GoodTherapy | Learning to Accept Love After Experiencing TraumaLove is one of the most elemental of emotions. It is a building block of some of our deepest relationships and a component in many of our happiest days. Yet the ability to freely give and receive love is a fragile skill, which traumatic experiences can all too easily dent or damage.

Learning how to be loved is a vital part of your healing. Here are a few things to think about as you regain your ability to accept someone’s care, concern, and nurturing.

Part of learning how to be loved again is learning how to interact with people who express kindness, care, concern, nurture, and attention. Because you have experienced a traumatic experience, you have learned that people are capable of great cruelty. To avoid experiencing cruelty again, a part of your mind may have decided to ensure that you will never be hurt again. One of the ways that your mind tries to protect you from future cruelty is to assume that people are dangerous. This assumption in turn results in you leaning towards mistrust, avoiding vulnerability, and shying away from emotional intimacy.

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One way to practice opening yourself up to love is to practice opening yourself up to trust, vulnerability, and intimacy. But you have to make sure that you are practicing this with a safe person: someone who will not be cruel, let alone abusive, to you.

First, assess the level of vulnerability you open yourself up to if you take in the token of love.

Once you assess the level of vulnerability, take a moment and decide if this is a level of vulnerability you are safe with. If the vulnerability exceeds your level of healing, claim your right to do what is wisest for you, and back off or decline the token of love.

Consider the giver’s genuineness and accuracy. Is this someone with whom you have enough history to know their usual level of genuineness and accuracy? If you’re not sure, consider only accepting an expression of love that is low on your level of vulnerability. If you do have enough history with this person, then let their history of genuineness and accuracy help you decide whether to take in the expression of care, concern, or love. Someone who has proven to be genuine, truthful, and accurate is most likely extending an expression of love that is worthy of trust.

Consider whether there could be an ulterior motive. How would the giver of this token of love benefit from you accepting it? Could this benefit be damaging to you? When accepting an expression of love that makes you beholden or indebted to someone, think long and hard whether there could be an ulterior motive on the behalf of the giver.

If the expression of care is within your range of vulnerability, and is from a genuine and accurate person who does not have a damaging ulterior motive, then take in the love. Practice taking a deep breath while reminding yourself that you are actively healing one of the most fundamental of skills. Recognize that this is a moment in which you are being cared for, loved, and nurtured. Try not to miss these moments of kindness and care.

If you can believe the giver’s statements of friendship, respect, or love, then rejoice in the fact that someone believes these positive things about you. If believing these messages of love is out of your reach right now, then simply practice listening. Avoid disagreeing and don’t rebut the person’s opinions of you. Give voice to your gratitude, and express your thankfulness for this token of love.

If you are working on your healing with a therapist, try using that relationship to practice accepting care. I hope you have experienced your therapist to be the kind of genuine, accurate person with whom it will be safe to practice accepting love. Those questions about how you are, how your week was, and so on, are not just the standard questions of therapy: they are also tiny moments when therapeutic care and concern are being expressed. If nothing else, practice listening to these statements of care without disagreeing. I encourage you to take in the warmth of your therapist.

A man pushes his son on a tire swing.I was talking to one of my colleagues about our children; his are much older than mine. He had some great experience to pass along. The wisdom was that “friendship, with kids, comes later.”

What I gather from that is when a child is younger, what they need is to be parented. Parenting is teaching, guiding, and leading the child to know how to make wise choices, to be disciplined when he/she is not making a wise choice, to be shown how to love self and others, to make friends, and to evolve into a wise young person.

There are parents out there who are concerned about being their child’s friend. What is challenging is that if you are, first, a friend, then when the child is a preteen or teenager, the child will not need you as a friend. By then, he or she will have friends their own age to listen to. As teens, they need you as a parent, but they are not going to tell you that. When you become their friend first, parenting becomes difficult to establish. The child may not see you as an authority figure, and when you try to establish authority, the child will most likely question you even more. That’s not what you want.

When you are a friend first, it sends a message that you want your child to like you, to share with you, and to help you feel connected. If that’s the case, that puts a lot more pressure on the child. It is not your child’s job to help you feel good about yourself. If that is why you are your child’s friend, rather than being his/her parent, then you may need to get some counseling for yourself. You and your spouse (if married) will need to focus on a healthy relationship so the lines of parenting and friendship, even with your child, can be reassessed and altered, if need be.

When you, the parent, behave as a parent, you are laying a solid foundation for a healthy friendship with your future adult child. There will be many challenging times, and parenting is going to be difficult. Yes, you are developing a friendship with your child based on how you respond to, love, guide, lead, and, of course, have fun with him/her. But, in the beginning stages of childhood, you need to be the parent, always. Over time, the parenting will change because the child will need different amounts of parenting.

Here is an example: My son, who will be 1 year old, needs a lot of parenting. He’s mobile and will get into everything. I need to be there to make sure that he is not getting into anything that will hurt him.

As he gets older, I will still parent him to make sure he learns and makes wise choices, but as he gets older, I will have him make more decisions on his own. When he can dress himself, I will still help him but will allow him to make decisions on what he wants to wear. If he does not want to wear a seatbelt, I will of course enforce that he wears one because that is the law. Parenting changes when the child is able to make his own decisions; but you will still need to be there to see that he is making healthy decisions. If he does not make the best decision, then he also needs to learn that he will have a consequence for that decision.

As you parent, you are laying a foundation for a friendship later on with your adult child. You are still his or her parent, but when the child is 18+, it is more of a friendship with your adult child, and adult children will seek out parenting advice when they need it. At that stage, you can ask if they want you to speak as a parent or as a friend.

Think on this: Your child will have plenty of friends, but only one parent (two, of course, if you are married).

With football season nearing end, emotionally charged teen boys, who are taught how to use aggression on the field, will no longer be able to use that physical outlet for their youthful frustrations. Because of the high level of violence in the sport, experts have wondered if these teens, who are encouraged to use coercion, intimidation, and other aggressive tactics during play, are more likely to engage in bullying behaviors off the field than their nonathlete peers. Nearly half of teens today report that they have been either the victim or perpetrator of bullying. And although football does not endorse bullying, players are encouraged to aspire to masculine norms and conformity. Therefore, researchers have asked, do these factors make the players more vulnerable to bullying behaviors?

To answer this question, Jesse A. Steinfeldt of the Department of Counseling and Educational Psychology at Indiana University-Bloomington led a study involving 206 high school football players and looked at peer relationships, masculine conformity, bullying beliefs, and male role models. The results revealed that the football players would only accept or encourage bullying behavior if their peers did. Additionally, the players who conformed the most to masculine norms were among the most likely to bully, regardless of peer influence. Adhering and aspiring to masculine norms has been shown to negatively influence psychological well-being and can increase one’s risk for depression, sexual aggression, substance abuse, and low self-worth.

However, Steinfeldt discovered the highest risk factor for accepting bullying behaviors was having a male role model who also endorsed bullying. Specifically, the most influential male in the boys’ lives, whether it was a coach, uncle, father, or big brother, was the strongest indicator of bullying behavior. This discovery has significant implications for interventions and youth programs that target bullying. Steinfeldt said, “Thus, psychologists working with adolescent football players may want to consider bullying within the broader context, particularly the ways that traditional masculine norms are conveyed by peers and influential males within the unique context of football.” Steinfeldt also suggested that psychologists who work with teen football players might consider asking coaches and fathers to participate in the design and delivery of interventions in order to more powerfully influence the teens.

Reference:
Steinfeldt, J. A., Vaughan, E. L., LaFollette, J. R., & Steinfeldt, M. C. (2012, January 23). Bullying Among Adolescent Football Players: Role of Masculinity and Moral Atmosphere. Psychology of Men & Masculinity. Advance online publication. doi: 10.1037/a0026645

Woman sitting on bench near beachA death, divorce, illness, sudden unemployment, or any major loss can create chaos in your life. This emotional fracturing, as well as the practical aftershocks of dealing with estates, lawyers, housing, finances, and doctors often yields intense feelings that can be overwhelming.

When you can’t assimilate another thing, it is crucial to just stop. Even if you have never meditated, simply sitting or lying down and paying attention to your breath can calm your nervous system and give you the literal breather you need.

If it is too hard to stay still, take a walk. It is imperative you give yourself a break from the internal chatter and incessant activity that may be consuming every waking moment. When you think you do not have a minute to sit, lie down, or walk, that is when you need the break the most. Take it, and watch the world continue to spin on its axis.

Practice Beginner’s Mind, Witness Consciousness, and Self-Compassion

[fat_widget_grief_right]A big part of healing through grief is connecting with yourself while putting all the parts back together in a new way that makes you feel safe and whole. This process of reconnecting all the emotional, physical, and spiritual dots can be an exhausting and chaotic ride. One minute, there is a sense of control and growing mastery; the next, you are surfing a sea of feelings.

Part of the immediate task is showing up with what yogis call beginner’s mind and witness consciousness. Beginner’s mind refers to an attitude of openness when approaching something new—without preconceived notions—just as a beginner would. This particular grief experience is terra incognita; you haven’t had it before. By abandoning all your ideas about how you “should” feel or behave, you allow yourself to safely feel what is true in the moment. That cosmic permission slip, coupled with open awareness, allows you to fully experience the moment and all it entails emotionally. While you may want to run from it, the only way out is through it. Avoidance may provide short-term relief, but it often brings long-term pain.

Achieving witness consciousness means retraining your mind to detach enough for objectivity. It is practicing watching something with a neutral perspective and not identifying with it. Both of these yogic techniques encourage you to leave your ego outside. You might never succeed in completely detaching from your ego, but these practices can allow you to experience the freedom and joy of not taking everything personally, while enhancing your chances for greater inner peace.

Beginner’s mind, witness consciousness, and self-compassion can be the trifecta for healing from almost anything. They shore you up, increase your perspective, and allow for enough detachment to see things more clearly.

Simple Routines Can Help Ease the Chaos

Just as in yoga, where each visit to the mat reveals something new, the process of unraveling the threads of grief is fresh every minute. Whether it’s a crying spell, a fit of anger, guilt, or deep sadness, recognizing how each one is unique can keep you open to change and transformation.

The chaos of grief is sometimes caused, in part, by the old issues it triggers, such as abandonment and posttraumatic stress. During times of acute emotional turmoil, being gentle with yourself can ease the pain. Recognizing unhelpful thought patterns and challenging them as much as possible may help you to feel better and more in control.

The chaotic emotional fallout of grief can also be assuaged by establishing simple routines, such as:

Simple and readily available tasks can have a greater chance of providing you with an enjoyable way to calm the chaos.

Related articles:
Learn to Sit with Discomfort in Your Life
Surviving Suffering
How to Be With Someone Who Is Grieving

 

Happy woman lounging on park benchMany people, but primarily young, educated, Western women, struggle to sustain a positive body image—for a multitude of reasons that have been discussed in previous posts. Often a negative body image leads to a poor relationship with the body and other aspects of self. It is associated with impoverished self-care and unhealthy eating and lifestyle habits.

Having a negative body image is related to general low self-esteem and depression or anxiety. Women with poor body image often struggle with boundaries in relationship to self and others. In this post, I will attempt to shed some light on the issue of boundaries related to poor body image, a concept often discussed and infrequently understood.

Women with poor body image tend to have a compartmentalized approach to well-being. For example, they may be overly focused on certain parts of the body or particular goals, such as weight loss, while devaluing other important aspects of overall health and fitness. People who have poor body image demonstrate an all-or-nothing approach to wellness, swinging from one extreme to the other, sometimes within the same day. They tend to have an exceptional level of acquired knowledge about what is healthy and set idealistic goals based on this knowledge and also are frequently disappointed and blame themselves when they are unable to attain these goals.

The lack of a holistic perspective is evidenced in an inability to balance fitness with relaxation, healthy food choices with enjoyment of food, and so on. Not surprisingly, it is common to hear that they have dissatisfying relationships with others. The all-or-nothing tendency is implicated in their sense of being overwhelmed in relationships. They sometimes become preoccupied with the other person, swinging from feeling too close to feeling uncomfortably vulnerable even feeling lost in a relationship and wanting to cut it off.

The biggest and most obvious issue I see in working with women with poor body image is that most of the information used to make decisions about relationships and well-being comes from external sources. A total and complete lack of trust in the body and the self’s ability to regulate is obvious in their decision making. There is usually a clear history in the development of this lack of trust with regard to personal, familial, and cultural messages that have been internalized. (A full discussion of these factors is beyond the scope of this article). A lack of trust in the body and in the self leads to poor listening and misinterpretation of the cues that emerge from within. After a prolonged period of not paying attention to these signals, one’s ability to understand and act in accordance to one’s own needs becomes weakened. The needs of others become the focus of too much energy and attention, often referred to as a boundary issue.

Boundaries can be physical, mental, or emotional. Clear boundary violations are easy to identify and are well known as something that is usually morally or legally wrong and/or clearly harmful to another person’s safety, integrity, or well-being. However, there is a huge gray area between what is ideal and what is harmful, and sometimes subtle violations can lead to hurt, shame, self-doubt, and low self-esteem. Violations usually happen by the person who is in a perceived position of power, as in the obvious case of an adult taking advantage of or imposing his or her personal needs on a child, or a doctor over a patient. But there are other relationships in which people can feel vulnerable and open to influence, harmful or positive. In these more subtle cases of power and vulnerability, the delivery of emotional (or more direct) messages about the self can also lead to unhealthy attitudes, self-doubt, and low self-worth. For example, people in positions of perceived or felt power who regularly directly or indirectly impose their opinions and choices can influence others to have doubts about their own choices.

A healthy boundary between people is a perceived buffering zone, whereby a felt sense of acceptable difference exists. Respectful support of differences by people in positions of perceived power and influence can help a person grow a strong sense of self and hence the ability to re-enact these perceived boundaries in other relationships. Good boundaries lead to healthy awareness of needs of the self and also positive choices that enhance the sense of self and relationships. Supporting an individual’s development involves a strong sense of self and honoring differences in others, an open attitude of acceptance and humility. A supportive stance involves allowing another person to feel, think, struggle, learn, and identify what is right for him or her without unwelcome advice or control tactics or too much distance or silence.

Recognizing and accepting differences, a supportive stance, involves sharing personal views and opinions with a sense of humility and recognizing that they are indeed personal and individual and should not be imposed on others. Offering help when it is asked for and refraining from taking over, micromanaging, or rescuing another person is important. Healthy boundaries lead to healthy relationships, and healthy relationships lead to healthy development of individuals.

Where the development of healthy boundaries has been challenged, an individual will often be overly dependent on external information and feedback to feel safe in their decision making and hence may have a poorly developed or negative sense of their own worth. In the case of the person with poor body image, this person becomes adept at information gathering, using perceived feedback to set expectations for the self that are often unrealistic. Perception itself is flawed and is often skewed towards negative, self-fulfilling ideas of self-worth. By engaging in a selection bias, people with low self-esteem will seek out and attend to cues that confirm what they think they know about themselves that is usually negative. In addition, they may believe it is possible to please others all of the time, which is clearly faulty.

Emphasis on interpretation and internalization of other people’s expectations is a recipe for impoverished self-worth. Living according to perceived notions of other people’s expectations often leads to repressed resentment, disempowerment, and disappointment. In some cases, the only way to assert the self is in a passive-aggressive manner, which is usually not received well by others. While indeed it is healthy to have a sense of social expectation and be kind and thoughtful towards others, these behaviors need to be enacted based on a clear and healthy sense of self, which requires an awareness of personal thoughts, beliefs, feelings, and needs and the differences between self and other. Healthy self and healthy relationships interrelate and influence the development of both. The development of clear boundaries has a positive impact on individuals and on others with whom they have relationships.

However, the responsibility for nurturing clear boundaries falls on individuals in a position of power of any kind. Most people in some domain of their lives are in a position to help or hinder the development of another person. It is important that we always be aware of the difference between our own needs and feelings and those of others and to refrain from overstepping and imposing or, conversely, mistakenly taking on responsibility for other people in a way that invalidates or challenges their own development.

Where boundaries were violated, or not properly developed, psychotherapy can help to personalize new ways of being that include more emotional self-awareness and self-regulation, as well as assertiveness and effective communication skills. Healthy boundaries and self-esteem are achievable goals.

Related articles:
Our Bodies/Ourselves
The Vanity Myth: Eating Disorders and Beauty
Self-Esteem and Standards

A young woman lies on the floor, studying with books and a notebook.Now that you understand how codependency develops in a family surrounding a dysfunctional person, what are you supposed to do next?

Many people have said to me in therapy, “Joyce, now that I understand where my fear of abandonment comes from, how do I stop being so scared of it that I mess up my relationships?”

You can learn to do this, but it certainly isn’t easy. As you go through this series of codependency workbook articles, you may feel uneasy when you try on new behaviors. It’s okay. Try to give yourself permission to be awkward. You don’t have to do everything perfectly. Ideally, you have a therapist available to you or, at minimum, a 12-step program and a supportive friend.

The first step in my series of workbook exercises is to write out or to record a statement about how your family is dysfunctional. I know that you do not wish to dwell in the past, nor do I wish to bring up so many painful memories for you. However, to begin your healing, it is important to face some of the things that you have successfully survived. Denial or constricting your feelings will not help you get to where you want to go.

Try to answer some of these questions in writing:

  1. How is your family dysfunctional? Is there addiction, mental illness, physical illness, poverty, sexual abuse, something else, or a combination of these things?
  2. Is it one or both parents? Stepparents?
  3. Were your parents able to assume most of the normal parental duties? If not, did they get done? If so, who did them? If not, how did that affect you?
  4. Did odd things happen that you began to see as normal? If so, what?
  5. Were you afraid to have friends over? Did your parent(s) ever embarrass, scare, or anger you?
  6. Did family members walk on eggshells to try to avoid an explosion? If so, did they happen anyway?

Okay, I think you get the idea. Some people choose to write their family history in the form of a letter to their parent or guardian. You don’t necessarily have to send it. You can revise it, and it will at least help you begin the process of identifying your feelings. People who are codependent usually learn to constrict their feelings in a vain attempt to keep everything calm. When people write out or record their histories, they often feel angry, sad, scared, and/or hurt.

If you share those painful feelings with your therapist, your sponsor, or a supportive friend, you will find that after letting them out, you will feel some relief. Yes, it is painful, but avoiding it is even more painful in the long run.

If there were a website where people could post their family histories, you would find out that there would be many similar stories. You would realize that you are not alone. Those of you who have found your way to a 12-step program like Al-Anon or Codependents Anonymous already know this. Isn’t it a relief?

Take out a sheet of paper or a notebook or a computer and start writing your family history. If you choose to do this in the form of a letter, then tell them that you are writing this letter to let them know what it was like for you to grow up in your home with them. Or, if you prefer, start with a title like “Growing up in my family.”

A young woman with a sad look on her face talks to her therapist.Psychotherapy is the first form of treatment for depression or anxiety and involves a variety of treatment techniques. During psychotherapy, the person experiencing depression or anxiety speaks with a licensed psychologist or therapist who helps him or her to identify and work on the causative factors. These factors trigger depression or anxiety by working in combination with chemical imbalances in the brain or heredity factors.

Psychotherapy helps people with depression or anxiety in the following ways:

Although psychotherapy can be performed in different ways, such as individual, family, and group therapy, there are also different approaches that psychotherapists can use to provide therapy. After having a brief talk with the client, the therapist will decide on the approach to use based on the underlying factors that contribute to the person’s depression. Many therapists specialize in one or more specific techniques or approaches. These different approaches to psychotherapy include psychodynamic therapy, interpersonal therapy, cognitive behavioral therapy, and solution focused therapy.

Psychodynamic Therapy
This therapy assumes that the person is depressed due to unresolved, unconscious conflicts that often stem from childhood. The goal of this therapy is for the person to understand and cope better with these feelings by talking about such experiences. Psychodynamic therapy usually takes place over several months and can produce excellent results.

Interpersonal Therapy
 Interpersonal therapy mainly focuses on the person’s behaviors and interactions with family and friends. The goal of this therapy is to enhance self-esteem and improve communication skills during a short period of time. This therapy usually lasts for 3 to 4 months and works well for depression caused by social isolation, mourning, major life events, and relationship conflicts.

Psychodynamic therapy and interpersonal therapy help people resolve depression or anxiety caused by loss or grief, role transitions (like becoming a parent or caregiver), and relationship conflicts.

Cognitive Behavioral Therapy
Cognitive behavioral therapy helps people experiencing depression or anxiety to identify and change inaccurate perceptions they have about themselves and the world around them. The psychotherapist helps the client to think differently by directing attention to both the accurate and inaccurate assumptions they have about themselves and others.

This therapy is recommended for the following types of persons:

Solution Focused Therapy
Solution focused therapy is a symptom-specific approach, which means it targets one or two stressors that are causing problems. The result might be helping the person find a better way to handle the boss at work or children at home. A person may simply learn techniques to handle anxiety. One therapist commented that solution focused therapy is like getting new tools in your toolbox to use immediately in your life, therefore helping you feel better quicker.

For an individual living with depression or anxiety, psychotherapy can promote better understanding of the condition and associated symptoms. For a person with depression, being able to talk with a psychologist or therapist who is there to listen, inquire, and help can be comforting as well as rewarding. After just a few sessions of psychotherapy, clients may feel a difference. Research suggests that three to five sessions often cause significant change. Talking through the issues can help identify behaviors and detrimental reactions or circumstances. Coping techniques can also be investigated during therapy sessions, and progress reports can be used to keep track of how these techniques work. For individuals experiencing anxiety or depression, being surrounded by loved ones or being encouraged to attend therapy sessions can provide immense support.

Value affirmations, also known as self-affirmations, are positive assessments of one’s abilities, traits, and personality qualities. Value affirmations can increase self-esteem, self-worth, and fulfillment of one’s needs. When an individual recognizes their own worth and has a strong sense of identity and autonomy, they are more willing to help others meet their needs. This relationship between self-worth and prosocial behaviors has been examined in the past, but until now, few studies have looked at the effect of value affirmations on prosocial attitudes in adolescents. Sander Thomaes of the Department of Psychology at Utrecht University in the Netherlands recently conducted a study that sought to determine if subtle value affirmations could have a short-term and long-term positive effect on adolescents’ prosocial behaviors and attitudes during the crucial years of identity formation.

The participants were required to write down things that they felt were positive attributes about themselves. They were instructed to identify traits or skills they had and briefly write about them. Six weeks later, the teens were again required to acknowledge their positive traits during a booster exercise. Three months after the first writing exercise, the researchers noticed that the participants who practiced the subtle value affirmations were more inclined to exhibit prosocial behaviors than the participants in the control group. The effect was most noticeable among teens who had exhibited antisocial behaviors prior to the exercise. Thomaes believes that the results occurred for several reasons. First, teens with a strong sense of identity are not subject to the stress and pressure of trying to assimilate to others. Also, the students participated in the exercise as they transitioned into secondary school. This critical time in relationship formation was positively, rather than negatively, influenced by the feelings of love and fulfillment gained from the writing exercise. Thomaes added, “In summary, the practical value of the present research is that it identified value affirmations as a promising intervention technique, and illustrated the possibility of helping students to adopt a more prosocial orientation by allowing them to reflect on their personal values—by providing them a stronger sense of who they are.”

Reference:
Thomaes, S., Bushman, B. J., De Castro, B. O., Reijntjes, A. Arousing “Gentle Passions” in Young Adolescents: Sustained Experimental Effects of Value Affirmations on Prosocial Feelings and Behaviors. Developmental Psychology 48.1 (2012): 103-10. Print.

GoodTherapy | What Is the Right Thing to Do When an Old Lover Connects with You Online?What would you do? An important romantic figure from your past finds you on an internet social media site. Perhaps this was your first love. This renewed connection brings to mind the passion and enthusiasm of youth—before children, financial problems, and middle age. In your mind, you travel back to a time before career worries, mortgage problems, and thinning hair to a time of anticipation, optimism, and more energy. What would you do? Is it a wrong choice to maintain contact on-line? Is it wrong to have a texting relationship? Where do you draw the line? What is the line that would determine that this is an inappropriate relationship?

Infidelity is high on the list of issues that prompt couples to seek relationship therapy. As a therapist who has worked with couples for over 25 years, I see couples struggle with the aftermath of affairs. Typically, both partners are in considerable pain as they work to heal their marriage and build the trust back. Most couples are able to navigate the storm with the help of therapy, good intentions, and motivation to save the marriage.

Recently, social media has been a player in the triangle when individuals find the old flame or school love that has been out of their lives for the last 15 years. The story has become well known. At first, the reunited lovers are happy to find each other on line and enjoy the new “friendship” and reconnection. There is no threat to the marriage. The new spouse is told about the on-line relationship and nothing seems amiss. But slowly over time, the relationship returns to romance. The now married partner struggles with the old emotions getting stirred up again and begins to feel guilt. They try to work it out on their own by not telling their current spouse about the feelings only to find the appeal of the former romance growing stronger. They decide to meet for coffee. They don’t tell their current spouse because they don’t want to worry them. The secrets continue to grow until they become lies. They kiss and an affair begins. It ends when their current mate stumbles upon text messages or email. A few more lies follow when the wrongdoer is confronted and tries to limit the marital damages. At this time, the current spouse is hurt by the infidelity as well as the lies and denial. The lies become worse than the offense. When they come to my office for therapy, they work on repairing the damages and fixing the elements of the marriage that weren’t working before the affair. It is a lot of work to do.

When I review the choices that the wrongdoer made along to way, it is clear to me how the situation could have turned out better. Here is my advice on choice points. As soon as you begin to have feelings for another person, tell your partner, even if this disclosure causes you pain, embarrassment, or discomfort. Have long conversations with your spouse. Expect the conversations to be difficult. Expect to talk about any unhappiness that may be seeping into your relationship. Dissatisfaction that didn’t have words previously will now have names.

The names of these dissatisfactions are stress, money problems, job troubles, parenting issues, or other family concerns. These difficulties are some of the things that send partners into the arms of someone else. They are looking for an escape from the demands of life, and the old flame takes on the bright shining light of deliverance. The deliverance is short lived. The once bright light that looked like a beacon of hope in the storm was more like a kraken leading you towards the rocky shores of a shipwreck.

My advised choice point looks quite logical in hindsight, but if you are in this situation now, it does not look so simple. If there is something going on in your life that you can’t tell your partner, then the relationship is in trouble already. Talk over your choices with a trusted friend or counselor. There is more at stake here that finding relief from stress. You may be making a choice that will change your life forever. Most people who cheated on their spouses say, afterwards, that they wish they could take it back. Choose wisely.

 

Cannabis use issues (also known as Cannabis Use Disorder, or CUD) are on the rise among military veterans with posttraumatic stress (PTSD). “Indeed, rates of PTSD diagnoses among veterans increased 60% between 2002 and 2007, and rates of CUD diagnoses within the Veterans Affairs (VA) hospital system increased more than 50% between 2002 and 2009,” said Marcel O. Bonn-Miller of the National Center for PTSD and Center for Health Care Evaluation at the VA Palo Alto Health Care System in California. However, when these vets enter treatment and discontinue their cannabis use, their symptoms linger.

Anxiety increases when individuals stop using cannabis to cope with their symptoms, but until now, the cessation of cannabis in relation to PTSD symptoms had not been explored fully. To address this gap, Bonn-Miller and his colleagues conducted a study on veterans who entered treatment for PTSD with a CUD and theorized that they would have smaller treatment gains after abstaining from cannabis use than veterans without a CUD.

The researchers evaluated 260 male veterans that were receiving inpatient treatment for PTSD. They assessed the veterans at two different times over eight years, using the PTSD Checklist-Military Version. They found that the veterans who had CUD realized less change in symptom severity than those without. “Specifically, individuals with a CUD diagnosis who discontinued use, compared with those without a CUD diagnosis, had lower levels of change in total PTSD symptoms, PTSD avoidance/numbing symptoms, and PTSD hyperarousal symptoms,” said Bonn-Miller.

“In addition to these results being statistically significant, they are clinically meaningful.” In particular, those with CUD saw treatment gains similar to veterans who received no treatment at all. Additionally, with more states legalizing cannabis for medicinal purposes, veterans with PTSD who use cannabis may be unknowingly negatively impacting their recovery. This study also demonstrates the relationship between PTSD and cannabis use, underscoring the importance of further research in this area. Bonn-Miller added that clinicians should provide their clients with adaptive coping techniques before they recommend cannabis cessation for the purpose of treating PTSD.

Reference:
Bonn-Miller, M. O., Boden, M. T., Vujanovic, A. A., & Drescher, K. D. (2011, December 19). Prospective Investigation of the Impact of Cannabis Use Disorders on Posttraumatic Stress Disorder Symptoms Among Veterans in Residential Treatment. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0026621

MSca child plant MH900430999It is not a surprise that we have heard much stirring in the last several years about the importance of empathy and its role in everything from attachment, to neural development, to world positivity. There is an empathy shortage in the world, and we are seeing the far-reaching effects. Bullying. Violence. Insensitivity. Selfishness. In practice, we often see the damage done with children who are traumatized because of early life experiences characterized by a lack of empathy. Abuse, neglect, emotional bankruptcy, painful attachments and a violation of trust all contribute to a child’s ability or disruption in naturally cultivating this inherent trait.

As play therapists, we are placed in a critical position to help do something about this. But how do we teach empathy to traumatized children? Because of the unique link between trust and empathy, how do we help them develop a sense of empathy for others without worry that trust will be broken? Aside from the basic child-centered approach that demands an empathic approach from the therapist, we can further this in tangible ways to make it come alive.

First, remember the important points about emotional intelligence, moral development, and capacity for empathy:

Beyond that,  I call my approach “Kindfull” Play, and it looks something like this:

Modeling – It sounds basic, but remember that not only are we as therapists modeling empathy toward the child, but also toward the world in general. Seize opportunities to show kindness – from the stray bug that wanders into the room, to the dolls they are playing with, to a character in a sandtray. Point out feelings and ask children to recognize them in others. You are demonstrating that others can be trusted.

Sensory words and Practices – Remember that empathy is not only a thought or feeling alone; it is an Experience. It is the ability to not only think, but feel kindness, compassion, and concern for another’s situation or being. With that in mind, help the child FEEL this by using sensory words and language to engage that part of their brains. Use poetry and storytelling to enhance this play. Favorite tip:  Present your client with a list of feeling words and ask them to create a poem or write a story based on the words. For older children/teens, ask them to pick a song that instills an empathic feeling. Review the lyrics together and how they are affected by it.

Dolls, Puppets and Faces! – Empathy can be demonstrated most easily through facial expressions. Play facial expression games, faces flash cards, and ask them to create a show for others to guess Feeling Faces. Favorite tip:  Face Focus x 3 – Ask a child to choose a feeling, draw the face of the feeling, and list three possible reasons the face feels that way. Then ask them to list three ways to helpfully respond with kindness and compassion.

Bibliotherapy – Stock your playroom with terrific books on empathy and caring. Use these frequently and strengthen this activity by then engaging your client in creative crafts related to each story. Favorite tip:  Add the titles ‘Understand and Care,’ and ‘Don’t Laugh At Me’ to your collections. Also, see http://booksthathealkids.blogspot.com/ for one of the most comprehensive bibliotherapy resources available for working with children.

Nature Niceness – Bring nature play into your sessions, as it is a resource rich in opportunities for practicing kindness. Introduce them to every form of life and teach respect for it. Engage their senses on an instinctual level with kind words. Let them marvel over a blade of grass, and delight in the ant walking busily over the dirt. Touch the tree bark and notice how hard, rough, or smooth it is. Do not pick flowers, but let the growing petals brush over their skin. How soft is it? What does it smell like?  Favorite tip:  One of my favorite activities is to go on a nature walk with a child and find a special rock. Create a pet rock and design a Care List outlining what the rock needs and how it will feel if it doesn’t receive this.

Caregiver Compassion – Incorporate caregivers as empathy teachers! This is a critical point in order to help empathy grow outside of your sessions. Here, you will want to incorporate elements of filial play within your sessions and also teach parents how to continue this at home so that empathy forms where it will be most important – with their caregivers. Teach parents how to be emotionally in tune by practicing the same kinds of empathy building play you do in your sessions. Favorite tip: Have them plant a seed of any sort together, and nurture it to life. Keep a diary of how the plant feels when it receives water, when its leaves unfurl, or when sunshine warms the soil.

Share Your Self – End every session with your experience and expression of empathy toward what they have completed and accomplished. Favorite tip:  Also ask them to summarize and share, choosing one way they will apply this until the next time they see you.

My experience has taught me that there is a clear link between empathy, resilience,  and post traumatic growth. Higher levels of empathy for self and others appear to strengthen a child’s ability to heal and find trust in the world again. When we cultivate empathy in the play therapy room, not only is a child then more able to experience empathy for others, but he can experience it for himself and translate it into self-compassion and gentleness. Because empathy itself is an experience, play and play therapy are the perfect places to integrate this important healing step. In so doing, we will help set their personal stages for a lifetime of resilience, aid in moral development and values clarification, and strengthen the cycle of kindness for generations ahead. Wishing you Kindness in all things!

Related Articles:
Play is Important for Children & Their Parents
The Spirit of a Play Therapist
Moving Out From the Shadow of Trauma

Working Alliance (WA) describes the relationship between a client and therapist and the underlying bond formed during the therapeutic process.  The majority of researchers believe that a strong WA is essential to a positive treatment outcome. Ethnic and racial differences between clients and therapists can impair the working alliance and therefore influence the outcome as well. “Members of racial/ethnic minority groups may experience greater challenges in establishing a trusting therapeutic relationship due to perceived or actual cultural differences or cultural biases,” said Sherry Muterspaugh Walling of the Department of Psychology at Fresno Pacific University.

Because half of the therapists in the United States are Caucasian or of European decent, Walling believes this presents an obstacle, especially for men seeking treatment for violent crimes. “White therapists working with clients who are members of racial/ethnic minority groups may symbolize past experiences of mistreatment or discrimination or experiences of racism within the criminal justice system,” said Walling, lead author of a recent study that evaluated WA in interracial client-therapist settings. “The current study seeks to address this important research need by examining therapist and client reports of working alliance (WA) by client race/ethnicity across four time points during a 16-week cognitive– behavioral treatment program for male perpetrators of intimate partner violence (IPV).”

The participants included 107 male offenders, half of whom were Caucasian. The other half was Hispanic, American Indian, Asian American or African American. Walling discovered that the Caucasian clients who met with white therapists experienced an increase in WA over the 16 weeks. However, the minority participants did not. “The interaction between client race/ethnicity and WA was also a significant predictor of treatment outcome at 6-month follow-up,” said Walling. “The current findings point to the importance of race/ethnicity in the development of the therapist– client relationship.” She added, “Further exploration into the mechanisms underlying these differences is essential to enhance the effectiveness and quality of treatment programs for partner-violent men.”

Reference:
Walling, S. M., Suvak, M. K., Howard, J. M., Taft, C. T., & Murphy, C. M. (2011, December 19). Race/Ethnicity as a Predictor of Change in Working Alliance During Cognitive Behavioral Therapy for Intimate Partner Violence Perpetrators. Psychotherapy: Theory, Research, Practice, Training. Advance online publication. doi: 10.1037/a0025751

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