Repairing a Relationship

It has been an embarrassingly long time since I have sat down to reflect and write in this space. Michael and I have been spending most of our time providing therapy to some incredible couples over the past few months. Time flies when we are working together… it is such a privilege to do this work.

Something we keep running into time and time again is the myth that when couples enter therapy the past wounds will be covered with immediate action like homework. Clients are eager to ask for the next task but the work is a little harder to spot and it certainly cannot be checked off a to do list.

The work lies often in holding both realities. The reality that the relationship is being worked on and will improve and the reality of the damage that has been done. Part of repair then is being able to sit with your partner in those tense moments when one or both of you lacks confidence in the relationship. Having compassion for one another and being able to see that the past hurt is just as real as the new future you are creating together.

The magic ingredient is not letting those moments set you back. Instead have confidence that this uncomfortable space of rehashing isn’t the past argument, it is a new conversation because it now exists in the context of working on the relationship. Rehashing for couples before therapy often happens in the context of “will we stay together” or “is this relationship healthy for me/us.”

Can you hold both the past hurt and the desired future just long enough to start to see it change?

Remember, change in humans is the same as a growing plant. It is hard to detect until you look for it.

 

Resolve

I still love New Year Resolutions. I love that there is a time of year that people feel some sense of inspiration about their future. There is a magic in the air as one year closes out and a new one begins. A magic that seems to help some people give themselves a chance to dream or reimagine themselves.

The problem comes when they wake up two weeks later in a culture that doesn’t support change and growth. We live in a time when it is easier than ever to keep the status quo, avoid personal responsibility, and busy ourselves into oblivion.

Still, I believe in people. I have the honor of seeing people change their lives all the time… not just in January. I also know that sometimes people need a few false starts. Sometimes the journey is trying out new ways of being and discarding what doesn’t work. I don’t blame people for quitting gyms after two weeks. Have you been to most gyms during January? The place is packed and its cold and flu season… gross. Maybe it will lead you to finding the right gym, the right workout community, or the right sport that keeps you fit. Sometimes we make progress in quitting.

But I digress.

I promised myself this wouldn’t be a blog of “Joella’s new year opinions.” Rather, I wanted to talk about Cascadia Family Therapy’s resolve to provide the highest quality couple and family therapy we possibly can. We are more committed than ever in 2018 to creating massive change in the lives of our clients and in our industry.

It is time for the old way of therapy (you know the once a week, bill your insurance, only to get a bill months later, all the while wondering what your therapist is trying to accomplish with you kind) to get out of your way. It is time for a new way of therapy. Therapy that is transparent, empowering, and collaborative. Therapy that trusts the clients to do the work and believes in people’s resilience and possibility. 

We are here to do that work. When a couple or family is ready for change, we are here to work, support, encourage, provide skills, whatever it takes.

We believe in YOU to build the life you want. Make your resolution stick!

At The Speed of Life

Sitting down and writing about therapy is one of my favorite things to do. Being a marriage and family therapist requires a lot of reflection not just on what clients bring in but on what I am saying, doing, suggesting, inferring, the list goes on!

For me therapy is equal parts where have you been and where you are going. In fact, the best part of my craft is that I have the honor of dreaming for my clients. When hope is low and obstacles seem insurmountable, I have the freedom as an outsider and a trained professional to dream of different approaches, perspectives, or narratives. This is also part of the pleasure of running a fee for service business, clients get a therapist who makes time to reflect. But I digress….

I have felt myself having to just crank along this past week. Michael and I moved a couple miles up the road and it has felt like a sh*t storm  (yes, that is the clinical term). Boxes, chapped hands, microwave meals, and lack of sleep have all driven us into the ground. I try my best to shield my clients from these stressors and keep my office a sacred space but I know I am not perfect. I was reminded of this when I saw my last blog was so long ago. It seems the website and blogging are always the first off of my list.

All that being said, this season to me is all about reflection. With the new year approaching, the short days, and long nights, it feels like mother nature forces us all to slow down. I look forward to having some extra time  off to catch up and get back to the creative part of being a private practice. Michael and I have some massive goals for 2018 and hope to reconnect many more couples!

 

Things to ponder…..

How do you make time to reflect?

How do you reflect? Writing? Talking?

What are your intentions for 2018?

Showing up for life 

The theme of my week has been the importance of showing up. In a world where with the click of a mouse and/or the swipe of a debit card we can send condolences, comfort, and pseudo connection I’ve been struck by the power of showing up. No one can read your mind and often our intentions are assumed by others. By showing up we communicate our thoughts and intent clearly. 

Here are some ideas of how to show up in your life for those most important to you:

Take flowers to someone

Say thank you in person

Look people in the eye

Compliment what you admire

Shake someone’s hand

If you love them, say it! Again and again.

When you feel the urge to say just about anything to make someone feel better; hug them instead.

Hold your loved ones hand

Be patient with emotion. Feelings come and go but some linger… that’s ok.

Human interaction truly matters. Don’t let the digital world fool you into thinking otherwise.

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.”

autonomy

The longer I practice therapy the more passionate I become about client autonomy.

Autonomy from a sociological perspective defined by wikipedia is, “the capacity of a rational individual to make an informed, un-coerced decision.”

The foundation of my work is in reflecting back what clients present as the problem or their perspective, educating clients about what I know (typically what research says) and sharing my perspective as a professional. With these components clients will often uncover more options.

More options create a sense of autonomy. It’s the shift from this is happening to me to I am happening to it.

My goal is for clients to leave sessions feeling like their life is back in their hands, they are no longer held captive by patterns or habits, and that they are armed with information and options.

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!

Humanity

I recently listened to an episode of This American Life in which they were exploring the old adage, “you will understand when you are older.” In the final act, they are talking to a man in the early stages of dementia. He describes what it is like to go to his doctor and be asked questions like “Who is the president?” and “What day is it?” and worst of all, they ask him to draw a analog clock depicting a particular time.

The man, a former engineer professor, is bothered that he struggles so much with this task. His life before was centered around numbers. He sits down one day and deconstructs the issue. He figures out and later articulates to his wife, the difficulty is that they are three layers. The hours, 1-12 (even though there are 24 hours in a day), the minutes (which correlate with the numbers 1-12 but represent 5’s) and on top of that, the larger hand tells the minutes while the smaller hand tells the hour. No wonder I am 30 and still have trouble reading an analog clock!

Anyway, this was an amazing story but that was not what fascinated me the most. What caught my attention was that his wife of decades kept feeding him words and prodding him along. It reminded me of many therapy sessions with parents and children. This constant need for your loved one to achieve in a way that society can recognize. It broke my heart. Here are people, young or old, trying to find their way in their own words, as fragile and disjointed as it may be, and we as a society have lost our ability to simply wait.

The evidence of this impatience and obsession with boiling every part of a human into a number is all around us. The survey of your doctor, what stories post in your Facebook feed, or what makes me most sad, the number of smiley or sad faces an elementary child comes home from school with.

I wish I could remember who said this, but I heard someone say that the true tragedy of our society isn’t what law has been or will be passed or the absolute joke of candidates in this presidential election, but instead the loss of humanity. The loss and oversimplification of the infinitely complex experience of being a human being. Our children are not numbers and our loved ones are not defined by the words they struggle to find. And each one of us deserves patience and quiet loving support to find who we are today even if it appears to be drastically different from yesterday.

So next time you feel like filling in a word or take a test score to mean something about you or a loved one’s intelligence, ask yourself, “does this really mean something or do I just feel a general pressure from society?” Or if you are really up for a challenge, “what is it about this score, lack of ability, or mistake that makes me feel uncomfortable enough to correct this person?”