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Life Rhythms

A rule of life helps keep you in tune with the natural rhythms of the world. Therapy can help you find the balance and live into your values.

Traditionally, creating a Rule of Life has been a key component of spiritual growth and direction. These rhythms are not only helpful for spiritual growth, they are also a good foundation for your mental and relational health.

Rhythms involve opposites. These patterns of life include solitude and companionship, rest and work, knowledge and experience, prayer and service, action and meditation. Notice that these go back and forth between active effort and passive refreshment.

Life involves ups and downs. The idea of rhythm is natural and normal. Many people struggle to accept both sides of life, particularly the low points. Creating a life rhythm gets you back in tune with the natural rhythms of the world.

I hear from many people that they wish things could always be good, that they could always be happy, and that they could be more outgoing and positive. But this isn’t realistic and sets you up for disappointment.

It takes effort to get in tune with yourself to see what you need. You will have times of expansion where you do feel social, active, and capable. There will also be times when you feel a need for rest, for stepping back, and for quiet solitude.

Notice this solitude is different from the isolation that often comes alongside depression. This is where discernment is important. If you feel like your desire to be alone comes from depression, your true need is social activity. Soul-refreshing solitude balances times of activity when you give from your strengths.

If you feel like your life is out of balance or if you feel pressured to keep up action and positivity without rest, go back and read the list above. Notice what words you are drawn to. Use your discernment to see what you truly need.

I can help you discern your values and find balance between action and rest. Through therapy, we can look at your patterns of life and examine how it is affecting you, your relationships, and your spiritual life. Then we can gently restructure your schedule to allow you to return to the natural rhythms of life.

Couples Counseling for One

Couple’s therapy can still be effective even if your partner doesn’t want to work with you to change the relationship. Individual therapy with a couple’s focus is possible and effective.

You may know there’s a problem in your relationship, but your partner isn’t willing to go to therapy with you. Does this sound familiar? If it does, there is hope.

Most people think of couple’s therapy as sessions with all partners in the session where they learn and practice skills to improve the relationship. While this may be an ideal for couples to transform their relationships, it’s certainly not uncommon for only one person in the relationship to want to go to therapy and put in the work for change.

Being an individual doing couple’s work can feel awkward or strange. You’ll learn communication skills that your partner isn’t learning along with you. When you go to practice your new skills, they may respond in a way you didn’t want. It can feel devitalizing and demoralizing.

But even if both of you attend couple’s sessions, these scenarios may still happen. Skills you both learn and practice with the therapist may be difficult to bring into your home. This is a normal part of growth and change.

It only takes one person to change a system. As an individual, your work in therapy can transform your relationship even without your partner participating with you. It may take more work on your part, but it is not only possible, it is effective!

I use the Gottman method with couples, and it is also a valuable resource for individuals to learn to change their relationships. If you are feeling disconnected from your partner, wanting better communication, or looking to revitalize your relationship, you can!

Reach out today to start the process of building a solid foundation for your relationship to grow and flourish.

Therapeutic Journaling

Keeping a journal can be very beneficial for your mental health, but not all journaling gives you the benefits you’re looking for. If you want to make the most out of your writing time, try these tips to make sure your journal is a therapeutic part of your day.

Know your focus. Journaling for therapy benefits is different from simply keeping a daily diary. Dedicated therapy journals should focus on the issue you’re dealing with. If you’re trying to be more outgoing to improve your dating life, your therapy journal should focus on your thoughts, feelings, and dreams about dating as well as reminiscing about past dates, family attitudes about dating, and your ideal dating life.

Keep it secure. One of the major drawbacks of traditional journaling is that your intimate details are open to the world. Whether you lock it up, hide it away, or use a private online journal, it’s important to keep things secure. Journaling for therapy is most beneficial if you can be completely honest and get everything out, but you won’t want to do this if you’re worried about someone else getting access. Find a secure place to keep your journal so you can get the most by being the most honest.

Stay in the habit. Just like traditional therapy is most effective when you go weekly, therapeutic journaling is most beneficial when you practice often. Regular journaling is the key to noticing trends in your thoughts and emotions. This is most important if you’re using journaling to help track depression or anxiety. The more you can observe yourself and your processes that might be fueling your negative emotions, the easier it will be to learn how to interrupt those processes and overcome the cycle.

Check in with how you feel. For the most part, therapeutic journaling is highly beneficial. But if you notice yourself feeling more angry, tense, or sad after you spend time writing, you might be using your journal time wrong. If your journal is just a repeat of the negative thoughts, feelings, and experiences you had in your day, it might easily make you feel worse by the end. This is a sign you need to change up your focus. Instead of writing down why everything is the worst, use your journal space constructively to challenge your negative thoughts and reframe them to something more positive and helpful.

 

Was this helpful? Look out for future series on journaling tips just for anxiety, depression, parenting, and relationships!

What is Prepare/Enrich?

Prepare/Enrich is an assessment tool to help couples and parents discover what their relationship needs to grow.

I am a certified Prepare/Enrich facilitator. I offer Prepare/Enrich (P/E) as a lower cost alternative to couple and family therapy.

Prepare/Enrich uses solid research into what makes a strong relationship and developed an assessment to show you your areas of strength and growth as a couple. The assessment is based on FACES, the Family Adaptation and Cohesion Evaluation Scale.

After our initial consultation, I’ll send you links to take the assessment at the Prepare/Enrich website. You’ll each take the test individually- the results will be much better if you don’t work together and if you feel like you can be honest about your answers.

After you take the assessment, I’ll get your results about each area- expectations, intimacy, chores, family, and more. During our sessions, we’ll go through each of these areas, focusing on areas of growth. With this system, you can expect to have 6-8 sessions together, each targeting needs indicated by your assessment results.

At the end, you’ll get your copy of the results along with practical suggestions to grow and develop your relationship. If you feel like you need more support based on your results, I also provide couple’s sessions using the Gottman method.

Ready to take the assessment or have other questions? Contact me today for a free 15 minute consultation or to schedule an appointment.

Community and Vulnerability

Vulnerability- the willingness to be open, to share our weaknesses, to be honest with others- is the foundation of true, authentic, healing community.

Most people want to be part of a group where they feel fully known and accepted for who they are. Most of the time, that’s not our experience. How many times have we shared something about ourselves and had a negative reaction from others? It’s discouraging to say the least.

This often starts in childhood. Your family usually knows you the best, and when you feel like your family doesn’t accept you as you are, it’s difficult to trust others. The solution is to create a community where you can be vulnerable and seen and known and accepted and loved just as you are. The difficult part is bridging that gap.

As we try to create community, the only way to do that is to increase our vulnerability. We all have our stories we use to test the waters to see if people are safe to trust and if they will be open or rejecting.

This is where boundaries come into play. Some people, desperate for connection, overshare from the start. They want to get everything out in the open right away to create a deeper bond with a new person. Others, careful of their privacy, don’t share much if anything when they meet new people in order to protect themselves. Neither is ideal.

Appropriate levels of openness and engagement include five stages, each with an increasing amount of self-disclosure. People should only move down the stages to closer relationship as they demonstrate that they are worthy of your trust. This can be incredibly difficult, especially if you’ve been abused, abandoned, or betrayed.

  1. Strangers. These are the people you run into at the store, at church, at a party. You may know their name or recognize their face but that’s about it. The appropriate level of openness for a Stranger is called External Facts. These External Facts give and receive knowledge that is publicly available. Appropriate self-disclosure includes how you know the host if you are at a party of a mutual friend, commenting on the weather, or talking about the activity if you are at an event. You don’t have to decide if they’re safe to trust because you’re not sharing anything personal.
  2. Acquaintances. This step up from Stranger occurs when you see them enough to feel like you have a sense of their habits and way of being. Many coworkers are Acquaintances since we spend a significant amount of time around them. Even during a long conversation, a Stranger could become an Acquaintance fairly soon after meeting. Acquaintances should have a Basic Knowledge level of openness. This includes some information about your personal history including where you were raised, where you were educated, what neighborhood you live in, your current family, and any hobbies you have. As a step up from Strangers, Acquaintances don’t necessarily need to prove trustworthiness since Basic Knowledge tends not to be very private.
  3. Friends. As you continue to spend time with Acquaintances, they may become Friends, particularly if you live near each other, have hobbies in common, or have children at the same school. Friends get to a level of openness called History and Process. History refers to your own personal history, how you came to be who you are. Process refers to your current thoughts and plans, your working determination of where you are now and where you plan to be in the immediate future. These are people you share your free time with doing mutual activities. It takes the most trust to move from an Acquaintance to a Friend. These people should be able to keep your confidence and be consistent when you agree to meet up.
  4. Close Friends. Not all Friends are suitable to be Close Friends. The level of openness here is Internal Knowledge. The distinction here is that you don’t just share your activities, thoughts, and plans but also more intimate knowledge of your hopes, dreams, fears, and concerns. More than just sharing your plan to leave your job and start your own business, you also share how excited you are to have your own store and how worried you are about paying the mortgage if it doesn’t go well. Close Friends are those you can trust to hear your hopes and fears and give you support and encouragement along the way. The shift from Friends to Close Friends usually takes trust over time to develop. It often happens slowly and organically.
  5. Inner Circle. While it seems like Close Friends should be enough, it’s also good to have and Inner Circle that gets access to your Core Knowledge. Even Close Friends shouldn’t necessarily know everything about you. Ideally, your Inner Circle contains only a select few people who you can absolutely trust. That’s why this shift should be a very conscious decision on your part.

How do you relate to this list? Do you find yourself oversharing or undersharing with new people? Most importantly, how do you decide when someone is safe to trust with an increasing level of openness?

Openness and Engagement

Teresa’s Prayer

Teresa of Avila wrote a prayer that helps me refocus my negative thoughts when I’m worried about change.

Lately, I have been meditating on this prayer written by Teresa of Avila. Meditating on prayers is one of my favorite ways to refocus my mind when I’m feeling anxious or stressed. I hope it helps you in the same way.

Let nothing disturb you, let nothing upset you

Everything changes, God alone is unchanging

With patience all things are possible

Whoever has God lacks nothing

God alone is enough

When everything seems to be changing around me and I feel worried, I think it’s helpful to remember that everything changes. Change can be very stressful, and there’s a tendency to think that change is the exception and if only things could settle down we could get back to normal. But this prayer reminds me that that’s not how life works.

In therapy, I often meet with people whose goal is to always be happy, have a relationship without any conflict, or find a perfect job. If your goal is to be happy or positive all the time, that’s unrealistic. There is no perfect relationship or job that will completely fulfill you or complete you. Having negative moods or a bad day at work fan derail you, but only if you let it.

Part of the goal of therapy is to build resilience. Given that change is constant and nothing will be perfect, how can you develop the mental skills to handle the ups and downs of life?

The stories we tell ourselves shape the way we perceive and react to the world. If your mental narrative tells you that you need to always be happy all the time in order to be okay, you’ll be consistently on the lookout for negative thoughts and emotions and it will ruin your day and your self-image. And a consistent focus on your negative thoughts can create a downward spiral that sucks you down into depression.

If this sounds familiar to you, consider meditating on this prayer to help break the negative thought cycle and get you back to a healthier narrative.

When things change, remember the times you overcame difficulty in the past, all the times change brought you a positive result, and how you made it through negative changes through your own strength and help from others.

Then ask yourself this question: What if everything works out well?

 

Parenting Teens by Parenting Toddlers

Parenting teens is a lot like parenting toddlers. Their process of individuation through saying no, isolating, or outright rebelling is frustrating and difficult to work with. And how you work through this process with your teen affects how they will grow up.

Toddlers and teens may not seem like they have much in common, but developmentally, they’re going through a very similar process both biologically and psychologically.

Toddlers are going through the process of individuating, or discovering who they are aside from their parents. You may recognize this as the main task of the “No!” phase. While infants are generally happy to go along with their caregivers, toddlers are learning that they have their own preferences and individuality. They’re becoming more aware that others are separate people with their own thoughts, emotions, and preferences.

Parenting toddlers in this phase requires patience and gentle boundaries. You want your child to explore and grow while still making sure they are safe. Most parents are familiar with how to support toddlers through the difficult phase of individuation. But even though teens are very similar to toddlers in their needs for individual development, parents are often reactive and fearful about the teenage years.

Teens are going through the exact same process as toddlers, although they aren’t small and cute anymore. They may or may not be saying, “No!” out loud, but they are separating from their parents either through isolating and withdrawing or joining with outside social groups. After puberty, many teens look more like adults than children, so it can be hard to remember that they still need the patience and gentleness their parents gave them as young children.

Consider these scenarios:

  • A two year old doesn’t want to stop playing with her toys to go to the store with her family. When her parents insist, she throws a tantrum.
  • A sixteen year old doesn’t want to leave her bedroom to go to her cousin’s birthday party with the family. When her parents insist, she refuses to go.

It’s hard for most parents to treat the sixteen year old with the same compassion and patience as the two year old. We expect tantrums and explosions from toddlers, and most parents know how to hold quiet boundaries while they cry and throw things until they are able to calm down and get back on track. But the sixteen year old has the same needs as the toddler in this case- to establish herself as an individual with her own preferences. She wants to be heard and respected. The parents have the same task as well- to help her express her thoughts and feelings so she feels heard and supported while maintaining adult control and ensuring the toddler and teen follow the rules and expectations of the family.

Parenting teens ideally should look a lot like parenting toddlers. Parents need to learn how to navigate teen individuation with the same patience, modeling, and safety with which they navigated the toddler years.

With that in mind, here are 3 lessons from parenting toddlers you can use in parenting teens through their second individuation phase and managing their withdrawing, sulking, and rebellion.

  1. Safety first. Too many parents of teens get caught up in the trap of focusing on power and control instead of safety. The goal of parenting is to raise an adult, not to maintain control forever. When a baby is learning to walk, we expect them to fall down and make sure their environment is safe enough they can fall without injury. Likewise with teens, as they learn how to make adult decisions, we can expect them to fail at times. Let them fail without stepping in to help, but make sure they are able to fail in a way that doesn’t injure them.
  2. Don’t take it personally. Your teen’s rebellion is not a challenge to your parental authority but their way of testing boundaries and developing independence. Neither isolating nor arguing are about you as the parent, they are a way for your teen to explore their identity apart from you.
  3. Keep seeking connection. Nearly every teen I’ve talked to in therapy has told me they wish they could talk to their parents about big things in their life. They want to talk through major life decisions with you. They want to process their feelings about their friends, about drugs and alcohol, about cutting and suicide, and about self-esteem. Teens often test their parents by bringing up small issues to see how you will react before they’ll risk venturing into deeper waters. If you want to keep communication open, watch how you respond in the little things to make sure they will feel safe talking about big things.

About Anxiety Disorders

Anxiety disorders are common. Learn about the three types of anxiety and the best ways to treat them in this introductory post.

Anxiety

Along with depression, anxiety disorders are the most prevalent of all mental health problems. The majority of people, sometimes estimated as high as 80%, will experience clinically significant anxiety during their lifetimes.

What Causes Anxiety?
There are a number of possible causes for anxiety. The three general categories are environmental, biological, and psychological. A serious anxiety disorder may involve one source or several. Different treatments will be more or less effective depending on the reason for your anxiety. Talking with a therapist about your anxiety can help you identify the reason for your anxiety and how it can be treated.

Environmental anxiety comes up when you are in a stressful situation. Outside stressors from your personal life, work, school, or home can result in clinically significant anxiety. When you deal with the stress, either by managing the situation or increasing your coping skills, the anxiety usually diminishes or goes away. Therapy can help you find ways to manage your environment to reduce stress. A therapist can also help you develop skills to increase your internal resilience to stressful situations that you can’t control and come up with things you can do to manage your feelings of anxiety in those situations.

Biological anxiety is caused by neurochemical imbalances in your brain that result in you feeling anxious even though there is no apparent reason for the feeling. These imbalances can happen for a number of reasons, and they can be treated by re-balancing your neurotransmitters through medication. There are several different kinds of medications that can be effective, and your doctor or psychiatrist can walk you
through your options. You may also benefit from therapy even with medication because when you experience anxiety, you can learn negative thought patterns that may continue even on medication.

Psychological anxiety is the result of your thought patterns. When you focus on anxiety-provoking thoughts, you begin to feel anxious. The feeling of anxiety reinforces the negative thought patterns which results in feeling even more anxiety. This kind of anxiety is treated best with therapy, though you may need medication to help break the cycle of negative thoughts before therapy is effective. Therapy can help you change the way you think to help you feel better.

Any questions about anxiety you want answered by a therapist? Leave a comment below or send a message and we may feature your question in a future post.

Who Owns Your Feelings

Do you find yourself saying things like “You make me so angry!” Stop blaming others for your emotions and take control of your own feelings.

In therapy, we have an idea called the locus of control. 

Locus means “position, point, or place,” and your locus of control is basically the place where your emotional control comes from. Your locus of control can be internal or external, but everyone has one.

Having an external locus of control means that whatever is controlling your emotions is outside of your own self. An external locus of control makes statements like “You make me so angry!” or “I get sad when you don’t listen to me.” Do either of these sound familiar? An external locus of control relies on others to feel okay.

An internal locus of control means that you are the one in charge of your emotions no matter what happens around you. You are able to respond appropriately to events, but you are able to choose how you feel. If the two statements above were reworked to have an internal locus of control, they would acknowledge the same emotion with a different reaction.

The first statement “You make me so angry!” could turn into a direct request- “When you come home late, please text me so I know you’re okay,” or “Please clean your room the first time I ask. If you can’t clean it by lunch, we’ll donate the toys you can’t find a home for.” The statement “You make me so angry!” doesn’t tell the other person what needs to be different. It’s also inaccurate. You are the only one with control over yourself and your emotions. Nobody else has the power to make you angry, only you can do that. In addition, nothing gets solved. An internal locus of control acknowledges that you’re feeling anger in response to the situation, whether it’s because your partner is late or your child isn’t cleaning their room, but instead of reacting in anger you’re able to proactively ask for change that can resolve the situation.

The second statement is one I hear a lot from parents. They’re trying to emotionally manipulate their children or partners into behaving the way they want. The problem is, we can’t control others and most people resent being manipulated. “I get sad when you don’t listen to me” doesn’t teach your child or partner to listen to you, it only teaches them that they can easily control your emotions with their actions. An internal locus of control sees the sad feelings that come up when others seem not to hear you, but it doesn’t blame others for your sadness. Instead, an internal locus of control would say something like “This is really important to me and I’d like to talk to you without the TV on” or “When we need to leave the park, I’d appreciate it if you would come and help me pack up the toys when I ask you, especially when I’ve given you a five minute warning.”

During the process of therapy, I teach people how to move their locus of control from external to internal. This is especially important for people who are sensitive to the emotions of others or who tend to overreact to situations.

Say to yourself, “I am in charge of how I feel.” Try to notice when you make statements that give others control of your emotions. With your observations, pay attention to who has control of your feelings if it’s not you. Many times, we have a certain person we give control to. It’s usually a parent, partner, or child- someone close to us who knows how to push our buttons.

Carefully consider how you are going to take back control of your emotions. When you are feeling calm and separated from the situation, look back and try to figure out what you really want and come up with a way to ask for what you need without giving up control of your emotions. Whether you need better communication, firmer boundaries, or just some peace and quiet, you are the only one in charge of your emotions and you are the one responsible for making sure you get your needs met.

Just like you can’t control others, they can’t really control you- it just seems like they can sometimes. Others can’t read your mind to know what you want out of a situation, you need to ask for what you want in a way that doesn’t blame them for what you’re feeling.

Treating Refractory Schizophrenia

Refractory schizophrenia occurs in about 30% of cases. When medication doesn’t work, traditional therapy can still be effective.

I’ve recently had a few new people come in for therapy with diagnoses on the schizophrenia spectrum. Not only that, but they’ve tried a few different medications with no significant reduction of symptoms. Refractory is just a fancy way of saying treatment resistant.

As a therapist, when I hear that my new clients have treatment resistant schizophrenia, my first thought is this- Can therapy help someone who isn’t helped by medications? After all, schizophrenia is a pretty major mental illness.

It’s not like depression or anxiety where the cause could be either biological or psychological, and the origin of the symptoms shapes treatment. Instead, schizophrenia is understood as a primarily biological disorder with clear ties to dysfunction in major brain systems.

With schizophrenia, medication works to relieve symptoms in approximately 70% of cases. That’s a much lower number than I expected. That means 30% of people who experience schizophrenia get little to no help from medications. There’s a lot we don’t know about schizophrenia though, so we could see that number decrease as we learn more about the brain and how it works in mental illness. In fact, I just read an article today about scientists searching for brain cues related to major mental illness. They discovered tons of tiny factors that all play into the etiology and course of major mental illness.

But that’s a bit of a tangent. My goal was to learn if there were any therapy interventions that were designed to work for people with refractory (treatment resistant) schizophrenia spectrum disorders.

I was actually surprised to find that this has been studied by a few different researchers. I found two different treatment protocols based on CBT that were demonstrated to be effective with refractory schizophrenia. They seemed similar, with slight differences. I figured it would be easy to combine these approaches and create a protocol of my own that will hopefully be effective in my three new clients.

I’ll post the full protocol in a separate post. For now, here are the two studies I used to develop this method of treatment for refractory schizophrenia.

 

Cognitive–behavioural therapy for refractory psychotic symptoms of schizophrenia resistant to atypical antipsychotic medication. Lucia R. Valmaggia, Mark Van Der Gaag, Nicholas Tarrier, Marieke Pijnenborg, Cees J. Slooff. The British Journal of Psychiatry Apr 2005, 186 (4) 324-330; DOI: 10.1192/bjp.186.4.324
The omnipotence of voices. A cognitive approach to auditory hallucinations.. P Chadwick, M Birchwood. The British Journal of Psychiatry Feb 1994, 164 (2) 190-201; DOI: 10.1192/bjp.164.2.190