WHY: Context Matters

Western science reduces experience and other processes down to understand them. Reduction has helped the scientific community understand a great deal in the medical world. 

However, when people’s emotions are reduced to something like a simple chemical imbalance there is no clear path to health. How much serotonin is too much? How little is too little? How do we test for these chemicals? If there is an imbalance, what contributed to it in the first place? And if it is a chemical imbalance why doesn’t someone experience full healing from medication? Why have so many people ended up on medication for life?

As Marriage and Family Therapists, we see the client as a whole person. Jobs, relationships, socioeconomic status, physical health, safety, race, ethnicity, religious beliefs, family of origin, experience, all of these play an important part in mental health and well being. Instead of reducing down, we zoom out to capture a full picture of the person. 

By zooming out, we (the client and therapist) are able to gain alternative perspectives and intervene on different parts of the persons context. This perspective also makes it easy to illuminate a path toward healing that can be discussed and shaped by the client and therapist. 

For Example:

A man in his forties seeks therapy. He reports he used to love running but no longer enjoys it. He had planned a trip to the Caribbean but has felt so sad and not like himself, that he decided not to go at all. He reports he has felt this way for about three months and it is beginning to affect his career.

If we look at these facts and symptoms, it seems clear this guy has depression. One could say it’s just a “chemical embalance.” 

Where would you start treating his depression? How do we test to confirm he has a chemical embalance? 

Instead let’s zoom out and look at the whole picture. By finding out about more in this man’s life it turns out both his parents passed away in a short time frame and he has been the only executor of their estate. It has added enormous stress to his life and has lead to exhaustion and feeling sad and overhwhelmed.

With that information the therapist and client can begin to highlight strengths he has that have prepared him for this painful task. They can work together to develop coping skills and identify healthy relationships that may help him through this time. The therapist and client can also look at the meanings and stories he has ascribed to his relationship with his parents and begin to change the way he perceives the situation. And that is just to name a few ways to intervene. 

WHY: Cash Only

For both of us at Cascadia Family Therapy, 2017 is about making our practice and philosophy known. This is the first of many blogs, and in the future videos, about what we do and more importantly, why we do what we do.

You may have already read our webpage about why we are a cash only practice. On that page we list some consumer benefits of paying cash for psychotherapy like confidentiality and mental illness diagnosis.

Many health insurance plans do not pay for family sessions or couples therapy sessions. The way the system frequently operates is that one person in the family or couple gets diagnosed with a mental illness from the Diagnostic and Statistical Manual for Mental Disorders (or DSM) and then sessions are billed to their insurance through that information. (I could go on at great length about the faults of the DSM, how it was created, and it’s bias but I think I will save that for a future blog post….)

We believe that the act of diagnosing someone with a mental illness shapes the therapy process even if it is “just for billing purposes.” We believe in our client’s innate strengths that they bring to therapy with them. We actively choose to not see our clients, even just for billing, as having mental illnesses. Instead, we see our clients as strong capable people that are caught in strong patterns of interaction, behavior, or relationship dynamics. We simply offer another perspective, the tools needed, and the direction to help our clients break the patterns that are negatively impacting their life.

Family and couples therapy is a lost art and more work for the therapist. If you were to look at psychotherapy on a timeline; we have moved from the extreme individual perspective from the Freudian days, to a more family centered approach, back to the individual perspective over the past 100 years. Family and couples therapy often gets picked on in the media and misrepresented in movies and TV shows (except Hope Springs… but who’s counting 🙂 )

Family and couples therapy offers the power of multiple perspectives to approach problems, break patterns, and find solutions. More people in the therapy room equals more information for the therapist about the key components and potential benefit or function of a pattern.

For example:

A teenager is brought into therapy for smoking weed. His parents, understandably so, are worried about him and just want him to stop. After a few family sessions, the therapist can clearly see that the parents argue frequently in front of the teen. The therapist starts to identify a family pattern that has developed. When the teen smokes weed he gets a break or to check out from the stress at home. When he gets into trouble for smoking weed, his parents come into agreement and are able to work together for the goal of getting the teen to stop smoking weed. A marriage and family therapist could highlight this pattern for the family and identify the ways in which everyone is participating in the pattern. When each family member sees the way they participate it opens the door to new ways of interacting. Therapy then could move toward  just the couple to restore the parents relationship so that the teen would not feel the same need to smoke weed to check out from the arguing at home which would stop the pattern of getting caught and bringing his parents together.

That is a super simplistic example, but it highlights the way in which all family members regardless of age participate in family patterns.

It can be hard to face how you contribute to a pattern that hurts others or is destructive, but once you know, it makes it clear how to change. In society today, we are quick to label people with mental illnesses which can absolve people from the consequence of their actions and mask the behaviors or interactions contributing to the problem which disempowers people from taking action.

These hard to face truths are what empower people to make necessary change and have the life they have always wanted. We believe in those moments so much we have built our practice around them. And those moments are why we take cash only.

And in case anyone is wondering… we live our lives around these philosophies too so we are a cash operated business. Cascadia Family Therapy has not and will not take out business loans.

4 Ways to Change (right now!)

There is a tendency in our culture to think that change, like love, is just something that happens. However, there are steps or access points to engage in change. Use a combination of these access points and watch the results pile up. I will list these from easiest to more difficult.

  1. Physical State: One way to encourage yourself to think differently or make different decisions is to get in a good work out. If you are using a workout for this specific purpose, schedule it as early in the day as possible. Think about how you feel post workout: strong, empowered, ready to take on anything, and a bit proud of yourself. These feelings are great places to start making new decisions or renewed commitment to the decisions you are trying to make. If this is hard for you to imagine, think about the decisions you tend to make when you are feeling sad or stressed out or after binge watching Grey’s Anatomy all afternoon. Try tracking this for a week…. I am not supposed to guarantee anything as a therapist… but I can guarantee this strategy! You don’t need me to make this change!
  2. Behavior: Make a commitment to changing a behavior like drinking more water, writing more, picking up a new hobby, or joining a club/community. I find it is easier for most people to add a new behavior or learn something new rather than making the focus quitting something. For instance it is hard to keep repeating to yourself “watch less tv” because you are reminding yourself of TV every time. Try repeating “write more” it will guide your thoughts in a new direction.
  3. Food: Let’s face it, nutrition is not a rocket science these days. It is common knowledge that less food from a package and more fresh fruits and vegetables is a healthy way to go. Don’t discount the power of food on your mood and perception of your context. Eating fresh foods that you know are good for you can dramatically change the way you think and interact. Try drinking less caffeine … I know, that one is hard for a lot of people but caffeine is a stimulant and all stimulants no matter their legal status increase anxiety, jitteriness, irritability, and can prevent you from getting a good nights sleep.
  4. Insight: We all have those moments when we “know” something but still choose to act the same way. It is hard to generate new insight inside the mind that got you to where you are now. New insight can be generated however through a coach, a class, or a therapist. These are contexts in which you can share where you get stuck and a new person with a different experience of you and your context can generate new ways of thinking about it.

I encourage my clients to make an attempt at all four. If a client is making change in a couple of these areas, therapy becomes exponential accelerating change and helping it stick. Michael Long, the other therapist here at Cascadia Family Therapy, calls therapy “New Year Resolution super glue.” Adding that fourth component to your commitment to work out more or eat healthier adds momentum.

Give it a try and let me know what you find in the comments below!

Inclement Weather Policy

I wanted to take a moment as we are under yet another snow storm warning to share our weather policy.

As soon as you suspect you will not be able to make it to your scheduled session, please send a text, an email, or leave a voicemail letting your therapist know.

We follow the Bend-La Pine school districts closures but also allow clients to discern for themselves whether or not it is safe for them to drive to their session.

In other words, if the schools are closed we are closed and if you don’t feel safe driving in the snow for your appointment, please let us know and we will waive our less than 24 hour cancelation notice fee.

Our Passion

At Cascadia Family Therapy, we are passionate about providing therapy to couples and families. Some of that passion comes from the imperative situation standard “mental health care” has put young kids in. It has become common practice to diagnose children with mental illnesses that only 20 or 30 years ago were thought to be unethical to diagnose a child with (i.e. Bipolar Disorder).

Excellent therapy that helps young people cope with stressors whether biological or environmental, shouldn’t come at the price of a diagnosis that could stick with them for life (especially as the nation moves to electronic healthcare records).

This is part of the transparent, simple and effective therapy offered at Cascadia Family Therapy. We see young children as often the best indicators that something within the family system needs to change or needs a new way of coping. We honor our younger clients by listening to them  and tuning into their needs while helping parents keep the necessary rules and boundaries in place that lead to family harmony.