Interconnected

One of my favorite parts about being a marriage and family therapist (or systems therapist) is that we can pick from a wide variety of context to create change. Our minds and bodies are deeply connected and our relationships and environment are also connected to us. When you think of humans in the way, you can see how picking one area of life and making a positive change can impact the other areas.

If you are stuck in some area of your life or if you are feeling depressed or anxious pick one of these areas and do something different:

  • A relationship
  • work environment
  • home environment
  • physical health
  • give yourself the benefit of the doubt
  • how you greet your loved ones
  • go to bed earlier
  • eat more fruit and veggies
  • spend time outdoors

All of these things alter our chemistry and help us to get into another state of being.

What works for you?

The Resistance

Over the summer I have been pursuing all sorts of creative endeavors. Painting, music, videography, anything and everything that piques my interest. To me having a creative outlet is a key ingredient to self-care. And as a therapist, I am always seeking to add to my self-care repertoire.

These creative endeavors lead me to the book The War of Art by Steven Pressfield.  I have not been able to put this book down! The concept is that art is a part of our souls and often a higher calling but it is commonly met with different forms of resistance. From alcohol to love to procrastination, Pressfield describes in detail the many faces of resistance.

In reading these descriptions of resistance, I couldn’t help but think of therapy. Therapy is often an artistic endeavor where my professional expertise meets the wide variety of human experience and together we create a new paradigm for the future. When I reflect on it that way, I can’t help but ponder how the resistance may show up for my clients.

  • Dreading sessions perhaps?
  • Too afraid to pick up the phone to even schedule a session?
  • Perhaps beating yourself up for even feeling as though you need a therapist?
  • Ignoring the issue hoping it magically disappears?
  • Trying once again to solve it all yourself?
  • Too stuck to even find a therapist?

Resistance is a powerful force that often prevents us from moving forward. But as Pressfield articulates, “the greater the resistance, the more important the work.”

3 Reasons Life Feels Unsatisfying

While this may not be an exhaustive list, here are a few reasons to explore and get you started:

  1. Something NEEDS to change or be addressed: If there is one thing I have learned from years of working with people it is that human beings are extremely resilient. The body, mind, and spirit can endure and cope with large amounts of stress. Whether it is the physical stress of not addressing a medical need or the emotional stress of staying with a harmful relationship. People are able to cope themselves into corners and dark places. Taking time to reflect on life and truly look at how long a relationship, job, or physical condition has been going on can provide clarity into what truly needs to change. It never ceases to surprise me how many years people will endure things (especially jobs and relationships) that are literally destroying other areas of their life.
  2. Change Requires New Narratives: It doesn’t matter how far someone moves or how great the new job or relationship is, the old story will still replay from time to time. Be prepared to remind your wandering thoughts that life is changing and to give it time before feelings of satisfaction or peace come with that change. Keep track of successes and milestones that mark your way to the life you do want. Proactively choose the narrative or story that you replay in your mind. I ran into this problem when I went from a grueling internship to private practice. I had days I would catch myself dreading going to work or feeling anxious about my practice. I finally realized, I was addicted to that way of thinking because I had endured and coped with a harsh environment for so long. It may sound silly but I had to literally remind myself that I was not doing that kind of work any more. I had to create a new story to tell myself about my career. I would reflect on how lucky I am to spend my time helping people and if there is something I can change it.
  3. Gratitude is a practice first and a feeling second: A practice of gratitude is truly life changing. When clients discover the ability to be grateful for the change that is occurring in their lives or focus on the parts of life that are going well feelings of happiness and satisfaction abound. The ability to not let work stress or one relationship bleed into other areas of life is important. Just because there is a couple difficult people at work doesn’t mean a person has to hate the whole job. Practicing gratitude helps keep life in focus and can offer clarity about what needs to change. I see this commonly with the most intimate and important relationships in client’s lives. When there is marriage or family stress, it appears to affect all areas of life. Staying grateful for what is going well in life keeps people focused and offers an honest reflection of your present context or environment.

Questions to ask your Therapist

Important Reminder: You are in charge of your mental and emotional health. No one should tell you what your experience is and mental health concerns are not a reason to feel disempowered and/or helpless. Your therapist/doctor/counselor/psychologist/psychiatrist should be able to clearly articulate risks and benefits of the treatment they are suggesting. It is my opinion, after 7 years of training and practice in this field that medication should always be approach as an absolute last resort and never a first response to mental health concerns. In addition, a diagnosis (such as bi-polar or depression) is not a treatment plan. 

When looking for a therapist, it is important to know a few important but simple questions to ask to ensure you get the best therapist for your situation.

  1. Where & when did you attend school? If the school doesn’t sound relatively familiar, look it up. Make sure that live supervision and an internship were part of the program, especially if you are working with an intern. If the clinician is fully licensed, you know they have had three years of supervision in Oregon.
  2. How long have you been practicing and what is your license in? It doesn’t matter whether the therapist has been in practice for 9 months or 29 years, neither guarantees a good therapeutic fit. What you are looking for in this question is for a confident response. If you get a shaking, “only a few months” or a cocky, “too long!” it’s a red flag. You want a clinician who is hungry to learn but confident in their skills. It’s a delicate balance!
  3. How do you believe change occurs? Some clinicians believe change occurs when brain chemicals are altered, others believe it happens over a period of time when you gain more coping skills, others believe change happens in the moment in therapy. It is important to know how your therapist believes change happens. For example, I believe that change occurs when the habits/patterns change whether it is emotional, behavioral, or interactional (between two people) patterns. Therefore it would not be a good fit for me to work with a therapist who believed that my emotional state would improve by changing chemicals in my brain.
  4. What is the average amount of sessions you work with clients? The answer to this comes down to preference and what you believe change looks like. I typically work with clients for 12 session. I believe clients should pay me only for the sessions they need and as they begin to experience change and healing we should start spacing out sessions. Clients can always come back if they need more support and I never want to foster dependence or send a message that a client needs me. Other therapists have a more long term approach, I can’t speak to that because I wasn’t trained in it, so it comes down to what you believe.
  5. What is your treatment plan?  Of course you may have to attend a couple sessions to get the answer to this question, but a good therapist can always articulate how they are seeing the problem and how they seek to help you with it.

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!

The Missed Point About Teens and Social Media

It is always encouraging to me when articles like this one hit the web. It is a sign that the the effects of social media are a continued discourse in our society. But these articles frequently miss one important point. The point is that more and more children and teens are spending time alone on social media with no parental involvement. It is not just what social media is displaying, it is that our children are receiving these messages alone and internalizing them. Children are no longer confronted by images on the TV that then can be discussed as a family or even a group of peers. Instead, the information they are digesting is frequently experienced alone.

If your teenage daughter is appearing to lack confidence or becoming more anxious or nervous, try to open up a conversation about the fact that social media is still media. Everyone is projecting what they want you to believe, not how things actually are. There are also a number of great videos on YouTube showing how much models are airbrushed. And keep in mind, problems can seem so much bigger when we are experiencing them alone. By opening up a conversation, you are not only bringing your teen back in touch with reality, but reminding them that they can talk about these experiences, that everyone is impacted by social media.

Pop Psychology

I saw this article titled, Why You Should Never Go Back To Someone Who’s Hurt You by Sophia Wu, from Huffington Post circulating through my Facebook feed. It’s a great example of a common pattern I see as a therapist. This describes what I would call, a pursue withdraw pattern. Both parties are participating in keeping this cycle going as the author points out. The pursuer so infatuated, continues to do so at all costs, and the other continues to withdraw at seemingly just the right moment. The result, sometimes for both parties, are feelings of depression, worthlessness, anxiety, and overall stress.

As a marriage and family therapist, I am most interested in the pattern and a little less interested in the symptoms. While some therapists may be quick to hone in on those difficult feelings of depression or anxiety and how to alleviate them, I see those symptoms as neon signs. They are pointing out to my client that he or she is stuck in a pattern that is not helpful or worse, harmful. Other important parts of themselves are being ignored in strong pursuit of this one person. LIfe is out of balance for this person and the effects are beginning to show.

What should the client do then? Well, I have seen some pretty extreme versions of this. I have seen whole marriages spent in this pattern. But it is never too late to try something different. Yes, it is that simple.

Patterns give therapists and clients many points to evaluate possibilities for change. Patterns can also offer a more playful way to look at these problems. For example, instead of deciding in this very moment whether a person should stay with the withdrawer or leave, what if they just decided not to answer the phone every time the person calls? How might that change the pattern? Or what if they began to fill their time with more people and activities that don’t magically disappear every time they need them?

Take an new art class, go out with some friends, do something to invest in oneself. All of these suggestions serve to change the pattern. They may not fix the pattern immediately, but they help to break up that obsessive focused feeling to do the same thing you have been doing. I firmly believe that though our minds may be inclined to get stuck in these patterns, our minds thrive on change and expanding our options. The small steps listed above could be enough for someone to gain back neglected relationships, self-respect, and give the courage needed to leave that relationship. I have also seen it go the other way, as the pursuer gains more self-respect and courage, the withdrawer feels attracted again. They feel the balance restored in the relationship.

When you tackle a pattern, you never know what can come of it. Sometimes it is far better than you ever imagined.