Let’s Talk about it: Post Traumatic Stress Disorder (PTSD)

By Rachel D. Miller, LMFT

By Rachel D. Miller, LMFT

June is PTSD Awareness Month. While PTSD is most commonly connected to combat soldiers and veterans, it can also develop in first responders, survivors of domestic violence (abusive relationships), childhood, and sexual trauma, and natural disasters. Truthfully, any traumatic event can result in PTSD.

What is PTSD?

Post-Traumatic Stress Disorder, according to the National Center on PTSD, is a “mental health problem that some people develop after experiencing or witnessing a life-threatening event.”

Who might experience PTSD?

Anyone at any age can develop PTSD. It is more likely when a traumatic event is intense, occurs over a longer period of time, or the individual is injured in the event. Factors such as gender, age, level of social support, and previous experiences of trauma impact whether or not a person develops PTSD.

What are the symptoms of PTSD?

Symptoms may present within a month or so of the event or can develop years later. It can be short lived or be more of a chronic condition. Here are some of the common symptoms from the National Institute of Mental Health (NIMH):

• Re-experiencing the trauma via flashbacks, nightmares, or frightening thoughts which disrupt sleep and daily routines. Symptoms can start from your own thoughts and feelings or from reminders of the event such as sords, objects, or similar situations.

• Avoidance such as:

o Staying away from places, events, or objects that are reminders of the traumatic experience

o Avoiding thoughts or feelings related to the traumatic event

• Reactivity or hyperarousal:

o Being easily startled

o Feeling tense or “on edge”

o Having difficulty sleeping

o Having angry outbursts

These symptoms are typically constant, rather than triggered by reminders of the event, have you feeling stressed and angry, and may make it hard to do daily tasks.

• Changes in mood and cognition challenges such as:

o Trouble clearly remembering the event

o Negative thoughts about oneself or the world

o Loss of interest in enjoyable activities

o Distorted feeling like guilt or blame

If the symptoms last more than a month, seriously affect your ability to function, and are not due to substance use, medical illness, or anything except the event itself, you might have PTSD. Symptoms in children may look different, be sure to check with your child’s doctor or mental health care practitioner, if you have concerns.

Trauma focused psychotherapies recommended for PTSD:

• Eye Movement desensitization and Reprocessing (EMDR)

• Trauma-focused cognitive behavioral therapy (TD-CBT)

• Prolonged Exposure (PE)

Even if you are not experiencing all of the PTSD symptoms, it can still be helpful to have a therapist support you in processing your trauma. Please reach out to our office or utilize any of the resource below.

Resources if you or someone you love has PTSD:

The National Center for PTSD

The National Alliance on Mental Health (NAMI)

Sidran Institute


Grief is like a Tail

By Kayla Harris, MA, AMFTPhoto by Liza Summer from Pexels

By Kayla Harris, MA, AMFT

Photo by Liza Summer from Pexels

I often think of grief like a tail.
Ever-present to you, but invisible to others.

When you experience a tough loss, your tail may feel prickly and sore all the time.

It is always on your mind just how much it pains you, how much it keeps you from enjoying your life.

Every once in a while, you pinch it in a door behind you or someone steps on it.

And it's not their fault; they did not know it was there because they cannot see it.

And yeah, maybe you've mentioned that you have this tail and that it throbs (around the holidays, for example).

However, other people will forget that it is there and will still ask you things like, "What are you doing for Father's/Mother's Day?" and OUCH.

Even people who care deeply for you will do this.

The thing is, they do not have to live with your tail or make space for it, so they'll quickly forget you have to go through life with it.

Other people trip on it and step on it, songs and movies will play that will remind you of hurts, even your mind will replay memories that bring everything back.

In those moments, it may feel like a part of you was just jammed in a car door or like you bumped your head on a low ceiling.

It's as if the central nerve of your tail is tied directly to your heart, throat, or tear ducts.

You may act out in anger or sadness that onlookers won't immediately understand.

The trick is to acknowledge when your tail is hurting and share your feelings with someone you trust.

The more you talk about your losses and how they've impacted you, the more resilient your tail becomes.

What starts as raw and scabby later becomes soft and durable.

As the losses pile on over the years, your tail may feel fresh and vulnerable all over again.

Still, when you care for yourself and make room for the aches, you may be comforted in feeling your grief tail as a part of you and not all of you.

The Vulnerability Cycle Part 1

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By Michaela Choy, LMFT

When couples feel stuck in their communication with one another, report the same fights over and over, and share that these conflicts are happening frequently, I consider framing their challenge as a cycle.

Generally, our fights with our partners become patterned at some point. We learned to fight from our caregivers, environment, and what we witnessed growing up and this can follow us into our adult relationships. Inevitably, our conflict style will interact with someone else’s and create a dance so to speak. This partner is also carrying experiences and ideas of how conflict is supposed to work and will bring this into relationship with us. We see when we do X with our partner Y will happen and so on. Some of these cycles can feel validating and move towards a resolution. Some feel stuck and painful. Some fall between those places.

Consider the cycle below. Notice that there are things called vulnerabilities and survival strategies. This cycle illustrates that when a vulnerability is tapped into, a survival strategy is used for protection. This same survival strategy can activate the other person’s vulnerability and their own survival strategy. Your partner’s survival strategy can activate your vulnerability. And around and around you go.

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This is a specific cycle that names pieces interactions that are operating without our awareness. This cycle incorporates something called a vulnerability which you can think of as a sensitivity that we carry from our past experiences. These vulnerabilities come from past relationships, the context of the world we live in, trauma, and so forth. Some examples of vulnerabilities include the feeling that partners will always abandon us, feeling very scared and sensitive to someone yelling, and feeling untrusting of doctors or the police force. All of these vulnerabilities come from real experiences and our bodies are primed to react to protect us when vulnerabilities are activated. This response is normal and good.

Survival strategies come into play when a vulnerability is triggered. These strategies are highly adaptive. I have deep respect for the ways in which we protect ourselves from pain. They are called survival strategies for a reason, and I believe they help us get through tough and maybe even life-threatening moments. There are times when these strategies need to be here. I also know that sometimes these strategies can get in our own way. For example, when someone yells at us, we can shut down, get very quiet, and not interact anymore. This is an attempt at protection when our bodies recognize something scary is happening. For example, if that person yelling at you was a parent and or partner that you couldn’t get away from at the time, this strategy helped you survive those moments. Fast forward to another time in your life when that partner or parent is not present, and this survival strategy appears with someone new, it could get in the way of this new relationship thriving. Shutting down with this new person could leave them in the dark and leave conflict unresolved.

Prompts for Reflection

Pause here. Think about the stuck points in your relationship with your partner(s), and consider the following questions. These questions can bring up a lot. Give yourself permission to pause and come back to this as needed. It will always be here to explore. Be gentle in this work. It’s courageous to explore these parts of yourself:

In my relationship(s), when we have conflict, is there a pattern here?

How do I protect myself when I’m feeling vulnerable (what is the survival strategy)?

How has this served me?

 Thank your survival strategy for protecting you. It served a purpose and kept you safe. 

How is this survival strategy holding me back?

When I use this survival strategy with others, how do they respond to me?

What is this survival strategy protecting? What is the vulnerability underneath?

Where did this come from?

Do my partner(s) know where this survival strategy came from?

What would it be like to tell them about the origins?

Would they treat that information with love and care?

Do I feel like I want to share this information?

In my next post, I will talk further on how we can change these cycles.

References:

Scheinkman, M., & DeKoven Fishbane, M. (2004). The vulnerability cycle: Working with impasses in couple therapy. Family Process, 43(3), 279-299.

3 Common Problematic Communication Patterns.

By Rachel D. Miller, LMFT

By Rachel D. Miller, LMFT

How we communicate our wants and needs, love and appreciation, concerns and criticisms strengthen or erode the foundation of our relationships. The most helpful communication aligns our words with our body language, thoughts, and feelings. When these things aren’t congruent, we risk sending mixed messages leaving our relationships vulnerable to conflict, misunderstandings and disconnection.

Effective communication in addition to being congruent also considers self, others, the larger context, and the relationship involved. Failing to take these into consideration often manifest as the below unhelpful communication patterns.

1) Blaming

Pointing a finger in accusation while feeling direct, useful, and even vindicating, in the moment, rarely leads to the change we are seeking. Blaming is identifiable by the frequent use of the word “you.” What is missing in blaming conversations is acknowledgement of any larger context at play and self-reflection. Thoughts, feelings, words, and body language might be aligned when we’re angry and blaming, but if we focus solely on the behaviors or attributes of the other person, we’ll likely be met with defensiveness, stonewalling, or counter attacks.

If you recognize this pattern in yourself, I encourage you to get curious about what need or ask you might have under the blame. Take some time to consider the larger context around the situation and get curious about how it might be impacting things. I statements and focusing on your feelings, needs, and asks can keep defenses down, communication moving, and maybe get you closer to what you’re wanting. If the relationship is one that is important to you, ask for what you need in a way the other person is most likely able to give it to you. Remember, you’re on the same team.

2) Listening to respond instead of listening to understand

Too often when we listen to complaints, criticisms, or requests to change we immediately begin crafting a defense. When I see this happen in the therapy room arguing people are rarely arguing about what they think they’re arguing about. Typically, the listener missed the point the speaker was making because they were too busy figuring out all the reasons the speaker was wrong in their assessment of the situation or of them.

I urge clients in that moment to pause and take a deep breath. Then I inquire around what they believe the speaker said that is hitting a little too close to an uncomfortable truth for them. If it isn’t that, then I get curious about the story they are telling themselves about what they think the speaker means. Once the story is revealed we often discover it is a far cry from the speaker’s meaning and words.

If you recognize this pattern as something you do, there is a tool you might find helpful called Speaker/listener. You can read more about it here. Remember, if you notice yourself reacting to what you think someone said, curiosity can slow down the process and reduce reactivity. Ask questions; make sure you understand before you respond. Remember even common words can mean different things to different people in differing contexts. Which brings us to our third problematic pattern.

3) Assuming

When I work with people in therapy, I remind them often that how they define a word or concept may not be the way the person they’re communicating does. When your partner says that they are “close” with their family, you might assume that you know what that looks like for them, but the word “close” can mean everything from “my family and I did a lot of activities together when I was growing up” to “I talk to my mother twice a day.” We have to continually check in with people about how they are defining words and concepts rather than assume that what it means for you, is what it means for them. As my kids used to say to me, “Don’t assume, Mom. When you do you make an ass of u and me.”

If you find yourself assuming, as most of us will, I encourage you to shift to assuming you don’t know, assuming you can never fully understand someone else’s experience, and assuming the best of intentions from those you are in relationship with. Before responding, clarify meaning. Ask questions that can provide insight and empathy into what the other is experiencing.

It is impossible to be in relationships and be vulnerable without occasionally hurting someone or being hurt. What matters most is that we take accountability, apologize when necessary, be generous in our interpretations of the intentions of others, and attempt to make repairs when and where we can. Even the best communicators will screw up. Perfection is not the goal here. Commitment to practice and growth is all we can ask of ourselves and each other.

Notice and Describe – A prescription for High Conflict Couples

By Anne DeCore, AMFT

By Anne DeCore, AMFT

Let’s look at the following scenario.


A husband and wife argue about cleaning the kitchen. They have an understanding that when one cooks, the other cleans. Tonight, it was the husband’s job to clean because the wife cooked dinner.

Wife tells husband: You do the bare minimum of just loading 75% of the dishes. I then have to do a whole second job of finishing the dishes, cleaning the table tops and the high chair. Why do I have to supervise you? We agreed, you would clean if I do the cooking.

Husband says: You have a ridiculous standard for cleanliness. And you fail to appreciate that I also have to walk the dog and go back to work in the evening.

Wife: You “work” with the basketball game on in the background. What happens is you’ve come to expect that I’ll pick up the slack when you sit back and relax. You’re being lazy. I don’t get to be lazy.

Husband: I’m lazy?! If it’s so easy to make a living, you go ahead and do it. Last I checked your salary barely pays for the kid’s summer camp. The reality is I could do the kitchen perfectly and you’d still nag! You love to micro-manage me! Nothing is ever good enough for you.

In this vignette, what husband and wife consciously experience is a back and forth of what they believe to be their genuine thoughts and feelings. These attacks escalate, polarizing the couple and moving them further away from understanding and solutions. They each storm off and feel overcome with a piercing disappointment that verges on a sense of betrayal. Each one thinks “You hid your true self from me. You’re not what I believed you to be. You don’t even know me.”

The damage happens fast; the repair will take much longer. They are left wondering “how did this all happen?” The answer lies in a hidden process which occurs below the level of consciousness, based in the brain.

In a regulated state our brains employ perspective taking, long term views, and balanced thinking and reasoning. These are necessary for interpersonal success. When we begin to enter a state of high emotional arousal we lose these faculties which are critical in relationship management.

High emotional arousal is followed directly by biased thinking: our thoughts become overwhelmingly negative and imbalanced.

Next, we produce negative judgements and assumptions about our partner. The negative judgements and assumptions are what lead directly to misunderstanding and high conflict.

This process is automatic. The dangerous thing is not that this happens; there are many strategies for self-regulation which aim to bring our reasoning faculties back online. The dangerous thing is that we are mostly unaware when we are under the influence of biased thinking. We tend to think we are governed by reason when reason has long left the building. And the deeper (higher emotional arousal) a couple gets into the fight, the more indignantly each believes that their judgements and assumptions about each other are objective, verifiable fact. One partner’s brain supplies the missing parts (assumption) to the other person’s story and then the brain reacts to that story (judgement).

In the example above, we see it happen right away. Both make assumptions about the other: she assumes he’s only pretending to work. He assumes she doesn’t appreciate all he does for the family and that she has it easy. Both make judgements: she calls him lazy and he calls her critical. The frustration she felt over the incomplete kitchen put her in a state of high emotional arousal and from there they were both off to the races in creating narrow and inaccurate narratives.

Developed chiefly by Marsha Linehan in the field of Dialectical Behavioral Therapy, an antidote to this automatic process is to employ a deliberate method of thinking we can call “Notice and Describe.” You might like to think of it as relationship mindfulness.

In this mode a person notices and describes what is going on around them, much like a sports event announcer does on the radio. This means sticking purely to what is noticeable in the environment, noticeable about our partner, and noticeable inside our body. We pay attention. We notice. We describe. We do not engage in making any interpretations in this mode. This helps keep arousal at a manageable level and keeps us from straying into judgements and assumptions.

In the book “The High Conflict Couple” Alan Fruzzetti writes: “When you assume what his feelings are, interpret or evaluate her response, question his motivation, or focus on how illogical she is being, you have stopped paying attention to your partner, lack awareness, and are not being mindful of him or her. Mindfulness of your partner is the gateway to listening and understanding, and eventually to collaboration, support, conflict resolution, and closeness.” (p. 26).

The notice and describe mode leads us to curiosity and wanting to understand more. It highlights the parts of the context that we are missing and invites the other person’s experience to fill those blanks. It creates open thinking instead of closed thinking.

So what does it look like in practice? Let’s revisit the couple from above.

The wife says to herself: “I notice the dishes haven’t been completely finished. I notice he put all the food away. I notice he changed the lightbulb that I asked him to change. I notice myself feeling upset that he hasn’t wiped down the high-chair or the counters. I notice he looks tired. I notice he hasn’t changed out of his work clothes. I notice my own fatigue too. I notice how the fatigue feels in my body next to the frustration.”

This is an example of more balanced thinking. The wife can then share with her husband what she’s noticing without attacking.

Wife: “You look tired. Did you have a long day at work?”

Husband: “I did. The performance evaluations are really stressful this year. I have 3 more to write tonight.”

Wife: “I’m sorry. I know this has been a big project.”

Husband: “How was your day?”

Wife: “All good, I’m just really overtired. Baby has been waking really early. And I know when I get overtired it can lead to me being impatient with everyone. We are both working really hard for the family right now.”

Husband: “I know. Everyday is a marathon.”

Wife: “You had a long day and I don’t want to pile on but I have a quick request. When you clean the kitchen would you mind doing one final sweep to pick up any dishes you may have missed? And can you wipe down the high chair. I clean it using the Mrs. Meyers spray that’s under the sink.”

Husband: “Did I miss some dishes?”

Wife: “Yes.”

Husband: “Ok. Sure. I think I don’t even realize because I’m still thinking about work.”

Wife: “I get that.”

Husband: “Yeah I have to be honest, I don’t think to clean the high-chair because you always feed the baby. Like, I don’t even look at it. Generally, I do the kitchen kind of rushed because I still have to get the dog out and, on a night like tonight, there’s more evaluations I have to get done tonight.”

Wife: “That makes sense. I will leave the high-chair next to the sink so it’s right in your sight line. Also, on the nights when you’re doing the kitchen, I’m happy to take the dog out. I can’t believe I haven’t thought of this before. I would actually love some fresh air. For me, on the nights where I’ve cooked and done the kids dinner, the thing I just can’t stand is spending more time in the kitchen. If I take the dog could you do all the clean-up and close up the kitchen.”

Husband: “Definitely.”

In this version of their interaction, we learn about his context, her context, and each one’s needs and worries. They have come to a solution that works by redistributing tasks and making expectations explicit. They have communicated successfully by keeping emotional arousal low through the notice and describe approach. Neither asserts themselves to be an expert on the other person’s experience (as they did in the high arousal version). They do not load meaning into each other’s actions. They seek to understand what meaning, if any, should be made.

In this version, they walk away feeling a boost in relational competence. They worked together in solving a problem, and in doing so came to understand each other’s inner worlds more intimately.

References: Fruzzetti, A. (2006). The High-Conflict Couple. New Harbinger, CA.

COVID-19: We’ve Really Gone the Distance

By Kayla Harris, AMFT

By Kayla Harris, AMFT

We are coming up on the year mark of COVID-19, changing the world as we knew it. While things are looking hopeful with vaccine distribution, I have reflected on the many adjustments that people had to make do to the virus. Here are just a few areas I have been thinking about, as well as suggestions for further adjustments:

Loss

As I write, the current number of COVID-related losses is 519,075 lives (covid.cdc.gov). The current total number of cases is 28,602,211 people. All of these folks were/are members of families or communities who were affected by the diagnosis. They have had to cope with it during this most unprecedented, isolating time. Over the last year, many hospitals did not permit more than one visitor to see loved ones in the hospital to reduce the virus's spread. Medical facilities also applied this policy to non-COVID cases, such as surgeries, check-ups, etc. For the most part, only patients were allowed in the facility to limit the spreading of the virus. Funeral homes also had to limit the number of people in their buildings at any given time. Many people lost loved ones in the last year and could not mourn or grieve in the way they wanted to.

I would encourage folks living with the weight of unacknowledged loss to find time to honor the people lost this year.

• Watch a movie you know a loved one enjoyed

• Journal about what you think about when you are reminded of them and what you would say to them

• Find ways to embody traits you admired about them in your day-to-day functioning

• Write down job opportunities, trips, celebrations that could not happen due to the pandemic and find time to acknowledge those losses too

• Share these reflections with a friend, partner, colleague, or therapist.

The Harvard Business Review interviewed grief expert David Kessler, who provided some additional thoughts on loss during the pandemic. Here is that article if you want to see his tips for coping with losses we have experienced this year.

Aside from the deaths of loved ones, people also experienced losses in jobs, planned experiences, and routines. These must be acknowledged and honored as well.

Relationships

You may be familiar with Gary Chapman's "Love Languages" popularized by the media. (Here is the link to his website in case you are unfamiliar) His love languages concept focuses on five behaviors that people might use to show love and how they receive love: Gifts, Quality Time, Physical Touch, Words of Affirmation, and Acts of Service. Well, recently, people have been talking about adding a sixth love language- distance. (Click here to read a related blog post by Jessica Wildfire) When different states and cities enacted shutdowns, we learned the way distance impacts our relationships. Whether you were spending way more time inside your home with a partner or you were unable to travel to see loved ones as you did, distance was a massive theme of the year. Couples have needed to find a balance of alone time, together time, and quality time, all while sharing the same air for days on end.

This year, people learned how often they need space in their relationships, physical environments, and even jobs.

Here are some tips from Vanessa Marin at the New York Times for easing the stress caused by the Coronavirus.

Work

While many businesses could move to a work-from-home format, other professions could not (first responders, healthcare workers, utility personnel, mail persons, to name a few). Their workloads were increased due to additional sanitation procedures or covering down for quarantined employees. For people who began working from home, there were struggles in even just finding a physical space to operate and maintain a proper work-life balance—screen fatigue.

Across the board, many of us were not trained to maintain our workloads during a global pandemic. We have adapted in a lot of ways to fit our companies and customers' needs, sometimes at our own expense.

Here are some ways to reduce the effects of digital eye strain and fatigue.

This post from the Today Show provides tips for achieving better work-life boundaries for those working from home in the COVID-19 pandemic.

• In this piece from the Jefferson Center, they offer ways to help you balance your career and personal obligations.

Parenting

Whether you are a pet, plant, or human parent, you probably did not expect to spend so much time in the home caretaking without much ability to engage in activities outside the home. In the beginning, there was this renaissance happening where parents and caregivers were scrambling to figure out how to operate in the "new normal." This scramble ignited creativity for many folks. They could make time in the home more conducive for remote learning or found alternative activities to celebrate special occasions. I have heard many parents express a burnt-out feeling where they feel depleted and defeated. I want to take a second and normalize that. What was projected to last two weeks is going on a year. The finish line was moved, and expectations changed several times over. Factor in the difficulties connecting with other parents, support systems, and professionals at the same time.

Please try to remember that you have been doing the best you can in an unprecedented time. Your kids (human, furry, or leafy) will remember the effort you put in, not necessarily all the ways you feel you have failed. Also, here is this nifty website created by psychologists who are also parents living in this pandemic. They offer short videos and tips for pandemic parenting.

Mental Health

We have seen an increase in inquiries about mental health services this year due to the stress brought on by the virus and TeleHealth becoming more widely available as a more accessible option. I would also like to acknowledge the uptick in substance use disorders and anxiety diagnoses. (Read specifics in this brief from the Kaiser Family Foundation) Circumstances that are already difficult have been made worse by additional, unprecedented hardship.

Overall, this year has been a ginormous collective challenge that pointed out or exacerbated problem areas in our personal lives and society as a whole (in our criminal justice, educational, and healthcare systems especially). Try to find understanding for yourself and honor the different parts of your life that the COVID-19 virus has impacted. Give yourself props for adapting to the many changes you had to make, even when you were unsure that they would help.

Finally, the CDC has recommendations listed here for coping with the stress you may be experiencing due to the COVID-19 pandemic.

Four Relational Pitfalls and Their Antidotes

By Michaela Choy, LMFT

By Michaela Choy, LMFT

I refer to John Gottman’s research around the four horsemen of the apocalypse to better the relational skills of my clients (mostly couples) and myself. The four horsemen of the apocalypse are criticism, contempt, stonewalling, and defensiveness. All of us use one or several of these negative strategies in our interactions at some point. Gottman’s research found that the heavy presence of these behaviors will corrode a relationship by increasing negativity and distrust. These factors largely contribute to Gottman’s ability to predict whether a couple will stay together or separate after observing a couple’s communication for 15 minutes with 96% accuracy. These behaviors are that powerful and that indicative of relational success (Gottman, 2015).

How to use this information.

I will outline the four horsemen as well as their antidotes below. I encourage you to think about which of these are present in your communication with your partner. It may be tempting to identify what’s wrong with your partner first, but for the sake of this exercise, keep this focused on you. You have more agency and power in changing your own behavior than your partner’s. If you find this exercise resonates, perhaps you can encourage your partner to read through this blog post or refer to the resources I’ve shared below. Clients have the most success in using this information when they own which of the four horsemen they bring to their interactions.

The four horsemen in greater detail.

1) Criticism

This is a statement that expresses negative opinions or judgements about the other person. These statements generally target a person’s character or personality. Here are some examples: “You always forget to load the dishwasher. How are you so forgetful? I can tell you really don’t care about our home because you don’t clean up after yourself.” or “You’re always looking for an opportunity to leave me at home with the kids. You are selfish. Can’t you see I’m drowning?!”

The antidote for this is to turn your criticism’s into complaints. Complaints are more vulnerable, objective, and give your partner a way back in. A complaint starts with an I statement (“I’m feeling really stressed”) followed by an objective description of the situation (“when the kitchen is messy”) followed by a need or a preference (“can you start putting away your dirty dishes in the dishwasher?”)

2) Contempt

This suggests a superiority over someone else. This often disrespects others through mockery, sarcasm, eye-rolling, or scoffing. This is often the result of pent-up resentment or unaddressed negative thoughts. Couples who are stuck in contempt are at the highest risk of divorce and are at higher risk of developing colds and the flu (Gottman, 2015).

The antidote for contempt is building appreciation and respect back into the relationship. Look for moments to highlight your partner’s efforts and increase moments of appreciation. Also look for opportunities to show affection (think about love languages) towards your partner. What you pay attention to grows. Get into the habit of noticing the positive parts of your partner and then make this known. Words of appreciation can sound like, “Thank you for making me a cup of coffee this morning. That really saved me time.” or “I’m so grateful you’re my partner. Thank you for listening to me vent about work.”

We can find ourselves in a place of contempt if the bad outweighs the good. Gottman has found that for every negative interaction, you need 5 positive interactions to balance this out to feel healthy and happy in your relationship. Start monitoring this ratio and up the appreciation and affection if needed (Gottman, 2015).

3) Stonewalling

This occurs when we withdraw from our partner. This can look like walking away during mid conversation, shutting down, appearing busy, etc. This can result from receiving too much criticism or contempt to the point where we need to disengage. This can feel protective, but when we stonewall, we are inaccessible to our partner so we cannot address what’s wrong.

The antidote to this is taking some time away from your partner deliberately and responsibly. Ask for some space if you’re feeling overwhelmed and use the time to regulate your emotions. Do something soothing (take a walk, read a book, listen to music, engage in an activity that takes your mind off the moment) for at least 30 minutes. Do not stew on the hard conversation. When you return to your partner, you will be in a better place to listen and offer your own perspective in a respectful way.

4) Defensiveness

We generally engage in defensiveness in response to criticism. It sounds like not taking responsibility for our behavior and blaming our partner instead. Here are some examples: “You’re really angry with me? I would help around the house more if you weren’t so mean to me!” or “I’m not the only one who yells, you yell at me all the time!”

In both of these instances, there is no recognition of the other person’s experience, and it sounds like blame which escalates things further. The antidote is taking ownership for the part(s) of the statement that make sense and acknowledging your partner’s experience. It generally involves some curiosity and validating statements. For example, it might sound like this: “I can understand why you want me to help out around the house. What are you needing?” or “I do yell when we argue. I’m going to try to work on that.”

Prompts

After you have a grasp of what the horsemen are, consider the following prompts:

- Which of the four horsemen do I identify with?

- When do I notice myself using one/some of the four horsemen?

- How do my partner(s) or loved ones respond when I do this?

- What are my alternative responses?

- If I try to practice an alternative response, what will make this challenging?

- What will help me? What can I do to set myself up so I can choose an alternative response?

- If I use one of the four horsemen, and catch my behavior after the fact, how can I take accountability?

- What does that look like and sound like?

Resources:

The Seven Principles for Making a Marriage work by John Gottman and Nan Silver

Brene with Drs. John and Julie Gottman on What Makes Love Last

Handout of the four horsemen and antidotes

References:

Gottman, J. (2015). The Seven Principles for Making Marriage Work. Hachette UK.


Michaela Choy, LMFT

Michaela Choy is a Licensed Marriage and Family Therapist, specializing in therapy services for couples, families and individuals.

Michaela received a Bachelor of Science from the University of Illinois at Urbana-Champaign. She went on to pursue her Master’s Degree in Marriage and Family Therapy from the Family Institute at Northwestern University.

Michaela has experience working with couples and individuals seeking help with anxiety, conflict, communication, and intimacy. She is a trained facilitator of PREPARE/ENRICH, which is an effective assessment tool used in couple therapy.

Michaela’s therapeutic style is strengths-based, warm and collaborative. She focuses on developing relationships with clients built on understanding and trust in order to safely explore change. She believes it is an honor to work alongside clients in their journey and works to promote an environment that is both culturally sensitive and safe.

Michaela’s strongest interests in therapy include working with couples who seek to strengthen communication patterns, improve conflict resolution, and build connection and intimacy. Michaela works with individual clients around family or origin issues, dating, and life transitions.

Michaela is a Clinical member of the American Association for Marriage and Family Therapy (AAMFT), as well as a member of the Illinois Association of Marriage and Family Therapy (IAMFT) Chicago Chapter. 

No More New Year, New You.

By Rachel D. Miller, AMFT

By Rachel D. Miller, AMFT

January is somehow already upon us. And while the world we are inhabiting presently is different in many ways, some things do not seem to be changing in 2021. Just like in Januarys of old, our social media feeds and inboxes are currently flooded with all kinds of “New year, new you” messages. Everything from fad diets and must-have “nutritional” supplements to gym membership, meal delivery plans, and home workout equipment deals are being splashed across our television screens. We are constantly bombarded with ideas about what our bodies are supposed to look like and what is healthy, continually shamed into restricting our eating and manipulating our bodies into society’s current standards of acceptability and beauty.

These standards ensure that every January people jump to set unrealistic and unsustainable goals around losing weight, exercising, and/or dieting that often leave them disheartened and feeling things like guilt, shame, disgust, and despair by the end of the month. To make it all the more demoralizing, this cycle can lead to a lifetime of disordered eating and other health issues and ensures that we continue to line the pockets of what Emily Nagoski and Amelia Nagoski call, The Bikini-Industrial Complex, This is the term they use to describe “the $100 billion cluster of businesses that profit by setting an unachievable “aspirational ideal,” convincing us that we can and should — indeed we must — conform with the ideal, and then selling us ineffective but plausible strategies for achieving that ideal.”

What if we did something different this year? What if we place the focus on loving and accepting our bodies as they are? And recognizing that food is not good or bad, nor is it the enemy? What if we unlearn the idea that health is dictated by a number on the scale? (Spoiler alert. It’s not. You can learn all about this lie via the resources below) What if radical self-love, acceptance, and compassion were the resolutions and goals we gave our time energy and money to? Do you think, maybe, just maybe, these might prove more helpful in supporting your overall well-being? I suspect they might. If you’re ready to start this new year differently, you’ll find some resources below.

Books

Health at Every Size: The Surprising Truth about your Weight by Lindo Bacon

The Body is Not and Apology: The Power of Radical Self-Love by Sonya Renee Taylor

Intuitive Eating, 4th Edition: A Revolutionary Anti-Diet Approach by Elyse Resch and Evelyn Tribole

Mothers, Daughters, and Body Image: Learning to Love Ourselves as We Are by Hillary L. McBride and Rumani S. Durvasula, PhD.

Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff

Radical Compassion: Learning to Love Yourself and Your World with the Practice of RAIN by Tara Brach

Podcasts

The Feminist Survival Project 2020: Episode 41: The Bikini-Industrial Complex

Food Psych Podcast with Christy Harrison

The Soul Science Nutrition Podcast: The Problem is in the Culture Not Your Body- Interview with Lindo Bacon, PhD

Websites

Self-Compassion by Dr Kristin Neff

Health at Every Size

The Original Intuitive Eating Pros

Christy Harrison- Intuitive Eating Coach and Anti-Diet Nutritionist


Adapt to Accomplish

By, Kayla Harris, MA, AMFT

By, Kayla Harris, MA, AMFT

I don't know about you, but when I hear "productivity" or "efficiency," I immediately picture working myself like a robot to get things done. Lately, I've been chasing "accomplishment" instead. Accomplished is a feeling we get when we overcome things that are challenging for us. It's also the feeling I get when I've spent my time wisely and dedicated the necessary energies to a task. Sometimes, I feel accomplished when I say "no" to things people ask of me.

The COVID-19 pandemic has changed work for a lot of folks. Outside of jobs, people are also grappling with immense feelings of uncertainty, loss, and even hopelessness. We are coping in the best ways we can. Some people are trying to regain some semblance of normalcy by using as much time as possible to be "productive." What is that by your standards? How does that differ from society's expectations? Or your friends/colleagues? Please remember this is an unprecedented time! You are figuring it out like everyone else. I'm here to arm you with some new strategies to ultimately help you feel more accomplished and empowered rather than shamed and overwhelmed.

Note: Some people are magical and do not need to write/type things out to remember to do them. I am not one of those people, so most of my strategies below involve jotting things down! No matter how you work, take whatever suits you, and try it on!


To-Do Lists

  • Start with a brain dump of all the things you worry about getting done. Put it to paper, write it in a note on your phone, in an email to yourself, whatever!

  • Try sorting them by the due date or by the level of importance to you.

  • You may even want to categorize or color code them by source and sort them that way. For example, things your job asks of you would be in one color. Then tasks you'd like to do around your home would be another color. Items your family needs from you would be in a different color, and so on. Sometimes, examining who is asking what of us can help to see where we are overexerting ourselves and where we need to establish firmer boundaries or delegate!

*TIP: Categorizing and switching up different tasks may help to break up the monotony of your workday. Suppose you are working from home, chipping away at an intense project, and struggling to stay focused. In that case, you could tackle a small task from your household category before going back to work. Or if you're physically at work, instead of drudging through a project for hours, check and respond to emails, or use a different part of your brain for a little bit.


Time vs. Energy Grid

I recently learned this from a therapist on TikTok (@the.truth.doctor), and it has been a game-changer!

1. Draw a Tic-Tac-Toe grid on a sheet of paper, sticky note, or in your planner.

2. Next, write LOW, MED, and HIGH above the top 3 boxes. This represents how much of your energy you need to complete a task.

3. Turn the paper and write 3 segments of time along the side axis. These are rough estimates of how long it might take you to finish things. I use "less than or equal to 30 min.," "about an hour," and "greater than or equal to two hours" on mine. See below.

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4. Take whatever list of to-dos you have and plug tasks into the grid based on how much energy and time each task will take. As you go through your day, think about how much of each you have to devote to something and then work on something that is within those parameters. The crucial part of this is to be honest with yourself about how much energy/time you have and take breaks or switch gears when struggling to stay on-task.

*TIP: Highlight with category-specific colors when you finish tasks for an extra accomplished feeling and to see where you spent your time!

Pomodoro Timing

  • The basic premise is that you set aside time to dig into work while also honoring breaks. So as you go through your tasks, you may feel the pull to get distracted, but with this technique, you can simply jot down that distraction and know that you'll come back to it when you get your break.

  • Pick a task you'd like to work on. Then set a timer for 25 minutes of uninterrupted work time. Work the entire time and when the timer goes off, take a quick break, maybe 5 minutes. Then set the timer again for another 25 minutes and dive back into your project. Once you've completed 4 rounds of this, reward yourself with a nice long break (20-30 minutes)!

  • You'll be amazed at how much you can get done when you allow yourself the time to dig into work and take breaks periodically. Here's a website that outlines all the potential benefits of the technique and how to customize it for you: https://francescocirillo.com/pages/pomodoro-technique

*TIP: During breaks, get some steps in, drink water, snack, do whatever makes you feel energized to keep going for the day!

Mindset Shift

Sometimes it can feel like we are our own worst enemy when it comes to getting things done. Work feels better when we are on our own side.

  • Try and shift even just the way you talk about your duties (whether you get them done or not!) using "will" instead of "should." There is a massive difference between "I should have gotten X done yesterday" and "I didn't get to X yesterday, so I will get it done today!"

  • Fake it 'til you make it - Act as if you are the master of your schedule! Of course, you probably have bosses and obligations that dictate what you have to do for the day, but take control of your schedule where you can and make it work for YOU.

  • Schedule unmovable things in your planner/calendar in sharpie (kid pick-ups, family events, medical appointments, etc.)

  • Write specific tasks in pencil/erasable pen - give yourself some room to adjust! You are the one who has to get these things done after all!

  • Set up your weekdays to be "themed" tasks- "I don't have to make the house spotless today. Friday is my cleaning day." "I'm too tired on Sundays. I'd rather meal prep on Tuesdays." The big thing here is to actually follow through on the tasks you set aside for a specific day. And keep in mind you can always adjust that! Do laundry on Wednesdays if that's what works for you.

  • Say no, delegate, and ask for help when you need it!

I hope you found tidbits you can use in your day-to-day life. Remember, strive for the feeling of accomplishment, not some grinding level of productivity.



Sex and the Pandemic

By Anne DeCore, AMFT

By Anne DeCore, AMFT

Many couples are reporting a steep drop-off in sexual activity since the onset of the pandemic. To look at what’s driving this phenomenon lets first look at the ingredients that fuel desire.

In her TED talk entitled “The Secret to Desire in a Long-Term Relationship” (watched over 17 million times!), Esther Perel shares an important finding from her research with couples. When asked, “When are you most drawn to your partner?” the resounding theme of answers from participants was “when my partner was in their element – at a party, in the studio, on stage”. How does Esther interpret these responses? That we are most drawn to our partner when they are “radiant, self-sustaining, and they don’t need us.” She describes it as a “momentary shift in perception that makes me open to the mysteries living right next to me”. There is no neediness in desire. No caretaking in desire.

Our crisis-response behaviors call upon certain relational strengths that stand in stark opposition to what drives desire. In a crisis we acknowledge our deep need for each other. We lean on our partners for emotional support and problem-solving power. When the nature of the crisis is ongoing and the stress chronic, there is a daily requirement for spouses to depend on each other in order to promote the family’s sense of security in the face of a threat. Partners ask for help, for loyalty, and for caretaking from one another as they face the relentless waves of loss, sickness, and economic hardship that this pandemic has caused. These are connective and loving moments, but they are a world away from the erotic connection couples cultivated pre-pandemic.

Perel says “sex is a place you go, not something you do.” This description captures the sense of play, exploration and freedom associated with desire. But we can only travel to this place if we feel safe, if we feel the (metaphorical) home we leave behind is secure for a short time while we are absent. Our prolonged exposure to fear and uncertainty throughout the pandemic has readied our physiological selves for fight or flight. Because stress hormones like adrenaline and cortisol have been flooding us at a white-water-rapids rate, we tend to have a steady stream of stress hormones even on the days where there’s no shocking news headline or riots in the street. The chronic nature of this chemical process impacts our thinking and our behavior in this way: we constantly prioritize our needs around survival. The brain simply doesn’t have the resources for imagination and play.

So what can we do about this situation? Anything that lowers stress (exercise, sleep, rituals of affection, mindfulness, grounding exercises) will help relax our brains so we can make space for pleasure. But I think the most powerful therapeutic at this moment in time is acceptance. Simply lowering our expectations. This is an unprecedented experience. Be gentle with yourselves and you partners. Above all, don’t make the mistake of attributing no or little sex during the pandemic as a symptom of poor relational health. Absolutely stay curious about what factors impact sexual connection in your relationship, but consider waiting until the pandemic is over to harden any beliefs about your situation.


Healing Strategies

By Michaela Choy, LMFT

By Michaela Choy, LMFT

This is a chaotic time in which we are holding so many painful things - a pandemic, continuous social injustices, concern for our democracy, the list goes on. Holding pain and uncertainty is taxing. Especially during this election, I’m noticing a continued need to process all I’ve been carrying. To find support, I’ve turned to a list cultivated by Jake Ernst, a fellow therapist. He names movement, sound, storytelling, and silence as the core strategies people have leaned on for centuries to heal. I return to this list time and time again. Most of these items are from Jake Ernst, and I’ve peppered in a few of my own ideas.

  • Movement: Solo dance or dance with others, walks, exercise, deep breathing, rhythmic exercises, touch, massage, yoga, stretching, etc.

  • Sound: Listening to music, making music, creating music with others, guided relaxation, drumming, tapping, humming, chanting, sound bathing, low frequency tones (gongs), cooing and coregulation, etc.

  • Storytelling: Talking with a friend, journaling, creative writing, talk therapy, narrative therapy, connecting over shared experiences, making meaning, reading books, watching movies or tv, studying history, reading folklore and fables, etc.

  • Silence: Sitting with thoughts and feelings, leaving space for silence in conversations, meditation, mindfulness, slowing down, sleep, rest, spending time in nature, taking a long bath or shower etc.


Michaela Choy, LMFT

Michaela Choy is a Licensed Marriage and Family Therapist, specializing in therapy services for couples, families and individuals.

Michaela received a Bachelor of Science from the University of Illinois at Urbana-Champaign. She went on to pursue her Master’s Degree in Marriage and Family Therapy from the Family Institute at Northwestern University.

Michaela has experience working with couples and individuals seeking help with anxiety, conflict, communication, and intimacy. She is a trained facilitator of PREPARE/ENRICH, which is an effective assessment tool used in couple therapy.

Michaela’s therapeutic style is strengths-based, warm and collaborative. She focuses on developing relationships with clients built on understanding and trust in order to safely explore change. She believes it is an honor to work alongside clients in their journey and works to promote an environment that is both culturally sensitive and safe.

Michaela’s strongest interests in therapy include working with couples who seek to strengthen communication patterns, improve conflict resolution, and build connection and intimacy. Michaela works with individual clients around family or origin issues, dating, and life transitions.

Michaela is a Clinical member of the American Association for Marriage and Family Therapy (AAMFT), as well as a member of the Illinois Association of Marriage and Family Therapy (IAMFT) Chicago Chapter. 

Let’s Talk about Gender Roles in Marriage

By Anne DeCore, AMFT

By Anne DeCore, AMFT

The gender beliefs, attributions, and norms that we come to hold as individuals show up in the ways we structure our households and define our partner roles. Gender considerations tend to be at play, explicitly or implicitly, in the distribution of household labor and childcare, in career negotiations, in spousal spending power and in sexual satisfaction.

 

While some people hold firm, fixed beliefs on gender, others revisit and revise their beliefs across the life course. To be sure, a person’s ideology at any given point in time is a product of layer upon layer of influence: family, religion, culture, biology, and government to name a few. An important function of couples therapy is to unearth, to the level of consciousness, the ways that our attitudes toward gender and our gender role expectations in relationships have been informed by childhood conditioning and various social influences. This process leads partners to have a greater sense of agency over how they want roles to be assigned and responsibilities allocated. When couples avoid talking about these hidden forces, partners often slide into roles which are at odds with their beliefs (i.e. a progressive-minded individual finds themselves in a traditional role, or vice versa). Research has shown that the dissonance that one experiences when beliefs/values do not align with behavior often leads to both psychological and relational distress. The therapy process can help couples arrive at an explicit agreement about the kind of roles they want in their relationship or marriage.

 

Outlined below are the 3 most common models of marriage (among heterosexual couples). Use this as a framework to open discussion. It may help identify your current situation or clarify desired goals. (Note, these are generalized buckets; every couple is distinct and nuanced!) From Hamburg, S. R. (2001). Will Our Love Last?: A Couple's Road Map. New York, NY: Simon and Schuster.

Traditional marriage: Husband earns the money and wife takes care of household and kids. They occupy “separate spheres”. Male-identity closely tied to provider status. Big difference in power between husband and wife. In this model, there is a clear definition of roles.

Egalitarian marriage: Both spouses view their respective income as collective and household responsibilities as shared. Couples view each other’s jobs as equal and necessary (regardless of income differentials) and earnings as “ours”. If there are kids, neither partner is automatically the primary caretaker. Both partners make whatever changes are necessary to work schedules/commitments to accommodate the kids needs. Requires coordination and negotiation as roles are not fixed.

Nontraditional marriage: Somewhere between traditional and egalitarian. Both partners work outside the home but the defining feature is the wife has the primary responsibility for the children. Husband helps with housework, but it is wife’s responsibility to “manage” it. For example, he may do the grocery shopping but she plans the meals, makes the list, and reminds him to go. More equal power balance but traditional role of mother as primary childcare provider is preserved. Can lead wife to experience a disproportionate feeling of a “second shift”.

Below are some questions to use as a starting template at home or with your therapist to explore how attitudes toward gender show up in relationships:

  • How do you both negotiate the distribution of household management and labor? Are these decisions based on skills and interests? Are the decisions are based on relative earnings? On time availability?

  • When one partner earns and the other does not (or makes less) what are the ways marital power is tied to income?

  • Are rewards and demands fairly distributed in your marital relationship?

  • Is unpaid work by a stay-at-home partner valued the same/differently than the way paid work is?

  • Is there a balance between decision-making (i.e. scheduling travel for the holidays) and labor (packing the bags)?

  • What is the load of invisible work (worrying, planning, processing) that each partner carries?

  • In “post-gender” couples with egalitarian ideals, what factors determine who does what and how did you come to agree on these factors?

  • What is each partners level of motivation to align on a “model” for their relationship?

  • How similar or dissimilar are your current roles compared to what you witnessed in your parents’ roles growing up?

  • What (if any) sources of pressure make you feel that you should conform to certain roles?

  • Are there certain areas of labor distribution that are chronic sources of inflammation? (i.e. walking the dog. What have you tried to reduce conflict and what are some possible alternatives?

 

Role Reversal Exercise (Source: Prepare/Enrich): Plan a day or week when you can perform each other’s household responsibilities/schedule. This role reversal experiment will help you gain insight around each other’s responsibilities/routine and promote perspective turn-taking.

Conversations about the role of gender within relationships and households can be uneasy. Yet, leaning into the discomfort is likely to have a big payoff:  the process of listening to understand your partner and the process of collaborating on the household structure creates a vital sense of “we-ness” in the couple. It also promotes a sense of living out one’s values within the individual.

Let’s Talk About It: Suicide

By Rachel D. Miller, AMFT

By Rachel D. Miller, AMFT

Suicide remains a taboo topic in our society but failing to talk about it does not prevent it from happening. Instead not talking about it creates stigma for suicide survivors, their families, and those whose loved ones die by suicide. It also reinforces the myth that suicide should not be openly discussed. September is Suicide Prevention Awareness Month making it the perfect time to talk about it.


Let’s start by looking at its prevalence in the United States.

  • Suicide is the 10th leading cause of death in the US for all ages (CDC)

  • Approximately 123 Americans die by suicide every day (CDC)

  • There is a death by suicide every 12 minutes in the US (CDC)

  • White males accounted for 69.67% of suicide deaths in 2018 (CDC)

  • In 2018, firearms accounted for 50.57% of suicide deaths (CDC)

  • There were an estimated 1.4 million suicide attempts in 2018 (CDC)

  • Lesbian, gay, and bisexual kids are 3x more like than straight kids to attempt suicide at some point in their lives (SAVE).

  • 41% of trans adults said they had attempted suicide in one study. The same study found that 61% of trans people who were victims of physical assault had attempted suicide (SAVE).

  • Lesbian, gay, and bisexual young people who come from families that reject or do not accept them are over 8x more likely to attempt suicide that those whose families accept them (SAVE).


What is Suicide?

The National Institute of Mental Health (NIHM) defines suicide as “death caused by self-directed injurious behavior with intent to die as a result of the behavior.” A suicide attempt is “a non-fatal self-directed injurious behavior with intent to die as a result of the behavior” (NIHM). It may or may not result in injury. The term suicidal ideation refers to the thinking about, considering or planning suicide.

Signs and Symptoms

Knowing the warning signs and symptoms is key to suicide prevention. Some of these are:

  • Talking about wanting to die or wanting to kill themselves

  • Talking about feeling empty, hopeless, or having no reason to live

  • Making a plan or looking for a way to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun

  • Talking about feeling trapped or feeling that there are no solutions

  • Talking about being a burden to others

  • Withdrawing from family and friends

  • Changing eating and/or sleeping habits

  • Talking or thinking about death often

  • Displaying extreme mood swings, suddenly changing from very sad to very calm or happy

  • Giving away important possessions

  • Saying goodbye to friends and family

A more thorough list of signs, symptoms, and risk factors can be found here on the NIMH website. If you or someone you know is exhibiting any of the above, please reach out for assistance as soon as possible and prioritize safety, particularly if the behaviors are increasing or have developed recently. Crisis hotlines and additional resources are listed at the end of this post.

Myths

Myths about suicide further complicate our ability to talk about and prevent it. The World Health Organization has complied a pamphlet debunking the most common. You can find it here.

What to do if someone you know is in crisis?

It can be scary to recognize the signs of suicide in someone you know. Being uncertain about what to do or being afraid of doing the wrong thing can lead us to doing and/or saying nothing. Despite the myth that asking about suicide increases the risk, expressing your concern, and inquiring about whether they have a plan can be helpful. It is vitally important to let them know you care and to encourage them to get professional help. Learn more about what to do and say here and here.

Additional resources:

National Institute of Mental Health: Suicide Prevention

Suicide Awareness Voices of Education (SAVE)

Teens and Suicide: What Parents Should Know

How to Talk to Children and Teens About Suicide: A Guidebook for Parents

How to Talk to Your Child About Suicide

Talking with Kids About Suicide

Talking to Kids About the Suicide of Someone Close to Them

Telling a Child About a Suicide

Speaking with Your Teen About Suicide

What to Say to a Suicidal Teen

If you or someone you know is in crisis call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the Lifeline’s website or the Crisis Text Line’s website. (https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml)

The Veterans Crisis Line connects Service members and Veterans in crisis, as well as their family members and friends, with qualified, caring Department of Veteran’s Affairs (VA) responders through a confidential toll-free hotline, online chat, or text messaging service. Dial 1-800-273-8255 and Press 1 to talk to someone or send a text message to 838255 to connect with a VA responder. You can also start a confidential online chat session at veteranscrisisline.net/get-help/chat.

The TransLifeLine is a peer support service run by trans people, for trans and questioning callers. Operators are located all over the U.S. and Canada and are all trans-identified. Trans Lifeline’s Hotline can be reached at 877-565-8860

Sitting In Your Impact

By Michaela Choy, AMFT

By Michaela Choy, AMFT

Our impact on others can be positive; it can look like encouragement, understanding, support, love, etc. Our impact can also feel negative; it can look like betrayal, hurt, ostracization, misunderstanding, etc. When the latter occurs, and someone has the bravery to share they have been negatively affected by you, it’s important to make space for their experience. This looks like honoring our impact before we share our intent.

In these moments it is most helpful to be curious, to listen, and to validate feelings. These moments can be tough. It’s challenging to hear the ways in which we’ve hurt others. When this happens, we are pulled to respond with our intention - “But you’re not understanding where I was coming from or what was happening for me…if you knew, you wouldn’t feel that way.” We need to resist the urge to respond with our intention first because this sounds defensive and therefore feels invalidating. Here are some helpful responses instead that make space for another’s experience:

- Thank the person for sharing with you.

- “I’m so grateful you told me, otherwise, I wouldn’t have known you were hurting.”

- Speaking to understand. Sharing your intention will come later.

- Be curious and ask questions

- What did you need from me instead?

- What else are you feeling?

- Is there more you need to share with me?

If you feel defensive, try the following:

- Remind yourself of your worth

- You are more than this moment and you are allowed to stumble. This is how we learn and grow.

- Slow Down

- The pull to defend is strong and automatic. Interrupt this by slowing down, take a breath, or restate what you’re hearing.

- Name it

- Share that you are getting defensive and notice that you need to shift modes. This keeps you accountable and will signal to others that you need some time to regulate. You can ask for a short time out if you need to gather yourself.

The appropriate time to share intention is after the hurt person feels understood. The easiest way to gauge this is to ask if they feel understood or if there is more you need to know. Once this is achieved, ask for permission to share where you were coming from. If now is not a good time, establish another time to connect.


The Next Phase & Living in the Grey

In the beginning of March, when many of us were beginning to quarantine, there was so much anxiety. How big are the risks? Will we get sick? How long will this last? Will the grocery stores restock? Will we have enough food? Will we keep our jobs? Of course, all of these questions persist, but the palpable anxiety has diminished (for many of us) as we’ve settled into new routines, transitioned from in-person to Zoom meetings and gatherings, and have continued to keep our day-to-day life confined under our roofs.

For many of us, it has been incredibly difficult (isolating, no childcare, homeschooling, more stress and fighting at home, etc.), AND we’ve also had the privilege of staying home, staying safe and staying healthy. Now, as we begin to enter the next phase of all this - and we see our neighboring states open up their parks, bars and restaurants and Chicago begins to “soften” on the lock down - I’ve been seeing another spike in tour collective anxiety. There is a new sense of uncertainty, a new challenge for us -- how to live in a grey area of risk.

Just weeks ago, it was pretty black and white - you can only leave the house for emergencies, essential services and groceries. Restaurants, bars, playgrounds, schools, the lakefront are all closed. Now, we each have a million and one questions to ask ourselves; can a friend come over if we stay outside and are six feet apart? Can grandparents finally come see their grandkids? If daycares reopen, is it safe to send our children? Should we go to a restaurant if outdoor seating is available? The list goes on and on… and unfortunately, there are no clear answers.

Anxiety breeds in uncertainty. When we perceive risk, when we feel scared or threatened, it grows. This is an unprecedented time in our collective memories, and this new phase is no different. Many of us have to ask some really hard questions of ourselves and our families and friends. Navigating school, playdates, gatherings etc, will now all require a new level of personal introspection, couple & family communication and trust in our communities.

Here are some resources that may be helpful as you and your families begin to think about next steps and make decisions about what feels safe for you and your loved ones:

A New Thing to Fight About; Virus Risks, Jessica Grose Interview with 3 couples: When Couples Fight about Virus Risks, Jessica Grose

What Parents Should know as States ReOpen, Annie Sneed

Safety Advice for Reopening, Andrea Petersen

The Horror of the Corona Virus Data Log, Amanda Mull

Growing Your Self Awareness

By Michaela Choy, AMFT

By Michaela Choy, AMFT

This poem is a beautiful representation of how we grow and change. It acknowledges our pull to the familiar; we are patterned beings, the longer we’ve done something a certain way (manage conflict, date, etc.) the harder it feels to show up differently. And, good news, it’s also very possible to show up differently.

The path to growing our self awareness is winding and not linear. It’s common to have moments where you break harmful patterns and then moments of sticking to them. Just because you fall back into a pattern doesn’t mean you’ve regressed. It means that is a big pull for you that you will need to watch and take care of.

As we are confronted with our patterns, we build awareness of what we are doing. And we must give ourselves compassion in choosing the familiar path even when we see the alternatives. I have deep respect for where old patterns come from and how they’ve benefited us. At some point, your old pattern most likely served, protected, or helped you survive.

Too much compassion, however, can leave you stuck, so we must be accountable for our behavior. We must commit to building awareness of our patterns, find choice points, and do the newer, harder thing. When we deepen our self awareness, we must hold compassion AND accountability tightly.

Equal or Equitable? Deciding what to spend on your kids.

By Rachel D. Miller, AMFT

By Rachel D. Miller, AMFT

With graduation season right around the corner, the issue of what or how much to give your graduate will be much discussed in the coming weeks. And it raises the larger question of equal spending on gifts when you have more than one child. The Wall Street Journal recently asked me my thoughts on this topic. I’ve shared and expanded on them below for those who are not subscribers.

Parents typically want to spend the same amount of money on each child in the spirit of fairness. But an event like graduation complicates the situation. Birthdays happen annually for each of the children, but a graduation is a one-off situation, causing parents to calculate amounts in their head and strain their memories to remember what was gifted older children for comparable graduations.

Spending equal amounts on children, generally, is a sound policy, though it is a complicated formula. When you have siblings in varying age categories, or when parents’ financial circumstance change over time, or parents split up and re-partner – those are circumstances that can affect an “equal spending” mantra. Additionally, there are many other places parents spend money on children throughout a year that might need to be part of the equation.

Instead of pure equality in dollar amounts, parents should strive for fairness over time rather equal spending at each gift giving opportunity. Fair does not necessarily mean equal. Fairness considers the larger context, specific circumstances, and each child as an individual.

Suppose your middle schooler wants a pair of super pricey sneakers for his or her birthday. While this means nothing to a 7-year-old sibling at this juncture, when that child reaches middle school but is told, for example, she cannot have the expensive hair straightener she is requesting that cost about the same. These feelings may be directed at you the parent, the sibling, or internalized to mean something about how you feel about her.

You’ll also see this in reverse as parents are able to spend more on younger siblings as the older ones move out or parents begin to do better financially. An older sibling may feel some kind of way when his younger brother is given a brand-new iPhone for his 14th birthday but at 14 all he got was “crummy refurbished laptop.” Again, these feelings may manifest as resentment and anger at the parents, the sibling or both. Or the child may internalize this to mean their parents have a favorite child.

With a goal of fairness over time it becomes easier to consider other costs such as extra curricular activities. If one child is involved in travel sports that eats greatly into a family’s budget, and another child is into electronics, it might be fair to spend more on the second child’s electronic gifts at Christmas or their birthday than the gifts purchased for their athletic child. These things can and typically do balance out over time.

It’s also important to consider your individual children. Some children care more about these things than others. It can be helpful to know your child’s love language to you can better assess what each most needs and deems important. A quality time or acts of service kid might not pay any attention to the gifts given to a sibling if they are personally getting the quality time or meeting their acts of service needs consistently. This is also a way to consciously attend to the ways equity and fairness are not always about equality. Parents can discover their child’s love language via this site.

There are different quizzes for different age groups.

I believe in being as age appropriately open, honest, and transparent as possible with your children when it comes to most issues, this includes money and finances. Open up around how you make decisions around buying gifts and spending money in general. Kids don’t need all the specifics, but you can let them in on your process. This is how they begin to learn about making financial decisions. These are great topics for family meetings and a positive way to break the taboos many families have around not talking about money.

When children are included in conversations and provided insight into how you make decisions, resentment is less likely and securing their buy in and cooperation becomes easier. When you don’t talk to children, they fill in the blanks themselves and make up their own stories about what things mean in relation to themselves. Children understand more than most parents give them credit for, and even if they don’t fully understand, they’re willing to go along If they are made to feel included and allowed to have a voice in the process.

Lastly, if there are wounds that around this topic impacting sibling and/or the parent-child relationship, a family therapist can help you navigate the healing process.

Love Languages

By Sasha Taskier, LMFT

By Sasha Taskier, LMFT

We all give and receive love in different ways. However, many of us believe that once we’ve fallen in love and have partnered, we assume we’ve already mastered the ways to our partner’s heart. That, of course, may be true for some - yet, I sit with couples every week and continue to see the same dynamic in which both partners feel they are showing love, but neither of them feel themselves to be the recipient of that love. Both are trying, in their own way, and both are falling short.

Gary Chapman’s theory and approach to Love Languages tends to be a great entry point into this conversation, and one of the simplest ways to address the disconnect these couples are experiencing. His book, The 5 Love Languages: The Secret to Love that Lasts, helps to explain the importance of speaking and understanding your partner’s love language and vice versa. After years of clinical experience, he formulated five ways in which people tend to feel loved.

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1. Words of Affirmation

2. Quality Time

3. Acts of Service

4. Physical Touch

5. Gifts


Words of Affirmation

“Actions don't always speak louder than words. If this is your love language, unsolicited compliments mean the world to you. Hearing the words, "I love you," are important – hearing the reasons behind that love sends your spirits skyward. Insults can leave you shattered and are not easily forgotten. Kind, encouraging, and positive words are truly life-giving.” (5LoveLanguages)

Quality Time

“In the vernacular of Quality Time, nothing says, "I love you," like full, undivided attention. Being there for this type of person is critical, but really being there – with the TV off, fork and knife down, and all chores and tasks on standby – makes your significant other feel truly special and loved. Distractions, postponed dates, or the failure to listen can be especially hurtful. Quality Time also means sharing quality conversation and quality activities.” - (5LoveLanguages)

Acts of Service

“Can vacuuming the floors really be an expression of love? Absolutely! Anything you do to ease the burden of responsibilities weighing on an "Acts of Service" person will speak volumes. The words he or she most want to hear: "Let me do that for you." Laziness, broken commitments, and making more work for them tell speakers of this language their feelings don't matter. Finding ways to serve speaks volumes to the recipient of these acts.” (5LoveLanguages)

Physical Touch

“This language isn't all about the bedroom. A person whose primary language is Physical Touch is, not surprisingly, very touchy. Hugs, pats on the back, holding hands, and thoughtful touches on the arm, shoulder, or face – they can all be ways to show excitement, concern, care, and love. Physical presence and accessibility are crucial, while neglect or abuse can be unforgivable and destructive. Physical touch fosters a sense of security and belonging in any relationship.” (5LoveLanguages)

Gifts

“Don't mistake this love language for materialism; the receiver of gifts thrives on the love, thoughtfulness, and effort behind the gift. If you speak this language, the perfect gift or gesture shows that you are known, you are cared for, and you are prized above whatever was sacrificed to bring the gift to you. A missed birthday, anniversary, or a hasty, thoughtless gift would be disastrous – so would the absence of everyday gestures. Gifts are visual representations of love and are treasured greatly.” (5LoveLanguages)

How do you use Love Languages?


We tend to rank one or two of these languages highest - which is a great indicator that these are our primary and secondary love languages. Within each of these ‘languages' there is a wide spectrum; Chapman describes it as having multiple dialects through which we express affection. This allows us to become creative in how we can show our partner love.

I tend to have my clients each take the quiz, (provided for free online) and first examine their own results. As with any online quiz - it is not perfect and sometimes the questions can feel a little black and white, BUT it does begin to help you think about what does feel good for me? What is meaningful and why? A little curiosity can go a long way; many of my clients have explored the ‘why’ behind their primary and secondary love languages and have realized that much of it comes from their families of origin, or what was deeply lacking in prior intimate relationships. (For example, someone whose primary love language is Quality Time may have grown up in a home where their parents were always busy, and they desperately wanted undivided quality time, OR, perhaps that was the primary way their parents showed them love and care, so that has become the clear sign and pathway to feeling loved.)

Then - after each member of the couple has their individual results (and some insight and understanding around them), I invite a conversation of sharing. Partner X, can you share your results and insights with your partner, and give examples that would be helpful. Partner Y, can you listen, reflect back what you are hearing, and ask your partner how you can become an expert in their language. (Remember, you can have the same primary love language as your partner, but a different dialect -- this means, physical touch might be important to both of you but sexual intercourse might be the most meaningful way to connect for one partner, and holding hands in public might be more important for the other. So, better to ask than assume!) And then, switch! Partner Y will share their results and insights, and Partner X will listen, reflect and probe for examples.

In my experience, the most important part of this entire process is follow through. Especially after this exercise, keep your ears and eyes open for the ways in which your partner is trying to use your love language. If your love language is Acts of Service, and you see that your partner filled up the car with gas - thank them. If physical touch is your language and your partner offered to give you a foot massage after a long day, or you’ve noticed them initiate more physical intimacy between you - tell them you appreciate them and their efforts to show you love.

As with any new habit or practice, we are far more likely to continue doing something (that may not be comfortable or ‘natural’ for us), if we see the positive impact of our actions. This practice can become an incredibly rewarding positive feedback loop of love, or it can stop after one attempt. The difference between those outcomes is vocal acknowledgment of your partner’s efforts and words of appreciation (even if they don’t hit the nail on the head on the very first go.) Even better, if you swiftly reciprocate by practicing their love language.

Deepening Your Listening with Validation

By Michaela Choy, AMFT

By Michaela Choy, AMFT

One of the most powerful and connecting tools I use in my personal life and in therapy is validation. Validation is the act of acknowledging and honoring someone’s experience. When done well, the speaker will feel seen and heard, and the listener will be taking in what the speaker intended. It’s very simple and very powerful. Without it, we run the risk bypassing someone’s experience, inserting our own spin on what’s happening (so dangerous), and can leave people feeling dismissed.

How do I use this?

Validation comes in a variety of forms listed below:

Reiterating what you’re hearing:

  • “What I’m hearing you say is…”

  • “It sounds like…”

  • “So when X happened you felt Y.”

Giving non-verbals that indicate you’re present

  • Head nods

  • “Mm Hmms” or other sounds to indicate you’re tracking

  • Eye contact

  • Let your body lean in

Asking curious questions

  • Tell me more about that.

  • What was that like for you?

  • What were you hoping would happen?

What challenges can I anticipate?

The number one fear around using validation is that validation equals agreeing with the speaker. And if the speaker’s experience is different than your own, why would you betray your own experience? Validation does not equal agreement. Validation is an acknowledgment of another person’s experience; Validation honors that someone has their own unique experience that may be similar or different from your own. There is always space for different experiences.

Additionally, you may be in the habit of waiting to talk versus listening to respond. It’s okay if this happens. This is such a familiar pull for all of us. Listening is hard. Take a deep breath when you notice this comes up. Take ownership for not taking in what the listener is saying. And ask for them to repeat what they said.

When should I do this?

As much as possible. This is especially helpful when a conversation gets heated or a conversation is hard. It will prevent the speaker and listener from rapid-fire responding. Rapid-fire responding is automatic which means you’re not listening, inserting what you think the other person thinks and feels, and will lead to fighting more times than not.

Reflection

Challenge yourself to incorporate validation into your daily life. If you do, ask yourself these questions:

-       How did people respond after I validated them? Is this different than what normally happens? If yes, how so?

-       What did it feel like to tune into someone else’s experience?

-       What makes this challenging to do? What makes this easy to do?

Understanding Anger

By Anne DeCore, AMFT

By Anne DeCore, AMFT

Many people have a hard time managing anger. Some deny it completely, splitting off their emotions and suppressing their needs. Others experience it intensely, escalating into anger quickly when in conflict with a spouse or child, for example. Few experience it in a productive way. Much of how we respond to anger is based on how anger was modeled for us in our homes growing up. Was it the primary way of communicating? Was it deemed shameful? Could anger be talked about in an open way? Do we shut it down in ourselves because we had a parent who was quick to anger? The good news is that despite how we were conditioned to orient ourselves toward the emotion of anger in our early lives, we can learn to gain control over it in adulthood and even use it to our benefit.

When anger is excessive, frequent or disruptive to our functioning and relationships we need to work on anger reduction. Here are some key methods.

PHYSICAL AROUSAL SELF-AWARENESS

When an aversive thought or incident occurs that triggers our brain’s fight or flight response, a cascade of physiological reactions follows: stress hormones are secreted, the heart speeds up, our muscles tighten, breathing increases, and sweating may occur. In this state, our bodies are readied for action and our behavior becomes hyper-reactive. Practicing physiological awareness, or “self-monitoring” means we are able to identify that our fight-or-flight system has gotten the better of us and we are able hit the pause button. Interrupting the amygdala’s activation and letting the mind and body cool down is a simple, yet critical step in taking control over anger. Labeling what we are feeling, deep breathing, meditation, exercise, and yoga are some proven ways of regulating emotion.

RECONNECTING TO OUR PROBLEM-SOLVING CAPACITY

Writes Greenberg and Goldman in Emotion-Focused Couples Therapy (2008), “in couples conflict, partners rapidly explode with rage or freeze in fear well before they have any conscious sense of what is happening or can regulate their emotional response (p.21).” Practicing a time-out when one or both partners is flooded with anger increases the likelihood that, upon reconvening later, the capacity for problem solving and perspective turn-taking will have returned. This is because when we are filled with anger our capacity for creative thinking and problem solving is blocked. The part of the brain engaged in these processes, the pre-frontal cortex, goes completely off-line. If we can reduce the anger to a moderate level of arousal, we can engage in a thoughtful, systemic examination of the problem. Taking a break/hitting pause allows us to slow down and get in touch with our ability for reflection. I advise clients to use the time-out to focus on what you want the other person to really hear and understand about you. I remind clients that the anger response does the opposite – makes it near impossible for people to hear your needs. And, the anger response almost always leads to more conflict. This is because anger causes us to experience cognitive or perceptual distortions and deficiencies. We become governed by biased attributional thinking, meaning the stories we tell ourselves about why things happen are inherently negative.

SHORT TERM V. LONG TERM CONSEQUENCES

In the short term, anger often leads to compliance. However, intimidation to get what you want is irrevocably costly to interpersonal relationships. Your child or spouse may do what you want, but lose respect for you, carry resentment, and conceal things from you in the future to avoid your reactivity. Remembering that frequent and excessive anger will lead to dishonesty in your relationships long term is a tool to help you choose the pause button.

PAY ATTENTION TO THE THOUGHTS

To adopt alternative responses we need to first understand that our thoughts drive our feelings. Identifying the thoughts that are associated with anger episodes is the first step to reclaiming control and choice. When we become conscious of the self-talk that precedes the anger, we can begin to build flexibility around those rigid thought patterns or core beliefs. We can draw out the thread of self-talk and engage in a meaningful dialogue with that narrative which underlies the anger. If we learn to tune in our inner worlds, anger can cue our attention toward a more vulnerable primary emotion like shame or fear that is the root cause of the anger. The Tree Metaphor (see image) is one I share with clients often to help them understand that our behavioral displays are the surface level defenses that we use to manage and hide our underlying emotional experience.

USING ANGER TO OUR BENEFIT

Suppressing anger is not a healthy alternative either; internalizing anger can lead to depression and deteriorate self-esteem. Therefore, we want to strive for the healthy middle ground where we are open to what anger wants us to pay attention to, but we aren’t carried away with angry behavior. Anger can be a very valuable emotion, in fact. It can alert us to important boundary violations. Anger tells us that we need to pay attention to our needs. When we, in turn, express ourselves respectfully to others, this feedback loop is working successfully.

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