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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.

Opioid Addiction and Community Support

Opioid Addiction and Community Support

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Recently I (Lianne) was asked to be a part of the Mental Health and Wellness Summits created by Missouri Care, A Wellcare Health Plan, Inc.’s Community Impact Council for the Faith-based Community as a panelist.  The first Summit was on April 7 at The City of Life Christian Church in St. Louis, MO and it addressed the Opioid Crisis within the Faith-based Community.

Thankfully the Summit was recorded because the information shared is valuable and educational.

During this half, you will learn about why opioids are so addictive and how this epidemic has grown to where it is now.  You will also learn about how Mental Health stigma’s are hurting our communities and the people within them.

The second half of the Summit talks about the addictive cycle and then the panelist’s field questions about this issue, care, counseling, and faith.

I hope you take some time to listen to the recordings of the Summit.  The information and wisdom shared will prove helpful to those in social work, counselors, parents, teachers, pastors, and other care providers.  Teens would also benefit from watching these videos with their parents and could lead to beneficial conversations to help your teen make good choices and bring understanding to them about the seriousness of the opioid problem.

To those with a loved one struggling, there is hope!  There are many services available to those who are struggling and for their loved ones.  These resources are highlighted in these videos.

There are more Summits coming up over the next few months.  Below is a list of Summit topics and dates.

-Saturday, May 12, 2018, The Church and Suicide (Body Shaming, Self-Image, Bullying, Depression)
-Saturday, June 2, 2018, The Church and Trauma: Mental/Behavioral Health and the Homeless Man
-Saturday, July TBD, 2018, The Church and Trauma: Domestic Violence

By: Lianne Johnson, LPC, CTP

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

Survival Tips for the Holidays

by Courtney Hollingsworth, LPC

Here are a few small tips for changing the ways you engage with your relatives around the holidays. It isn’t easy to change the ways we relate to people we’ve known most or all of our lives, but it is often worth the work. This list is by no means conclusive, but a good place to start.

Take people at their word.

Try to notice how often you are attempting to read between the lines of others’ words or times when you feel expected to know what someone else feels or wants without them actually saying anything. Reading between the lines or finding the hidden meeting is common in family systems that operate more passive aggressively. Taking people at their word forces others to speak up on their own behalf, say what they really mean, and address one another with respect.

Mean your words.

The reverse of taking people at their words is true as well. If you are frequently not saying what you truly mean, then feel upset when others are not doing as you want, odds are you were not meaning your words. Speak directly and kindly, and you can avoid many of the passive-aggressive communication games that conflict avoidant families tend to get bogged down in.

Check your expectations.

Holidays are filled with expectations and typically time with family is also, therefore holidays with family members can be a double whammy. It can become the perfect traffic jam of various expectations.

Know your limits.

Try to realistically assess your limits on various planes prior to making your holiday plans. Are there certain family members you have a lower tolerance for spending time around? Is your social/extroversion threshold depleted more quickly at family gatherings? Are there certain relatives’ houses where you become a worse version of yourself longer you stay? Does being around babies and toddlers bring out the worst in you? Is your alcohol tolerance lowered in family settings? Assessing your limits prior to making your plans can help you make a more informed choice, and perhaps plan action steps toward self-care when you can’t predict that your limits will be tested and or pushed.

Know your triggers.

This one is similar to knowing your limits, in that it can be helpful to do some self-assessment prior to walking into family dynamics that are laden with emotional landmines. Try to think about instances in the past when time spent with family has led to blow-ups, arguments, hurt feelings, or even the silent (or shouted) conclusion that you’ll never go back again. Try to see if there’s a pattern between these various situations. Do you tend to be triggered by your mom’s passive aggressive comments? Do you tend to be triggered by your brother’s constant bragging about his successful career? Do you tend to be triggered by your niece talking all of the toys leaving them for the other cousins? Whatever your triggers, knowing them in advance can help prevent them from being a surprise, or even activated at all.

Make a private game of unavoidable unpleasantries.

Now, this is a little bit nuanced because it needs to be done discreetly and with wisdom, but can be helpful in surviving unavoidable unpleasantries. However, if you and your spouse or sibling share a negative feeling towards a person or behavior, you can make a private game out of how often you have to witness or endure that behavior. For example: does your dad tend to condescendingly correct other peoples grammar? Making bets on how often that will happen during the time that you spend with him. Does your aunt make snide comments under her breath? Rather than fume as you, it can be a survival strategy to find a way to laugh about it. What makes this game nuanced is you certainly don’t want others to find out about it or extend it to the point of being disrespectful.

The Difference between Dangerous and Unsafe

by Jonathan Hart, LPC

Whether we are talking about job sites, relationships, or simply walking down the street, we routinely confront the question of safety.  The fact is that we live in a dangerous world, and safety is a real question for all of us.

I have recently struck upon a difference between dangerous and unsafe.  The world is a dangerous place, but it is not always unsafe.  In terms of relationships with other human beings, we are all dangerous to each other: we all have the potential to cause hurt, whether deliberately, by mistake, by ignorance, or by accident.  

What makes a person safe or unsafe is how they handle their dangerousness.  It’s what they do when they have caused hurt that makes the difference.

Driving a car is a dangerous thing in its very nature.  How I handle that responsibility is what makes the difference between being a safe driver and an unsafe (reckless) driver.   The reckless driver des not acknowledge the inherent dangerousness of driving a 2 ton vehicle at 40 miles an hour among dozens of other 2 ton vehicles.  A reckless driver does not consider what the other vehicles might be doing but demands his or her own way, and that everyone else must make way for their vehicle.  People who are reckless in relationship behave similarly, and they act in relationally unsafe ways.

I can get into a wreck whether I am a safe driver or not, but it is more likely and typically more severe when I am reckless.

Let’s talk about relationships.  My responsibility when I speak is ALWAYS to speak the truth and to be respectful. That responsibility never changes and is never removed.   If I speak to you harshly for any reason at all, I owe you an apology, period.  Having said this, I have to acknowledge that there are a lot of reasons I might speak to you harshly.  I might be having a bad day.  I might be in a hurry, or in pain.  You may have done something to offend me.  You might have made a mistake that affected me somehow.  You might have been a jerk toward me and I responded in kind.  In this, I am dangerous: I have a lot of potential to hurt you.  

What makes me safe or unsafe is how I handle that responsibility both before and after I cause hurt.  

I am a safe user of words when I consider the words and tones I am willing to use, when I resist the tendency to speak in anger or harshness.  I can still get into a “wreck” so to speak:  I am still capable of speaking in hurtful ways.  When I am safe, I will do so less often and with less intensity, and I will stop myself sooner.

When I do cross that line, what happens next is important.  If I blame you or say you deserved it, I am creating an unsafe environment.  If I refuse to acknowledge the hurt, I am creating unsafety.  If I tell you you’re too sensitive or that you’re making a big deal out of nothing, I am creating unsafety.   If I say “I’m sorry, but…” I’m actually saying, “This is why I ‘m not sorry,” and I am creating unsafety.

What makes me relationally safe is when I own my responsibility and the fact that I broke my responsibility, and I genuinely apologize for crossing a line.  When I am open and accepting of the fact that I am human and fallible, I am more willing to be called out on misbehavior and better able to resist the defensiveness that naturally arises.  If I can accept my own humanity, I am likely more able to accept your humanity and we can have a human conversation. 

We are always dangerous to each other, but it is never a foregone conclusion that because we are dangerous, we are unsafe.  As we pay attention to the dangerousness of living and interacting with other human beings, take up our responsibility for conducting ourselves appropriately, and own our mistakes and limitations, we engage in “safe driving”.  So… buckle up, it’s dangerous out there.

Change is Loss and Loss Requires Grief

by Melinda Seley, PLPC

Several months ago, I went on a very restricted diet in hopes of resolving some chronic health issues.  And quite frankly, even with the hope that this change could bring about something good, it was haaaard.  I felt totally overwhelmed by having to figure out a new way to eat, with new recipes and new ingredients, and finding the time and energy to do so.  I wanted to throw a 2-year old style tantrum – particularly by flailing on the floor – for not getting to just eat what I want to eat.  And throughout the process, I was reminded of two things: change is loss and loss requires grief.

Change is Loss

In their book, Leadership on the Line, Linsky and Heifetz note that “people don’t resist change…they resist loss”.  Have you thought about change as loss?  Even when change is due to the best of circumstances, it requires us to lose something – whether it be a routine, a relationship, familiarity, a place that holds memories, convenience, a reputation, a known experience.

Change means unknowns. Change means having to relearn something. Change requires you to face the reality that you’re not in control.  And change often makes us face things within ourselves that we could conveniently avoid when things were status quo.

How might naming the change you are facing as loss be helpful to you in navigating it well?

Loss Requires Grief

The English Oxford Dictionary defines grief as “intense sorrow, especially caused by someone’s death.”  Grief is most often and naturally associated with death – so much so that the Oxford Dictionary even defines grief with a reference to it.  However, any loss we experience – big or small – is a cause for grief.  Not just the death of someone.

I am often asked in the counseling room what it looks like to grieve.  And though it looks different for everyone, in every situation, I believe there are some core components to this process of grieving:

  1. Name what has been lost. This includes very specific details of what you lost – because every single detail matters in understanding how you have been impacted.
  2. Allow yourself to feel. Sadness can be uncomfortable. And deep sorrow can be scary. But healing cannot come until you face your pain.  
  3. Consider if there is something you need to do to honor your pain or what has been lost. Do you need to journal about what ____ meant to you?  Do you need to create a photo book? Do you need to tell someone something?  
  4. Recognize that grieving is not a linear or predictable process. Grief can often be surprising and strike us when we are most vulnerable. A smell, a taste, a word spoken can bring with it a flood of thoughts and emotions that require going back to step one above. That is okay. That is how grief works. It is an ongoing, unpredictable process.

If change is loss and loss requires grief…it logically follows that change requires grief.  Have you considered this in your life?  Even changes that are bringing about something good have some element of loss intertwined with them when we stop to fully consider it.  How might it be helpful for you to name change as loss and grieve that loss today?

Seven Desires of Every Heart

by Melinda Seley, PLPC

In their book, The Seven Desires of Every Heart, Mark and Debra Laaser outline the following seven universal desires that every person has – regardless of age, gender, culture, or religious background:  

  • To be heard and understood  

This includes thoughts, feelings, needs, struggles, and opinions.

  • To be affirmed (specific and concrete acknowledgement of someone’s strengths)

This includes specific and concrete acknowledgement of one’s strengths.

  • To be blessed

Not only being affirmed for specific strengths and things we do well, but knowing that we are worthy and loved just for being who you are (not what you do).

  • To be safe

This includes physical, mental, emotional, and sexual safety.  

  • To be touched

We never outgrow the need for non-sexual touch and particularly a lack of confusion between sexual and non-sexual touch.  

  • To be chosen

  • To be included (more of a community aspect than “to be chosen”)

This is more of a community aspect than “to be chosen” above.

When you think about your own life and experience, how have these needs been met or left unfulfilled for you?  Perhaps it would be helpful to read that list again.  Often, when needs are met, we are not even explicitly aware that we had the need because it was inherently satisfied.  However, when our needs are not met, it can be overwhelming and stir within us very strong emotions.  We can become angry with the person not meeting our needs. We can become angry with ourselves for having the need.  Or think there must be something wrong with us for having the need in the first place. Unmet needs, particularly in childhood, can shape us deeply.

If you can identify one or more needs above that have been left unfulfilled in childhood, in a previous stage of life, or currently, I would encourage you to consider – what does it look like to grieve that unmet need?  Perhaps it looks like naming what has been left unfulfilled and allowing yourself space to sit in the sadness of the fact that you, as a human being, have a fundamental need that has not been met.  Can you give yourself permission to do that?

The motivation for considering these unmet needs in your life is not to point a finger of blame for pain you have experienced, but rather to grow in awareness of how your heart and mind have been shaped and how that impacts the way you engage in relationship with yourself and others.  And to consider where there is cause for rejoicing…and where there is a need to grieve.  Doing so ultimately allows us to live whole-heartedly and connect more fully with others.

What Not to Say to Someone Struggling

by Melinda Seley, PLPC

Sitting with someone else in their pain can be hard.  We don’t know quite what to say. We want to fix it. Make them happy. Change their perspective so it doesn’t seem as bad. Keep them from wallowing in their pain. Or maybe we just don’t want them to bring us down. Feel their pain. Or for something to be required of us due to their struggle.  

This blog is for myself as much as it is anyone else, because sometimes – when someone else is struggling – we say things without even realizing how hurtful or unhelpful they might be.  In hopes of reducing the number of times this happens for all of us, I offer this list of “what not to say to someone who is struggling”:

  • “Just wait until…”

“You’re struggling with being single?  Just wait until you’re married, then life gets hard…”
“You’re struggling with being a new parent? Just wait until you have three kids…”
“You’re stressed out working part-time?  Just wait until you’re working full-time…”

Just wait until.  It can be hard not to compare our struggles to those of others, can’t it?  When someone else expresses a difficulty and we feel that our current position has more challenges, more pain, more stress, it’s difficult to meet that person where they are and offer empathy.  It is easy to diminish the pain of others when we don’t fully know what it is like being in their shoes.  We are all different. We have different strengths and weaknesses; different personalities that make certain things harder for some than others; different support networks; and we’ve had parents and teachers who have equipped us differently to handle life’s challenges.  If we are farther along in a particular life situation (relationships, parenting, working, etc.), it is easy to forget that the first time at something is often the hardest.  There are lessons you learn along the way that lead and guide for future increased responsibility, depth of relationship, etc.  If we had more supportive, loving, present parents than others, we forget that that makes a profound difference in our ability to handle stressors.

If you find yourself saying “just wait until” …what keeps you from being able to step out of the place of comparison, see the other’s struggle where they are, and offer a response of empathy?

  • “At least…”

“You’re struggling with paying your bills on your current income? At least you have a job…”
“You’re struggling with pain your parents caused you? At least your parents are still alive…”
“You’re struggling with being a parent?  At least you were able to have kids… “

At least. I find myself saying this to a friend when I want to point to what is still good or what didn’t happen that could have made their situation even worse.  At times, this can be helpful. Putting situations in perspective and finding things to be grateful for is not bad.  But when I consider my motivation for saying “at least”, it is often because I am afraid of feeling the other’s pain or “giving them permission” to sit in the pain of what is happening.  When I say “at least”, I am indirectly saying – “you can’t be sad/disappointed/angry/etc. about ____, because it could have been worse.”  Instead of validating their emotion in response to a bad situation and being with them in it, I basically said “you just need to be grateful it wasn’t worse.”  

What keeps you from giving the other space to feel their emotions before pushing them into a place of gratitude?  

  • “It’s only/You’re just…”

“You’re struggling with your husband being deployed? It’s only 3 months…”
“You’re in 10th grade and sad you just broke up with your girlfriend?  It was just a high school relationship….”
“You say you’re struggling with depression?  You’re just sad…”

“It’s only” and “you’re just”.  These are the phrases of minimization.  Of invalidation.  Communicating there is no reason to feel what is being felt.  Or at least to the extent that they may be currently felt.  Thinking that if they only had my perspective, they would see it’s not that big of a deal.  And again, while it can often be helpful to frame our experiences within the context of a bigger picture or in light of gratitude, I ask us to consider our motivation when inviting another to do so.  Does it help us avoid having to acknowledge that what they are going through is hard for them? Do we view our suffering as greater and therefore need to make sure others know that what they’re going through isn’t that big of a deal?  Can we be humble enough to consider how they, unique as they are, might be feeling this pain?

What keeps you from validating another’s pain rather than minimizing what they are experiencing?

If you read the responses above and a specific interaction with a friend or acquaintance came to mind, know that you are not alone.  Feeling another’s pain is uncomfortable. Often scary. And awkward. It requires something of us in that we have to see life from the other’s perspective and feel things on behalf of someone else.  

What keeps you from being able to step out of comparison, give someone space to feel their emotions, or validate their pain?

The Danger Your Kids Need You Notice

by Courtney Hollingsworth, LPC

We protect our kids from germs, strangers, bullies, curse words, sunburns, violent movies, car accidents, trips and falls, traumatic news stories, mosquitos, too much sugar, a chill in the air. We go to great lengths to keep them safe. And yet many of us are overlooking an ever present danger. In fact, we are handing it to them.

Would you let your kid wander around an adult video or book store? Of course not! The impact could cause a great deal of harm to such a young, impressionable mind. It certainly would not be the way you’d like your child introduced to sexuality or be educated on what mature naked bodies look like or on how babies are made.

That is essentially what you are doing when you give your child a phone, tablet, or any other device that has access to a search engine without any filters or parental controls.

You may think this is an exaggeration, and perhaps it is, though not a big one. The generation raising kids at this moment in history did not grow up with the world at our fingertips, which is quite literally the reality for kids today. With a few simple taps of their fingers kids can see images, videos, and words of pretty much anything in the world. Anything. And kids know it. Curious about something? Overhear other kids talking about something you don’t know about? Have a question you don’t want to ask an adult? Google it! Kids are curious by nature and they have easy and immediate access to more information than probably all the generations before them combined!

 Unlike the web search history on a browser, you cannot erase the images from your child’s mind they will readily find.

The vast amount of sexual material readily available on the internet is astounding. Kids are more and more, younger and younger, stumbling across pornography without even know what it is. They simply take their curiosity to the place they’ve already learned holds all the answers, the internet. Unfortunately, the internet does not provide child appropriate, parent approved, or even accurate images and information for their curiosity.

If you wait until your child comes to you asking about sex, pornography, girls and boys kissing, girls and girls kissing, boys and boys kissing, where babies come from, the sexual anatomy of the opposite sex, or any other sexually related thing they may be curious about or have overheard, it will be too late. If you wait until you catch them looking at sexually explicit images or videos on the internet, it is too late. Talk to them BEFORE this happens. Add filters and parental controls BEFORE this happens. Protect your kids from the stuff that isn’t good for them BEFORE they find it without even knowing what they’re doing.

The next blog will introduce some resources that might be helpful with regards to these topics.

 

 

Why Communication Skills Can’t Save Your Marriage

by Jason Pogue, PLPC

In 6th grade I remember we had a day set aside where we watched videos on bullying in order to promote awareness and prevention. As part of this educational program we were taught how to communicate our feelings using “I” statements, and some small pieces of what we now call assertiveness training. Though I’m thankful this is even a part of some school curriculum, I’m not so sure it works. The next time I actually ran into a bully my heart was racing a little too fast to remember my “I” statements and the strategies for assertiveness.

It is a prolonged myth in popular culture and even in the field of counseling that teaching communication skills is effective at creating connection in distressed relationships.

Most of the research shows what my 6th grade self knew – our physiology takes over in the moment and our “skills” go out the window. So does that mean we are doomed to distress? Absolutely not. It is possible in the midst of our distress to really get at the heart of the matter and connect with one another, but it takes hard work. When something cues up our “fight or flight” response our emotional system (limbic) has already processed what’s happening multiple times before our rational system (prefrontal cortex) even comes online to explain what’s happening. From there we make a decision – and if our relationship is distressed we likely make a decision that is confusing to our partner. Take the following example:

Sarah is angry at John because she feels she is doing all the chores and he comes home and just sits on the couch. Really underneath it all Sarah feels she isn’t appreciated and seen for who she is and all she’s doing – but instead of being able to connect with this deeper place, John only experiences her anger coming after him. So, John responds by going into his ‘shell.’ He shuts down out of fear, freezing and hoping desperately to not make another wrong move. Deep down he feels like he can never get it right – like maybe something is just fundamentally wrong with him – but though this happens inside what John shows on the outside is further avoidance. He shuts down, closes up – his face goes blank and he has no words. This makes Sarah even more scared she is losing John, and so Sarah tries even harder to get her man back – so she pokes harder to try and get him to respond. But, this makes John feel even more paralyzed with fear and shame, and he shuts down even more…and round and round we go!
The point is, we can have all the communication skills in the world, but when we are dealing with the most important relationship in our life – the person to whom we put our trust that they will be there for us and available to us in our time of need – when it feels like they aren’t we can be hi-jacked by deeper waters that render our “skills” mostly meaningless.

The key is finding a way to meet one another in this deeper place with an open posture, seeking to understand why they are there and meet them in the chaos to connect instead of self-protect.