Honoring Veterans Mental Health

By Bree Minger, amft

This month we pause to recognize, honor and thank Veterans, active duty service members, and reserve members this Veteran’s Day. Often, many do not realize the depth in which service significantly impacts Veteran’s lifestyles, families, and mental health. In 2020, there were 6,146 Veteran deaths by suicide (2022 National Veteran Suicide Prevention Annual Report). This jarring number is one that the VA is on a mission to lower. Thankfully, mental health has become a greater focus for Veterans and their families in recent years. 

Are you a Veteran or active duty member struggling? We thank you and there is hope. 

The VA has many mental health resources for different topics such as anxiety, bipolar disorder, depression, traumatic brain injuries, military sexual trauma, PTSD, schizophrenia, substance abuse, tobacco use, suicide prevention, the transition after returning from deployment, women, LGBTQ+, seniors and family or friends. 

For many years within the military, mental health has been stigmatized for how it may impact a service member’s career. This is changing. Military One Source offers free and confidential counseling to service members and their families. 

There are also many resources available from Military One Source including webinars, podcasts and apps designed for service members, spouses and children. 

Local to Chicago and looking for a resource? Chicago Veterans provides a strong social support system for Veterans and their families transitioning from service. 

Do you know a Veteran, active duty service member or a family member of a service member? Here’s how you may make a difference. 

Reach out this month to thank them and check in to see how they are doing. Ask if there is any way you can help such as driving children to school, driving to doctor appointments, raking leaves, shoveling snow, running errands or making a meal.

Consider supporting a Veteran-owned business. 

Find a volunteer or donation opportunity that honors or supports Veterans such as ride programs, service dog training, food banks or shelters.

https://www.mentalhealth.va.gov/

https://www.militaryonesource.mil/health-wellness/mental-health/mental-health-matters-in-the-military/

https://chicagovets.org/

Back to School Blues: Tips and Tricks for Helping Your Kids Study

By Nicole Marino, AMFT

With school being a few months in now, kids are back to doing homework and studying. The transition back into work from the fun of the summer can be tough. It can be hard for kids to switch back into having to do homework and focus on lessons throughout the day. It is important to make sure your kids are having an effective and productive study time.

Here are some helpful tips for any parents struggling to get their kids to complete homework assignments or study for tests/quizzes:

Eliminate any distractions

• Kids can be distracted by things in their environment such as toys, tv, music, siblings, electronic devices, etc. so it is important to make sure they have a clean and clear study space where they can just focus on the tasks at hand. It is also a good idea for kids to have a specific space where they do their homework preferably not in the same space as where they like to relax or go to sleep. It can be helpful and more motivating for kids to have a space that they can associate with being focused and working.

Break things up into smaller tasks

• It can be very overwhelming to cram a lot of work or studying into one session or night so make sure to break up the work. Break large tasks or assignments into smaller ones. It can help kids feel more accomplished by completing each smaller task rather than getting discouraged by a large task that takes a long time.

Create a schedule

• Creating a homework/study schedule can give kids more structure to their after-school time. They know when to start their homework, and when they can have breaks, have dinner, go to sleep, etc. Having a schedule can also help keep them focused and on the task at hand.

Take breaks

• It is so helpful to take breaks when it comes to maintaining focus. When we get tired or distracted, it probably means it is time to take a break. Maybe that means taking a break after a specific amount of time has passed or when a certain homework assignment or task is completed. It can be an opportunity for kids to have a reset and some time to recharge before getting back to it.

Have snacks and water

• As discussed above with taking breaks, it is also important that kids are not hungry or parched during their homework or studying time. Having snacks and water before studying (or during breaks) can help with focus and energy levels. Making sure kids are getting enough hours of sleep each night also helps with focus and energy.

Motivate and help when needed

• Parents are obviously a big factor when it comes to implementing productive study habits. Kids need help with encouragement and positive reinforcement from parents to help motivate them to maintain their hard work and habits. If kids are struggling, try to stay patient when it comes to helping them, or finding a tutor or teacher than can better guide them on how to solve the problems.

It is not always easy to get kids to study or do their homework, but it is important for parents to stay diligent and consistent with implementing these habits and tips. The more they do these tricks, the more natural it will become for them to continue doing them after school each day.

Navigating the Maze: Understanding High Functioning Anxiety

By Megan Allcock, AMFT

Anxiety is a common mental health condition that affects millions of people worldwide. While it manifests differently in each individual, there is an unofficial subtype often labeled as High Functioning Anxiety. So what is that exactly?

High functioning anxiety is not an officially recognized mental health diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, it's a term used to describe individuals who outwardly appear to have their lives together while silently battling persistent anxiety beneath the surface.

Some of the key characteristics of High Functioning Anxiety include:

• Perfectionism: Setting impossibly high standards for themselves, striving for flawlessness in every aspect of their lives.

• Overthinking: Constant overthinking and ruminating about past events or future scenarios.

• Procrastination: Ironically, some individuals with high functioning anxiety may procrastinate tasks due to the fear of not meeting their own high standards.

• Constant Worry: Excessive worrying, even about trivial matters, is common as well.

• Difficulty Relaxing: People with high functioning anxiety may find it challenging to relax or "switch off," always feeling the need to be productive or busy.

• Physical Symptoms: While not always present, physical symptoms like muscle tension, restlessness, and gastrointestinal issues are common too.

So how is it different from typical anxiety? The main difference between high functioning anxiety and typical anxiety is the ability to maintain a presence of “normal”. High functioning anxiety often goes unnoticed because individuals suffering from it have developed coping mechanisms to navigate daily life effectively. They may excel at work, maintain social relationships, and fulfill responsibilities, all while concealing their inner stress and anxiety. 

If you think you might suffer from this, here are some tips to help manage it better. 

• Self-awareness: Recognizing and accepting that you have high functioning anxiety is crucial. Understand that it's okay and often necessary to seek help and support.

• Therapy: A therapist can provide tools and strategies to cope with anxiety symptoms as well as navigate some of the underlying causes for your anxiety.

• Medication: Medication prescribed by a healthcare professional may be necessary and very helpful to alleviate anxiety symptoms - usually in conjunction with talk therapy.

• Self-care: Prioritize self-care activities such as regular exercise, adequate sleep, a balanced diet, and relaxation techniques as often as possible.

• Set realistic goals: Challenge the need for perfectionism and set achievable, reasonable goals for yourself. Practice self-compassion.

• Establish boundaries: Learn to say no when necessary. Setting healthy boundaries can prevent overcommitting and feeling overwhelmed.

• Seek support: Share your feelings with trusted friends or family members. Often, simply talking about your anxiety can provide some relief.

If You feel Adrift at Work, Try This Exercise

By Anne DeCore, lmft

We all experience periods in our professional lives that feel adrift. Sometimes it’s a feeling of disconnect to your work persona, your work culture, your work goals. When this happens, one place to start is with a values check-in. It may be that your values are out of alignment with the path your on at work. Clarifying and ranking values is an insightful exercise that can help you clarify the path forward.

1. Start by making a list of your core values:

Values are chosen qualities of being and doing. They describe how you want to live your life. We don’t achieve them; rather we live in accordance with them. Examples of values are: cooperation, creativity, freedom, justice, generosity, industry, responsibility, persistence, trust, spirituality, adventure, gratitude, etc.

2. Next, ask yourself:

Do my values connect to my work identity and goals? If so, how? When goals are detached from values, we tend to lose a sense of purpose. When goals flow from values we tend to feel motivated. Goals that flow from values are inherently more meaningful.

3. Close the gap:

Explore what you need to do to infuse your values back into your work life. Subtle tweaks or radical changes? Grant yourself permission to think beyond practical constraints. Even if you can’t implement the necessary changes immediately, it will soothe you to know that when the time comes, you’re already clear on what will guide you.

Values are enduring. Goals are finite.

Guiding Yourself: Progressive Muscle Relaxation

By Jessy Weston, AMFT

In the midst of life's hustle and bustle, finding moments of calm can feel like an elusive quest. I often find myself sitting with clients who are struggling to navigate stress and anxiety in their lives and are unsure of how to slow down. In those moments, I find it can be helpful to practice a mindfulness exercise together. One of my favorite mindfulness techniques is progressive muscle relaxation.

Progressive muscle relaxation (PMR) is a relaxation technique based on the concept that physical tension and mental stress are closely connected. Developed by American physician Edmund Jacobson in the early 20th century, PMR aims to reduce both physical and mental stress by systematically tensing and then relaxing different muscle groups in the body.

The theory behind PMR is rooted in the idea that when we consciously tense and then release muscle groups, we become more aware of the physical sensations associated with tension and relaxation. This heightened awareness allows us to recognize and differentiate between states of tension and relaxation more effectively. By repeatedly practicing PMR, we can learn to identify when we are holding tension in our bodies, even in day-to-day situations. Over time, PMR can lead to reduced muscle tension, decreased anxiety, improved sleep, and an overall sense of calm and well-being.

Step 1: Find a Quiet Space

Choose a peaceful environment where you won't be disturbed. Sit or lie down in a comfortable position, and close your eyes if you feel comfortable doing so.

Step 2: Focus on Your Breath

Take a few slow, deep breaths to ground yourself. Inhale through your nose, feeling your lungs and belly expand, and then exhale slowly through your mouth, releasing any tension.

Step 3: Tense and Release

Begin with your toes. As you inhale, curl your toes tightly, feeling the tension in your foot. Hold for a few seconds, then exhale as you release the tension. Notice the difference between tension and relaxation.

Step 4: Move Up the Body

Continue this process, moving progressively up your body. Focus on each muscle group for 5-10 seconds before releasing:

• Calves and shins

• Thighs

• Abdomen

• Chest and back

• Shoulders

• Arms and hands

• Neck and throat

• Face (forehead, eyes, cheeks, jaw)

Step 5: Embrace Sensations

As you work through each muscle group, pay attention to the sensations. Notice how tension feels different from relaxation. Notice the soothing sensation of letting go.

Step 6: Slowly Return

When you're ready, gently bring your awareness back to the present moment. Wiggle your fingers and toes, stretch your body, and open your eyes if they were closed.

There Is More When It Comes To Listening To Your Body

By Bree Minger, AMFT

Often, the phrase “listen to your body” makes one think of the body’s basic needs like hunger, thirst, and sleep. For all of those needs our bodies send us clues that tell us to grab an extra snack when we are hungry, drink a glass of water after a long walk, or head to bed a little earlier on days that just felt like too much. 

Outside of those needs, our bodies communicate other messages that are often more subtle and harder to notice. These messages are related to our emotions. They don’t just exist in our heads; emotions are held and experienced throughout our entire bodies. 

In fact, the body, through the nervous system, can inform us of our emotions before our brains can identify our feelings. Have you felt butterflies in your stomach and that is when you realize you’re nervous for a big presentation? Or have you noticed your heartbeat pick up when you are feeling lost in a place you’ve never been? What about that feeling of pins and needles on your arms as you think about having a hard conversation with a loved one? 

Each body experiences emotions differently based on past experiences, stories, or traumas. Some of these described sensations may feel familiar, and if some feel unfamiliar, you are not alone. Day to day, many people live in their head and ignore their bodily cues, sensations, discomfort, or pain. Dr. Bessel Van Der Kolk in The Body Keeps the Score, describes this as a muffling of one’s senses. Why may living in your head, and ignoring your body, be dangerous? A lack of connection between the brain and the rest of the body has the power to influence our interactions and relationships, as well as block the path to healing past traumas and difficulties. 

Wondering how to start listening more closely? 

1. Mindfulness is key. Paying attention to bodily sensations can allow one to more closely understand the waves of their emotions and therefore gain more control over them according to Van Der Kolk. A helpful meditation practice may begin with deep breathing or a body scan. 

2. Yoga can be an effective exercise to restore the brain and body connection. The combination of deep breathing, different postures and meditation has powerful effects. 

3. EMDR (eye movement desensitization and reprocessing) therapy is an effective way to treat trauma. Different from talk therapy, EMDR allows access to memories and can be helpful to observe experiences from a different context of external stimulation, including eye movement, tapping, or other stimuli.  

Ultimately, the word “emotion” comes from the Latin word emovere or “to move out.” This tells us that healing from past traumas, both big “T” and little “t,” involves listening to our bodies and discovering the movement, rest, postures, mindfulness, and/or processing it requires. There is so much to learn about your body and how it informs who you are today. 

Curious to learn more or get started with a therapist? We have made this easy. Visit our website and fill out the intake form today.     

References: Van Der Kolk, Bessel. The Body Keeps The Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books, 2014. EMDR Institute, Inc. 

Not Your Typical Date Night

By Nicole Marino, AMFT

Date nights have always seemed to be such a huge topic discussed for couples when it comes to connecting with one another and spending quality time. I discuss this with my clients all the time and think it is so incredibly important! But I also think there is a misconception that date “nights” need to be dinner and a movie or dinner and drinks, or something having to do with spending money. Sure, that is one way of going about having dates, but it doesn’t always have to be at night, and it doesn’t always have to cost money.

I completely understand that for those who go into the office and work a 9am-5pm job that your schedule is a bit less flexible. You can still come home and spend some time before bed at least once a week with your partner. I also think many couples (specifically those who do work at home) think that living together and being around one another is spending time, but there is a difference between that and spending quality time where you are interacting and sharing an experience.

There are so many free post work activities you can do with a partner such as cooking dinner together, going for a walk, exploring a new area of your town that you don’t usually go to, playing a card/board game, having a movie night in the living room, using the free Gottman Card Decks app and asking each other questions, going to a museum, doing an at-home workout together, and many more! Those are just a few options that don’t cost any money and don’t really take too much time. I understand after work, you might be exhausted and not in the mood to do much, but even doing one of these dates once a week can make such a difference feeling connected and in tune with one another.

For those of you that have more flexibility in your schedule throughout the day and don’t necessarily have a 9-5 job, you can still implement these dates at different times in the day, such as sitting down and having coffee or breakfast together, going for a walk, doing a workout, having a picnic in a different area or even your yard, etc. The book “8 Dates” by John and Julie Gottman is another cheap way to have meaningful and intention dates with your partner, and you’re reading something together as well.

Sometimes you must prioritize one another and find a time that works in your everyday routines. Especially those partners that crave quality time as their love language, this is a need that has to be met to feel loved, cared about, connected, and  listened to, so work as a team to find the time that is best. That may be different given the week, but that’s okay. Be creative! Find activities that the two of you really enjoy together whether that costs money or not but remember if you are trying to save money and are on a budget, dates do not have to be an added expense to worry about. There are so many free options and fun things you can do, especially when trying to take advantage of the weather while it is nice out!

Intrusive Thoughts VS. Impulsive Thoughts

By Megan Allcock, AMFT

I’m sure many of you have seen tiktoks, reals, and memes about letting your intrusive thoughts win. These videos or photos are often jokes about smashing a cake randomly, or kicking someone, or breaking a plate. They are meant to be harmless and funny videos about how sometimes, we don’t have full control over our thoughts. The power of social media has made this a commonly discussed topic, which is great - mostly. There is however a large, and very important difference between intrusive thoughts and impulsive thoughts. 

Intrusive thoughts are unwelcome, distressing, and unwanted thoughts that pop into our minds involuntarily. They are often repetitive and difficult to control or dismiss. These thoughts can be disturbing, bizarre, or even violent in nature, and they can evoke feelings of anxiety, guilt, or shame. It's essential to understand that having intrusive thoughts does not mean you want to act on them or that they define who you are as a person. An example of an intrusive thought might be, you're standing on the edge of a tall building, and the thought of jumping off unexpectedly crosses your mind.

Impulsive thoughts, on the other hand, refer to thoughts that arise suddenly and compel you to act without much consideration of the consequences. They can be linked to impulsive behaviors and actions, which are often done without careful planning or foresight. Impulsive thoughts can lead to impulsive decisions, and while they might not necessarily be distressing like intrusive thoughts, they can still have significant impacts on one's life, relationships, and well-being. An example of an impulsive thought might be, you're angry with someone, and an impulsive thought urges you to yell at them without thinking about the potential damage to the relationship.

It's important to remember that both intrusive and impulsive thoughts are part of the human experience, and they don't define who we are. If you find yourself struggling with either type of thought, seeking support from a therapist can be beneficial in understanding and managing them effectively.

Ambiguous Loss: What Is It?

By Anne Decore, lmft

All of us have or will face situations of ambiguous loss.

“Rarely is there absolute presence - or absence - in any human relationship” writes Pauline Boss, the leading expert on ambiguous loss, in her book “Loss, Trauma, and Resilience: Therapeutic Work with Ambiguous Loss”.

Ambiguous loss is felt when physical presence and psychological presence don’t align.

The first type of ambiguous loss speaks to situations where a loved one is physically missing but kept psychologically present. War, terrorism, and natural disasters are catastrophic examples of this type of ambiguous loss. A child’s experience of a parent who leaves or is absent due to divorce, work relocation, family members emigrating, and incarceration are also examples of this kind of loss.

The second type of ambiguous loss is often described with the simplified language of “there but not there”. Dementia, Alzheimer’s, brain injury, addiction, depression: these are quite recognizable examples of a person being present but not psychologically available.

Psychologists now understand that the experience of this type of ambiguous loss emerges from common circumstances too (and feels no less profound):

a partner or parent always on their phone; a partner/parent relentlessly preoccupied with work; stepparent-child relationships; interactions with an ex-spouse because of co-parenting; lack of acceptance of one’s identity by family or community are just some examples.

In this type of loss, emotional processes freeze. Roles and statuses become confusing. People don’t know how to act.

All of us have or will face situations of ambiguous loss. It’s important to apply language to the process in order to make the invisible visible. I hope that by sharing this concept and the language of “ambiguous loss” it can become the first step to feeling seen, connecting with others, finding support, and growing resilience.

Reference: Boss, Pauline. Loss Trauma and Resilience. WW Norton & Company, 2006

Embracing the Both/And Mindset: Letting Go of the Either/Or Perspective

By Jeessy Weston, amft

As a therapist, one of the most common mental hurdles I observe among clients is the dichotomous trap of either/or thinking. We are often inclined to categorize life into black and white, right and wrong, good and bad. While this binary approach may occasionally serve us in decision-making or problem-solving, it frequently oversimplifies our intricate human experiences and realities. I'd like us to consider a healthier, more balanced approach: the both/and mindset.

The Both/And Mindset

This way of thinking is all about accepting that different, even contradictory, things can be true at the same time. It allows us to see and accept the messy, layered parts of life. It's like saying, yes life can be tough, but it can also be amazing, all at the same time.

The Downfalls of Either/Or Thinking

Either/or thinking is a one-way street. It boxes us into corners, makes us judge ourselves harshly, and can turn little problems into big ones.

Imagine you've had a challenging day at work. You made a mistake on an important project, but you also received praise for your communication skills in a tough meeting. The either/or mindset might lead you to label your day as 'bad' due to the mistake. However, the both/and approach allows you to recognize that your day was challenging but also rewarding, that you made a mistake but also succeeded.

By transitioning from the either/or mindset to the both/and mindset, we create space for growth, self-compassion, and resilience.

How to Think in Both/And

Now, let's look at how we can start thinking in both/and:

Embrace complexity

Understanding that life is inherently complex and nuanced is the first step. It’s important to remind yourself that people, emotions, and situations rarely fit neatly into binary categories.

Practice self-compassion

Self-compassion is fundamental in transitioning from an either/or mindset to a both/and mindset. This means accepting that you can be a work in progress and yet still be worthy and capable. Messing up doesn't mean you're a failure. It just means there's room to learn and grow.

Seek balance

Instead of choosing between success or failure, think about learning and growing. Remember, you can be strong and still have moments of vulnerability.

Question your thoughts

If you find yourself thinking in black and white, challenge those thoughts. Ask yourself, "Is it possible for both of these things to be true?" or "Are there other perspectives I could consider?" Most of the time, you'll find there is.

Seek support

Changing a deeply ingrained mindset takes time and patience. If you need support, seek help from a mental health professional who can provide you with tools and strategies to navigate this journey effectively.

Conclusion

In the end, life's a crazy, messy, beautiful mix of experiences and feelings. Embracing a both/and mindset allows us to see and accept all of that. As we learn to let go of the rigid either/or thinking, we open ourselves up to a more forgiving, balanced way of living. And that's something we could all use a little more of, right?

Summary/Review of The ADHD Effect on Marriage: Understand and Rebuild Your Relationship in Six Steps by Melissa Orlov (and Edward M. Hallowell)

By Nicole marino AMFT

Recently, I had the privilege of reading The ADHD Effect on Marriage. I thought the book was well-written and incredibly helpful for marriages consisting of an ADHD and non-ADHD spouse. As a therapist, I found this book enlightening to how ADHD shows up in many relationships, and how it impacts both the ADHD spouse and the non-ADHD spouse. The book was broken down into three main parts: Understanding ADHD in Your Marriage, Rebuilding Your Relationship in Six Steps, and Worksheets/Tools. I am going to go through each part and give a brief summary of what you can expect when reading.

The first part went through the common symptoms of an ADHD diagnosis and how the symptoms present for both the ADHD and non-ADHD spouse. It is important to note that not every relationship has a non-ADHD spouse and an ADHD spouse, but for the purpose of the summary, this is the language and dynamic that was chosen to highlight. This part of the book, from my own experience, allowed me to have a better idea and understanding of what ADHD looks like and how to cultivate empathy for both partners in the relationship who may be suffering. This part went through and explained many statistics and research around ADHD’s impact to a marriage., and the different types of dynamics within a relationship. This part also highlights the rewards of rebuilding a marriage that has been affected by ADHD in a very encouraging, positive, and motivating way. This section goes through symptoms that the non-ADHD spouse may be experiencing and normalizes the impact by including real life examples posted from Melissa Orlov’s interactive blog: adhdmarriage.com.

The next part, and the main part of the book is broken down into six steps to take towards bettering the marriage/relationship. I am not going to fully go through what each section explains but will give a brief overview for reference. To learn more, I highly recommend reading the book to gain more insight, information, understanding, and tools!

1. Cultivating Empathy for Your Spouse: The first step is incredibly important, especially when it comes to healing past resentment. It is key to understand your partner and their experience in the marriage, whether that is the experience of the ADHD spouse or non-ADHD spouse. Being able to empathize with what both partners are going through is a main step towards feeling more connected and on the same page. This also helps when it comes to reactions and responses towards certain triggers or symptoms. Gaining empathy can slow those reactions down to be able to choose a different response to the symptom knowing what the other person is experiencing as well.

2. Addressing Obstacle Emotions: This section better highlights different emotions and responses to symptoms of ADHD specifically from the non-ADHD spouse. For example, anger was a common response to the ADHD struggles in a marriage. The author did a good job including examples to show how anger presents and how it impacts the ADHD spouse most likely on the receiving end of the anger (even though impulsive anger is also another symptom of ADHD). This step discusses how to let go of certain negative emotions/responses as they do nothing productive for the relationship and partner interactions.

3. Getting Treatment for You Both: This step discusses the importance of seeking treatment for both the ADHD spouse and non-ADHD spouse throughout the process of bettering the relationship. For the ADHD spouse, it is helpful to seek professional help to understand symptoms better and gain tools for symptom management. For the non-ADHD spouse, it is important to seek professional treatment to gain support and better coping techniques to manage reactions and emotions towards partner. This step also talks about the choice around medication.

4. Improving Communication: This part walks you through different techniques around having various conversations in a marriage and how it is vital to improve communication in order to improve connection. It is important to listen to one another, validate each other’s experiences, negotiate/compromise respectfully, and increase emotional safety for both partners. This step also goes into how gender plays a role in communication differences, and what to look out for.

5. Setting Boundaries and Finding Your Own Voices: This section goes into personal boundaries, how to identify your own personal boundaries, and how to enforce personal boundaries. The author notes the importance of identifying which boundaries are most important for an individual and where your threshold is for each boundary. With this, you can better understand expectations for each other and what is realistic versus unrealistic to expect. The step then goes into processing how each spouse can respect their partner’s boundaries and create an action plan.

6. Reigniting Romance and Having Some Fun: This step discusses the importance of reintroducing romance and intimacy into your marriage, and how having fun together is a vital part of relationship success. It is important to try and get back to doing fun things together that you use to enjoy at the beginning of the relationship or trying new things together. Having new adventures brings you closer together and reignites that romantic spark and excitement.

The last brief part of the book is a reference chapter full of different tools, techniques, and tips for achieving the six steps. As you read each of the steps, there are different tips and tools specific to what the step’s goal is to help both partners improve on these skills and achieve overall betterment in the marriage/relationship. Not all the tools will be applicable for every person or marriage, depending on the specific struggles you are going through, but you can tailor your toolbox with whatever works best for you and your partner!

Overall, I found this book incredibly beneficial to read not only for my knowledge as a therapist and for my work with my couples/clients, but just to gain a better understanding of how ADHD presents in a person, and a relationship. As someone who has personal relationships with individuals diagnosed with ADHD, I have gained a different perspective on what they may go through every day and how their ADHD shows up for them in their personal relationships. For more information around the book, author, or ADHD in general, you can visit Melissa Orlov’s website at adhdmarriage.com (blog posts included there).

Ambivalence is Two Simple Things

By Anne DeCore, LMFT

Ambivalence is a natural human phenomenon, one that we all experience every day. It is common to want change, and also not want change, at the same time. The brain will contemplate the pros and the cons (the “decisional balance sheet”) of a particular change and then, voila, we find ourselves stuck. We come up with a reason for, and a reason against, and then ambivalence settles in.

As a clinician I regularly see clients experiencing ambivalence. Common ones are: ambivalence about changing one’s alcohol use habits; about whether or not to set a boundary with a family member; about staying or leaving an unstable relationship. My thinking toward ambivalence has been shaped by the works of Bill Miller. Miller is the author of Motivational Interviewing: Helping People Change, and he focuses on the topic of Ambivalence more directly in his most recent book On Second Thought: How Ambivalence Shapes Your Life. His writings, research, and techniques have been praised and used by professionals across disciplines such as teaching, coaching, medicine and psychotherapy to name a few.

Ambivalence, he says, is two simple things: change talk (arguments for change) and sustain talk (arguments against change).

Interestingly, when we want to help a friend or family member whom we think would benefit by a change in their lives we tend to argue for change. But because of the way the brain is structured, when we push for change in someone else, we end up evoking the other side of their own ambivalence. We often cause the other person to talk himself or herself out of changing. This happens between partners in a couple, between parents and kids, between friends, and occurs in the therapy and medical worlds between clinicians and clients: sometimes, the more a clinician pushes for change, the more the client responds with opposition. This oppositional reflex, found in all of us, is called the righting reflex. The clinician’s attempt to help can have a paradoxical effect, reinforcing the maintenance of status quo.

So what then is the path to resolving ambivalence? How does a person decide whether a change is advantageous?

The pathway to breaking through ambivalence is about setting your GPS to a clearly defined destination and asking if making that change helps you get to the coordinates you set for yourself. If you are stuck in ambivalence, have a series of wide-ranging conversations with yourself or with a therapist where you explore what you clearly know you do want in your life. What do you care about most? What do you want your life to mean? To look like? What is most important to you in terms of who you are, and who you want to be? Explore your values and goals. These talks will define the coordinates you want to travel toward. Then, and only then, do you ask yourself, does the change I’m considering help me get there. You look at your goals in relation to the alcohol use, the boundary, the unstable relationship. Does alcohol help you accomplish that goal? Does setting the boundary with the family member help you be the kind of person you described? Is the unstable relationship neutral or does it act as an obstacle to what you care most about?

As friends, family members, or therapists, when we know with clear conviction that a person really needs to make an important change, we need to listen to their sustain talk without trying to reason the person out of it. When we listen with empathy, their need to say it goes down because their experience of feeling understood goes up. Through non-judgement, empathy and curiosity we can be a helpful part of the person evoking their own reasons and motivations for change. As frustrating as it can be at times, we cannot instill in them our reasons for their change.

Reference:

Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford press.

Miller, W. R. (2021). On Second Thought: How Ambivalence Shapes Your Life. Guilford Publications.

The Five Languages of Apology

By Jessy westin, amft

Did you know that there are different ways to apologize? What one person considers an apology is not always what another person considers to be an apology. Gary Chapman and Jennifer Thomas, the authors of The Five Languages of Apology, identify five distinct types of apologies. When we feel hurt, we may differ in what exactly we are looking for to feel the most heard and seen by the one trying to make amends. Identifying your apology language and your partner’s apology language can help you better understand each other and provide a path toward a healing relationship.

Types of apology languages:

1. Expressing Regret - “I am sorry.”

Expressing regret focuses on the emotional aspect of an apology. It is expressing to the offended person what specifically you are sorry about and demonstrating that you truly understand how hurtful your actions were.

● “I am truly sorry for losing my temper and yelling at you. I know that I hurt you very deeply.”

● “I feel really bad that I disappointed you. I should have been more thoughtful. I’m sorry that I caused you so much pain.”

2. Accepting Responsibility – “I was wrong.”

Accepting responsibility means being willing to admit that you were wrong and recognizing the mistakes made. It can be challenging to admit to our mistakes, especially if those mistakes have caused pain for someone else. However, for some individuals, hearing someone accept responsibility for their wrongdoing is the most important part of an apology.

● “I was wrong. I could try to excuse myself, but there is no excuse.”

● “I take full responsibility. I know that it was my fault.”

3. Making Restitution – “What can I do to make it right?”

For some individuals, hearing ‘I’m sorry’ or ‘I was wrong’ may not always be enough. This apology focuses on finding a way to make things right. If you are the one hurt, you are looking for that “next step” and that reassurance that it will not happen again.

● “How can I make this up to you?

● “What can I do that would make this right between us?”

4. Genuinely Repenting – “I’ll try not to do that again.”

Expressing your desire to change is communicating not only that you regret what you did, but also that your desire is to not do it again. It may be difficult for someone to forgive if they see the same action being done again and again. This apology language focuses on how the person apologizing will change their behavior in future similar situations.

● “I regret what I did. I don’t want to do it again. Can we talk about how to avoid it next time?”

● “Can we put together a plan that will help me to stop doing this?”

5. Requesting Forgiveness – “Will you please forgive me?”

Asking for forgiveness gives the other the space to decide if they would like to forgive you. It is meaningful that the forgiveness was requested, not demanded.

● Can you please forgive me for what I did?”

● “I’m so sorry that I hurt you. I hope that you will forgive me.”

Questions to consider in identifying your apology language:

● What do I want the person to say or do to help make it possible for me to genuinely forgive them?

● What hurts most deeply about the situation?

● Which language is most important (or do I usually use) when I apologize?

References

Chapman, G., & Thomas, J. M. (2008). The five languages of apology: How to experience healing in all your relationships. Moody Publishers.

Goop. What it takes to give (and receive) a good apology.

Love Languages: A Give and Take with Couples

By Nicole Marino, AMFT

In my experience working with couples (and individuals), the importance on love languages is very prevalent. I see it similarly to the idea of showing support. We all have our natural ways of wanting to show support given how we know we want to receive support. But when the other person doesn’t need or want to be shown support in that way, they may feel the other person doesn’t care to fulfill their needs for support accurately. The same thing goes for love languages and the way we want to receive love.

We will be talking about the five original love languages: words of affirmation, acts of service, gifts, quality time, and physical touch. It is important to keep in mind that there may be differences in your love languages based on how you want to receive love and the way you want to show love. I find this distinction very relevant for couples work because it can take extra effort to shift your focus of showing love if the way your partner wants to receive love is different than how you naturally show love. I always tell couples that if this is the case, it doesn’t mean you can never give your partner gifts if that is how you express love; it just means that you also must make a conscious decision to put effort forth to give your partner words of affirmation if that is the way they need to receive love. Another thing to note is that many people do not just fall into one category for love languages but may be a mix of a few or have a certain priority list for which they prefer/need the most.

Words of Affirmation: A partner desires being shown love or giving love through verbal connection and affirmations. This can be as simple as an “I love you” in the morning, a sweet post-it note on the mirror, showing appreciation and acknowledgement for their efforts around the house, or even a handwritten love letter. Someone whose love language is words of affirmation needs emotional intimacy through words and hearing that a partner cares and loves them.

Acts of Service: A partner desires to be shown love when their partner is physically helpful and partakes in certain tasks, so the other person does not have to. This can be concrete tasks such as the dishes, laundry, cleaning the snow off the car, picking them up from the airport after a trip, or making dinner. It can also be smaller things such as putting toothpaste on a partner’s toothbrush in the morning, filling up their water bottle, starting the shower for them, etc. When living with a partner, there are many options of tasks around the home that can be done to show acts of service especially knowing a partner’s everyday routine.

Gifts: People who love gifts or gift-giving don’t always view this is as some grand gesture. Often, it is the little things that can make a partner feel special such as picking up their favorite meal from the grocery store, bringing back something they were running low on, their favorite sweet treat, flowers, and anything that made you think of them. A person with gifts as their love language just wants a partner to show they love them by thinking of them in little (or big) ways in the form of a physical item. To know their partner went somewhere and thought of them makes all the difference.

Quality Time: A person who needs to be shown love through quality time just wants to physically and mentally be present with a partner. They thrive from doing activities with a partner even activities like running errands, driving around, playing a game, going on a walk, going on a date somewhere, etc. It is so important to keep in mind that quality time is different than just passive time together such as living together and going about your routines and watching a show or movie. A partner who desires quality time wants the quality in it. Maybe try putting phones away and just enjoying each other’s company one on one.

Physical Touch: A person or partner who needs physical touch to be shown love doesn’t always want the touch to be sexual, even though that is part of it. Physical touch can be as innocent as hugging, holding hands, cuddling, and massaging. They feel most loved through someone physically expressing it to them and feeling a partner wanting to be close to them.

Now that we have gone over the five original love languages, it is important to figure out which love languages you gravitate the most towards whether that be one main way of showing and receiving love, or a mix of a few. It is also essential to understand the way your partner gives and wants to receive love. Like stated before, you can still show a partner love in the way that is natural and feels good for you to do so, but it is necessary to also learn their love languages to understand how you can show them love and when they are also showing you love in their natural way. It is a way to better understand each other and recognize when your partner is expressing their care and appreciation. There are many love languages quizzes and books to learn more such as: 5lovelanguages.com and The 5 Love Languages by Gary Chapman.

How to Improve Your Work/Life Balance

By Megan Allcock, AMFT

Work is a necessary part of our lives. Whoever said if you love what you do you’ll neve work a day in your life was simply incorrect, in my opinion. As a therapist who absolutely adores my job and going to work most days, there are still days I wish I could be a stay at home human (not wife or mom, just human). 

People work to pay their bills, keep a roof over their heads, feed themselves, and enjoy some fun things in life. That does not mean that work should be your whole identity. In fact, creating an identity around your career can cause issues with identity later in life, as well as rob you of your free time. When we identify SO heavily with our job we can often feel responsible for staying late, taking on extra tasks, and eventually lose all our personal time to being a workaholic. If you struggle with finding the balance between work and life, try even just one of these tips to help improve your relationship with work. 

1. USE YOUR LUNCH - I so often have clients come in and tell me they work through your lunch. It is is necessary to give yourself a break during the day, even if its for 10 minutes. Use that lunch time to spend time doing something you like - getting lunch with a coworker or friend, reading a book, getting outside. Whatever it is, just do something other than you work.

2. Set time boundaries - It can be easy to say “I’ll just work one more hour” and eventually one turns into two and then three… you get my point. Try scheduling a workout class or social plans for a specific time, so you’ll be obligated to log off, or leave the office on time. 

3. Communicate with managers - In my opinion, this applies all the time but particularly when you’re having a hard time in life. A lot of managers will work with you to accommodate what you need and to help support you - that is often a big part of their job. 

4. Say no - I know this is a tough one because saying no to your boss when they’re asking you to take on a new project, but it’s important to use discernment when taking on a project. Think about if you realistically have the time, energy and are capable of it. 

When there is little to no work life balance it often breeds a perfect environment for burnout. In order to avoid burnout we have to get ahead of the snowball. Only you are capable of changing it.

The Importance of Play

By Anne decore, lmft

In today’s world one need not look far to find stressors. On a global level we are facing environmental threats, a war in the Ukraine that approaches the one-year mark, financial market uncertainty, and a globe still trying to understand how the meaning of health and illness have been reshaped by the recent pandemic.

The pause from work and school for the winter holidays can be a time of great connection and gratitude and joy. It can also heighten emotions of anxiety, grief, and intensify family conflict. When our own personal individual contexts and stressors intersect with the shared global stressors it can feel overwhelming. It’s normal to feel depleted and burnt out at the beginning of a new year.

As a response to this overwhelm many people begin January with pledges and resolutions - issuing themselves rigid new behavioral goals. I feel such compassion for this reasonable desire to gain a sense of control and order in a world that feels out of control. The problem with the over-emphasis on resolutions is that we become outcome-focused and then when we fail to meet our goals we feel a sense of failure, followed by a lack of motivation and that familiar feeling of burn-out. When we are outcome-focused, we are assessment-focused (did I do good enough?), and we are future or past-focused, not present-focused. The outcome-focused brain state has us teetering on the edge of activating our fight or flight system.

I want to offer a different intervention this January – play.

Mammals are hard-wired for play. Humans are no exception. Play is good for our mental health because it’s about the experience: process for process’s sake. Anything that gets us INTO an experience and OUT OF outcome-focus thinking is therapeutic for the nervous system and for relationships. So why do we abandon play as we age into adults? One answer is that our society values productivity and play is not productive. It is not measurable.

But our kids can remind us of its value. Play activates imagination, creativity, team-work, belonging, wonder, and humor. Often play involves learning new skills or problem solving. Sometimes it’s just outright tomfoolery and mischief. Play connects us to our physical body and to the flow state – getting lost in the present moment. Play helps us let go of the things we can’t control. Like grey winter weather. Play allows us to transcend boundaries that exist in the practical world. Play is always available to us and it’s usually low-cost.

So what do I mean in practical terms? Jenga. A trampoline park. Puzzles. Lego. Game nights with friends (charades, trivia, board games). Wild dancing to music. Card games. Twister. Bowling. Turn your kitchen into a restaurant and give everyone a part. Set up a bean bag toss. Make costumes. Play is a word with millions of interpretations. Invite silliness. Invite invention. Invite peace. And leave your phone in another room. Don’t let a notification or the pressure to post take you away from the gift of the here and now.

Play doesn’t replace worrying about the world or about the personal challenges we are weathering. It does gives us a respite from the worrying and restores our bodies and minds so that we feel more grounded and able to face the messy parts of our lives.

Family Boundaries During the Holidays

BY JESSY WESTON, AMFT

While the holidays can be a season filled with joy and celebration, it can also bring challenging feelings, situations, and conversations. The holidays are an important time to make sure we are setting healthy boundaries for ourselves and our families.

First, what are healthy boundaries? Brene Brown, a research professor at the University of Houston, defines boundaries as simply “what’s ok and what’s not ok.” A boundary allows you to define what is acceptable to you within any relationship or situation. Its purpose is to protect both you and others involved. It’s also important to know that setting boundaries is not always easy. In fact, it takes significant intention and effort. It means changing or challenging something that has historically existed.

How to set boundaries:

1) Identify your limits

To start, you can ask yourself the question, “what’s ok with me and what’s not ok with me?” This question can be asked within several different realms including, emotional, physical, financial, mental, spiritual, etc. An example of an emotional boundary may be reminding yourself that your feelings are your own and that you are not responsible for others feelings. A physical boundary could be deciding where you want to spend the holidays, even if that is different from what has been done in the past. A mental boundary could be altering the story you tell yourself about what the holidays “should” look like. These are just a few examples as it can truly take any form that you may need.

2) Share expectations with friends and family members

“We have our own thoughts, and if we want others to know them, we must tell them.” (Dr. Henry Cloud, Boundaries: When to Say Yes, How to Say No)

This statement seems so simple, yet it’s normal for it to be difficult to put into practice. It is normal to assume that those who know us should automatically understand our boundaries. However, that is often not the case and it can be challenging to express our honest thoughts and feelings with those around us. We can practice sharing our expectations (both what we want and what we do not want) in a respectful way by being calm and direct. The key is to use “I” statements. For example:

• “I appreciate the invite to spend the holidays at your place this year. I need some time though to not travel this year and to spend a quieter holiday at home. I’d love to find a different way to spend time together.”

• “I always feel overwhelmed when planning the dinner for our large family gathering. Can you please help me plan it this year?”

• “I’m not comfortable talking about my dating life right now. I would really appreciate it if you did not ask about it again.”

• “I feel a bit annoyed and embarrassed when you make jokes like that. I would appreciate it if you would refrain from making those kinds of jokes.”

3) Be compassionate towards yourself

It can be mentally and emotionally exhausting to maintain necessary boundaries. While people or situations may not always respect the boundaries you set, you did the best you could by advocating for yourself. It is important through it all to offer yourself kindness and compassion.

Breaking and Making Habits

By Nicole Marino, AMFT

With the start of the new year quickly approaching, many people often re-evaluate their habits and routines wishing to start the year off on the best foot. Breaking and making new habits can be challenging, but it is not impossible. It takes time to 1. Break a habit and then 2. Make a new habit because it takes a lot of effort to re-wire and re-train your brain to stop doing something to then start doing something else. This list of tips could potentially help with the process but do keep in mind that this is a process! Even if you make missteps along the way, that doesn’t mean you can’t get back on track and continue.

• Be patient: As stated above, this is a process. On average, it can take about two months to make a behavior a habit, so it can take even longer to break a habit to then create a new one.

• With that being said, Consistency is key: Take it day by day when it comes to creating your new routine. The more you do something, the more natural it will become with time. You will start doing that behavior without evening having to put much thought to it, meaning it became a habit and pattern.

• Don’t shame yourself: You might mess up and make mistakes along the way, but that is OKAY! It is normal to ebb and flow when it comes to breaking and making habits. Show yourself grace and compassion that this is not going to happen overnight and that is to be expected. The more you shame yourself, the more discouraged you are going to feel so remind yourself you are human; therefore, you are not perfect.

• Don’t take on too many changes at once: Take things one step at a time! Taking on too many habits and changes all at once, can be incredibly overwhelming leading to slipping into old habits and doing what feels easier. Taking on a few changes at once can give you more opportunity to focus your efforts more and stay consistent.

• Be mindful: There are a few elements when it comes to being mindful. First, when it comes to breaking a habit, try to identify your triggers and what contributes to you falling into those habits. Either eliminate those triggers or try to avoid them. If a trigger is unavoidable, being mindful of how you relate and react to the trigger. Replace the “old” habit or behavior with the habit you are trying to implement instead. This is easier said than done, but that is why being mindful and self-aware in those moments is beneficial. It helps slow you down so you can check in with yourself around your what you are doing.

• Incentivize yourself: When it comes to creating new habits, rewarding yourself can help your brain draw the connection between the behavior and pleasure. This can help encourage you to desire following through more with the habit when there is a positive correlation to it.

Self Care - Redesigned

By Megan Allcock, AMFT

Self care is a term that has really taken off in the past few years. As the awareness of mental health began to increase, so did the idea of self care. Unfortunately, it has become capitalized on and therefore been reduced to this idea of face masks, candles, and bubble baths. Which are absolutely a PART of self care, but not the whole. Self care is a lifestyle not a “thing” to do. So let’s talk about nine different types of self care and how to incorporate them into your life.

Physical Self-Care is taking care of physical wellness and overall health. Some ways to practice self care for your body physically are getting enough sleep, drinking enough water, moving your body in ways that feel good, making and keeping doctor appointments, eating nutrient dense foods and getting enough fresh air/sunlight.

Emotional Self-Care is taking care of your emotions using empathy and self compassion. Ways to practice this would be journaling, therapy, emotional check ins with yourself, self compassion, releasing energy through music or art, asking for help when you need it and managing your stress.

Social Self-Care is a type of care that involves health family, friend and romantic relationships. It is important when fulfilling this type to spend time with safe people, create and maintain health boundaries, understand and follow through on your emotional battery (balancing alone time and social time depending on individual needs), and asking for support from safe people.

Spiritual Self-Care this care often involves religious beliefs, but is important to remember this involved any activity that nurtures your spirit, soul and allows you to think about something bigger than yourself. Examples include meditation, yoga, going to a place of worship, spending time in nature, prayer, reflecting, etc.

Personal Self-Care prioritizes doing things that honor what you enjoy, need and want. This can include enjoying hobbies, treating yourself (traditional self care of face masks, spa, candle, etc), trying something new, and spending time alone.

Home Environment Self-Care can be a bit of a challenge for some because this can often be out of your control, particularly for kids and teens. This type of self care involved maintaining a safe, functional and comfortable home space. This can look like having physical safety and stability, but also includes having a clean, comfy organized space in whatever form that applies to you.

Financial Self-Care is another challenging one because it often can be somewhat out of people’s control. This means maintaining financial goals and obligations. Self-care in this form often involves saving, researching budget information, paying bills, managing money and budgeting, and getting advice from financial experts (this can be personalized, but also through a podcast or internet source).

Intellectual Self-Care addresses the inner thinker and lifetime learner that exists in all of us. This type of care involves expanding your knowledge, mindset or reasoning. Some examples to foster this include reading, listening to podcasts, watching documentaries, or even researching into a specific topic that interests you.

It is not necessary to do all of these everyday because first, that’s unrealistic and second, you don’t usually need all nine in one day. There will be some moments you are craving intellectual self care, so lean into that. There will be seasons of life that need more of one kind of self care than the other, so again go with that by listening to your brain and body. All you can do is your best!

The Dilemma of Attachment and Authenticity

By Anne DeCore, AMFT

Trauma expert and renowned physician Gabor Maté has a new book out that I highly recommend. He writes poignantly about something that therapists talk about every day with clients. In “The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture,” he states that the most widespread form of trauma in our society is the lower case “t” trauma of “disconnection from the self” in order to have attachment needs met by our parents. Because it is a largely invisible process, unlike upper case “T” trauma, people are often unable to identify how their childhood affected their development. I wanted to share Maté’s explanation of this process on the blog because I think this concept is essential for adults to understand as they self-reflect, and for parents to consider as they raise children.

Attachment is the core drive for proximity, responsiveness, and attunement from our caregivers from infancy and beyond.

Authenticity is the other core need: to be true to oneself, to honor our “gut” feelings, to express our felt emotions.

Maté explains the dilemma in these terms: “What happens if our needs for attachment are imperiled by our authenticity, our connection to what we truly feel?”

Maté tells us that the outcome of that dilemma is pre-determined. When a child senses that being true to their sense-of-self will not be acceptable to a parent, the child will conform to please the parent. We will always “secure our physical or emotional survival by relinquishing who we are and how we feel”. This adaptation is not something we have control over in childhood. Feedback loops with our caregivers over time get wired into our nervous systems and the internal adaptation to privilege inauthenticity becomes second nature. We even tell ourselves that certain traits within our personality are “who we are” instead of what they really are: the “scars of where we lost connection to ourselves”. A few examples of these traits are people-pleasing, hyper-responsibility, stoicism, perfectionism, compulsively charming, compulsively helping. Many of these adaptations in our families-of-origin are reinforced by society as admirable.

These adaptations work for us into adulthood until they don’t. There are costly consequences for repressing one’s thought, feelings and needs. Maté’s book impressively documents the link between inauthenticity and physical illness. Other consequences may be divorce, depression, addiction, and midlife fragmentation. These crises tend to force us to examine the self-concepts we hold. Often, these moments lead us to therapy.

Thankfully, Maté doesn’t leave us hopeless. He writes that developing self-awareness and self-compassion can carry us back toward authenticity. We can re-train the brain and nervous systems to expect both needs, attachment and authenticity, to simultaneously be served in our adult relationships.

Reference:

Maté, G. and Maté D. (2022). A Traumatic Tension: Attachment vs. Authenticity. In The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture; (pp. 96-112). Penguin Random House.