A good therapist wouldn’t treat his or her clients like a science project. Though there is a scientific basis for how brain chemistry and feelings correspond, we don’t experience our world through chemicals. We experience it through pain and sadness, joy, and relief. These are the mediums that the psychotherapist works with, and these are where we make sense of our world.

But that doesn’t mean that better understanding of brain chemistry and neurology can’t inform even more effective therapy. Take, for example, post-traumatic stress disorder. Those who’ve lived through trauma know that their experiences are the cause of their flashbacks, moodiness and other symptoms. But severe forms of PTSD can be very hard to work through, even with the help of a great psychotherapist. Late last year, scientists performed experiments with rats to better understand how the brain processes memory in relation to stress. Physically documenting changes between experience and brain behavior can help therapists better understand how things like PTSD work and, therefore, develop specific therapeutic strategies in light of that new knowledge. Those strategies don’t manifest through scientific terminology—they may be as simple as changing the therapy setting—but they use the science as a jumping off point for real-world strategies. (more…)

In my previous article, What Is Codependency? An Introduction, I covered what codependency is and how it develops. Now, where do you start your healing process? It involves changing some lifelong beliefs and behaviors.

Belief #1: I am responsible for everybody and everything.
No, you are not. You are responsible for yourself, your feelings, your choices and taking care of yourself. You have a responsibility to your children, but you do not have much control over what they do. You can encourage their good behaviors and discourage their negative ones. Accepting your powerlessness over others will give you a tremendous sense of relief. You no longer have the whole world on your shoulders. You can free up your energy to focus on what you can control. You can control your own recovery.

Belief #2: I can fix other adults, if I just care about them enough.
Really, we are not that powerful. If we try to control other people, we will fail. We will frustrate ourselves and alienate others. We may even push them further away from what we think they should do. Suppose we are concerned about a loved one’s addiction. We cannot convince them to seek help. The only thing that will persuade them to seek help is the consequences of their addiction. All we can do is step aside and allow them to experience the natural consequences. Suppose we love somebody and we are fearful that they will leave us for someone else. We may think that if we are hypervigilant enough that we will prevent this. In fact, we will alienate them and may push them away before they ever think about leaving. Whether it is your partner, spouse, child, boss, co-worker, sibling, or friend who is annoying, upsetting, or worrying you, you have no control over them.

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Belief #3: I cannot ever trust another person; they might hurt me, and I won’t survive.
The fact is that there are people in the world who are capable of commitment. Intimate relationships do involve an element of risk of abandonment. However, we can learn to be honest about how we feel and who we are. Then, if the other person does leave us, we haven’t really lost anything—we still have ourselves. We will be free to find someone who deserves us. Anyone who survives a relationship with a dysfunctional person is a survivor.

Belief #4: My needs are not important, and I should not spend time taking care of myself.
No, you are important. Your first responsibility is to yourself. You can’t take care of anybody else if you don’t take care of you. Tell yourself every day that you are important and deserve to have your needs met. Do you have any idea what they are? If so, make a list, and try to meet them. Treat yourself like your own very best friend. Please be nice to yourself. If you have no idea, start with the basics. Eat good healthy food, get some moderate exercise, rest, and try to do something that you enjoy. If you have read my blog articles on managing anxiety, Codependency Recovery and Managing Anxiety, Part I, there are many good ideas for self-care.

Belief#5: When I see that others need help, I have to help them.
Is it within your power to help them? Do you have the resources? Is it your responsibility to help them? Is this something that they are capable of doing for themselves? When we do something for others that they can do for themselves, we actually weaken them. What else would you be doing instead of helping them. Remember the three Cs: You did not cause it. You cannot control it. You cannot cure it.

Belief #6: I am not a worthwhile person.
You have an intrinsic value as an individual. This is separate from what you accomplish and what you do for others. When you treat yourself with love, as you would your own best friend, you will begin to feel better about yourself.

Belief #7: It is not okay to express negative feelings in my relationships.  I am afraid if I do there will be an explosion.
It is okay and important to express your feelings in relationships. If you avoid doing so, there will be barriers and resentments between you and others. You can learn to express your feelings in a tactful way, so that others may hear you and not feel defensive. I will teach you how in the next article Codependency: Changing Beliefs and Behaviors, Part II.

Here’s some interesting new insight into the human mind: first perceptions are even harder to overcome than most people had realized. According to research conducted on an international scale, our first impression of a person, place or idea becomes our brain’s default perception. If we later learn information that contradicts that perception, our brain categorizes it as an exception, rather than using the information to alter the rule. Specifically, we associate the exception with the context of that new information; all other contexts get the ‘default’ association. Say, for example, your first impression of a new coworker is negative, but you end up having a pleasant conversation when you run into him or her at the gym and change your mind. In the context of the gym, you’ll see the person more positively, but anywhere else (be it work, or even a new environment such as a restaurant), you’ll still be guided by your first impression.

This insight is especially interesting for therapists and counselors who help clients overcome phobias, said lead author Bertram Gawronski. “If someone with phobic reactions to spiders is seeking help from a psychologist, the therapy will be much more successful if it occurs in multiple different contexts rather than just in the psychologist’s office.” A similar pattern may be relevant for people struggling with profound anxiety and even PTSD. Learning healthy coping strategies in the therapist’s office can be helpful, but the idea of concept-based perception may explain why people sometimes feel less confident in their ability to apply those strategies in their daily life. (more…)

“The phrase ‘working mother’ is redundant.” Jane Sellman

“Making the decision to have a child-It’s momentous. It is to decide forever to have your heart go walking around outside your body.” Elizabeth Stone

I was inspired to write this article by many beautiful, courageous mothers, family, friends and clients.  I believe all moms are working moms, whether working at home and/or out of an office.  When I had my first son almost 10 years ago, I remember how difficult this transition was for me, as a mom who worked out of the home, and I needed all the support in the world. Having a baby for the first time is challenging enough. However, a second adjustment most definitely occurs when a mother returns to work after her baby is born. And if this mommy happens to also have other children, the transition can feel completely overwhelming.

I also want to add that for women who stay-at-home or who work part-time, they are working just as hard…doesn’t matter if work is at home, in an office, or both. Juggling it all can be tough, and all women need and deserve support. This article is geared mostly to the mom who is returning to an office job and/or a job that requires separating from baby. (more…)

When a loved one hurts you through excessive criticism, put downs or abuse of any kind, you experience emotional and often simultaneous physical pain. But can emotional abuse be considered traumatic? Dr. Francine Shapiro defines two types of trauma—“big T” trauma and “little t” trauma. “Big T” trauma refers to what we commonly think of as trauma like war or natural disaster, “little t” trauma refers to incidents such as getting teased as a child or getting rejected by your first love. Most people experience “little t” trauma some time in their lives. People who live with and love someone emotionally abusive experience “little t trauma” on a daily basis. The experience of put downs, criticisms or whatever form emotional abuse takes, not only wears down self-esteem but also impacts the nervous system. Memories of the abuse can elicit negative feelings, tense physical sensations along with negative thoughts about yourself long after the abuse has occurred.

Human beings are born with a fight, flight, or freeze response. This is nature’s way of protecting us from danger. However, our minds can’t differentiate between the danger of let’s say the sound of a grizzly bear from the sound of the voice of someone who yells at you on a regular basis. In essence, prolonged exposure to emotional abuse can create similar symptoms to posttraumatic stress disorder experienced by a combat veteran. These symptoms include anxiety, depression, social withdrawal, and avoidance of situations or people that are reminiscent of the abuser, difficulty sleeping, flashbacks of abusive memories, difficulty focusing on the present or trouble concentrating. There can also be stress-related physical symptoms like migraines, digestive problems, fibromyalgia, or fatigue.

My work as a therapist is devoted to help heal those who have suffered from abuse. I believe the only way to facilitate deep and lasting healing is to treat the trauma associated with the abusive incidents. I do so with a technique called Eye Movement Desensitization and Reprocessing. EMDR has been well researched as an effective treatment approach to eradicate symptoms related to trauma. This technique can alleviate anxiety, depression, and other related disturbances resulting from emotionally abusive experiences. EMDR helps the individual eradicate any disturbance related to an abusive incident; the memory of the incident remains but the disturbing emotions and sensations associated with the memory are eliminated. Then, the person can move on in their life free from the “ghosts” of the past. EMDR can relieve symptoms fairly quickly.

Here’s a case example. “Jane” came to therapy lacking self-confidence in meeting men. When I took a look at her thorough history, it turned out she was mercilessly bullied by peers when she was a child. Jane agreed to EMDR treatment and after a few sessions, reported no leftover negative emotions or disturbances when she thought about the bullying. She reported feeling more confident and outgoing in the company of men. Even the way she carried herself changed; she held her head high with much better posture having an air of confidence.

You don’t have to suffer from trauma related to emotional abuse. You can free yourself of painful memories and move on with your life in a positive direction with the help of an EMDR trained therapist.

Did you make a new year’s resolution to do something differently in 2011? If so, you’re in a great position to improve your self-esteem while you’re at it.

Your level of self-esteem reflects the relationship you have with yourself. The more your relationship with you is based on trust, respect, interest and affection, the better your self-esteem. Having this kind of relationship doesn’t mean looking the other way when you screw up, or pretending it didn’t happen. It means holding yourself accountable in a respectful and constructive way.

One of the easiest ways to practice holding yourself accountable is by setting goals. Self-esteem is enhanced when you set a goal that’s meaningful and important to you, and you follow through to make it happen. So if you want to improve your reputation with yourself, go ahead and set some heartfelt goals. (more…)

The term “spiritual bankruptcy” is a word used in the rooms of 12-step programs to characterize addicts who have lost their connection to “higher power.” One dictionary definition describes spiritual bankruptcy as “a state of complete lack of some abstract property.” Recently, I’ve been pondering what I believe “spiritual bankruptcy” means and how it appears in the people I know personally and treat in my practice.

If I were to think of the personal qualities of someone who seems to be spiritually bankrupt, what comes to mind is despair. The spiritually bankrupt person cannot envision a future different from the present. The spiritually bankrupt person has lost his/her moral compass and makes poor choices. The spiritually bankrupt person is self-absorbed and often oblivious of the effects of his/her actions on others.

As I write this, these qualities are sounding an awful lot like how I would describe someone who is deeply depressed. And I also wonder, what’s chicken and what’s egg. Does someone become depressed because he/she is spiritually bankrupt or is it the other way around?

People become depressed for many reasons including genetics, life circumstances and temperament (sensitivity). Can we say that a person who has faith and is deeply spiritual will never become depressed? That faith and being spiritually grounded will always be the antidote to depression?

I’m not so sure. But what I do know is that those who have faith, who are connected to the God of their understanding, who have a relationship with a higher power do recover from bouts of depression faster and more completely.

The reasons for this I believe are that a spiritually connected person knows somewhere in the depths of his/her being that the depression is temporary, an aberration as opposed to a constant and permanent state of being. The spiritually connected person can look at the depression as holding value for him/her, perhaps in the form of some opportunity for deeper understanding of self and life.

In other words, the spiritually grounded person may not succumb to the same level of despair or lack of hope that someone without a spiritual connection might.

In my particular faith (Yoruba), we believe each individual has a destiny and it is his/her obligation to fulfill that destiny. Everything is part of it, including sadness, pain and even depression. Depression is not viewed as punishment for wrong doing or as some moral failure. Knowing that can be a strong hedge against losing that connection to higher power. It is a hedge against the sort of spiritual bankruptcy I started out describing in paragraph one.

We must each find our own spiritual path. Our beliefs can take many forms. We can be a part of many different spiritual and religious communities. But one thing all religions and spiritual paths have in common is the presence of the divine. A spiritual connection can help people feel a greater sense of fulfillment in life. The emphasis is on the “fill” in the word fulfillment. It is one of the best remedies for that deep-seated emptiness that many people feel. We as humans, by connecting to our spiritual selves, have the opportunity to compensate for what we never received in our families of origin and perhaps from society.

For those who feel cognitively sluggish or emotionally lethargic, it’s certainly admirable to turn to natural remedies before prescription drugs. But many of the foods and dietary supplements presented as “brain boosting” haven’t been thoroughly studied. New research on diet’s impact on mental energy finds that there is some truth to some of the hype: “The strongest evidence suggests” that omega-3 fatty acids may truly reduce the risk of cognitive decline, and that Gingko biloba does positively impact mood and attention. This research also highlights the need for further researchers before stronger claims are made. If your mood is low and you’re having problems focusing, it doesn’t hurt to incorporate a variety of vitamins and nutrients. If exercise, adequate sleep, and a varied, balanced diet still leave you feeling off, there might be something else going on: talk to your doctor or therapist. But if you’re pinning all of your hope on a single supplement, you may want to reassess.

As the New Year begins, we think about resolutions. Though couples may have resolved to have a better relationship, resolve their differences, have less conflict, it occurred to us that we don’t really “resolve” issues in relationships.

“Resolving” connotes the process of solving a problem or difficulty, finding an answer, making a decision, bringing a disagreement to an end. Though we certainly do solve problems, make decisions and conclude conflicts with our partners, we never fully finish. Most couples have chronic issues that they continue to dialogue about during the lifetime of their marriages. Actually, our relationships are in a continual process of “evolution,” growing healthier and stronger or becoming weaker and more fragile. As 2011 gets off to a start we want to share our thoughts with you about “Relationship Evolution.”

“Relationship Evolution” is the never-ending, continual process of consciously creating the head, heart, hormone connection through the ongoing actions and words exchanged between two people. (more…)

When we think of sex therapy, we generally assume this takes place with (and is for) adults or couples. This neglects the importance of helping our children understand sexuality and their bodies.

If you are a parent, an aunt or uncle, or a much older sibling, you know that when it comes to the subject of sex and children, we walk around on eggshells. Children are sexual beings from the day they are born, though, and in depriving them of sexual knowledge and their own natural expressions we do them an injustice, often stunting their sexual development and growth.

We worry about overstimulation: that we are somehow being voyeuristic when we encourage kids to talk about sex. We worry that we might encourage or victimize them by educating and informing them. As educators, we worry about not having the parental permission. We assume, also, that many children live in a world where they are protected from sexually explicit material. I think we know that even the most protected child is exposed to sexual material in one form or another. Parents cannot monitor everything, but we can provide kids with tools to make informed choices and to process what they see, hear, and read.

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It’s important to recognize that children are sexual beings. Children explore their bodies alone and with each other. This is normal behavior and should not be shamed or shunned. I am referring here to masturbation and mutual exploration (i.e. playing “doctor” or “house.”) Please note: I am not referring to sexual play between two or more youths of disparate age, or an adult with a child. Age is key here. A child is naturally inquisitive and curious about his or her body; an older individual should not exploit this. It is important to know, however, that same-age or close-in-age peer exploration is a part of natural and normal sexual development.

It’s important to recognize that children are sexual beings. Children explore their bodies alone and with each other. 

An example I make is of two girls, age 8, who are found being sexual in bed. The parents decide to punish the girls, separating them from future play dates. The parents are confused and shocked, perceiving this behavior to be wrong.

It is important to know, also, that exploration is often done with a peer of the same sex.

Punishment and shunning of normal and natural behaviors, including masturbation, may lead to shame and guilt about sexuality in adulthood, and confusion and embarrassment throughout development.

A great book to read on this matter is Sex, Therapy, and Kids: Addressing Their Concerns Through Talk and Play, by Sharon Lamb. If you are feeling ill-equipped, under-informed, or worrisome about talking about sex, it is important to know that when we’re silent, kids aren’t getting the adult guidance and help they need.

When we are silent in response to sexual material brought up by children, we mimic and reproduce the world the child is exposed to every day, one that excites and confuses him or her and provides little space for processing. As adults, it is important for us to take the lead and teach.

Seeking a trained psychotherapist in the area of sexuality can also be a great place to start.

Has my entire marriage been a lie? Am I to blame? Is there any hope for my marriage? Is divorce my best option? These are just a few of the questions that will run through your mind after discovering a partner’s sexual betrayal and sex addiction. You will experience a roller coaster of emotions.

You want to, first, encourage the betraying-spouse to take care of himself or herself while you seek support. Next, don’t make any permanent or rash decisions while the feelings are raw and fresh. Finally, realize that divorce does not have to be the answer, if both individuals in are willing to follow an intentional path toward healing the relationship.

Let’s take a look at these intentional, choices that can make healing a reality, in a relationship overwhelmed by sexual addiction.

• Both partners are willing to do their own work: Though there may come a time down the road for each individual to go to counseling together, it is very important for each person to be committed to a plan that will help them individually. The betraying partner may not be in a place to consider working on the marriage. Rather than forcing that the issue, work your own plan to deal with the grieving, the pain, the anger, and the actual betrayal. Focus on who you are, first, before concerning yourself with your role in the relationship, and how it has/will change. At the same time, the partner that has done the betraying needs to have a very clear and specific plan for himself or herself, individually.  If this step does not take place, it will prove to be very challenging. Each partner needs to be committed to their individual healing. [fat_widget_right]

• Steps to stop the sexual addictive behaviors: Once a betrayed-spouse knows about the sexually addictive choices and behaviors his/her partner has engaged in, it becomes increasingly difficult to stay engaged in the relationship. Major steps to end the behavior(s) need to be taken. This does not make him/her the dictator, but it is fair for the betrayed-spouse to set boundaries which state that, in order to stay together, the addictive behavior(s) must stop. This can look different for each couple, from having check-in meetings, to creating an actual written agreement. Again, this goes back to the betraying-partner’s willingness to face their sexual addiction, take accountability, get counseling, and engage in an openness of sharing that will foster and rebuild trust. This will have a dual benefit to the relationship. The hurt partner will see an effort in their spouse to take care of him or herself and also begin to honor the relationship. The partner facing the battle with sexual addiction will finally get some freedom from the shame they have been living with, and begin to find a new approach to life.

• Be willing to give each other space and respect each other’s healing process and timeline: Too often, when the betraying-spouse unloads on their partner, they feel a sense of relief; A weight has been lifted from living in lies. At the same time, their partner is realizing a terrible truth about the marriage in a way he/she never dreamed would happen. Now is NOT the time to press an agenda, other than agreeing to each take steps toward healing, and respecting that each person will progress at their own pace. By working on an individual path, each partner will be focusing their energy on him/herself, while, at the same time, honoring the work the other is doing. Each partner will have time to adjust to the changes that are now taking place in his/her own life.

Where divorce does not have to be discussed at this point, it will, more than likely, cross each partners’ mind. Before this decision is made, or things are said that will be difficult to overcome, take some time to work through each of these steps. Again, if there is going to be hope, and eventually healing, each partner will have to be committed to first focusing on themselves and then, when each is at a safe place and most likely with the guidance of a therapist, they can begin to take steps to restore their relationship.

Despite the perceived over-diagnosis and over-medication of ADHD among children, not addressing attention, hyperactivity, and impulsivity problems is also problematic. Kids whose symptoms interfere with their schoolwork and social lives—whether they’re diagnosed with ADHD or not—can benefit from working with a counselor or cognitive behavioral therapist to establish healthier behavior patterns. Untreated, ADHD can interfere with a student’s ability to succeed in school, driving them elsewhere to establish themselves and find ‘positive’ feedback. It also is associated with high impulsivity, a trait that increases the likeliness of both substance abuse and crime. The worst-case scenario of untreated ADHD was exhibited in a new study of Swedish prison inmates. In the study, a higher-than-average percentage of convicts met diagnostic criteria for ADHD, and while most had shown trouble since childhood, few received attention and even fewer received treatment.