How to Find the Right Fit in a Therapist

How to Find the Right Fit in a Therapist

By: Christine Webster, LMFT

I am currently a client, therapist and intake coordinator and because of those roles have an appreciation for how difficult it is to find a therapist who is also a good fit for you. You have to navigate insurance/cost, scheduling, and a myriad of types of practitioners and models before you can even step inside a therapist's office. Now that difficult task gets even more daunting when you oftentimes can’t physically step inside any office due to the ongoing health crisis we are all facing. I hope my experience of the process can help make it a little more palatable for anyone who wants help.

The first thing to consider is how you will pay for sessions. Checking with your insurance company around your specific plan’s coverage can save you a lot of issues down the road. Here are some questions to consider/ ask your insurance company:

• Does your plan cover mental health office visits/ teletherapy sessions? Is the coverage different for teletherapy? 

• Is there a copay/coinsurance that has to be paid each time? 

• Do you have to meet your deductible (paying full price) before your insurance will cover the sessions? 

• Is there a limit to how many sessions are covered/ do you need a referral/special permission before sessions are covered?

If you don’t want to use your insurance or don’t have good coverage, then there are out of pocket fees and sliding scale options. Therapists typically set their own hourly rate and thus there is much variance based on the therapist themself, where they practice and for how long they have been practicing. Some therapists also offer sliding scale/ reduced rates. If you don’t mind seeing a trainee/student therapist (who usually have lots of support from advanced therapists!) then look at training programs with clinics in your area. Often those students offer very reduced rate options. For example, our practice recently launched the Phoenix Clinic at CCRC which offers low cost sessions with graduate student interns. 

Once you get a sense of your needs and options financially you can start to dig into what you want in your therapist. Is there a specific presenting problem that you want to address? Would you feel most comfortable with a therapist who identifies the same way you do? Are you seeking therapy for yourself, your relationship or your family? Some therapists do not have specific training in couples or family therapy while some therapists mostly focus on those areas. Does a specific model/stance stand out to you? Directories can be a great way to start to narrow down your search. Psychology Today and Therapy Den are general directories which can be searched by payment options, presenting problems, gender, race/ethnicity, etc. There are also more specific directories for individual models of therapy or identities (Black Mental Health Directory & Therapy for Latinx are great examples). You can often get a sense of a therapist's areas of interest/expertise and personal style from their bio. Find a few therapists who feel like that would be a good fit and also match your criteria for payment and location/teletherapy.

The success of the therapeutic process is a combination between what the client brings to the space, what the therapist brings and how those two offerings come together. It’s so important to feel that there is a good fit between you and your therapist. They could give you all the “right” tools or say the “right” things, but if you don’t trust them or connect with them it might not be as effective. So don’t be afraid to try on a therapist for size before deciding. Ask potential therapists if they offer consultation calls or can answer some questions via email about how they approach therapy. Have clear goals and advocate for them and for yourself.  You don’t have to stick with a therapist or process that doesn’t feel safe for you, even if you’ve already been to a few sessions. 

I vividly remember sitting in the waiting room before my first ever therapy session being completely filled with anxiety. Making it in that door is a huge success on its own, and some anxiety is very normal. In my experience, being prepared for the experience can help soothe your nerves. As a therapist, I typically use first sessions to gather information, assess fit and set goals for the process. So having a clear idea of what is currently affecting you and your goals for change can help guide that process. You can try to make (mental or physical) notes on things you would like to address in the time leading up to the session so you don’t feel overwhelmed and on the spot during it. Keep in mind that things do come up naturally over time, so try not to worry about squeezing absolutely everything in. You and your therapist can shift and focus on new topics/issues as time goes on. 

I wish it was much easier to access qualified care, and know firsthand how frustrating the process can be. I hope this brief guide can help you find a therapist with whom you feel safe and connected.

Photo by Christina Morillo from Pexels

A Race to Writing an Intersectional Song: Becoming a South Asian Therapist in America

A Race to Writing an Intersectional Song: Becoming a South Asian Therapist in America

By: Michelle Ahmed, AMFT

I have been writing, re-writing, and considering this piece for over a year and far before this pandemic hit. I never seem to have the right words, the right organization, or the right resources—so here I am putting my thoughts and feelings into words however they come. I am a therapist—a South Asian, Bangladeshi American, bisexual woman, singer, artist, and writer—and I am the “other” in Black, Indigenous, and other People of Color (BIPOC).

The term BIPOC has only recently surfaced as an attempt to unify and connect us within this white supremacist system while emphasizing that B[lack] and I[ndigenous] folk are the most marginalized. There is an unspoken hierarchy amongst the men that built this country that continues today—one that has structurally divided people of color and pinned them against one another to keep Black folk at the bottom of the structure—one that has given other people of color (a.k.a. me and other white-appearing/light-skinned POC) access to white privilege in order to keep us silent in the disenfranchisement of our Black siblings as long as we are able to achieve some power, resources, and maintain safety in this world. This shows up in Chicago as: a lack of empathy and rivalry between the Latinx community and the Black community; this shows up as non-Black South Asians taking jobs that fill the POC markers that a company needs to fill; this shows up as discord and bigotry between South Asians and East Asians in academia and on racism; and it shows up as millions of Black folk intentionally set up to land in prison for crimes that white folk in positions of high power commit (i.e. drug trade, sex trafficking, the prison slavery system). The divide begins with the revocation of choice as this oppressive white system resists BIPOC from connecting, from communicating, and expanding the knowledge of shared truths.  

I am the other in BIPOC and I am excited and singing with pride. Finally—something that allows us to share our experiences and validate one another! On the other hand, the term BIPOC can also gloss over the diversity within marginalized groups and the ways in which we have been forced to compartmentalize and store each of our identities into different boxes on different shelves only to be taken out and worn when in the “appropriate” or in a safe environment. The pandemic has magnified (for the first time to white folk and many non-Black POC) the ways in which our system is shattered and crumbling with structural racism that dehumanizes BIPOC, specifically Black folk. Thus, the need for a term that unites BIPOC folk in allyship, yet somewhat begins to identify the individuality within our shared identities as we develop throughout this racist system, is high—and it begins NOW. Writing this song does not come easy and reading through this will not either.

As a therapist I invite you to take a slow, controlled inhale through your nose, feel your chest rise all the way, and then let it out slowly through your mouth as if you are blowing through a straw. Notice the physical sensations in your body scanning from head-to-toe. If you are feeling discomfort at any point during this song, I invite you to pause, bring your attention back to your breath, notice your body, and adjust as you need to. It is okay to take breaks, and we will make it through this journey together.

Ok, are you centered?

Let’s begin…

When I say, “I am South Asian, Bangladeshi American, bisexual woman,” there is a disclosure—and it is this: I did not possess an understanding regarding what these identities meant to me until I began graduate school and was forced to face them in Carl Hampton’s (lecturer for The Family Institute’s Power Privilege and Difference course) class at Northwestern University in 2017. Before this, these identities were empty words tattooed on my skin like a tramp stamp as if the identities were some large mistake I drunkenly got because someone else uttered them into existence and I went along with it. I would fill my lungs with nervous laughter and brush it off as if it were something taboo and not worth discussing further. It felt like a broken record—the “I smell curry” coughs as I walked down the hallway in high school, the “Boogawhats” when I identified Bangladesh on a map as a country next to India but is not India at neighborhood parks, the “what flavor of Brown are you?” as I attended cultural diversity and group relations trainings in higher education, and the “if you kiss a woman while dating a man is that considered cheating?” when I explored my sexuality outside of my bedroom closet. I could not seem to fix the broken record no matter what I answered. I was always met with blank stares, laughter, confusion, and my heart and lungs filled with repulsion and shame every time I had to sing the same old song again. Every time I took a shower, I would rub my skin raw in attempt to wash the tramp stamps away and hope that the sound of the water flowing through the tap would drown out my singing.

These words, "South Asian, Bangladeshi, and bisexual,” embodied shame, guilt, and embarrassment—none of which were mine. This Brown skin I wear has hidden depths. It is something I cannot take off because they (white folk) see it whenever they look at me, yet it does not feel like my own as others are constantly defining and assuming what it means without checking in with me. They are staring at my album cover, vibing with my beat, and disregarding the lyrics and the melodies and harmonies that I worked so hard to weave. To others it means that I am aggressive, exotic, erotic, summertime fun, abnormal, less than, object, token, a means to growth, stupid, naïve, colorful enough, and not Black. Carl’s class struck the “not Black” chord so loud it rung in my ears for days. I realized my marginalization not only isolated me from white folk, but from other people of color as well. I was not white or Black, I was Asian but specifically South Asian, I was South Asian but not Indian or Pakistani—I was Bangladeshi and a woman…a bisexual woman. I had never said that out loud in front of so many people. It was like singing through a microphone for the first time—I sang louder and louder only to hear a clamor of screeching feedback until there was no longer clarity in what I was singing. I can’t hear me. Can you hear me? Had I compartmentalized so deep that I had lost parts of myself in someone else’s lyrics?

Pause. Remember to breathe.

Just as I mentioned before, check in with your body, readjust yourself, and begin again.

We are in the present together.

Last week, I said to my mother for the first time in my life, “Mom, most of my friends have been Black or Brown my whole life. I only brought a few white friends around you because you and Papa are racist.” “We are not racist,” she exclaimed with furrowed brows. It was so easy for her to shrug race off. There was privilege dripping from her voice—and this is the same song I have heard other South Asians sing as they begin to achieve their white American dream in the suburbs. “Maybe you think you aren’t, but you just asked me, ‘Do you like Black people now?’, ‘Why aren’t you friends with Iranians or Asians?’, ‘Do your Black friends live in the South Side?’, and ‘We aren’t Brown, we are Asian.’ My mother could not comprehend why her questions were prejudiced towards and painful for others—she could not even see the colorism she exhibits within our own family. My mother’s skin is an almost-white, olive. My brother and I on the other hand, we are Brown, and my brother’s skin is a much darker shade of Brown than mine. I found myself singing:

She doesn’t see our skin.
She doesn’t see our shade.
She doesn’t see the pain I have been carrying throughout my life.
She’ll never understand.
She’ll never understand.
She’ll never hear the songs I’ve had to sing as I strive to rise.

The way that race continues to color my life whether I want it or not is invasive and traumatizing. It is as if I am in a constant state—of hypervigilance—and that I must work 10 times as hard just to get through what is considered a typical encounter for my white peers. It means that others point out the shoes I am wearing as unprofessional when I choose to wear boots instead of high heels to an interview, it means choosing to wear my glasses in order to demand authority in a white space rather than be deemed as unworthy or unintelligent, it means taking out my nose ring—an important aspect of Bengali female culture—every time I step into a “professional” meeting, it means feeling like I am being interviewed for my worth even when my white peers seek me out for my expertise, and it means holding my emotions together when I am in pain from the microaggression I just faced while conducting therapy with my white client so that my client can feel safe enough to process their emotions.

Pause. Remember to breathe.

As a therapist, silence can be a powerful choice—one that is survival, one that is as painful as a thousand daggers in your heart, or one that is loud enough to suppress history. To the listeners who are searching for white voices only, my silence will not be heard. I am choosing to stay silent no longer because as hard as I am working, I remember that my Black peers are working 100 times harder. It has been my access to white privilege as a non-Black other POC to stay silent to what I am witnessing happening to others and to myself. It is time for me to speak loudly and firmly. It is time for me to lament with all my strength for my dying sisters and brothers and to sing in crescendo for the voices that are elaborately and conveniently ignored. Difference is the most beautiful thing that exists in the world—it is the power to challenge, learn, and grow from one another and the opportunity to sing and harmonize in chorus. Where would our full song be without the different notes, intonations, and fluctuations in our voices?

Pause. Remember to breathe.

I was born a singer and an artist. My parents said that as an infant I never cried. If I needed attention, I would sing. “Sing?” I asked. “You sang,” they said, “back and forth between two notes,” and that is how I learned to vibrato. When I was three, I began to vibrato all over the walls and tables with finger paints—splashing vibrant colors and rich tones into my world. It was only in middle school when I realized I was any good. I was living in Bangladesh for three years at the time and I remember when I sat in my very first music class. We were going to sing Sunny Day, and I was terrified because I had never sung in front of anyone other than my parents before. I felt my heart racing and my body trembling as I heard everyone else’s voices—and then I sang. In that moment everything shifted—it was as if I could feel everyone’s voices in my own heart and feel them vibrate throughout my entire body. My heart slowed down, and I relaxed as I began to crescendo. In that same week, I created artwork for my history, science, and math classes. I used paints, colored pencils, and clays to build figurines. My body rhythmically swayed from side to side as I used the colors to express how history made me feel—it was as if I were dancing to music no one else could hear. I had never been happier or more relaxed in my life as I am when I am singing or painting. I always believed I was born with a passion for music and art, however, three years ago I realized that it was my body’s natural way of healing from trauma. Through this natural development of what felt good in my lungs, my heart, my body, and my mind, I chose to become a singer, a painter, and eventually a writer.

As a singer, artist, and writer, I was able to explore my emotions in a way I could not elsewhere.

Here is my pain,
Here is my grief,
Here is the joy that no one else sees.

This song and colorful dance came with failure—failure to connect with others, failure to connect with myself, failure to make sense of my experience, and failure to getting it down right. However, through the process of failure—all the missed notes, the mismatched pitch, the coloring outside the lines, the bleeding and blending of unwanted colors—I started to find healing beyond the joy and solace it initially brought me. I was experiencing the mind-body connection I learned about decades later. The singing was strumming a vibration from my vocal chords that connected the following: the natural rhythm of my heart, the resonance, the deep and controlled breathing, the use of my right brain (emotions/non-verbal processing, visuals, creativity), and the use of my left brain (language/verbal processing, analytical thought, planning). The art was connecting my mind to my body, allowing me to engage several senses, shift movement from side-to-side in a way that regulated my nervous system through the right and left brain movement, and sit through the present moment while expressing and tolerating the distress I was experiencing. Soon enough, I was able to sit through the process and put it into poetry and even into a blog post that connects personal experience, poetry, and research in psychology. Inadvertently, naturally, and then intentionally, I reclaimed my identity defined in my own terms not by my family, not by my society, not by some class I took, but bit by bit through the process of failure, repair, striving, and maintenance—like many other people of color.

Pause. Remember to breathe.

Making mistakes is like wandering in unknown territory in the dark. Of course, you didn’t know where you were going, it’s unknown territory and it’s dark! All you need to do is breathe, tell yourself it’s okay, and slowly put one foot in front of the other as your eyes adjust to the night sky and your ears adjust to notes you’ve never heard before. Only once you allow yourself wander fearlessly will you start to learn how to navigate this new path.

I have been searching for a way—more specifically the “right” way—to connect my personal experiences to what is going on in this world when I came to the realization that my experience is both nuanced and also shared with many. In my work with clients I see interracial and multicultural individuals, couples, and families struggling with their identities within this larger world and within their intimate relationships. For many of my biracial clients, it means yearning to be seen as a person of color while simultaneously pushing that part of their identity away because of the pathology and pain that comes along with that in this country. For many of my multicultural clients, it means figuring out which identity they are safe to embody in any given space, a.k.a., codeswitching to match the audience in their environments. Which version of myself am I safe to show up as here and now? This is the shared experience that bicultural and biracial people experience in varied and nuanced ways. There is no “right” way. There are just the simultaneous songs we sing in synchronized harmony.

As a South Asian, Bangladeshi American, bisexual woman, singer, artist, and writer, I invite you to: Pause. Breathe. And sing your song.

One love,

Michelle Ahmed, AMFT

Acknowledgments:

Thank you all for this invaluable life lesson. You have all helped, encouraged, and challenged me to find my voice and bloom my song into so much more.

Bukky Adeyinka, LMFT

Joe Bozeman, PhD

Rayne Bozeman, PhD

Beth Chung, LMFT

Magdalene Gorecki-Eisenburg, Art Educator

Cicely Green, Counselor

Carl Hampton, LCSW

Johnny Hayes, Music Producer

Nosheen Hydari, LMFT

Rory F. Jeanniton, Counselor

Fabrice R. Lubin, PsyD

Chaaze Roberts, LMFT

Nadira Shah, Music Educator

Daniel Tapanes, PhD

Amy Wu, LMFT

The Surge: A Therapist's Advice on Emotionally Healthy Responses to the Rise in COVID-19 Cases

The Surge: A Therapist's Advice On Emotionally Healthy Responses to The Rise in COVID-19 Cases

By: Sara Morrow, LMFT

The US hit an unnerving record high of new COVID-19 cases on July 2nd (Bellware et al., 2020). There’s a lot of uncertainty about what this means for the rest of the year and beyond. Amidst these surging numbers in several states, it makes sense that levels of worry may also rise. Add fear and uncertainty, and you’ve got a perfect recipe for anxiety and helplessness. 

From “Learned Helplessness” to “Learned Optimism”

If you ever took a Psych. 101 class, you may have read about the theory of “Learned Helplessness” by Drs. Martin Seligman and Steven Maier. This theory taught us that after repeated aversive and inescapable events, mammals learn a sense of helplessness (Dingfelder, 2009). However, many years later these researchers are looking at this theory differently. Dr. Maier has found that our neurological “default” actually seems to be helplessness; we learn that we can do something, and develop a sense of greater control (Dingfelder, 2009). Dr. Seligman speaks of “learned optimism” now (Ackerman, 2020). Given this, of course we feel helpless during a peak of infection rates! We have to develop our sense of agency to get out of the helpless state. What CAN we, in fact, do right now? We can adhere to social distancing guidelines, we can be diligent about handwashing, we can wear our masks in public, we can self-quarantine if we’ve been traveling, and we can get tested if we know/suspect we came into contact with someone who has developed COVID. We can cut down on social media if that contributes to anxiety. Perhaps it would help to get your COVID-19 news from unbiased, scientific sources that don’t come with sensationalist headlines. We can invest in research so that scientists can understand the virus better. I downloaded an app that gathers data for researchers at Massachusetts General Hospital, Stanford School of Medicine and King’s College London, so that they can study the virus more. 

Radical Acceptance

While there are some things I can do, I also have to recognize that there are some things I can’t do to save myself, my family, and the world from this Pandemic. That’s a hard realization, right? I may not like feeling it, so I push it away. However, this rarely works. Practicing “radical acceptance” of the present moment is a skill that is taught in Dialectical Behavioral Therapy (DBT) to reduce suffering. The idea is that suffering occurs when we feel pain and we fight the current reality of it (Linehan, 2015). There can be peace when we accept that “this is how it is in this moment.” It doesn’t mean we agree with the situation or have “given up.” In fact, in order to change reality, we have to first accept it (Linehan, 2015). If I know that I am doing what I can by adhering to social distancing, wearing a mask, etc., there may be nothing more I can do right now. I have to accept that fact, even if there is some unease in it. Accepting uncertainty is hard because of the unpleasant emotions tied to it, but these emotions aren’t necessarily “bad.” By continuing to obsessively read about the virus, ruminate, or push away the discomfort, it only grows stronger. I find some calm when I drop into the here and now and remind myself that “this is how it is and it’s hard.” Acceptance and Commitment Therapy (ACT) talks about “dropping the rope” to end the struggle with reality (Coleman, 2015). You can use this metaphor when you’re working to accept something! 

Self-Compassion

Self-soothing can be very important during an uncertain and tough time. One way to work on self-soothing is to practice mindful self-compassion. These are the three elements of self-compassion: kindness toward oneself instead of self-judgment, recognizing our common humanity instead of mentally isolating ourselves, and being balanced and mindful rather than being fused with our thoughts (Neff, 2017). Dr. Kristin Neff’s Self Compassion practices can aid in developing acceptance while also growing our capacities for self-soothing. It can feel strange at first if you normally relate to yourself in a more critical way, so just give yourself some time to get used to the practice. 

I know reality is hard right now. What’s difficult for me during this this time may be different than what is hard for you. Regardless, I want to offer compassion to whomever is reading this, and I hope that the above can help, even if in small ways. 

References

Ackerman, C. (2020). Learned helplessness Seligman’s theory of depression (+cure). PositivePsychology.com. https://positivepsychology.com/learned-helplessness-seligman-theory-depression-cure/

Belware, K., Grady, S., Shaban, H., Knowles, H., Dupree, J., Sonmez, F., Itkowitz, C., Goff, S., & Brice-Saddler, M. (2020, July). U.S. sets record for new coronavirus cases, surpassing 55,000. The Washington Post. https://www.washingtonpost.com/nation/2020/07/02/coronavirus-live-updates-us/

Coleman, S. (2015). Acceptance and commitment therapy tug-of-war metaphor script. Third Wave Psychotherapy. https://www.thirdwavepsychotherapy.net/therapy/ewExternalFiles/tug-of-war%20script%2015-1-2.pdf

Dingfelder, S. (2009, October). Old problems, new tools. Monitor on psychology, American Psychological Association. https://www.apa.org/monitor/2009/10/helplessness

Linehan, M. (2015). DBT skills training manual. The Guildford Press.  

Neff, K. & Knox, M. (2017). Self-Compassion. In V. Zeigler-Hill, T.K. Shackelford (eds.), Encyclopedia of personality and individual differences. Springer International Publishing. 

Cover Photo by Gustavo Fring from Pexels

Conversations for Cautiously Re-Connecting with Consent

Conversations for Cautiously Re-Connecting with Consent

By: Anikò Blake, LMFT

Your friend has just invited you to a party. A year ago, you may have asked a few questions before accepting the invitation. Perhaps you’d ask if you can bring anything, who will be attending, and how late will it go?

In the summer of 2020 this conversation sounds quite different. Our current global health threat, COVID-19, poses many more considerations before choosing to interact with others. It can be hard to know what questions to ask before making critical choices about our own and other’s health. Thankfully, your friend’s party isn’t much different than other situations where making decisions about your health and safety is critical: communication and preparation is key. 

About Consent

There are a few different types of consent, depending on the context and who is involved. When considering a situation amongst friends, there are two key features to consent: sharing thorough information and frequent check-ins with self and others. This process is called affirmative consent and is used most often for sexual activity. Affirmative consent is so important that in 2014 California voted it into law for students in their state. The Bill, SB-967, reads that this consent is “… affirmative, conscious, and [a] voluntary agreement … [it must] be ongoing ... and can be revoked at any time.” This consent is an informed decision, meaning all parties have requested and shared appropriate information to make agreements with no surprises along the way. We cannot fully consent without knowing what we are consenting to. Consent is an explicit action: there should be no confusion on when it’s happening. As the California Bill describes, it’s also ongoing: it happens before, during, and after the event. The process of consent requires us to check-in with ourselves, what do we know about what makes us feel safe or unsafe? 

Having conversations about consent can be uncomfortable. Common concerns are, “What if I sound paranoid?”, “Will it ruin the fun?”, “Will they become upset with me for asking?” Sometimes the most challenging conversations can be the ones most worth having; just because it’s hard does not mean it’s wrong. Contrary to our worries, conversations about consent often boost enjoyment, since there is less potential for someone to be unintentionally harmed. Setting-up boundaries beforehand creates mutual expectations and promotes respect. Having conversations about our health and safety models self-care and shows others how we expect to be treated by them, as well. Clear expectations, respect, and care of self and others are good qualities to promote in any relationship.

Building Conversations

Considering thinking ahead about how you ask questions. Try framing them in a non-accusatory manner by beginning them with “I” followed by a “why”. Emphasizing why you’re asking and how the information might be helpful will help make your request clear. And keep it to just a few sentences.

Below we’ll look at how a consent approach can help you make an informed decision about attending your friend’s party (and other similar decisions this summer), and keep you and others as safe as possible. 

Before 

Now you’re gathering information and coordinating about the event. Some questions and recommendations might sound like:

• “It will be helpful for me to know more information about your party so that I can enjoy myself when I’m there. Can you please let me know how many people will attend?”

• “I really like the idea of this party but I’m feeling uncomfortable with it being inside your house, is there a way we can sit on your porch or front yard, instead?” 

• “I plan on wearing a mask, which will help me feel safer when I’m there. Is this something you have asked others to do, as well?”

During

Now you're checking-in with others while engaging in the activity to see how you and others are feeling about your health safety. Communication during this time may sound like:

• “I really appreciate you having this party on your porch, it really helps me enjoy myself. How are you feeling about the party right now?”

• “I notice that a number of people here are not wearing a mask, like we discussed. Is this something you can talk to them about?”

• “There are more people here than I expected and I’m feeling uncomfortable. I think I’ll go now. Let’s catch-up soon, just the two of us.” 

After

Now you’re following-up with those at the event to see how it felt. Sometimes new feelings arise afterwards, and may need to be addressed before planning something, again. This discussion can sound like: 

• “I felt like the party was a success and people were very respectful of each other. How did you feel about it?” 

• “I realized the next day that X was coughing at the party*. I’m a little worried about how they are doing and the impact their current health has on the rest of us.”

• “I would like to attend another party at your place, but will feel more comfortable if there are less people. It seemed a bit crowded. Is this something you’re open to?”

*Please note that COVID-19 disproportionately affects BIPOC (Black, Indigenous, and People of Color), due to higher risk factors as a result of systemic racism and historical oppression. Be mindful of implicit bias, or stereotype confirming, towards BIPOC and how this may impact your perception of their health. We can care for our safety while also not discriminating against others.

Practicing consent, especially with friends, family, and partners, is a life-long task. The more we practice the more effective and comfortable we are with it. Consider the summer of 2020 another chance to hone this important skill. There may be bumps along the way and we may not do it perfectly every time, yet some effort is still better than none. And nothing is more crucial than the care of our health. 

A COVID-19 Pep Talk: Introducing The Phoenix Clinic at CCRC

A COVID-19 Pep Talk: Introducing The Phoenix Clinic at CCRC

By: Taylor Pettway, AMFT

If ever there was a way to survive, the act of humor is inherent. “2020 is cancelled!” or “When the outside opens again, I’m throwing a New Year party. We’re starting this year from the top!” are phrases that shield the pain of these uncertain times in laughter. One of the key elements of humor is that there are always nuggets of truth, and in what feels like a semi-/post-pandemic world, it seems like the hopes and visions that many of us had planned for the year lay ravaged by financial upheaval and mental anguish. Our hospitals overflow, and our mortality rates increase. The technical strain of e-learning and remote work persists, and unemployment rates rise. Racism and its vast digital reach remain, and our individual and collective anxieties grow by the hour. Yet, we wake up every morning (read: maybe early afternoon). Our feet hit the ground. Our lungs fill with air, and even if we’re worrying, we’re existing and thinking with the mental faculties to do so. We are granted another chance every time we’ve awaken over these past two months, to take care of ourselves, to take care of each other during this time, to hurt and heal, and to build still.

So, this is a COVID-19 pep talk (and if the word pep talk causes you grief, think of it as a friendly note from someone who cares about you… because I do). This is to all of us, who even in the middle of this tragedy, have found moments of triumph and still dare to hope for the future. We do not know what it holds, but if you are still here, there is still more here for you. 2020 isn’t over.

You’ve found ways to show up for yourself so well over these past two months. I’ve heard us being kinder to ourselves. Those voices of critique and pressure, though still present, have spoken of your strengths and held compassion for the worldly, professional, and the personal expectations that exist for you.

You’ve gotten active, gone for walks when you’d have complained of the weather, virtually found peace in yoga. When your body is on track and can breathe and feel you (and you can feel your body) even in the midst of a trauma, you fair differently on the other side with more tools than torment and more understanding than unraveling.

You’ve pooled your resources. From schools administering e-learning and providing lunch to the healthcare providers leading remote check-up appointments and teletherapy to the hotel industry supporting those who live without homes, we have rallied around each other, showing tangible kindness to our most vulnerable populations.

You’ve connected with so many folks, and BOY, have I seen us really connect with each other in authentic, warm, life-changing ways. We’ve had Zoom graduation parties and drive-by baby showers. Some of us have attended remote graveside services, and some of us have been just recently afforded home-based internet services to connect and engage in ways we never could have imagined.

You’ve allowed yourself to feel your feelings and name your emotions. Because who wouldn’t need to communicate with both your head and your peace in mind when you’ve been working in the middle of your home for the past 60 days? You’ve had to name the experiences of being isolated away from loved ones. You’ve had to understand the impact of your routine being upended and not being able to lift weights the way you’re used to and not travel the way you had grown accustomed and not have the job you need because of a lay-off or an indefinite furlough.

You’ve even planned for the future. You’ve worn your masks to view new properties as your first foray into property management. What you haven’t spent on food (and it’s okay if it’s been a lot), you’ve been able to save for the first time in years. You’ve still gotten acceptances into undergraduate and graduate school, worked on resumes and CVs, interviewed for school leadership positions, and you haven’t run away. You put your mask on. You put one foot in front of the other, and you’ve risen. We’ve risen.

In this time and in this place, I have seen us collectively decided that though we may still be in the fire, there is as much healing and building that can be done right now as there will be at the end. 2020 isn’t over. For this reason, we, too, at the Chicago Center for Relationship Counseling prepare to open our affordable mental health clinic and internship program in downtown Chicago, the Phoenix Clinic at CCRC. There is currently and is expected to be a very present need for mental health support in our community at-large; there are increases in domestic violence as well as expected increases in suicide rates, depression, and anxiety (Holmes et al., 2020), and we must rise now. In seeking to proactively create an equitable and collaborative space for clients and therapists, our mission at the Phoenix Clinic at CCRC is simple: we are committed to launching folks into the world to thrive. By connecting those with less access and limited resources to therapeutic and community resources to the support of budding therapists with competency, compassion, and cultural sensitivity, we strive to heal, learn, grow, and rise together.

So, the next time you hear someone cancelling the year in jest (or in all psychological earnestness), remind them of their recent victories, “You went on that walk today, man,” or “You ate before 3:00 p.m. for three days this week,” or “Congratulations on your graduation/marriage/baby or all three,”, or even “I know you can’t really spend it anywhere, but at least you got paid!” Remind them that they’re doing the best they can. Remind them that if they are still waking up, there’s still a chance. And if you or a loved one are still really struggling to cope with this thing or we make it to our launch of services here at the Phoenix Clinic in August 2020 and you’re still in need of someone to talk to, someone who understands, and someone skilled in providing quality therapeutic support for communities with limited income and/or the ability to pay, come find us in Chicago. We’ll be ready, and we will rise with you.

Source:

Holmes, E. A., O’Connor, R.C., Perry, V. H., Tracey, I. Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Silver, R.C., Everall, I., Ford. T., John, A., Kabir, T., King, K., Madan, I., S. Michie, Przybylski, A.K., Shafran, R., Sweeney, A., … Bullmore, E. (2020. Multidiscplinary research priorities for the COVID-19 pandemic: A call for action for mental health science. Lancet Psychiatry, 7(6), 547-560. https://doi.org/10.1016/S2215-0366(20)30168-1.

Mental Health Matters: A Therapist’s Thoughts on Coping in the Age of COVID-19

Mental Health Matters: A Therapist’s Thoughts on Coping in the Age of COVID-19

By: Sara Morrow, MSc, LMFT

As I write this, I am sitting in the corner of my bedroom, which has now become my make-shift therapy office. I have a new chair and a folding desk, both purchased to accommodate this new “space.” I communicate with my clients via a computer screen now. My partner and I have been trading spaces while we work to get a “change of scenery” once in a while. Sound machines are blasting throughout the apartment. The dog is a very content co-therapist at my feet. If you had told me in January that this was going to be my day-to-day, I don’t know if I would’ve been able to fully believe you or grasp what it’d mean. I own the fact that I am someone who deals with anxiety. I need structure, rhythm and planning in my life. The COVID-19 pandemic has totally upended that for me (and probably you too). I often say: “uncertainty is anxiety’s best friend.” I don’t know who I borrowed that saying from, but it’s very apropos in this situation! Given that we do not know when this will end, how do we cope with the uncertainty and anxiety?

I am eternally grateful to the medical professionals, scientists, grocery employees, delivery drivers, and many others who are doing what they do to make life possible right now. As a therapist, the least I can do is share some ideas about coping in the time of COVID. We have to take care of our mental health during this time too.

Soothe your Nervous System

Our bodies have a built-in mechanism to deal with threats and emergencies. Our nervous system is comprised of the Sympathetic Nervous System (SNS), involved in arousal, and the Parasympathetic Nervous System (PNS), involved in rest and digest. The Limbic System, which is commonly thought of as the emotional part of the brain, responds to threatening stimuli by initiating a cascade of internal events activating the “fight, flight, freeze” of the SNS. Evolutionarily this has been critical for human survival: in the short-term, it can help with performance and problem-solving (Anzia, 2020). The problem is that our nervous systems can go into overdrive and in the long-term, this is not beneficial for our health. It is fair to say that COVID-19 is a novel threat, and many of us have a very active SNS right now! We need to help our SNS calm down and actively engage our PNS in order to initiate relaxation. Here are some ways to do so:

·       Diaphragmatic Breathing: this is a great way to get your PNS going. Try breathing in through your nose, expanding your diaphragm as you do so. Then, breathe out through your mouth, contracting the diagram. Pace your breathing by making your exhale longer than your inhale. For example, I might breathe in for a count of 5, and exhale for a count of 7 (Linehan, 2015).

·       Grounding Techniques: With fear and anxiety, our minds are often overactive and future-oriented. By “grounding” ourselves, we can come back into the present. You can use your five senses to do this: what is something you can see? Hear? Smell? Taste? Feel?

·       Initiate the Mammalian Dive Reflex: when we are immersed in very cold water without Oxygen, our heart rate slows down. We can mimic this by dunking our faces in ice cold water and holding our breath for 30-60 seconds or by using an ice-pack over our eyes (Linehan, 2015). Our PNS is activated by doing this.

·       Name your Emotions: ever wonder why talking about how you’re feeling is helpful? When you name an emotion, effectively putting an affective state into words, it decreases the activity in the amygdala, which is a brain area very involved in SNS arousal (UCLA, 2007). Talk to a therapist, friend, or keep a journal about how you are doing.

Boundaries

In psychology terms, a boundary is a limit that a person puts in place to protect their mental, interpersonal, and/or physical space (Hereford, n.d.). Boundaries matter right now. You may wonder: “what do you mean boundaries? I’m not even seeing anyone!” Beyond interpersonal boundaries, we can set limits around the amount of COVID related information we are exposing ourselves to. I encourage you to create a boundary around any or all of these: amount of time spent reading or watching news about the pandemic, the types of sources you are getting information from, time spent on social media, and time spent engaging in “COVID talk.” In a longitudinal study examining the link between acute stress symptoms and media exposure of 9/11 and the Iraq War, results indicated that prolonged exposure to media (in this case TV), led to a higher likelihood of acute stress symptoms (Silver et al., 2013). This doesn’t mean you have to cut out information completely; it’s important to stay informed. Get your information from trusted sources that don’t have monetary or political stakes in their reporting. Just limit the time spent engaging with this information.

With many couples working from home right now, it makes sense that there may be increased tension as each of you navigates the use of space. Do you need to implement some alone time to re-charge? Can one parent watch the kids for half an hour while the other takes a (socially distanced!) walk? Maybe even closing the bathroom door and taking a hot shower will do the trick.

Back to Basics: Sleep, Diet and Exercise

This may seem obvious, but pay attention to sleep, diet and exercise. These can get disturbed easily when we don’t have to wake up as early to commute or when snacks are within an arm’s reach at home. Many gyms are closed now which may demotivate us to maintain our fitness routines. Maintain sleep hygiene by going to bed and waking up at the same time each day. Try to do an at-home workout (YouTube has many!) or take a walk when there aren’t as many people outside. Try to stick to three meals a day. Adhering to these routines helps to build structure, which many of us need to curb anxiety.

Connect

We need to practice social distancing as much as we can to contain the virus and slow its spread. However, isolation is very hard for humans since we are social beings. In fact, it is very linked to health; a lot of data show that isolation increases the risk of death more than other leading health causes (Holt-Lunstad, 2015). Therefore, try to reach out to people via phone or video platforms. I have seen people get very creative with virtual video dinners and/or happy hours or even by playing online games with friends.

 Loneliness has been a big problem in the U.S. even before the age of COVID (Simpson, 2020). If you know someone who lives alone and may not have many connections, check in on them with a call or an email. If they are elderly and don’t use email as much, write them a letter and mail it using “snail-mail.”

Start a Mindfulness Practice

Sorry to sound like a broken record, but mindfulness is good for us! This is the deliberate practice of focusing on the present moment without judgement (Linehan, 2015). We know this is beneficial for our wellbeing because there is countless data to support it. It is known to help in the following ways: decreased depression symptoms, decreased anxiety, lessened emotional reactivity, decreased symptoms of physical pain, greater sense of well-being, and decreases in distractibility (Linehan, 2015, p. 162). Of particular note during this time, mindfulness practice has also been shown to help boost our immune systems’ ability to respond (Linehan, 2015)! If you need a place to start, try these practices from UCLA’s Mindful Awareness and Research Center

 Now is as good a time as any to try it out. Be patient with yourself as you start!

Self Compassion

This is a very difficult situation. How might you talk to a friend or loved one during a difficult time in their life? With criticism and harshness or with kindness and patience? How would you like to be treated? Rather than being our own worst enemy, now is the time to be our own best friend. Neff & Germer (2017) summarize research on self compassion: higher scores on the Self Compassion Scale (SCS) are associated with greater levels of well-being and lower scores of depression and anxiety. By the way, I highly recommend Dr. Kristin Neff’s work; she is one of the big names in the self-compassion research. Her “Self Compassion Break” practice is very helpful.

Therapy

If you are thinking about initiating therapy to deal with stress but are afraid to go in person, I’d encourage you to try out tele-therapy as an option! A lot of therapists are offering telehealth during the pandemic. It’s a great way of getting some extra support during this time. Myself and my colleagues at CCRC are all equipped to do video sessions in a HIPAA compliant way. Don’t hesitate to reach out for help. If you are a medical provider caring for COVID patients, I especially encourage you to reach out due to the potentially traumatic nature of your work.

My hope is that some of this is helpful to you. This is a time of great uncertainty and we are all navigating our way through it at the same time. There seems to be a lot of content on social media advocating self improvement and using our time at home well. It is 100% ok if you subscribe to this. It is also 100% ok if you do not. In fact, maybe you are on a roll with your reading project on Monday, but on Tuesday you can’t even get through one page. Confession: I was really in the zone writing this piece last week but then couldn’t write for days because I was emotionally spent. I judged myself over the weekend. But maybe, just maybe, I am doing the best that I can right now. I’m sure that you are too. Please take good care of yourself and be safe.  

References:

Hereford, Z. (n.d.). Healthy personal boundaries and how to establish them. Retrieved from http://www.essentiallifeskills.net/personalboundaries.html

Holt-Lunstad, J., Smith, T., Baker, M. & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 227-237.

Linehan, M. (2015). DBT skills training manual (2nd ed.). The Guildford Press.

Neff, K. D. & Germer, C. (2017). Self-Compassion and psychological wellbeing. In J. Doty (Ed.) Oxford Handbook of Compassion Science, Chap. 27. Oxford University Press

Silver, R., Holman, A., Pizarro-Anderson, J., Poulin, M., McIntosh, D. & Gil-Rivas, V. (2013). Mental and physical health effects of acute exposure to media images of the September 11,2001, attacks and the Iraq War. Psychological Science, 1623-1634.

Simpson, B. (2020, April 03). How to prevent social isolation from making loneliness worse. Johns Hopkins Bloomberg School of Public Health. Retrieved April 13, 2020 from https://www.jhsph.edu/covid-19/articles/how-to-prevent-social-isolation-from-making-loneliness-worse.html

University of California - Los Angeles. (2007, June 22). Putting feelings into words produces therapeutic effects in the brain. ScienceDaily. Retrieved April 13, 2020 from www.sciencedaily.com/releases/2007/06/070622090727.htm

Telehealth Explained

The coronavirus has had a profound impact on mental health. Luckily, there’s Telehealth! Here is a video that answers some FAQ’s regarding Telehealth, by CCRC therapist, Emily Gabelman LMFT.

Looking for Good Models of Straight White Masculinity

Looking for Good Models of Straight White Masculinity

By: Josh Hetherington, LMFT

It’s hard to create an identity out of a shadow. Trying to “not be” a bad person is much harder than emulating a good person. It’s one of the central challenges  for white men in this age of toxic masculinity. I’m very excited about white men looking at their unearned privilege and entitlement. It’s been a long time coming. I don’t think there’s any arrival, I think there’s only a journey. That being said, I am also always on the lookout for some kind of positive models. Who seems to be doing a good job of being a man? Specifically, a cis gender, straight white man?  

This question dips into the idea of white fragility. How can a cis gender, straight white man look at identity without defensiveness? How can I, as cis gender, straight white man, look for a role model and have a discussion with myself, my friends, family and colleagues about identity and have some sense of being a positive person in the face of so many individuals, who share these markers, who are doing so many bad things? I think it has to come from a place of recognition that I do have an unearned privilege based on my skin color, my gender and my sexual preference. And a willingness to understand my spot in our current culture.  This doesn’t mean that I didn’t work hard, or that I’m not smart or industrious. It means that I was supported by our society every step of the way from the time I was born. The white members of my family have been supported by our culture from the time that my first white male ancestor came to America. This country’s racist and patriarchal history has told me that anything is possible for me. That is a very powerful starting place. Many have taken this starting place as an entitlement. Many do not understand the impact of this starting place. I don’t claim to fully understand it, but I’m trying to be dedicated to a path where I explore this history and this privilege and push myself to see new perspectives.

As I try to walk this path and gain understanding of my blind spots, I’m looking for some other straight white cis gender men who are doing the same. Maybe, specifically, I’m looking for fathers who are trying to do the same thing.

I’m gathering resources and I want to share them as I find them. There seem to be many possible spots to look. I’m a fan of podcasts. Right now, I’m subscribing to two male-oriented podcasts that have some value for what I’m looking for. They’re not perfect, but they seem to be doing their best to explore male identity, and often cis gender, straight, white male identity.

• The Good Dads Project: https://gooddadproject.com/

• and The Art of Manliness: https://www.artofmanliness.com/podcast/

I’ve been a fan of the Art of Manliness for a while. Brett McKay is the host and he’s looked at a wide variety of issues from a male perspective in over 500 podcasts. He has interviewed authors, philosophers, coaches, doctors, psychologists and researchers on diverse sides of the political spectrum. His interviews have a very intellectual feel and he focuses on take-aways. 

The Good Dad Project is something that I’ve been listening to for only a few weeks now. I have heard about 10 podcasts and feel like I can suggest this. The host, Larry Hagner, bills himself as a regular guy who is working hard at being a good dad. He only met his own dad when he was 30 and he’s written about his experiences with this and with being intentional about fatherhood.

I’m interested in many identities and experiences and there are resources out there that support a whole lot of experiences that are different from mine. I really enjoy those as well, but this post is about sharing some resources that support aspects of my own identity and looking for positives as a straight white man.

Having a clear idea of my own identity and feeling a level of support for that identity allows me to cultivate appreciation, curiosity, empathy, caring, and understanding of other identities. I share these resources as a way to build a foundation for caring about ourselves and others. Please share your resources with me in return! I’m always looking for a new story!

Look at Yourself in a New Light: A Thought Experiment You Can Try Right Now

Look at Yourself in a New Light: A Thought Experiment You Can Try Right Now

By: Laura Hagen

Self-love: it’s a term you hear everywhere these days.  But what are we really talking about here?  What does it really feel like to love yourself?  Maybe it reminds you of those other terms therapists seem to talk about a lot, like self-acceptance or self-compassion.  Or maybe it makes you think of a funny news article you read about a recent trend called sologamy, people marrying themselves--you may wonder, are those people real embodiments of self-love, or are they taking it a little too far? You’re not alone if you’re unsure what self-love really means, or if the idea of loving yourself makes you uncomfortable.  Maybe it contradicts your cultural or religious values, or maybe it just sounds selfish.  Today, though, I’m going to ask you to open your mind, because I’m on a mission. I want to try to open you up to what self-love really feels like. Don’t worry-- I’m not claiming that I have a recipe to get you to love yourself forever by the end of this.  What I will do is ask you to join me in an experiment, with no right or wrong outcome.  My intention is simply to have you consider a new way of looking at yourself.

As a starting point I wanted to offer a clear, evidence-based definition of self-love.  This task proved more challenging than expected.  While searching through peer-reviewed journals for a definition of “self-love,” a lot of the results are actually about narcissism.  It seems that Aristotle coined the terms self-love and other-love, with self-love defined as a preference for self over others, a trait seen as evidence for the inherent selfishness of human nature (1). Maybe this has something to do with our tendency to feel uncomfortable about self-love, and to view it as selfish.  This definition of self-love as a preference for self over others seems a bit black and white, though. If we dig further into psychological research for some help in finding a more nuanced definition of self-love for modern humans, we won’t find much.  There’s research about self-esteem(2) and self-compassion(3), but there seems to be no operationalized definition for self-love.  Of course, it makes sense that it’s challenging, maybe impossible, to create a standardized definition for a concept as nebulous as self-love.  If there are love languages for how we express and receive love with others (4,5), there must be differences in the way each of us would love ourselves.

That’s why rather than searching for other’s definitions or trying to create a definition for you, I want to try and open you up to what your kind of self-love feels like.  If all this talk about loving yourself feels uncomfortable, or maybe a little cheesy, I get it.  What do you think this reaction is about?  Notice what comes up for you, and acknowledge it.  Ask these feelings or thoughts to step aside for a moment, so that you can try something new without your self-consciousness breathing over your shoulder.  Give yourself permission to join me in an experiment right now.  Remember, we’re not looking for a specific outcome, I will just ask you to notice how you feel as you give this a shot.

1. First, I want to try jumping off from a familiar starting point. Many of us naturally and without a second thought give our love and support to those close to us. Some of us will even devote vast amounts of time and energy in order to do this. Fewer of us know how to, or even think about directing some of this incredible human energy and warmth toward ourselves. I want you to think of the most cherished, safe, trusting relationship you have with another person in your life. This could be a best friend, partner, parent, or someone else. I want you to close your eyes and picture your person sitting in front of you. They are looking into your eyes and you see that they are sad, you know they need comfort.

a.  How do you show them the tenderness, the depth of your care for them? 

b. What words, looks, or gestures do you share with them? 

c. Notice how their face changes as you offer them your love... notice how it feels for you to give this love...linger on this feeling…

2. Now I’m going to ask you to test the waters, to see what it’s like to try and direct some of this natural, human power towards yourself. Picture yourself as a kid, it helps if you pick a specific age, maybe an age you were when something hard happened to you. I picture myself at 11 years old; shy, perceptive, sensitive as all hell, and battling my own version of an evil stepmother who saw me, quite literally, as the red-headed stepchild. Bonus if you can pull up a picture of yourself to look at, I like to use this one. Close your eyes and imagine that the kid version of you is sitting right in front of you, looking up into your eyes. Think of their innocence, their earnestness, their awkwardness.

a. What is kid you missing? What do they need to hear from the present day you?  The you that has grown wiser, that knows how to make better sense out of the wild world we find ourselves in.

b. Imagine how you today would show your care, affection, and understanding for that confused, overwhelmed kid...how does their face change as you talk to them, hold them, comfort them…linger on this image…

3.     Finally, I’m going to challenge you to see what it’s like to experiment going somewhere new with yourself.  Stand alone in front of a mirror.  Remind any self-consciousness or skepticism to give you some space for now, they can come hang out later if they insist. Look at yourself in the mirror.  But not the way you usually do, like checking how you look or using a critical eye. 

a. I want you to look into your own eyes with an intention to genuinely connect, in the same way you would with your most trusted person.  I want you to truly see yourself, and the soul that looks through those eyes of yours. 

b. Remember all of that powerful, real human love that you have to share with others.  Remember that vulnerable, sincere kid that lives on in you, deep, deep down. 

c. Look at yourself with that same gentleness, concern, and empathy that you give out as a natural, human gift.  Look into those eyes of yours, and try to share some with yourself.  However it feels right... linger here…longer….

. . . . . .

How did it feel? What I have asked you to do is not easy by any means, and you’re brave for being willing to consider yourself in a new light. You might have felt some resistance, or maybe a lot. This doesn’t mean the experiment was a failure, it means you tried out a new perspective, and you can learn about yourself from it, in a seriously intimate way. This gives us the chance to look at two important things:

1. What was hard? Which parts were uncomfortable? Which parts did you find yourself reacting to (e.g. “I’m not actually going to do that, Laura”)? Which parts of what I asked you to imagine were the hardest of all? If you felt something blocking you, what do you think it is?

2. What felt good? Which part of this was the easiest for you to think about? Was there a part of you that felt quietly warmed by some of what you pictured? Maybe you couldn’t help but smile, just a little, at yourself in the mirror.

In the end, I don’t believe there is any guide or solution to finding eternal self-love. What I do believe is that us normal, every day human beings are capable of creating our own self-love, no matter how small the moment or fleeting the feeling, when we give ourselves permission to shine the warmth of our own light, inwards. You’re worth it. Really.

(1). Aristotle (350 BC/1925) The Nicomachean ethics. Oxford University Press, New York.

(2). Heatherton, T., & Wyland, C. L. (2003). Assessing self-esteem. In S. J. Lopez & C. R. Snyder (Eds.), Positive psychological assessment: A handbook of models and measures (pp. 219–233). Washington, DC: American Psychological Association.

(3). Germer, C. K., & Neff, K. D. (2013). Self-Compassion in Clinical Practice. Journal of Clinical Psychology, 69(8), 856–867. doi: 10.1002/jclp.22021

(4). Chapman, G. (2010). The Five Love Languages: How to Express Heartfelt Commitment to Your Mate. Chicago, IL: Northfield Publishing.

(5). Egbert, N., & Polk, D. (2006). Speaking the Language of Relational Maintenance: A Validity Test of Chapmans (1992) Five Love Languages. Communication Research Reports, 23(1), 19–26. doi: 10.1080/17464090500535822

A Therapist's Review of "The Lighthouse" (2019): A Film About Coping?

“The Lighthouse” (2019): A Film About Coping?

By: Teresa D’Astice

A brief synopsis of the film:

Winslow (Robert Pattinson) is working at an isolated lighthouse during an intense storm under Wake’s supervision (William Dafoe, Wikipedia describes him as an “irritable elderly man.”)

My personal reaction when I walked out of the theater:

“Wow. Also, that was one huge metaphor for coping.” 

THIS SOUNDS LIKE A HUGE LEAP—HEAR ME OUT.

A BRIEF explanation of Internal Family Systems (IFS) (this is one of my favorite therapeutic models. Shout out to Richard Shwartz for coming up with it):

An underlying premise of IFS is that, as humans, we are embedded in systems, and we are also functioning as a system.

As systems, we are made up of MANY parts (see image for a detailed description of our parts), and we strive to maintain homeostasis.

(Image retrieved from: https://www.pinterest.com/pin/260786634659005141/)

This is important to notice because as systems trying to maintain homeostasis, we can be resistant to change.

When we are resistant to change, one of our exiled parts might be activated, and we are suffering from some discomfort/distress. Our managerial and firefighter parts are hard at work trying to avoid/soothe/distract us from these feelings. This shows up differently for everyone.

“The Lighthouse” captures this idea beautifully.

What I value from this model:

Parts are not inherently “bad.” Behaviors, thoughts, and emotions are all connected and functioning for a reason.

Instead of pathologizing a part, we try to understand what is happening in the system that is leading a part to show up the way that it does. We try to understand and welcome the parts instead of shame them.

How this all ties together:

—WARNING: SPOILERS AHEAD—

Okay we have made it through the explanation, now it’s time for the connection.

Before I saw the film, Twitter was blowing up about how the film is all about Winslow’s alcoholism. However, I think it is deeper than this. Addiction is deeper than this. Addiction is systemic.

Exiled parts:

As viewers, we are never directly informed what his exiled parts might be. These are harder to identify because they are buried within Winslow, and frankly, he has some strong managers and firefighters that are protecting them. Winslow is suffering throughout this film. Let’s do a quick Google search for a plot description:

“Maintain their sanity” is telling of where Winslow was at throughout this film.

Maybe he’s trying to soothe (and protect from) loneliness. Or guilt. Maybe fear of being helpless. How about not feeling like he’s enough? 

Managers:

Throughout the film, Wake was in charge of Winslow; Wake was supposed to guide and literally manage Winslow. Wake was critical of Winslow, at times demeaning. I’m thinking that Wake’s words were reflective of Winslow’s internal experience.

As the film progressed (and Winslow continued to struggle), Wake got louder. He got more difficult for Winslow to deal with. In my opinion, Wake served as Winslow’s inner critic throughout the film.

At first, Winslow was silent. He engaged with this part in different ways. He eventually was aggressive with Wake, and this only made Wake louder.

Another manager kept Winslow from consuming alcohol for the first half of the film.

Firefighters:

Alcohol consumption can be seen as one of Winslow’s firefighters. In the lens of IFS, what is this part trying to protect Winslow from? On a better day, alcohol consumption might be moderated and used for pleasure as opposed to soothing.

Masturbation could have been firefighters soothing Winslow’s exiled parts. On one of Winslow’s better days, this part might be accessing pleasure rather than soothing.

As the movie progressed (along with Winslow’s exiled parts becoming more and more activated), he had sex with a mermaid who I perceived as being defenseless and vulnerable, and she also did not consent. Did this make Winslow feel powerful? Is this protecting him from feeling powerless (exiled part)? Sex might be more about connection, intimacy, or pleasure if Winslow is not struggling.

What did Winslow do?

He decided to rid of all his protective parts after he hit a certain point; he literally killed his manager! REMEMBER: no parts are “bad.” They all have a function. They just might be polarized/extreme due to distress.

Right before the movie ended, Winslow is washed up, unable to move, and being eaten by birds. Was this depicting his exiled part? Helplessness? No power?

These protective parts have been important for Winslow to survive. He stripped himself from his protective parts, thinking he would be better off without them.

Winslow’s exiled parts were exposed. He was vulnerable and unprepared with how to cope with his exiles. He spent the film with his managers and firefighters out, continuously functioning as protectors over his vulnerable parts.

How would he have known what those exiled parts really needed? Exploration around his exiled parts would have been helpful in finding this out. But Winslow did not seem like he was in a safe space to do so.

Take-aways:

• We have to work on understanding and accepting our parts! Rejecting and shaming them is not productive.

• Trying to dispose of parts that we might struggle to appreciate in ourselves is not beneficial. It makes these parts louder and polarized. We have to make an effort to be nonjudgmental and caring towards all of our parts.

• Parts that we struggle most with (e.g. inner critic, addiction, deep shame) are embedded in a system but can seem all consuming/polarized when facing distress.

• When our parts are understood, there is potential to free the self from over functioning parts. This is where transformation happens.

Getting Real With Gratitude

Getting Real With Gratitude

By: Melissa Larmon, AMFT

It’s gratitude season! Yep, it’s that time of year where people ask what you’re grateful for, and we all tend to focus a little more on counting our blessings. That can make for a nice holiday, or social media challenge, and perhaps it even makes us feel warm and cozy, but what if we practiced gratitude the rest of the year, and in our relationships? Would that be helpful?

Well, it turns out gratitude IS helpful. Research shows that gratitude can have a positive effect on mood and relationships. I’m not talking about the glass-half-full-Pollyanna-find-the-silver-lining kind of gratitude that is often suggested by well-intended friends, family, and colleagues who are trying help us improve our mood. That can actually feel annoying, right? It’s invalidating. When you are having a tough time, frustration, anger, or sadness in that moment is appropriate and normal. And those feelings won’t be erased simply by finding something for which you are thankful. It’s 100% okay to feel the tough emotions. Difficult emotions are a part of the process, and when you acknowledge and accept them, you might find space for gratitude down the line. And when we find space for gratitude and start to practice it, it becomes a tool we can choose to use for improving our well-being and relational functioning.

What is gratitude, and what can it do?

Being grateful is simply defined as being appreciative of kindness or benefits received. Practicing gratitude is the act of being grateful; a readiness to show appreciation, and to receive it. Ample research has demonstrated that feeling grateful improves mood, helps us cope, and even improves physical health. Expressing gratitude has also been shown to increase our life satisfaction and happiness, reduce depressive symptoms, reduce stress, and improve quality of sleep.  Wow…that’s pretty powerful…all that from just a little gratitude?  Probably worth implementing year-round and not just in November. I mean, who doesn’t want to be less stressed, more satisfied, and get better sleep? Sign me up!

But what about our relationships? Can gratitude have an impact with the people we share life with? Again, research answers with a resounding YES. When partners receive gratitude from each other, they feel closer and more satisfied with their relationship. Closeness…satisfaction…sounds pretty good…what else? They also feel more responsive to their partners’ needs, more committed to stay in the relationship, feel safer to voice relationship concerns , and are more likely to engage in healthy relationship behavior (like trying to resolve conflict). In addition, when partners perceive gratitude for a behavior, they are more motivated to continue that behavior. (So, if you like what someone is doing, saying thank you might mean you get more of it). Amazing news! That means gratitude not only makes us feel more connected and happy in our relationships, but it also encourages future positive behavior that strengthens and protects our bonds. In short, gratitude helps our relationships grow stronger and better.

How can I practice gratitude?

Sounds pretty darn great, but how do we “practice” gratitude? What does that look like? Well, for one thing, you can’t force gratitude. Forced gratitude feels like an obligation, and doesn’t produce the same positive results. That’s exactly why when people try to erase our tough emotions by telling us to “look on the bright side,” it doesn’t actually help. In those moments, allowing space for difficult emotions and finding compassion for ourselves or others can leave the door open for more positive feelings, like gratitude, in time.

That said, expressing gratitude and saying thank you makes a difference. Being intentional about acknowledging positive behavior not only improves your own mood, but it encourages your partner, too. This can be as simple as saying thank you when your partner helps you put away the dishes, or as complex as expressing thanks for help received when you are in pain or distress…and really wish you didn’t need help at all. And the good news is that when you say thank you, you are more likely to receive the help you need in the future.  

It’s also important to practice receiving gratitude. Recognizing and acknowledging gratitude is also important and beneficial. It’s helpful to recognize that even a small thank you is an expression of love and appreciation from your partner. Recognition and acknowledgement of gratitude can happen internally…simply noticing and absorbing the love in your mind and heart…and it can happen outwardly…with eye contact, a smile, touch, or kiss, or a few words like “you’re welcome,” “happy to help,” or, “of course, I’m here for you.” 

Quick Gratitude Practices:

·       Find compassion for difficult emotions in yourself and others.

·       Be intentional about expressing gratitude…say thank you!

·       Acknowledge gratitude when it happens.

·       Recognize gratitude as an expression of love and appreciation.

Give it a try! See if you can implement a practice of gratitude in your daily life and relationship. Even small efforts can yield big benefits in terms of mood and relationship wellness. Every new habit starts with awareness and a few small steps, and as you learn to practice gratitude in simple ways, you’ll strengthen your mood and relationship for future challenges.  

Thank you for reading! I hope this season of thanks inspires a year-round gratitude practice for all of us.

References:

Kindt, S., Vansteenkiste, M., Cano, A., & Goubert, L. (2017). When is your partner willing to help you? The role of daily goal conflict and perceived gratitude. MOTIVATION AND EMOTION, 41(6), 671–682.

White Fragility

White Fragility

By: Josh Hetherington, LMFT

We’ve been talking about race and the impact of racism at CCRC over the last year on a regular basis. It was overdue. Our often awkward and uncomfortable discussions continue and I’d like to share some of what I’ve learned so far as I’ve tried to focus on this idea and what can be done about it. I’m far from a full understanding of it. I don’t really believe that anyone will ever be able to have a full understanding of it, but as a heterosexual, cis-gender, able bodied white man I am in the position of being the most blinded by the impact of internalized white supremacy and anti-blackness. I am in the position of benefiting most from the ideas of individualism, meritocracy, capitalism, and freedom. 

In White Fragility, by Robin DiAngelo, the author lays out a definition of racism that helped me deepen my understanding of America and whiteness. She describes it as a systemic group concept rather than an individual trait. We live in a culture that was founded on the idea of white and black. Our country was colonized by European conquerors who were told by Pope Alexander VI in the 1493 that god thought people with black (or brown) skin were sub human and so people with white skin should take their land, enslave them and use them for labor and sex as they pleased. This idea of white supremacy has been internalized over centuries at this point. 

As a therapist I can relate to the concept of internalization. We’re working with people all the time to understand the messages they’ve internalized about themselves and to keep the good beliefs and mitigate the bad beliefs. These ideas are often held as truths. A child who is hit by his parents can internalize the idea that he’s a “bad person”. This belief can lead to all kinds of problems as the child grows into adulthood. If the adult believes that they’re “bad” in some way then they are likely to do bad in order to feel a sense of congruity. “It’s just who I am and what I do. I’m bad”. You can substitute “unlovable, lazy, dishonest, crazy…” for the “bad” and get a whole bunch of outcomes based on this internalized concept.

So we have internalized ideas about the color of people’s skin and what that means about them as a group. This is inside us no matter what color our skin is. If we’re fortunate enough to be born with white skin then we have to understand the impact of internalized white supremacy. If we were born with dark skin, we have to understand the impact of internalized oppression and messages about being less than. 

This means that Racism always favors whiteness and punishes blackness. This is different from prejudice which can go in the other direction, but which does not have the history of massive power behind it. A white kid being bullied in an all-black school is not racism, it’s racial prejudice. The well documented economic, educational, and health differences between whites and blacks in America is racism. Racism affects us all and is about our large groups and the internalized ideas we have taken in about what our skin color means. 

What can we do?!?!

One powerful idea from DiAngelo and others  is to look at whiteness. This has been a request from black scholars and activists for a long time. One of the main insidious tools of white supremacy is the denial of whiteness. If the white majority thinks of most values and beliefs as “mainstream” or “normal” rather than having a basis in whiteness, then all the problems of race are only black problems. Whiteness is normal. Blackness is other and less than. Whites have to acknowledge and explore whiteness. 

That’s what I’ve been trying to do since this idea has come on board for me. What does it mean for me, as an individual to be white and what does it mean for the whole group of us to be white? And for the whole group of none of us to be white? We are all truly biologically the same. Skin color is a mere genetic variation, like eye color. 

 DiAngelo describes many internalized beliefs that live inside my sense of whiteness. Here are a few:

I’m supposed to be perfect.

I’m supposed to be a boss.

I’m supposed to bend the rules in my favor.

I’m supposed to be free.

I’m supposed to be happy.

I’m supposed to own a house.

I’m supposed to be married.

I’m supposed to have a child.

I’m supposed to be a professional.

I’m entitled to good customer service.

When I talk, people are supposed to listen.

I can always ask for whatever I need because the worst that will happen is someone will say no and then I’ll just find another way to get my needs met.

I’m entitled to have all my needs met.

I’m “everyman”.

If I can do it, you can too.

I need to solve every problem.

If I don’t do it, no one will. 

I’m “normal”. 

I’m a “good white”. There are “bad whites”. 

I’m entitled to comfort.

I won’t presume to understand or list the concepts left inside a black person or person of color based on internalized oppression, but DiAngelo does. She also lays out the internalized ideas of anti-blackness. These differ from internalized oppression and act more as a list of concepts that we have baked into us about Blacks being bad. White goodness doesn’t exist without Black badness. 

These are uncomfortable discussions. This is one of the concepts that conflicts with whiteness. Don’t talk about it if it’s uncomfortable. I invite you into these important thoughts and discussions. How does whiteness impact you? How does blackness impact you? If we talk about whiteness and acknowledge it’s powerful place in our culture we can begin to disrupt racism, which will impact everyone. 

Take a Deep Breath: Meditation & Mindfulness 101

Take a Deep Breath: Meditation & Mindfulness 101

By: Taylor Pettway, AMFT

There are no more than 17 hot topics being spun around in the world and our news cycles nowadays: $200 dates, self-care, “being triggered”, social media, D***** T****, #MeToo, the perpetual loss of Black life, and the like. Since becoming a therapist, I choose to disconnect from almost all of it in order to show up mentally and emotionally for my clients and families day in and day out. So, I could imagine that I would seem somewhat of a hypocrite for saying that what keeps me afloat, what gives me breath, what keeps me in the present, and what has changed my life for the past five years is yet another buzzword of 2019: meditation. 

Now, for some of us, I know it seems like some far off distant land, whether you immediately bring to mind Tina Turner chanting a Buddhist mantra to deal with Ike’s brutality in the epic movie, What’s Love Got to Do With It, or you just imagine sitting Indian style with your hands in the air. But, meditation has not been a fad for me. When I say that slowing down, feeling my body in the space, and looking at my thoughts one by one has been a sanctuary for me, it’s because it has. Understanding the connections among my emotional, spiritual, and physical experiences and its impact on how I show up in the world, has been balm to my bruises and stillness in my storms.

Because of my own transformation, I will tell anyone within earshot that being mindful about your body and its connection within your universe is where healing begins. I have witnessed what happens for folks when they connect their bodies with their stories. I have watched them heal. So, think of the considerations below as steps into your own healing.

Connecting your body to your thoughts, feelings, and emotions

 Within your story, there are an infinite amount of emotions to be sensed, thoughts to be pondered, and feelings to be felt. By realizing that these three elements are three wholly separate experiences, both interconnected and mutually influential, you can step into the awareness that is the present moment.

1.   For example, say you are overworked, under stimulated, and in need of some care (I know I’m talking about us, but I won’t be too loud). That’s how you’re feeling. That feeling could manifest as being agitated by your significant other or friend at work, or instead, maybe it’s a sadness that you can’t quite name but is turning getting out of bed into a marathon.

2.     Agitation and sadness are the emotions.  

3.     The thoughts associated with these experiences could be numerous: “I need to keep going”, “This is just too much”, “Who are you to take on so much work anyway?”, “But, what if ____?”, “You can’t do this” or the most defeating one, “If I don’t do ____, I’m not _____.”

By way of mediating, plugging into your senses, getting physically active through drumming, sports, yoga, running, just walking a few times a week, or even a combination of it all, you have the power to preventatively and presently understand how your different experiences are impacting you and your decisions moment-to-moment. Once you can tune into your body and slow things down enough, you truly do have the power to choose.

Getting curious, not judging, your feelings

We’ve all done it–“I’m so mad I’m even mad about…” or you’re 3 seconds from BIG crying at what should be one of the most joyous moments of your life (I’m looking at you, graduation brunch). There you are in all of your humanness and glory, having your feelings, and then there you go judging yourself for it. By allowing yourself to feel whatever comes up at whatever moment, you give yourself permission to essentially say that you are important. When you allow yourself to lean into the emotion and really feel it, you are saying, “I am valid. What I feel matters. What I think is okay. I am okay.” WHO DOES THAT? You do. You can. Try curiosity on for size the next time you feel an emotion you’d rather run away from in the other direction. Give these a try: “Oh, I see that I’m feeling ____. Hmm... I wonder why I’m feeling that right now. I wonder where that’s coming from. Where and when have I felt that before?” I’d like to see where you end up (and bring the tissues).

Regulating your body and its reactions

Most importantly, how you calm down and take care of yourself is key. If you have a storm going on within the inside of that beautiful clay vessel of yours, you’ll have a difficult time standing in the sunshine of the present moment. Breathing deeply really changes things.

• What would it be like for you to breathe in from the soles of your feet, following your breath as it rises through your body and through the top of your crown, over and over again for five minutes?

• What would it be like for you to set aside 10 minutes doing absolutely nothing with minimal engagement (no phone, no music, no sleep)?

• Progressive Muscle Relaxation (Hey, YouTube!) is my go-to when inviting others to a life of mindful living. Knowing where you hold your tension, where your body remembers and is keeping score, further helps you connect to your body and really listen to what it needs.

 While eating kale chips and aligning your chakras may not be for you, meditation and mindfulness is for everyone, and it’s what you and your body and your loved ones and those in your sphere of influence, deserve. Give breathing in and remembering who you are a try, and watch how being your own breath of fresh air, be what you need.

Thanks for reading! If you found the tips above meaningful and helpful, this article and more can be found at TaylorPMFT.com. Come join us!    

Transforming Shame

Transforming Shame

By: Anikó Blake, AMFT

Shame is often so overwhelming that it can be hard to imagine breaking it down into components to change it. This article will take you through the formation and experience of shame and help you, the reader, work step-by-step to transform the pain of shame into the comfort of connection.

Origins of shame

Shame often arises when we believe that an aspect of who we are, how we appear, or what we do will lead to social rejection. Isolation runs contrary to our innate human need for connection. The self-conscious feeling of shame helps us keep an active radar of any potential risk of losing our socially contingent resources: belonging, intimacy, support, food, shelter, etc. It works as a regulating tool for anti-social behavior. 

Shame focuses on our worthiness of love and belonging, often brought by binary measures of being either a “good” or “bad” person. This is different from guilt, remorse, or regret: which are directed towards correcting behavior while maintaining healthy self-esteem. Psychotherapist and author Terrence Real describes that, “When you feel remorseful, your attention is on the people you hurt and their feelings. You’re moved to do whatever you can to make amends, to repair things.” (Real, 2017) Guilt, regret, and remorse tend to allow for more self-complexity by allowing us to be “good” people who are still, at times, capable of causing pain in others and towards ourselves. They allow us to take responsibility for our actions in a way that promotes self-growth and relational maintenance. Shame can also be distinguished from embarrassment and humiliation, which can feel like a passing moment of unwanted social attention towards something unfavorable about us or that happened to us, while also knowing that it does not define who we are. 

Accepting shame

Shame is neither inherently bad nor a feeling we can omit from our human experience. Instead, shame is a good indication that we are designed with our best interest for survival. Real (2017) describes that appropriate shame leads towards proactive remorse, which repairs our relationships. He adds that with “… a mature state of appropriate shame… we feel proportionately ashamed for our bad behavior and yet still manage to hold onto our essential worth as an imperfect human being.” 

As children, we are even more likely to interpret another’s actions as personal to who we are; children tend to see the world through an egocentric lens due to their location in cognitive development. Psychologist Erik Erikson’s identified that during the Guilt Versus Initiative Stage of social-emotional development, from three to six years of age, children are increasing their autonomy and independence while also receiving  more control and correction. Rule-based responses from adults “establishes basic moral or even moralistic orientation” (Erikson & Erikson, 1998), by helping children learn pro-social behaviors. Guilt helps deter them from behaving in isolating or harmful ways towards others. They might also experience shame by believing that adults’ correction and consequences are a result of the child being a “bad” person. Guidance through clarification on the intention of the rules and validation of the children's’ positive traits (including that it is healthy and acceptable to experience guilt) can help support them in this stage of identity and social development.

When to take caution

Shame becomes toxic when it begins to perpetuate the isolation we fear, by responding to the shameful experience with a “self-preoccupation” (Real, 2017). When we begin to linger in shame and identify with the thoughts and feelings it produces, we are adding to a narrative about ourselves that promotes a story of being alone and unwanted. If we believe that “we are flawed and therefore unworthy of love and belonging” (Brown, 2012), it may result in creating barriers to identifying and receiving care and inclusion- even if others are directly providing it to us. This is called a self-fulfilling prophecy: we are choosing to collect and respond to specific evidence, proving a belief that we fear to be true, thus manifesting it into reality.  

Shame can often be a feeling we omit from communicating to others, since we would rather hide from them the possibility of us being unworthy of belonging. When shame is hidden it can often fester. The experience of trauma and its subsequent symptom of shame can also produce paralysis (van der Kolk, 2000) which diminishes our sense of agency and motivation to talk about the pain we have experienced. Instead, we might behave towards others with aggression, defensiveness, or we withdraw, in order to avoid or beat them in our own game of deciding if we are a “bad” person, unworthy of connection. We can also displace our shame, particularly when it feels too painful to carry, by projecting a sense of unworthiness onto another. This behavior can also produce self-fulling beliefs about shame, since it can result in others distancing themselves from us and can create narcissism, which diminishes compassion: an essential ingredient for fostering human connection. 

Reducing toxic shame 

Famed humanistic psychologist Carl Rogers proposed that, “When I accept myself as I am, then I can change.” (Rogers, 1961) Shame cannot be erased and is best accepted as a reality of being human. The destructive effects of toxic shame can be reduced by talking through the thoughts and feelings that accompany it. Real (2017) sees this process as “working on letting go of contempt, letting go of control, experience empathy and true remorse.” We can do this by recognizing the vulnerabilities we carry that increase relational sensitivity and slowing down the application of our protective strategies to allow ourselves time to identify why they feel needed. We can also mitigate potential shame by identifying and assessing the validity of assumptions about social and self-created expectations. This can also include the expectations we place on ourselves due to family and cultural loyalties. An example of reducing and redirecting shame is shown through the following questions:

What is the belief I am telling myself about who I am?

“I am a failure because my marriage ended.”

What evidence do I have to support that belief?

“Some friends stopped speaking to me, others have turned down dates because of my “relationship baggage”*, and my grandparents said that they are disappointed in me.”

*here lies a relational vulnerability which could lead to reactivity, particular in the face of potential rejection while dating

What evidence do I have to challenge that belief?

“Some friends do still speak to me, that date last night went pretty well, and I was still able to enjoy dinner with family despite my grandparents’ feelings.”

 What rules am I using to measure that belief?

“People my age should be married, in my culture marriages are supposed to last ‘till death do us part’, I base some of my personal success off of being married.”

How is the belief affecting me?

“Telling myself that I have failed makes it difficult to experience self-compassion.” 

How can changing the belief serve me?

“It will be important for me to practice liking myself in order to believe that others can like me, too. It is possible for my marriage to have ended and that I am still someone worthy of receiving love from myself and others. There are a multitude of ways to live a meaningful life and foster belonging in this world.”

Redirecting shame
Along with having our own radars for rejection, we can also build awareness for others’ relational fears, as well. Shame can be contagious when we internalize others’ projection of believed low self-worth or fear of isolation. Noticing others’ relational reactivity and supporting them in exploring it further can help build a sense of connection that soothes and redirects the shame cycle. Often times, protective strategies are used to mask and shield the most human parts of who we are. Relating to others from our shared search for belonging and intimacy can help diminish the perpetuating patterns of shame while validating the need for connection. Some examples of redirecting shame are:

“I feel offended when you call me harsh names and can also tell that you are upset when say them. Can you tell me, using other words, what is bothering you so I can better support you?” 

“I feel frustrated when you become defensive because it makes it difficult for me to hear what you really need. How I can better understand what your concerns are right now?”

“I feel sad when I sense you pulling away, because I really value you in my life. I want you to continue being a part of it. Let’s talk about ways to feel more connected.”

A belief within therapy is that when we name our emotions we can tame them. Shame and the isolation it fears are often brought by immense physical and psychological pain. Recognizing in ourselves and others the thoughts and sensations that indicate we are experiencing shame can help transform shame into the connection we ultimately long for. 

References 

Brown, B. (2012). Daring greatly: How the courage to be vulnerable transforms the way we live, love, parent and lead. London, UK: Penguin.\

Erikson, E. H. and Erikson, J. M. (1998) The Life Cycle Completed (Extended Version). New York City, NY: W. W. Norton & Company, Inc., pp. 93. 

Real, T. (2017) The Awful Truth: Most men are just not raised to be intimate. www.terrencereal.com

Roger, C. R. (1961) On Becoming a Person: Therapist's View of Psychotherapy. Boston, MA: Houghton Mifflin Company, pp. 17. 

van der Kolk, B. (2000) Posttraumatic stress disorder and the nature of trauma. Dialogues Clinical Neuroscience. 2000 Mar; 2(1): 7–22.

Hey, You – Stop calling your partner "Too Needy!" (...and here's why)

Stop calling your partner "Too Needy!" (...and here's why)

By: Gabe Seldess, LMFT

     Are you feeling like your partner is asking for too much?  Are there too many demands being placed on your time and energy?  Are you feeling the urge to tell your partner he or she is Too Needy?  If so, slow down and think for a moment, please.

     Calling someone Too Needy can be a very judgmental and harmful thing to say to someone. 

     Everyone has a right to feel what they feel, and to pursue and ask for the things they want and believe will make them happy.    Sure, there is a difference between asking someone to do something and making a demand – But, everyone is entitled to advocate for what they want and need in a relationship. 

     What we are often trying to say when we label someone Too Needy is that we either can’t or don’t want to comply with a request from that person.  When we don’t want to accommodate, it’s our responsibility to be honest and direct with how we feel.  We have as much right to advocate for ourselves as any other person.  But it is OUR issue, not the fault of our partner.  It’s best to take responsibility for our own choices and our own needs.  If your partner is asking for more than you can give, maybe it isn’t the right relationship for you.  In that case, be mature and responsible, and call things off instead of blaming.  If you stand your ground and let your partner know your limits, then your partner gets to decide whether he or she is able to stay.  If your partner doesn’t change or leave, then it’s up to you – still your decision.

     I’m not saying our partners have no responsibility to try and make a change.  They do.  Better communication, making requests over demands, and allowing for some imperfections or learning curves in behavior change can surely be helpful and can temper the urgency of compliance.  Couples counseling may help before deciding on giving up.

     One of the problems with the term Too Needy, is that it is subjective.  Not everyone is going to agree with what is too much or too demanding.  We may not easily accommodate our partner, but someone else may not have any problems.  We don’t know, and shouldn’t predict.  What we do know is whether or not those demands or requests are too much for us.  So, again, our issue.  Maybe OUR expectations are too high!

     Another problem with calling someone Too Needy is that they may believe us!  Most people are only trying to advocate and find what feels right and good for them.  They are not wrong for doing so.  When that self-advocacy gets labeled and judged, some people develop shame over their preferences and needs, and shut them down.  They then feel wrong for asking for what they need and less confident in what will make them happy.  Not so cool.

     So - since people are not wrong for advocating for their needs, every person and relationship is different, and it’s our responsibility to be honest with what we are able to and willing to do, then it’s not really fair when we label our partners Too Needy.

Hope From a Black Hole

Hope From a Black Hole

By: Josh Hetherington, LMFT

Scientists around the world recently collaborated to capture the first images of a black hole. This is monumental. Until this point there has been no visual evidence of black holes; there has only been atmospheric, or electromagnetic evidence. It was easy for some to push the evidence aside and say that black holes are just theoretical, that Einstein just came up with the idea a long time ago but has never been proven correct.

But now we have proof. The swirling void exists.

I’ve often used the metaphor of the black hole for myself. The imagery of the Black Hole is poetic and profound. It stands well for our mortality, or the strength of depression, or oppression, or any intense emotional experience. These experiences are real and should not be avoided in our emotional lives, and now we know it’s real in the universe as well.

The planet came together to get the images; the worldwide collaboration known as the Event Horizon Telescope brought together astronomers and physicists from around the world. There is hope in this. Even as we all struggle with our day-to-day views here in America, even as we are lead by a president who doesn’t want us to collaborate with other countries, or wants us to actively keep out immigrants, this global community of scientists was able to achieve something monumental. They were able to look past their views of one another and focus their attention on the universe surrounding us all. Collectively, we can achieve so much, and this is proof of that. People can work together in peace to great ends, and therein lies Hope.

If these scientists can do it, can’t we all strive to understand each other and see the value in the differences we all bring to the world?

How to Know Whether Therapy Will Help, From the Very First Session

How do you know whether therapy will help?

By: Shira Galston, AMFT

 Obstacles abound for people considering starting therapy: lingering societal stigma surrounding mental health, high costs due to lack of insurance coverage or insane deductibles, the inherent difficulty of reaching out to a stranger for help when you’re in the midst of a crisis or just plain feeling too lousy to go outside, to name just a few. We, your therapists, are well aware of all this red tape, and as care-taking types we truly wish we could just make it all go away.  If only we had that superpower.

 Yes, there are still many constraints to accessing therapy. But there is some good news: fear of whether therapy will actually work doesn’t have to be one of them.

 Just as scientists use randomized controlled trials to study the natural world, the psychotherapy community has applied similar standards to the study of what we call “therapeutic efficacy”; in other words, whether therapy is successful. By this point in time, we’ve actually got a pretty good idea of what works best in therapy, based on scientific evidence.

 Of course, defining therapeutic success is a slippery concept to begin with. Is therapy more successful if you end up happier than when you started? Maybe. Or perhaps acceptance and meaning are higher goals? Clarity? A diagnosis? Motivation? Serenity? Medication? More sleep? And what about for a couple: is therapy only successful if the couple stays together? Or might a break-up be the most successful outcome at times? (The answer is yes, btw.)

 Due to the multiple possible goals a client might have in therapy, success cannot be defined by any one metric. But generally, a pre and post assessment of a client’s general well-being and belief that their goals have been achieved are a pretty good clue as to whether therapy was helpful to them.

 So, what leads to the most successful outcomes in therapy? What matters most? Is it the type of therapy? The style or personality of the therapist? The motivation of the client? The number or frequency of sessions?

Turns out, while each of these plays a small part in determining outcomes, none of them is the single most important factor in determining therapeutic efficacy.

The most important factor is actually something you can easily assess from day one of therapy: it’s the relationship between you and your therapist. We call this the “therapeutic alliance”, or “client-therapist fit” and it, too, is difficult to define, but you know it when you have it. A good alliance is a bond that feels safe, comfortable, and connected. It feels like a match of personalities, or conversation styles. It’s that feeling of whether you “click” with someone, or not. Therapists know that our relationship with the client is the most important factor in determining whether therapy will be effective, so most of us are quite focused on ensuring that you feel heard, seen, understood, respected, and all the rest that comes with any type of trusting and strong relationship. But even with all that in place, sometimes two people are just not in sync with one another, for indefinable reasons. We also can sense whether it’s not a good fit pretty early on, as can most clients, and we’re not offended if you choose to go with someone else based on not feeling that perfect fit with us. In fact, we applaud your self-awareness and self-caring willingness to advocate for finding the best possible chance at success.

So, on your very first day of therapy, pay attention to these questions most of all: do I feel a good fit with this therapist? Do I feel comfortable and safe enough to continue? Do I feel like we are in sync with one another, even though we just met? If the answer to any of these is no, then it’s important to bring this up with your therapist right away so they can either adjust or help you find a better fit.

But if the answer is yes, you can be pretty darn sure that therapy will help you. Which is pretty darn nice to know.

6 Ways to Validate Your Partner & Why This Skill is Essential to Your Relationship

“I get you”: Why Validation Matters

By: Sara Morrow, LMFT

Picture this scenario: it’s been a long day and everything that could go wrong, did go wrong. You missed the train in the morning. Then, the train that you did get on kept stopping. So, you were late for work. Then, you got yelled at by your manager because he/she was stressed and in a bad mood. You didn’t have a chance to eat lunch, and the phone wouldn’t stop ringing. So, you got no work done and you have to do catch-up tonight. You have a headache and to top it off, someone was rude to you on the packed train ride home. When you get home, your partner is already there, relaxing on the couch. You tell him/her about your terrible day and how defeated you feel. Which response would you rather have from him/her?

A: (half-glancing at you and the TV) “Why do you let things get to you like this? Just chill out, tomorrow is a new day!”

Or

B: (Pausing the TV and turning toward you) “That sounds awful. I can’t believe your manager took his/her stress out on you. You’ve been working so hard! Let me know what you need tonight, you’ve had a really trying day.”

My guess is that option A doesn’t feel so good. In fact, it’s pretty invalidating. There is no recognition of your emotions, or what you have gone through during the day. And there is a judgmental “why do you let things get to you?”, which could leave you feeling like there’s something wrong with you that you’ve reacted this way!

Number two is validating, and makes us feel heard, understood and even cared for. Who doesn’t want some of that?! Validation is a powerful relational tool that can foster great connection. So, what is it?

Linehan (2015) notes that validation is 1) “finding the kernel of truth in another person’s perspective or situation” (p. 295) and 2) “communicat[ing] that we understand the other person’s perspective” (p. 295). Validation helps our interactions with other people, improves our effectiveness in interpersonal situations, and makes support and closeness possible (Linehan, 2015). We feel accepted when our partner validates our experience. This, in turn, creates safety. It turns out, being invalidated is a very painful thing for us humans; our brains are always scanning for threat and danger (Boeder, 2017). Steven Porges, a leading neuroscientist, presents” Polyvagal Theory” and how our autonomic nervous system searches for safety through our “social engagement system” (Porges in Boeder, 2017). When the brain senses safety (for example, when our partner validates us), our social engagement system can act; this fosters connection (Boeder, 2017). When there is a threat (like invalidation), this can not happen.  

So, validation is important on a neurological level. But how to do it? Linehan (2015, p. 298) presents six levels of validation:

1)    “Pay attention.” Actually be present. When we are distracted, we communicate through our body language that the other person’s experience is not that important to us.

2)    “Reflect back without judgment.” Communicate to the person that you have heard them.

3)    “Read Minds.” Try to read what is happening for the other person on a non-verbal level. What does their body language say? But, be gentle and open to correction by the other person.

4)    “Communicate understanding of causes.” How does this person’s response make sense given their background, experiences, history? If I was attacked by a dog as a child, it makes sense that I am currently afraid of dogs, even if you are not.

5)    “Acknowledge the valid.” This is communicating that someone’s experience makes sense because they fit with the facts of the situation. You wouldn’t validate feelings about an email that was made up!

6)    “Show equality.“ The other person deserves the same level of respect as you; being condescending or preachy doesn’t show equality.

Here is my validation to you: if you haven’t done this much before, or if you haven’t experienced much validation from people in your past, it makes sense that you may need some practice! But, if you try it, it can bring many rewards to your relationship. If you already validate regularly, keep on doing it! You can also practice self-validation to self-soothe.

References:

Boeder, E. (2017). Emotional safety is necessary for emotional connection. Retrieved from:

https://www.gottman.com/blog/emotional-safety-is-necessary-for-emotional-connection/

Linehan, M. (2015). DBT Skills Training Manual. New York: Guilford Press.

How to Know If You're Too Dependent on Your Partner...And What to Do About It

How to Know If You're Too Dependent on Your Partner...And What to Do About It

By: Christine Webster, AMFT

Relational Dependency; How Much is Too Much?

The picture of a ‘healthy’ ideal relationship has changed significantly over time. As women gained more rights and freedoms, the typical submissive homemaker wife and dominant provider husband no longer fit (if they ever did). Much more often now, couples are opting for an equitable partnership and with that comes a new, relatively unexplored dynamic. Independence within relationships is highly prized, and the perceived codependency of past relationship dynamics get labeled unhealthy and old fashioned. The phrase “I don’t need you but I want you” has become a rallying cry for healthy independent relationships.

But why is it unhealthy to need your partner? Can there be healthy dependence within relationships? Are we really confined to one of the following extremes?

You’re independent and fulfilled on your own and definitely not dependent on anyone else for your own happiness (including your partner). Your well-being is fully your responsibility. You must have boundaries to make sure you don’t depend too much on your partner as that would show a flaw in you, in your ability to self-regulate.

You’re codependent and you and your partner depend on each other solely to be happy or fulfilled. You can’t be alone, you can only be soothed by your partner. Your ability to self-regulate is nonexistent as are your boundaries.

Many current models of therapy argue that dependency is normal and can be a healthy asset to individuals in a relationship. Attached (Levine & Heller, 2011) cites studies showing that when we attach to someone we become a physiological unit and our partner has an affect on our blood pressure, heart rate, levels of hormones and our breathing. Dependency does exist, and forms unconsciously when we enter into an intimate relationship. “Partners co-regulate each other emotionally and physiologically, for better or worse” (Fishbane, 2013, p. 37). In fact loneliness has been found to be detrimental to our health and evolutionarily acts as a signal to seek out attachments. We are wired to connect, and when we are disconnected we feel that pain on a deep level including in our bodies (Fishbane, 2013). Accelerated Experiential Dynamic Psychotherapy heavily values connection as a healing factor. Undoing unwanted aloneness in the face of overwhelming emotion is a consistent therapeutic goal. Core emotions are developed in the space between the self and the other. AEDP posits that sharing affect with another person and seeing it mirrored will deepen resonance and help to make healing associations. Sharing our intense emotions with another creates a holding space that helps us not feel overwhelmed or alone (Fosha, 2000). It helps us regulate and feel more connected to others and to our own internal emotional experiences.

So how does all of this affect how we exist in relationships?

“Attachment principles teach us that most people are only as needy as their unmet needs. When their emotional needs are met, and the earlier the better, they usually turn their attention outward. This is sometimes referred to in attachment literature as the “dependency paradox”: The more effectively dependent people are on one another, the more independent and daring they become.” (Levine & Heller, 2011, p. 21). The keyword here is effective dependency, so what does that look like? We are dependent on and do co-regulate with our partners and have no conscious choice in that process. So where does our power lie in making relationships as healthy as possible?

We have to find a balance between self-regulation and looking for regulation from our partner. We need our partners to be attuned to us and support us, and we also need to be able to tolerate it when our partner isn’t capable of doing that for whatever reason. You have to fill in the occasional gaps that your partner leaves. That is your power, as the co-regulation is the relationships power. Easier said than done, right? There’s a discovery process individually. What are my specific triggers? How and when do I need soothing? How and when can I soothe myself and how and when can I get that support from my partner? People are complex and ever-changing and thus so are their relationships. Self and relational awareness are important skills in finding the right balance for yourself and your partner. The fact that you’ll be dependent on your partner in some way is a given, but your relationship to that fact and how you respond it is not. Therein lies our power.

References:

Fishbane, M. D. (2013). Loving with the brain in mind: Neurobiology and couple therapy. New York: W.W. Norton & Company.

Fosha, D. (2000). The transforming power of affect: A model for accelerated change. New York, NY: BasicBooks.

Levine, A., & Heller, R. (2011). Attached: The new science of adult attachment and how it can help you find--and keep--love. New York: TarcherPerigee.

Photo by Văn Thắng from Pexels

Learn What “Ignites” Your Fiery Arguments With Your Partner...& How to End Them

Learn What “Ignites” Your Fiery Arguments With Your Partner...& How to End Them

By: Josh Hetherington, LMFT

Consider a fire; it requires an ignitor, fuel, and oxygen to keep it going. Smoke fills a room and causes irritation, anxiety, coughing, partial blindness and lightheadedness. Remove the oxygen, and the fire dies.

A repeated argument in a long-term relationship requires similar ingredients.  Fuel: The triggers from childhood. Ignition: a statement or action that activates the fuel. Oxygen: a partner’s defensiveness, or willingness to engage in escalation. Smoke: emotional reactivity.

Once the “smoke” of emotional reactivity is activated it fills the room, making it hard to see clearly and causing an increase in panic and pain. Events and emotions are happening at the same time, and both are real. The person who is experiencing more emotional reactivity sees the events through more smoke, so the events are not as crystal clear as they are for the person experiencing less reactivity. They may be trying to yell “fire!” based on something from their past rather than what is happening right now.  Or, what is happening right now may feel like it could lead to serious burns, maybe even death, because of past experiences.

How can we manage the smoke and fire? Remove the oxygen: slow it all down.

Take a break when you start to feel the smoke coming into the room. Get a drink of water. Take a minute. Let your partner know that you’re going to slow down because you’re feeling the temperature rise inside yourself. You’ll be able to see much more clearly once the smoke of emotional reactivity clears.

Here’s a good video from Ze Frank. He sums up the best of relationship fighting advice in around 5 minutes. He’s funny too!