counseling

Why Group Therapy Works, Part 4

by Sam Bearer, PLPC

We’ve already looked at how group therapy is a great way to help individuals make changes in their lives by choose to be radically vulnerable with the other group member, fostering in himself or herself an outlook of unconditional positive regard, and allowing the very personal, negative feelings about himself/herself or others to be shared and eventually challenged by the other group members.

This final piece focuses more on how the group can invest and intervene in the individual member’s life. Following the individual work of being open, the group now has the opportunity to disrupt radically the emotional foundations underlying each member’s coping behaviors that got him or her into therapy.

As the group gently and slowly does this work of disrupting the members’ coping behaviors, the internal dynamics of personal guilt and shame frequently rise to a conscious level.  At this point, every man I have seen who comes through our groups retreats back into his comfortable style of relating. It is nearly impossible in the early stages of work for the man himself to see this happening and do anything to stop it.  Often, he can no longer differentiate his personality, style of relating, and identity without an outside perspective or help.  It is no longer a conscious choice.  He may not have even noticed it happening.  But, I am willing to bet 99 times out of 100 that some other member in the group noticed.

The group is meant to be that outside reference point.

Once again, vulnerability comes into play here, because the group member who noticed should be willing to appropriately, with unconditional positive regard, call out his group mate.  This reintroduces all the dynamics of the personal work from part one: vulnerability, maintaining unconditional positive regard, and personal investment.  It also adds to it the gut check of interpersonal conflict. The group members are doing exactly as they should when they can reflect back both the positive and negative they experience in relating to each member.  This work engages members both internally and externally at once.  This may seem obvious, but it is so important, not to mention difficult.  We do this kind of thing in our lives all the time.  However, we are rarely fully engaging our awareness of both pieces simultaneously.  It takes hard work to build up this new skill.  Like learning a new language, we have to take many fumbling attempts to communicate this new way, and we usually struggle at it for a while.  The safety created in the group should promote and celebrate these attempts as well as normalize the experience as something everyone in the group is fighting to do better.  It takes time as well as higher levels of concentration, self-awareness, and intentionality than we generally are used to.

It needs to be said here that this process, in therapy as well as practicing these skills in life, will take some time to sink in.

This is especially true when you consider there are years if not decades of reinforced acting out behaviors that a client wants to change.  It is likely to require a proportionate amount of time and effort for this new way of relating or sense of self to take shape.  Other factors that might increase the length of time and work to be done might be connected to and complicated by experiences of abuse or trauma.  Though the progress may be slower than an individual may like and expect, small changes over time add up to big changes.  These small steps along the way should be highlighted and celebrated as part of the greater changes each client wants to see in his or her life.

 

Why Group Therapy Works, Part 3

 by Sam Bearer, PLPC

Group therapy is a great way to help individuals make changes in their lives.  There are several aspects of group work that help make these changes possible. The first two I’ve talked about focus on the client’s investment in the group process. The first is for each group member to choose to be radically vulnerable with the other group members. The second is for each member to foster in himself or herself an outlook of unconditional positive regard in which it is safe to share, feel, learn, and empathize within the group setting.

The next piece focuses more on how the group can invest and intervene in the individual member’s life. Following the individual work of being open, the group now has the opportunity to disrupt radically the emotional foundations underlying each member’s coping behaviors that got him or her into therapy. This is one of the most difficult parts of group work, but as is usually the case with therapy, it is essential for change.

Each member must allow the very personal, negative feelings about himself/herself or others to be shared and eventually challenged by the other group members.

These negative feelings are both bound up in and displayed by each person’s style of relating.  Almost without fail, these negative feelings have been activated within the first few sessions of group work because of conflicting expectations, styles of relating, radical vulnerability of some members but not others, etc.  However, they most likely have not been fully expressed.

This is so difficult for many reasons. The most common roadblock is that the learned responses to emotional stressors, also known as styles of relating or coping patterns, are so ingrained and automatic that slowing the process down into separate phases or component parts can be daunting.

Individuals often identify themselves as inseparable from their comfortable style of relating.

In our next blog, we will conclude this series on why group therapy works.

New Year’s Resolutions

With the start of another new year, many of us find ourselves focusing on things we’d like to change in our lives – many of us call these changes New Year’s Resolutions.

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Popular points of focus include health and wellness, career goals, financial management, and planning for the future.  These are all very important things to evaluate regularly, and the beginning of a new year seems like a particularly appropriate time for evaluation and reflection.  However, we fail to actualize the vast majority of our resolutions, and this failure has a great, negative emotional impact.  This isn’t usually because of a lack of planning or resources to achieve our goals.  

Rather, it is because we lack awareness of the emotions driving us to make resolutions to change.

One of the clearest examples of this is with the proverbial commitment to eat better and lose weight.  Many of us overindulge, stress eat, or “reward ourselves” over the holiday season at the end of the year and then subsequently attempt to restrict our eating to healthier options or simply less volume overall in the new year.  We tell ourselves, “Well, I’ve had mine. Now it’s time to be good.”  We say we will “eat right” as if we were being bad or wrong previously and really knew it deep down the whole time.  This idea carries with it a subtle, or for some not so subtle, emotional sense of failure already. In addition, we may not acknowledge to ourselves the probability that we will eventually fail again, sooner or later.  Many of us reach this point and chuck in the towel.  The discomfort of making a change or the powerlessness we feel from our failures kills our energy and motivation to try again.  In the same way, our career has stalled for circumstances out of our control or our financial burdens may seem too great or confused even to attempt to overcome.  All or even one of these things can be enough to leave us feeling isolated and hopeless.

There is not a simple answer or solution to these problems, but a great place to start is by asking what emotion is motivating the resolution or desire to change.  It may be based on a negative view of self; for example, someone may feel that less valuable as a person because of dissatisfaction with his or her physical appearance.  A negative view of others may also motivate a resolution; for instance, it may stem from a desire to outperform a colleague.  Success at these kinds of resolutions will only reinforce the negative view of self or others.  It will validate the first negative, emotional experience as true. The person who had a negative view of self may feel more valuable after changing his or her appearance, but that only confirms the feeling that he or she lacked value before.  The person who wanted to outperform a colleague may feel even more contemptuous of the colleague after surpassing him or her.   On the other hand, failure often drives the negative emotional impact even deeper.  We can come away feeling even worse about ourselves or more embittered toward others than when we started.

This year, you might try making a few resolutions intentionally with positive emotional foundations, instead of recriminating ones.  The health and wellness resolution has always proven the most difficult for me to keep, but this year I am reframing my resolution.  I am going to give myself the opportunity to eat more healthy foods and exercise.  I know when I am doing so, I have more energy and feel more positive generally, but I am also giving it as a gift to my family.  Now more than ever I need to be present and active in their lives as my daughter begins to crawl and walk.  I want to give her as much of my energy as I can.  Try writing out your positive motivation on a flash card you post in your kitchen or bathroom.  Go back to it as often as you need to.  

And if you find yourself struggling to keep it, remind yourself that every new sunrise, and not just the new year, brings a fresh chance to recommit ourselves to living our lives in a way we choose, not only for ourselves but also for those we love.

By Sam Bearer, PLPC

Stopping the Runaway Train – Part IV: How to Name Our Experience

by Jason Pogue, PLPC

Here is the final blog in this series about gaining control over our emotions. So far, we’ve explored the very real experience of relational chaos and trying circumstances and looked at our ability to choose how we want to be in response to them, and we’ve discussed how the first step to stopping the runaway train is slowing down through relaxation exercises like the breathing one we tried together, and the importance of naming our experience. Here we are looking at how to go about naming our experience.

If you’re tired of being pushed around by the runaway train, and you’ve begun implementing regular relaxation exercises in your life, the next step is to really look at and accept the emotional experience present. For some this is easier than others, but for all of us we have a stunted emotional vocabulary so it can be helpful to use a chart of emotion words like the one below.

 

Take a minute and think of a recent conflict where you remember feeling overwhelmed internally. Think of the details of that situation – recount it in your mind. Are you feeling a bit of what you felt in your body then? Perhaps a tightness in the chest, or a sickness in your stomach, or a warmth in your arms and hands, or feeling like you just want to run out of the room – notice whatever is going on in your body as these are clues to our emotional experience. Now take a look at this chart. Notice we have all the words we typically use for emotion: happy, angry, sad, fearful, bad, surprised, disgusted. Try to identify which of these seems to fit what you’re experiencing, and then take it to the next outer-ring to further define that emotion. If you’re sad, are you lonely, vulnerable, despairing, guilty, depressed, hurt?

It may be more than one and that’s okay – emotions are complex.

You may find one of the more specific words that describe your experience are actually in an entirely different category than you thought. Perhaps you thought you were angry, but as you move through the layers you realize really you feel powerless. This chart certainly isn’t the master formula of all emotion, but it can be a helpful starting point to broaden our vocabulary of our internal world. Often we experience more than one emotion at the same time – and even those seem to contradict one another at times. We are complicated beings! The idea is to put words to what we are experiencing so we fully have a handle on just what’s going on inside us at the moment.

Again, it may seem silly or simple, but naming our emotional experience as precisely as we can is a crucial step in stopping the runaway train. Naming it period is actually a way in which we take back power, by putting boundaries around this experience and defining it rather than letting it define us.

Once we can precisely define our emotional experience, we will then be ready to explore why it’s there, whether it’s helping us or not, and how it may relate to our past wounds that are perhaps still pushing us around to this day.

 

 

 

 

 

 

Source: Russel Tarr, Using Plutchik’s Wheel of Emotions to improve the evaluation of sources (Available at: http://www.classtools.net/blog/using-plutchiks-wheel-of-emotions-to-improve-the-evaluation-of-sources/, last accessed February 20, 2017).

Does Validation Matter?

Validation: Why it matters.

 

by Mary Martha Abernathy, LPC

We have all experienced a situation where we have not validated a person’s beliefs or behaviors as we interact with them.  We also know what it feels like for someone to ignore our feelings, minimize our experiences, or change the subject of a conversation when the topic really matters. Validating our own feelings and those of other people is an important skill to have and to hone.    

What is validation?  Validation means “acknowledging that a person’s emotions, thoughts and behaviors have causes and are therefore understandable”.  

To validate someone means we are looking for the kernel of truth in another person’s perspective, even if we don’t agree with them.

Why is it important?  Well, it shows that we are listening to the other person and that we are trying to understand them.  It helps to strengthen our relationships because we can avoid a power struggle over who is right by validating the other person.  When we don’t validate others, it hurts.

How do we do it?  Pay attention to what the other person is saying.  Actively listen and reflect back to them what they are saying, without judging them!  We have to use our observation skills and we have to be pay attention to the conversation.  It is important to notice the little things, how is the person standing, are their arms crossed, is their face red, do they look like they are getting ready to cry?  All of these clues help us in conversation.  

We need to notice how a person is acting, listen to what a person says, and respond according to what we see and hear to help create and improve connection in relationships.

What’s the impact?  Like I said, validation helps to create connection. Validation challenges us to be present in conversation. We have to be listen to what the other person is saying in order to respond in a way that helps a person to feel understood. Validation can de-escalate a situation because you’ve avoided the fight and acknowledged the other person’s experience.  

Give it a shot!  

 

 

 

 

Information adapted from DBT Skills Manual for Adolescents, Rathus, Jill H., and Alec L. Miller. “Validation.” DBT Skills Manual for Adolescents. New York: Guilford, 2015. Print.

Reset Safe Connections Through Play Therapy

by: Isaac Knopp, PLPC

Reset Safe Connections Through Play Therapy

Big Figures, Small Worlds:

A big strong horse was the toy that Nate chose to play with in the sandbox. To anyone else this toy was just a small, plastic animal you might find at pretty much any toy store. But to Nate, who took his toy and plunged it beneath the sand and then looked up at me with wide and terrified eyes, it was more than a horse. Over the course of our time working together Nate was processing the sudden death of his dad. He always chose the horse, because to him, his dad was big and strong just like that horse.

Nate’s play was his way of telling me what he was wrestling with. Our kids have a different way of dealing with stress than we adults do. Play is a child’s way of grappling with the forces of the world and life that they cannot yet grasp. When our children encounter something too big, scary or difficult to grasp it gets incorporated directly into their play. Play is the essential and natural way a child resets their safe connections to others, self, and the world especially after they feel like their safe connections have been lost or threatened.

At times children will be classified as struggling with ADHD or having childhood anxiety, outbursts of anger, difficulty controlling emotions, self-regulating, and defiant behaviors. When in reality these classifications are simply symptoms of the child experiencing frustration in resetting their safe connections.

How do I give my child what he or she needs to succeed? As parents, our first thought is usually education, which is very important. However, often giving children what they need relationally can be a challenge because we feel ill equipped to meet them where they are. Learning how to connect with your child through play can give your child a big boost in self-image and development.

Connect Through Play:
  • Curiosity: Asking your child to explain what something means to them can be a window into their world.
  • Acceptance: Learning how to notice behaviors or play that seems bizarre yet may make total sense in their world of trying to reset their connections.
  • Empathy: Curiosity and acceptance create a platform for you to see the child’s expression of what they are really wresting with.
  • Trust: Once connections get established you will notice it is much easier for your child to rely on themselves as well as others. It will also be easier for you to trust that your child is doing important developmental work all the time.

In one of my last sessions with Nate, he walked up to the toy shelf to gaze at all the toys. His little hands brushed over that big strong horse, he then moved over to a red firetruck. He said, “I don’t need to play with the horse today”, instead he reached up and took hold of the truck. Although the horse was small it was big in Nate’s world. Through play, Nate was able to successful reestablish his safe connections.

What is trauma and do you have it? An Intro to EMDR

What is trauma and do you have it? An Intro to EMDR

by: Courtney Hollingsworth, LPC, EMDR Therapist

Do you have trauma in your past? Probably. It can be defined simply as a deeply distressing or disturbing experience. any event that causes an unusually high level of emotional stress and has a long lasting negative effect on a person. More than the mind or body can bear. If nothing in your personal life story comes to mind when you read those lines, prepare yourself for the day it does, because that day will come. Why can I say this with certainty? Life. Life is filled with brokenness, loss, sorrow, and pain. No one gets a free pass from that.

Sometimes mental health professionals differentiate between “big ’T’ Trauma” and “little ’t’ trauma.” Big “T” Trauma is a sudden, big traumatic experience such as sexual abuse, domestic violence, combat, natural disaster, rape, a life-threatening event, unexpected death of loved one, and crime. But even more common is little “t” trauma, which tends to be a smaller event, is often chronic, or experienced over and over, such as verbal abuse, bullying, loss of a pet or job, divorce, betrayal, etc. Just because the trauma feels smaller does not mean the impact is smaller. A helpful metaphor for the difference might be the difference between having your body set on fire vs being burned all over your body by matches. Both cause painful and lasting damage; it just occurs differently.

EMDR is helpful with a variety of big “T” Traumatic experiences that have caused a person to suffer from PTSD. EMDR can has also been proven to be effective for clinical issues that can be the result of little “t” trauma, such as depression, addiction, anxiety, and self esteem.

Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for trauma. More than 27 studies (since 1989) have demonstrated EMDR’s effectiveness in treating Post-Traumatic Stress Disorder (PTSD). The Department of Defense, Department of Veteran Affairs, American Psychiatric Association, and the World Health Organization all recommend this treatment.

For more information about EMDR or to set up an appointment, please contact Courtney Hollingsworth​, LPC, EMDR Therapist at ​courtney@avenuescounselingcenter.org

The Healing Presence of Brutal Reality

The Healing Presence of Brutal Reality

by: Jason Pogue, PLPC

Do you know that uncomfortable tension when you realize you are trying to be somebody or something you are not?

I’m not sure what it feels like for you. For me, it is as if my mind begins to separate itself from my heart, trying to press ahead and leave my knotted stomach and racing heart behind. If I just do these things I can pull it off and no one will know. Often my mind is so good at this that it can be in this place for weeks before I start to recognize my body aching from carrying all the tension – my tight shoulders and aching legs like clues to the mystery of where I actually am. And, no wonder it sometimes takes weeks! Prior to beginning my own counseling journey my mind was in this place for years unaware – racing ahead to avoid the deep fears of being “found out” as an imposter or discovered as someone broken beyond hope. Perhaps my mind was racing ahead at light-speed to avoid the deep pain that I didn’t know how to experience yet, unaware that this pain collects interest over time.

Recently I sat down with some colleagues to discuss an interview with a prolific psychiatrist and author, Irvin Yalom. Irvin recounted early in his career a moment when he sat in the therapy room with “a red-headed, freckled woman, a few years older than” him. In the first session, this woman shared with Irvin that she was a lesbian. Irv writes, “That was not a good start because I didn’t know what a lesbian was. I had never heard the term before.” I about burst out laughing when I first read that. This is the prolific therapist Irv Yalom! Yet even Irv has moments where he must make a choice. Am I going to try to be someone I’m not, or be real in this moment with this person?

Irv, being the gifted therapist he is, made the split-second decision that “the only way [he] could really relate to her was to be honest and to tell her [he] didn’t know what a lesbian was.” And so, he invited her to enlighten him in the coming weeks about her experience and they developed a great relationship in their work together.

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The truth that this little story reveals to me is that what we all need most is genuine and honest connection. If that exists, we can learn from each other and enjoy each other even in our differences, failures, finitude, and confusion. However, this connection is impossible when my mind is racing ahead of my heart – when I’m living in a world designed to protect me from the present, rather than risking being honest about the reality of what is happening right now.

Unfortunately the world we live in continues to tell our minds to run ahead…to forget about the moment because you have a million other things to do, too many things to worry about…or to forget about the moment because what if the moment is unbearable? And yet, it is only when we risk acknowledging the present reality of the now – when we don’t shy away from our fears, inadequacies, wounds, guilt, powerlessness – that we can ever truly enjoy the beauty in and around us and the joys of living in this world.

If you’re tired of trying to be someone you are not, what is stopping you from being who you are? What is stopping you from stopping, and entering into the reality of now?

(The interview with Irvin Yalom can be found at: https://www.psychotherapy.net/interview/irvin-yalom)

What does your Inner Voice tell you?

What does your Inner Voice tell you?

by: Courtney Hollingsworth, LPC

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“The way we talk to our children becomes their inner voice.” ― Peggy O’Mara

I came across this quote and was struck by its simple profundity. Such a sentiment can surely cause you to step back and reevaluate your typical interactions with the children in your life, which I do believe was the author’s intent. But we can also use this insight to look into the inner voice we each carry and what has informed it over the years. This inner voice has often been born within us from significant people around us as we were growing up and learning to make sense of the world.

I’m not talking about audible voices in our heads, I’m talking about the way we talk to ourselves inside ourselves. We tend to trust this voice; often to the extent that we don’t even notice it. It flows in and around us like the air we breathe. It feels true and informed. It feels like the one we can trust to keep us from believing we are capable, we can depend on others, and we are worth something.

I often find when talking with people that this voice is unkind, unforgiving, shaming, and critical. It’s cynicism feels trustworthy and it’s avoidance of hope or longing feels safe. And yet, it is all too holding us back from developing deep relationships, learning how to care for ourselves, striving to take risks in life, and hoping for something better.

Often, this voice is so embedded it can never be completely silenced. However, it can be identified, labeled untrustworthy, and we can learn to react differently to it. We can learn to tell it to be quiet, we can learn to ignore it, mistrust it, or even argue with it. We can learn to walk through our lives with a different narrator, one that is informed by the present, by reality, by trustworthy people. Counseling is a very effective way to begin to label that voice and learn new ways to talk to yourself.

Why am I so angry?

By: Andy Gear, LPC, EMDR Trained Therapist

Why am I so angry? 

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Do you ever ask yourself “why am I so angry?” Or maybe your life just feels way too frustrating and stressful. If so, this may be a sign of a deeper issue.

It’s tempting to blame others for our frustration, but irritants don’t have to cause outbursts. There are other choices; you don’t have to live like this. Here are four ways to change your life:

1. Notice the difference between the emotion of anger and our response to it. 

Anger is an appropriate response to legitimate injustice. But most of us don’t notice the transition from emotion to reaction.

That is where we can get ourselves into trouble. We feel like it is one big reflex that we have little or no control over. But that is generally untrue.

Slowing down our response allows us to notice the choices we are making. 

This is where anger management techniques can be useful. Breathing exercises, mindfulness, and other such skills can help us slow down our physical reactions and choose how we want to respond.

2. Notice your expectations.

Anger often springs from our unrealistic expectations. We are not entitled to a problem-free life, and life rarely goes as planned. As obvious as that sounds, our anger often reflects these illogical expectations.

It is important to objectively examine our expectations. If we find ourselves consistently frustrated by traffic, it is likely we have unrealistic expectations of what driving in a city is like.

Cars will cut us off, lines will be long, people will make mistakes, and customer service will be laughable. Accepting these as a given will drastically improve our enjoyment of life. The world isn’t out to get us, even if it feels that way sometimes.

People (even close friends and family) are not required to respond the way we prefer. If your pet peeve causes you consistent irritation, consider giving it up. It is unlikely that people will suddenly change.

3. Notice what anger tells us about our boundaries.

Anger can be a useful sign that our boundaries are being invaded. It warns us that something needs to change.

You may be too busy, too tired, or living an inauthentic life. Stress and exhaustion can significantly impact outlook. We may need to learn to say ‘no,’ pursue healthier relationship, or live more in line with our values. 

This may involve downsizing to what you really care about or pursuing a goal that is truly significant to you. Otherwise our deep seeded discontent may come out in unexpected and sometimes violent ways.

4. Notice what’s behind the anger.

Anger is often a secondary emotion. It is generally not the first emotion we feel. It is a reaction to softer emotions like anxiety, sadness, or hurt. But we often prefer anger over admitting that we are hurting.

Anger allows us to feel more powerful or in control, but it prevents us from dealing with the real problem. We neglect the roots of our problem—such as anxiety, depression, grief, or trauma.

Going straight to anger stops us from communicating with our loved ones about what’s really going on. Sharing our feelings of hurt or rejection would allow them to reassure and comfort us. We could have healing conversations that lead to greater connection. But communicating surface anger leads only to defensiveness.

Noticing what comes before the anger helps us to deepen our relationships through those healing conversations. This awareness also allows us to seek healing of the root issues that are driving our anger.

When we pursue this healing, we find that anger no longer holds power over us. We now have the capacity to respond differently.