you could name the thing that's holding you back, what would you call it?”

"Moshe: 'Procrastination.'

"When people go for therapy, it’s usually because of a series of events that they interpret as being problematic. In Moshe's case, he felt that he was stuck in a rut and lacking motivation to change. Defining the problem and giving it a specific name – procrastination – creates distance.

“In narrative therapy, we try to find a personalized name for the problem. In this case, Moshe named his procrastination problem 'Crass.' In subsequent sessions we spoke about how Crass was paralyzing him with fear, distracting him with silly computer games from accomplishing what he set out to do and forcing him to strive for perfection to the point that he was never ready to actually begin working. By defining his problem and giving it a name, Moshe had distanced himself from the problem and able to view it more objectively.

"Once we had defined the problem and given it a name, we searched for a story where Crass did not prevent Moshe from accomplishing what he set out to do. Moshe recalled how the previous year he had organized his shul's Purim play. We explored why, in that particular situation, Crass wasn't able to stop him, and discovered that, among other things, he was working together with other people, he had a position of responsibility, he enjoyed what he was doing and he had a deadline.  In narrative therapy language we call this the “unique outcome.” For Moshe the realization that in his not so distant past he had succeeded in overcoming Crass was extremely empowering.

"Once Moshe was confident that he had it within himself to overcome Crass, he began considering practical steps to carry out a project, in this case, it was writing. He applied some of the strengths that he had discovered in the "unique outcome" to this project, for example having a weekly deadline and receiving feedback from others. Although Moshe's still struggling with Crass, he's able to accomplish and keep Crass from taking over. In Narrative Therapy language we call that learning to form a "preferred story."

Ellen: As I mentioned earlier, I deal with eating disorders, usually anorexia or bulimia. These diseases are often caused by social pressure. The girls feel that they must be perfect mothers, have a perfectly shaped body, prepare a five-course dinner party every Friday night for at least a dozen people, and keep an immaculate house. They've set impossible standards for themselves and then are so busy trying to please everyone that they don't see where they fit into the scheme of things. So what do they do? They create an eating disorder and that becomes the one aspect of their life where they can be successful. It becomes their declaration of independence; here they —and not society – are in control. No one can tell them what to eat or how to eat!

"Helping a girl with an eating disorder is very slow work. Anorexia is a cocoon that both protects and defines. As a therapist, I explore why my client has chosen food to dominate her life.

"One woman, I'll her Sarah, slid into anorexia after trying to lose twenty pounds. Her problem was exacerbated by an extremely low sense of self esteem, which I later discovered was a result of being abused as a child.

"We started out by externalizing the problem to make it less personal and therefore easier to deal with. So if, for example, Sara complained that she's fat and doesn't want to eat, instead of asking, 'Why do you feel that way?' I'd ask, 'Is that the voice of anorexia telling you that?' At the same time I also asked Sara questions that would help her to understand her own negative behavior, such as, 'Why is being emaciated important for you?' Once we explored her negative behavior, we looked for the success story, or, as we call it in Narrative Therapy, the 'unique voice' so that the client can use those same strengths to overcome her anorexia. Together, we claimed victories such as sticking to the diet and eating 'scary' foods like pizza or ice cream. It was very slow work – I call it the drip, drip effect.  But each victory, no matter how small, made the voice of Anorexia a bit less dictatorial, until finally she was able to set herself free.

"In addition to individual therapy, many of the seminaries invite me to give a workshop on dealing with food. The girls share their difficulties, and when they discover that their friends are struggling with the same issues, they open up and explore what is bothering them. At these workshops, I'll ask, for example, 'What is Shabbos like for you?' 'How do you cope with sitting for hours at a food-laden table and eating four courses?' Instead of enjoying Shabbos, many of the girls are petrified that they'll gain weight. Part of that is because so many girls – and women – have no idea when they're full, or what it feels like to be hungry.

@As parents, how can we use implement these tools into our relationship with our children?

Rabbi Cornfeld: "When we look for our children's Unique Outcome, the times they succeeded and got it right, we can help them to attain what we call the Preferred Story. Also, it is really helpful to put our knowledge, ideas and prejudices to the side and just listen to our children for who they are. That way they'll feel safe and want to open up even more.

"Both Ellen and I feel privileged to be able to help people overcome their challenges. Through listening, asking the right questions and building on our clients' strengths, we are guiding them in rewriting their personal story, and hopefully giving it a happy ending."

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