What is Love?

It sounds like a strange question. However, through my experience in the therapy room, I noticed that most people have a hard time defining what “Love” means. We all want it. We are not the same without it. Marriages fail, families grow apart, and frankly people are just down right unhappy with out “Love.” In fact, research from many sources including Bowlby would suggest love is more than a want, it is one of our fundamental needs as human beings.

So why is it important to be able to define “Love”?

Simply put, we are better able to get and share “Love” when we can define it. Our skill in developing “Love” will increase as we better understand this elusive term.

• How do you define “Love”?

I have found there are many ways to define “Love”. However, none of the ways to define “Love” totally capture the entirety of what “Love” is. And yet, I have found that the more one explores and seeks to understand “Love” the better they are at getting and sharing “Love.”

One way to define “Love”

One way to define “Love” that I have picked up along the way is Robert Sternberg’s Triangular Theory of Love, or as I like to call it, the Love Triangle.

Love is made up of three separate parts: Passion, Commitment, and Intimacy.

• Passion is a strong feeling of arousal or emotional stimulus.

Example: One-night stand

• Commitment is a conscious decision to stay together.

Example: The classic “old couple” on TV that fights all the time and they really don’t like each other much but stay together out of commitment.

• Intimacy is the feelings of closeness and attachment that come because of what we share with one another.

Example: Best friends.

The goal is to have a healthy combination of all three, or Consummate Love. The people that can achieve consummate love, have strong feelings of arousal (sexual, emotional, or otherwise), are good friends with one another, and have a strong commitment to the relationship.

Applies to all Relationships

This can be applied to both couples and families. For example, I am passionate about my daughter, and having her around provokes strong emotion in me. I share my time and resources with her and feel close because of it. Also, I am strongly committed to provide and take care of her. These are all part of having a consummate love.

No one is perfect. We can all struggle with developing and maintaining a healthy loving relationship. But by being able to define love as with the Love Triangle, we are better able to steer ourselves back on track.

Back to School Tips

Can you believe we are already rounding out August and planning for September? It is amazing how fast time goes when you are having fun! I know some of you are getting school supplies, shopping for school clothes, and trying to wrap up the last of the summer adventures. To help keep you functioning, I thought it would be helpful to pass on some tips to for navigating the transition back to school.

1. Be patient with yourself, your kids, and the process of change. Expecting perfection sets you up for failure. Admitting to yourself and your family that imperfection is a normal part of being human teaches your kids that struggles are ok and manageable.  

2. Start setting a realistic schedule. It’s important to find the right balance between too little structure and overscheduling. Children are better equipped to deal with change when they know what to expect, but they easily get overwhelmed when they aren’t given time to relax and play. Give kids an opportunity to be part of the process. They will be better at following the family routine when they get to help plan it.

3. Offer choices instead of punishments. These choices need to be determined by developmental level. For example: Kindergarteners need breakfast. A good choice for this age group would be whether or not they want cheese on their eggs. For a teenager it would be appropriate for them to decide if they want to get up early enough for breakfast as long as they get out the door by a certain time. The natural consequences of that choice will help them learn how to manage their time better. Choices encourage empowerment. Limited choices encourage self-control.

4. Offer emotional support. Sometimes, as adults, we have the perception that children have life easy. We assume they couldn’t possibly be stressed out or worried or anxious, because their lives seem so simple to us. Validating their emotions as part of who they are will demonstrate acceptance and inspire confidence. Safe touch can also be part of validating emotions. A hug or a shoulder squeeze gives kids assurance that they are supported and loved.

5. Please take care of yourself. There is a difference between selfishness and good self-care. Selfishness is when you do things for yourself at the expense of others. Self-care is giving yourself nourishment so you can give more to those around you. You can’t give what you don’t have. Sometimes that requires that you to ask for help when you need it. Start allowing yourself to be more human and less superhero. Superhero’s are fun to watch in movies, but they aren’t real. Be kind to yourself starting today.

Your relationships with your children are so important. I hope some of these suggestions are encouraging and help your transition back to school be a little less stressful. Wishing you all the success you can create! You got this!

My child has a mental illness: What can a parent do?

I sat listening to my son try and describe his feelings of despair and anguish. While I’ve never been in his shoes or fully understand his struggles, I knew how he was feeling. I struggled with similar feelings of depression when I was his age. Unfortunately, this didn’t lessen his pain or mine as I watched his struggle.

As a mental health therapist, I know how to foster healing. I have knowledge and skills that have helped many young men, young women, adults, and children fight battles and come out successful. But no skills or good intentions will heal my son. It is a battle he has to fight, certainly not alone, but it is his battle. So, what can I do? What can any of us parents do to help our children who are struggling with mental illness?

1. Build strong connections. Relationships are so important to children and adults, for that matter. Too much isolation fosters depression. Play is one of the best ways to build good relationships. this. It isn’t easy to encourage a depressed or anxious child to have fun with you but providing the opportunities to bond together with play is good medicine.

2. Listen! Sometimes we, as parents, want to jump in and fix everything. However, a lot of these kids just want to know they are important enough for an adult to hear them. You can show you are listening through your body language. Are you looking at them. Is your body open and approachable? Change your body language and see what happens. You can show you are listening by what you say. Using positive and encouraging words rather than critical and hostile language fosters communication; so, does open-ended questions (questions that don’t have a yes or no answer). The idea is to help your child feel accepted.

3. Establish an environment that is shame free. Brene Brown said, “shame corrodes the very part of us that believes we are capable of change.”  Shame is negative and degrading. It never works in our favor or those around us. Your child is suffering from a complex condition with many contributing factors. Certainly, this does not mean you don’t have rules and expectations. It means you don’t indignify your child because he doesn’t meet societies standards of perfection.

4. Get professional help. Whether you see a counselor for you or for your child the skills you learn will be invaluable. A good mental health professional will help your family as part of a team effort.

5. Take care of yourself. This cannot be overstated enough. If you don’t practice good self-care you will not be able to give your whole self to your struggling child. As you practice good self-care you will also model self-love to your child. Some ways to do this are to take breaks when needed, exercise and eat healthy, short meditations, and grounding activities.

6. Be Informed. Being your child’s best advocate needs to include appropriate information on what your child’s mental health condition is and what the best treatment for his condition is. Ask your medical provider, look up legitimate websites, and talk to people that are further down the road with more experience to help you. Some helpful webistes: https://www.thenationalcouncil.org, https://www.nami.org, https://www.psychologytoday.com/us

7. Surround yourself with supportive people (ignore the critics). There are a lot of opinions about mental illness. Most of those opinionated people do not have the education or the experience to give you medical advice. However, a lot of others want to be supportive and helpful when you and your child are struggling. “Look for the helpers, “as Mr. Rogers would say. Your family needs support. There is no reason to walk this journey on your own. Support from family, friends, church members, and community helpers is available. Seek those people who have positive qualities, who will listen, and struggle with you.

I cannot promise that your family’s journey will end the way you want it to. It would be nice to have a math formula that fixes these types of situations. Sometimes the best we can do, as parents, is just to keep going. Each day will bring new complications as we fight mental illness together. There is no doubt this is a challenging time to be a parent. However, each day is one step closer to new hope and an opportunity to be courageous in spite of the difficulty.

Depression and Anxiety in Today's Youth

As a mental health clinician, mother of three teenagers, and a depression survivor I find the suicide rates in our state and country alarming. Many people are asking and looking into this teen suicide epidemic. Recently, Governor Herbert seemed to think it was important enough to form a committee/coalition to find some solutions.

When I was in my adolescent years (25 years ago), suicide happened occasionally, but not to the extent we are seeing now. What’s different? In reflecting on my clinical experiences and personal experiences, I’ve come up with a few ideas.

1. We need to build connection-

Connection with people- Brene Brown stated, “I define connection as the energy that exists between people when they feel seen, heard, and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship.”

When I was struggling with depression as an adolescent, I had a few excellent neighbors who let me into their homes when life felt confusing. They didn’t try to fix me. They just accepted me. I had a cousin that did the same. He and his wife would listen to my concerns. I don’t remember anything they said, but I knew their home was a safe haven for me. Today’s kids need neighborhoods, friends, and family who welcome them with open arms and provide safe havens.

Connection to spirituality. Spirituality does not necessarily mean the same thing as religion. Spirituality can be anything that connects oneself to something outside themselves (animals, nature, the cosmos etc.). I was deeply tied to God in my adolescence, but it was more than that. It was the knowledge that there was more to life than me. I understood that I was part of a bigger whole. I don’t think I really appreciated what that meant when I was younger. But looking back on my life I realize that my love of God connected me to things outside myself. Deepak Chopra stated “There are no extra pieces in the universe. Everyone is here because he or she has a place to fill and every piece must fit itself into the big jigsaw puzzle.”  The adolescent population today needs to be connected to spiritual things.

2. Systems Theory

Systems theory was the foundation for my training as a marriage and family therapist. Think in terms of a car engine or bicycle. All the parts work together to give the machine life. It’s the same in families. 1 + 1 does not equal 2. It is fundamentally more than that. The family is its own entity. Everybody has a role. Everybody has a part. When looking at dysfunction family therapists look at the entire family. It is not unusual for parents to bring their children to me expecting me to “fix” them. Most often the child is the one exhibiting symptoms of a family problem. Generally, it’s the family system that needs the fixing. It’s the same with our society and culture here in Utah.

Adolescents are the symptom bearers of our culture as a whole. Fix the system and the symptoms go away. Therein lies a much bigger problem than any committee can fix. But we can do little things in our homes that can change the larger system. First, we can start encouraging creative problem-solving. Our culture is very stuck in black and white thinking. For example, think of the immigrant issues we are dealing with. Some people want amnesty. Some want deportation. Both options are at either end of a spectrum. Why only two options? In between are a lot of other possibilities that nobody is talking about. The same goes for suicidal ideation. People contemplating suicide are thinking in terms of absolutes even when there are countless other options. Stay creative at home and the grains of solving problems in constructive ways will be sown.

Second, encourage feelings. We are living in an age that discourages feelings. We just aren’t taught how to use feelings to our advantage. Feelings are the flags that tell us something is going on that we need to pay attention to. We need to practice feeling. All feelings are good – angry, sad, happy, embarrassed, excited, etc. Learning to be comfortable with feelings is rarely accepted in our culture. It’s considered weak. In truth, recognizing your feelings can be a powerful tool in making deliberate choices. It’s what we choose to do with the feelings that change outcomes.

When all is said and done I think the teen years can be pretty exciting. There are new things to learn, new relationships built, and new ideas to be created. One death to suicide is one death too many. Taking little steps in your own life and in your own families will help to change the tide. Like a ripple effect, our small course changes can start to change this epidemic of suicide.

Valentines-Love it or hate it?

I hate Valentine’s Day. I’ve hated it for years. I get anxiety at this time every year because I feel like I don’t measure up, or I get let down. After thinking about it I’ve come up with two major issues I have with Valentine’s Day.

1. My marriage doesn’t look like those others. Do you remember when the Twilight books were a big deal? I was mad at my husband for two months, because he wasn’t Edward (the most romantic and beautiful man in the entire world according to Stephanie Meyer). It took me awhile to calm down about it all. It’s the same for every romantic movie. I like them, but I’m learning to look for ways my relationship is working instead of what others think it should be.

There is a really cute book called Fanny’s Dream, by Carolyn Buehner. It’s a children’s book about a woman who waits a long time for her fairy godmother to give her the man of her dreams. While she is waiting she gets married and starts a family. Over the course of many years, her fairy godmother finally shows up and offers to rescue Fanny from her life. Fanny declines because she realizes her husband has become the man of her dreams. You can watch the story on youtube: https://www.youtube.com/watch?v=RbgMuE469cM

If you can relate, then here are some tips to help you learn to appreciate and fall in love with your significant other every day in your own way:

-Keep a gratitude journal of daily events that your spouse/partner does that you love or appreciate.

-Learn your partner’s love language. What is it that helps them feel loved? (http://www.5lovelanguages.com).

-Think of quality over quantity. How do you and your main love build connection together? I like walks at the end of the day with my husband. It’s not a trip to Paris that I can brag about to all my friends (although we have done that too). It’s about sharing something between us on a regular basis that brings us together. It’s a chance to talk and hold hands and learn about each other.

2. People can’t read my mind. I get frustrated when people I love don’t do things for me that I think they should know to do – like buying me flowers on Valentine’s Day.  In the movies, one person just looks at their romantic partner and all of the sudden they are in her apartment drinking wine on a bed of roses. I don’t know how they do it, but one of those people in the relationship must have superpowers. My expectations for Valentine’s Day probably aren’t realistic if I’m expecting the hubby to know my thoughts and desires. He’s good at a lot of things, but he doesn’t have mind reading superpowers, so I guess I have to tell him. Yes, I’m saying you need to ask for what you need. It makes holidays like this much less anxiety provoking.

Here is how to ask for what you need:

-Know exactly what you want. If you don’t know, spend some time thinking about what you want, and why it’s important to you.

-Don’t send mixed messages. Say what you mean and mean what you say. Think about what your body language is saying? If you are standing with your arms folded and a scowl on your face, it’s probably not going to get you very far.

-Treat your partner the way you would want to be treated. If you don’t want a demanding, critical spouse then don’t be one yourself. Kindness, compassion, and empathy are skills that are often overlooked in long-term relationships, but they make all the difference.

A good book to help you learn good ways to communicate with your romantic partner is John Gottman’s The Seven Principles for Making Marriage Work. You can also look him up on youtube for some short clips. https://www.youtube.com/results?search_query=John+Gottman

I think I’m going to try something new this Valentine’s Day – I’m going to try and enjoy the holiday. By not putting other people’s expectations on myself and choosing in advance how I want to share my special day with my loved ones, I might enjoy it more and regret it less.

Stages of Change

Stages of Change:

Seeking help through therapy may be a hard thing to do. It is important to remember that when dealing with a behavior in life that you may need to change, everyone goes through stages of change. They might go through them quickly or it might take longer for some people. Some people regress and that is OK too. Keep in mind that every person is different and that we all move through the stages of change at our own pace.

Precontemplation:

The first stage is precontemplation, the individual thinks that there is not a problem and that their behaviors are not an issue, because of this, this is the stage where the individual doesn’t want help. The individual is usually not aware that there is a problem or a need for change, individuals only seek help in this stage if someone else encourages it or pressures them.

Contemplation:

The second stage contemplation is where the individual is more aware of their behaviors and the consequences they might face. The individual is considering change and is open to getting help but do not see a solution to the problem. This might be the stage that the individual is at when they decide to seek help through therapy.

Preparation:

Preparation is the third stage. This is where the individual is making plans to take action to change. They might be researching different ideas of what they can do to help themselves.

Action:

The fourth stage is the action stage. This is where the individual believes that they can change and they are actively working towards making that change. This can be the shortest stage and it also requires the most commitment of the individuals time and effort to change.

Maintenance:

The last state is the maintenance stage. This is where you’re maintaining the behavior change. This is where the individual needs to be able to avoid temptations and not return to their previous behaviors. This is also the stage where an individual will need to be committed to maintaining the change to prevent relapse.

Again, remember that is normal to regress and that this can be a normal part of behavior change.

Mental Health and the Holidays

Every time I hear the word “tradition” I’m taken back to a song with the same title from Fiddler on the Roof. Tevye, his family members, and the town folk all recite their roles in the song. It is insinuated that each role keeps the balance in the system, or the status quo. Traditions are a big influence on the way families function. Ask any elementary school child what traditions they have, and they will most likely reply with all the fun experiences of their family Christmas and Thanksgiving celebrations. Each of these traditions is full of rituals, routines, and procedures. I wonder if we, especially during the holiday season, consider how traditions affect our mental health. Everyone knows that the holidays can be stressful and full of triggers that can reveal even the most disciplined hulk-like parts of our personalities. I want to explore, with you, the power of traditions and how we can utilize the best parts and discard the worst, so our mental health is strengthened instead of weakened.

The Good

One of my favorite articles ever written on traditions is found on a website called The Art of Manliness (http://www.artofmanliness.com/2013/10/09/creating-a-positive-family-culture-the-importance-of-establishing-family-traditions/ ). The article addresses how traditions establish a positive family culture:

1. Traditions provide a source of family continuity and identity.

2. They strengthen family bonds.

3. Create comfort and security.

4. Teach values

5. Add rhythm and seasonality of life.

6. Pass on cultural and religious heritage.

7. Connect generations.

8. Create Family Memories

Using family traditions as a way to connect with others can be an important tool for strengthening our mental health. Mental illness and isolation are related, according to Hara Estroff Marano. She stated, “…we are built for social contact. There are serious life-threatening consequences when we don't get enough. We can't stay on track mentally. And we are compromised physically…” ( https://www.psychologytoday.com/articles/200307/the-dangers-loneliness ) . Think about all the feel-good movies on TV during the holidays. They are generally about a family or individual who overcomes isolation and finds connection. Connecting means interacting on many levels by sharing interests, listening, talking, working, laughing or playing together. It is saying “I see you” and “you are important to me.”  

The Bad

Sometimes family rituals can be used as a means of control or coercion. There can be lot of shame attached to our expectations of what we think our families “should” be doing. Despite what other families do or what great-great-grandmother did, you get to make deliberate choices about yourself and your own family. Putting boxes and walls around traditions kills creativity. And killing creativity takes the fun out of family traditions. If you want that positive experience with your family this year, pick out what you want to keep and let the rest go. You do have the power to decide for yourself how you want to create your traditions.

Another way to build a positive family culture is to change the language used. State what you want and why you want it. Use an “I” statement if you need to. Here is an example, “I really want our family to spend Christmas Eve together at the cabin, because it makes me happy. When you tell me you’d rather work I feel hurt, because your presence is important to me.” You can only make assumptions about your own feelings and desires. Shame can be passed on through accusations and wrong assumptions. You can tell someone how you feel, but it is their right to internalize it how they want. Another way you can beat shame is to accept another’s feelings. Reflective listening (acting as a mirror to the other person’s emotions) encourages respect. Saying something like, “I can see you are angry” in a calm and curious tone can keep that shame monster away. Shame in our celebrations dampens the atmosphere and keeps us from enjoying and connecting with each other. It also builds stress and increases the likelihood of depression, anxiety, or other mental ailments.

Try It Out

If you haven’t ever seen Fiddler on the Roof put it on your list to watch. While you are watching it, see if any of the ideas presented in this article resonate with you. You can also do your own experiments while visiting with family and friends this week. Pay attention to how you feel and what comes up for you when you start recognizing shame or find connection. Make that decision to connect with others. Using family traditions as a vehicle for connection can help improve your mental health, and this is a great time of year to try it out.

Getting Your Child Back to School Ready

It’s the time of year when the stores fill with great displays of school supplies and deals on kids clothing. As parents, we check off the list of recommended school supplies, find ideas on creating quality lunches and inventory our kid’s closets to know how to send our kids back to school in style. This year, I encourage you to consider started a new tradition to address any stress or anxiety your child may be experiencing.

If you think back to your early school years, you can probably remember the stress. This stress can be similar to the stress an adult would feel if they had to change jobs. An adult in this position would have to quickly adjust to many changes. There would be a new boss, coworkers, demands, and a schedule. Similarly, going back to school means coping with many changes in short amount of time. Some of these changes are:

• A new teacher

• New social group

• New academic demands

• A new schedule

How can parents help?

Begin sleep adjustment before school starts

Start adjusting their schedule with enough time to help their body and mind adjust. Most professional recommend that this adjustment begins two weeks before the first day of school. During these two weeks, you should start having your child go to sleep at an earlier bedtime with an earlier wake-up time. Remember that every child is different. Give your child more than two weeks if you have noticed your child struggling to maintain a healthy sleep schedule, or noticed them requiring more time to adjust to the school schedule in the past.

Facilitate bonding with the teacher and new peers

Attend your child’s school orientation to allow both you and your child to meet the teacher and even a few peers in the class. Before going to the orientation come up with a list of questions with your child that they would like to be answered. This will help reduce the anxiety by eliminating some of the unknown answers.

Throughout the school year, ask about the teacher and the other kids in the class. Taking an interest in your child’s peer groups encourages social development.

Talk about feelings

As you talk about feelings with your child it normalizes the fearful transition experience and reminds them that you care. Let your child know that it normal to experience many different emotions at the same time ranging from excitement to fear.

For younger children, consider purchasing feeling flash cards. These cards make talking about feelings fun and can be purchased at a number of online retailers.

Reassurance

Reassure your child that at the end of the school day you will see each other again. Remind them that it is very normal to feel nervous and it is okay to feel scared. If they have experienced another transition in school, ask them what could have made the transition easier.

Take care of yourself

Kids pick up on the stress that parent’s experience. Make sure that you are meeting your own basic needs and caring for yourself during this stressful time. If you’re feeling overwhelmed, remember that pausing for a couple deep breaths can help you refocus.  

Mindful or Mind Full

What is mindfulness?

Mindfulness is a wonderful yet unusually difficult skill to acquire. Mindfulness is the ability to be fully present and aware of what we are doing and where we are in that moment. This may seem easy in principle but think back to the last time you actually stopped to appreciate the present. All too often we’re focusing on what other people are doing around us or what we’re going to make for dinner that we let that beautiful present of the presence pass us by.

Mindfulness is a basic human ability that we all have inside us. However, like learning to walk, if we don’t take that first step and begin to practice it, we won’t be very good at it.

Mindfulness in Therapy

Becoming more mindful is a great skill for everyone but especially for those experiencing anxiety or depression. Anxious thoughts, worries, and depressed moods often take someone away from a mindful state. Although your mind may feel full, it is not fully present. Therefore, it is very beneficial to practice mindfulness during therapy. 

How can mindfulness help?

Mindfulness practice is great for stress reduction and relaxation. This in itself will lead to reduced anxiety and better mood. Additionally, it helps a person become more aware of their emotions and thinking patterns. For example, someone may feel sadness but not understand why they are sad or what to do about it. Mindfulness can help to increase awareness and attachment to those emotions so that those questions can be answered. Both these components are crucial in overcoming anxiety and depression.

Mindfulness practice

Most commonly, a therapist will use mindfulness meditations, which will guide the person to direct their attention to the present moment. However, there are various mindfulness techniques that can be used in conjunction or in place of meditation. One simple practice is called the “5 senses”, which works great for adults, adolescents, and children. Whenever you have a second, stop and think of:

• 5 things you can see

• 4 things you are touching (or that are touching you)

• 3 things that you can hear

• 2 things that you can smell

• 1 thing that you can taste. 

Once you have gone through all 5 senses, reflect on how it made you feel. Do you feel more aware of yourself and your surroundings? Do things seem clearer? Do you feel calmer?

Once the knowledge and skill of mindfulness have been acquired in therapy, the person is encouraged to incorporate it into their daily lives. These skills are especially useful in times of stress or in situations that are emotionally overwhelming.

Helping Your Child Increase Their Emotional Intelligence

Emotional intelligence—What is it?

Emotional intelligence is a term created by the two researchers Peter Salavoy and John Mayer. It is the ability to recognize, understand, and manage our own emotions. Additionally, it includes the ability to recognize, understand, and influence the emotions of others.

Why is it important?

With the skills of recognizing one’s own emotions and being understanding of the emotions of others, we are better equipped to work with others. With a higher emotional intelligence, we are able to more accurately perceive and understand social situations, manage our personal relationships, and communicate our feelings with others.

The skills associated with emotional intelligence helps both children and adults cope with change, manage emotions and behaviors, and have a higher satisfaction in life.  

How can we increase emotional intelligence?

Mirroring - How we act and handle our own emotions in front of our children shows them how to handle problems and emotions that arise in their own lives.  For example, if an adult expresses their anger by storming out of the house and never talking through the problem, then the child sees that when they experience anger avoiding the emotion is the appropriate response.

A more appropriate way to mirror this emotion would be to first recognize the emotion. Explain to the child that you are feeling frustrated and make sure that you use language to show that you own the feeling. As you own your feelings your child will begin to see that they have control over their feelings, too.  

For example, you would say “I feel frustrated because I wanted to have a day off next week” instead of saying “ I hate my boss. They made me so mad and they didn’t give me the day off that I asked for.”

After mirroring ownership of emotions, show your child the appropriate way to handle the negative feeling. If you need time alone, explain to your child that you need some alone time to think through your feelings before you talk through the problem. Later, when you are able to discuss the situation explain to your child what you were feeling and how you coped with the situation, without stating that the emotion was a bad thing.

Help your child recognize the emotions they experience

As your child grows and develops throughout life, they will often experience new emotions and feelings. By helping identify and name the emotion, it reduces some of the confusion that can be felt and normalizes the emotional experience.

If you see your child becoming tearful over a situation, recognize and empathize with what they are experiencing. “ I can see that you are really upset” This helps them put a name to the emotion and have an understanding that it is normal to experience such emotions.

Accept and acknowledge your child’s emotions

Disapproving of your child’s emotions may only cause them to repress their emotions further. Remember to accept and acknowledge your child’s emotions. One example of this can be seen when a child is crying. If the child is crying recognize that they are feeling upset or sad. Do not tell them “It’s okay, stop crying”.  When we tell the child to stop crying, we are telling them that they are wrong for experiencing the emotion they feel.

In order to accept and acknowledge your child’s emotions, you can try some of the following to let your child know you are there for them without shutting their emotional experience down.

Reassure them:

• I am here

• I hear what you are saying

• I see that this is really hard for you right now

Don’t ignore the emotion

• Tell them that what they are feeling is okay to feel

• Ask them to tell you more about the feeling they are experiencing

• Talk about the situation that the emotions are surrounding “ I see that you really wanted to go to the park today and you are upset that I have to go to work instead”

Things to try and avoid:

• Avoiding the feeling- “I know you are sad, BUT let’s go play a game to make you happy”

• Shaming the feeling- “You do not need to be crying over this” “Do you need me to give you a better reason to cry? “

• Fixing the feeling/situation- “I see that you are mad that we didn’t go to the park, I didn’t want to upset you maybe we will find some time to go today”

What you need to know about 13 Reasons Why

You’ve probably heard of the new Netflix series 13 Reasons Why and perhaps you’re wondering what all the controversy is about. The popular show is an adaptation of Jay Asher’s book, centering around the suicide of a teenage girl and the reasons why it happened. It creates a platform for conversations about suicide, depression, bullying, sexual relationships, friendships, sexual abuse, harassment, rumors, drinking and the impact of social media - quite a handful to fit into hour long episodes. 

Although the show appears to have good intentions, schools across America (including in Utah) have been issuing warnings to parents and students about the potential impact 13RW may have on vulnerable youth. 
 
Why is the show so popular?
While you may not understand why the show how become so popular, I think it’s important to understand the show from the perspective of a teenager. It’s relatable for those who don’t feel heard or understood -  which makes it extremely attractive. 

It is ultimately up to parents to decide whether their children should watch 13RW. However, I would encourage parents to view the show with their children to facilitate open dialogue. While watching, don’t be distracted by the “Hollywoodizing” and pay close attention to the core message. Suicide is not a game, it is not glamorous, and it isn’t anyone’s fault. It is sudden and ultimate, caused by significant trauma. A person’s suicide is not the responsibility of a bully, a counselor, or an ex-boyfriend. HOWEVER, it is the responsibility of all of us to take suicide seriously and it is our responsibility to build each other up rather than break each other down.
  
So, what can you do if you relate to the characters in the show?
It may feel like you’re alone, that no one understands what you’re feeling but know that there are people out there ready to help you. It may feel scary or uncomfortable to confide in someone but it can also be a relief to let all those powerful emotions and thoughts flow out (or explode, and that’s okay too!). If you’d prefer not to speak to your parents or friends, look for a third party like a therapist or school counselor.

Remember: 
•    There are people who want to and can help
•    Seek out someone you trust with your thoughts and feelings
o    Parent, friend, sibling
o    School counselor, teachers
o    Therapist (Google “therapists in your area”)
 
And, what can you do as a parent or friend if you think someone may be depressed, lonely or having suicidal thoughts?
Most importantly, know that talking about depression or suicide will not provoke someone to harm or kill themselves. If you think someone is depressed or having suicidal thoughts, ASK them, TALK to them and LISTEN. Avoiding the subject may seem like you’re being sensitive to their emotions but it will add to the person’s feeling of not being heard or that no one cares. In addition, people don’t always ask for help directly, be aware of subtle hints and sarcasm used to cover up deeper emotions.

To summarize:
•    Be aware of indirect calls for help
•    Don’t avoid the “elephant in the room”
•    Ask questions i.e. have you thought about hurting yourself?
•    Take time to have open, non-judgmental conversations
•    Demonstrate that you hear what they’re saying and are supportive
•    You may not be able to understand but you can show empathy

How can I help my community? 
As many in our communities are now seeing this trending topic, I would encourage you to use this opportunity to start a conversation. We need to have conversations, social interactions and open communication with our children. And, we need to be doing the same with people from diverse backgrounds, beliefs and ages. That is one thing that 13RW has at least raised awareness of.

It is also our responsibility to listen rather than just assume, and I mean really listen. The characters in 13RW demonstrate that everyone has their own story and this is usually split into what we showcase on the outside and what we hold close on the inside. People may put on a happy face and will probably answer “I’m fine” to “How’s it going?”. We don’t truly know what’s going unless we take time to listen, without any judgment or presuppositions.

If you or someone you know is having suicidal thoughts, these services can help:

13 Reasons Why help page: http://13reasonswhy.info/#usa

National Suicide Prevention Online Chat: https://suicidepreventionlifeline.org/#

National Suicide Prevention Lifeline: 1-800-273-8255

Utah CrisisLine: 1-801-587-3000

Utah "Safe UT" app information: https://healthcare.utah.edu/uni/clinical-services/safe-ut/

Are you in a toxic friendship?

Are you stuck in an unhealthy friendship?

As a therapist, I often work with clients to increase and enhance their positive relationships.  In most instances, as we describe and explore these relationships, we uncover unhealthy or toxic friendships. It always amazes me that regardless of the damage being done, some of us continue to rationalize or justify staying in the relationship.  Sometimes we feel sorry for them, maybe our lifestyles have changed, or perhaps we are just uncomfortable discontinuing the friendship.  Regardless of the reasons why we stay in these negative relationships, if you want to create and maintain emotional wellness it is important to begin evaluating your relationships to determine if it is a source of negativity in your life.

Let’s first identify the need for friendships.  In my experience, the top reason to develop relationships is to establish a connection.  This is a connection with someone besides ourselves, colleagues, spouse, or family members.  These social connections allow us to:

·         have someone to talk, laugh, or cry with

·         ask for help and provide help when needed

·         be ourselves, with nothing to hide

·         share secrets, that nobody else will ever know

·         encourage and support us in times of need

According to the American Psychological Association, research suggests that a sparse social circle is a significant health risk.  Other research indicates positive social connections might accelerate disease recovery. In a study of 200 breast cancer survivors, psychologist Lisa Jaremka, Ph.D., and colleagues at the Ohio State University found that lonelier women experienced more pain, depression, and fatigue than those who had stronger connections to friends and family.

What factors make an unhealthy friendship?

There are a few different factors that make an unhealthy relationship.  Friendships are about getting our social needs met – some of those needs are described above.  Many times, as we take a closer look at the dynamics of the friendship it turns out very one-sided.  In other words, if your friend is taking much more than they are giving, that is a normally a substantial factor in unhealthy relationships. 

Another factor would include a deficit in your own positive self-identity.  This lack of self-worth often leads to my clients finding and continuing toxic relationships.  In some cases, toxic relationships occur when an individual begins looking for external sources of self-worth rather than finding and believing their own internal self-identify and self-worth.  When we are unable to feel good about ourselves we begin to look for positive validation from external sources.  In many cases, these external sources are friendships that can be taken advantage of.

What should you keep an eye out for as warning signs?

An important element in getting and maintaining supportive, healthy friendships to stay mindful of warning signs that your friendship could be turning unhealthy.  For you to keep an eye out for warning signs, you first must believe and understand that unhealthy relationships really do exist.  Many people are in such denial or lack awareness that they do not even stop to consider it possible for them to be in an unhealthy friendship. 

This is the initial work I do with many of my clients.  First, we work on awareness of positive and negative relationships.  Clients must accept that fact that unhealthy friendships are possible and they could potentially be in one themselves.  Then we review each friendship, keeping a close eye on factors that make healthy and unhealthy friendships.  Once you understand the factors that lead us to unhealthy behaviors we begin to look for warning signs.  These warning signs could be obvious such as fighting/arguing without a desire to compromise.  Another warning sign could be that their morals and values or that they do not match your own.  Other warning signs could include:

·         they gossip about you behind your back

·         they lie to you or purposefully leave you out of details of their life

·         they criticize you alone or amongst other friends

·         they make you feel bad about yourself

·         they aren’t happy for your life success’

If you're in an unhealthy friendship, how can you get out of it, especially if there are mutual friends involved?

Suddenly realizing you are in an unhealthy friendship can be a tough pill to swallow.  It can be so tough in some cases that your immediate response is to deny the unhealthy nature or rationalize maintaining the friendship.  In this case, your best course of action is to work with a mental health care professional to identify and correct the factors that play into the dysfunction.  This could include working on self-identity and self-worth or being more mindful of your own needs. 

Once you have identified and overcome the factors that have led you to maintain an unhealthy friendship, the next steps would be to establish boundaries and use effective communication.  Using the warning signs that indicate an unhealthy relationship you would use those to set a boundary.  It would sound something like this:

“Last week you made me feel insecure about myself because you openly criticized my decision to quit my job.  I cannot allow that type of insecurity in my life so if you continue to openly criticize my life choices then we can no longer maintain our friendship”. 

This scenario uses effective communication to establish healthy boundaries within the friendship.  In a healthy friendship, they would try to respect your healthy boundary.  If it is an unhealthy friendship you will likely continue seeing the same type of warning signs.  At this point, you would make the decision to communicate to this friend – and any mutual friends – that you are choosing to discontinue the friendship and state the reasons (in this case it would be because they choose not to respect your boundaries).

What is it like to be in therapy?

Every therapy session is unique and caters to each individual and their specific goals. It is standard for therapists to discuss the primary issues and concerns in your life during therapy sessions. It is common to schedule a series of weekly sessions, where each session lasts around fifty minutes. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing personal growth. There may be times when you are asked to take certain actions outside of the therapy sessions, such as reading a relevant book or keeping records to track certain behaviors. It is important to process what has been discussed and integrate it into your life between sessions. For therapy to be most effective you must be an active participant, both during and between the sessions. People seeking psychotherapy are willing to take responsibility for their actions, work towards self-change and create greater awareness in their lives.  Let me give you an example.

I worked with a client – whom I will call Bob - who sought help because of issues at work.  Bob recently started a new job, which he had worked hard to get.  Even though this was a dream job, Bob reported a significant amount of stress and anxiety that seemed to get worse as each day wore on.  We worked for several weeks on coping skills and understanding triggers without much relief.  Finally, one day it just all came together.  We were discussing the actual physical feeling the Bob felt, and he said “this is what shame feels like”.  I asked a simple question, “when were other times you felt shame”?  Bob listed several other shameful experiences and then the proverbial lightbulb went off, “oh my gosh, I know what it is…”.

Bob went on to describe how his father used shame at the dinner table.  If Bob’s Dad felt like we were eating too much he would make hurtful or sarcastic comments to Bob or his siblings like, “geez, did you get enough” or “oink-oink”.  Bobs new job provided lunch for employee’s in a small cafeteria.  Each day at lunch the chef would stand at the end of the buffet line to refill dishes or make sure none of the employees were taking more than their fair share.  This chef was essentially supervising the employee’s as they dished up their food and this reminded Bob of times at the dinner table with his father.  Every time Bob went through the lunch line at work this chef unconsciously triggered him, then he would spend the rest of the day miserable because he had no idea why he felt so unsettled – or in this case, shameful.

Once we identified this dynamic as the cause for Bob’s stress and anxiety at work it quickly subsided.  Just knowing exactly what, and why this was happening, it practically made the disturbance go away.  In the rare instance it resurfaced, we identified coping skills for Bob to use moving forward.  Another benefit, which was more important is that Bob now understood this type of dynamic happens to us every day.  Most of the time we feel unsettled or emotional it is due to some unconscious trigger we are experiencing.  From this day forward Bob could understand that he needed to be more mindful about his emotions and what he was doing with his emotions.  For most of us, we go through our day on auto pilot, not bothering to really examine what, and why we feel the way we feel.

Is there a way to know if therapy is working?

As a therapist, I will constantly check-in with my clients.  Initially, this will include establishing goals for therapy such as reduction in anxiety, overcoming phobia’s, reprocessing traumatic memories, or increasing healthy diet and exercise.  Over time, as I check-in I like to use specific and measurable ways to determine whether goals are being met and identifying what is, and isn’t, working.  Questions like “how many days in the last week/month did your anxiety exceed 5 out of ten” or “please rate your disturbance of the nightmares on a scale of 0-10”.  These strategic questions and check-ins will allow my clients to reflect on their progress and allows me to make any necessary adjustments to treatment or modality.

Above all, the most important element in therapy is the relationship between the client and therapist.  We call this the therapeutic relationship.  Research has shown, repeatedly, that a trusting relationship between the client and therapist is the biggest factor in progress.  You will see this illustrated in the section below.  If the client didn’t trust the therapist, they would have a difficult time considering what the therapist was seeing or doing.

A number of benefits are available from participating in psychotherapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, sexuality, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that counselors can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:

·         Attaining a better understanding of yourself, your goals and values

·         Developing skills for improving your relationships

·         Finding resolution to the issues or concerns that led you to seek therapy

·         Learning new ways to cope with stress and anxiety

·         Managing anger, grief, depression, and other emotional pressures

·         Improving communications and listening skills

·         Changing old behavior patterns and developing new ones

·         Discovering new ways to solve problems in your family or marriage

·         Learning effective communication and relationship skills as part of premarital counseling

·         Improving your self-esteem and boosting self-confidence

Is therapy right for me?

With so many options now available at the tips of our fingers, it's not uncommon to ask the question if a particular service or product will benefit you. And while it's not uncommon to ask this question about therapy as well, it's important to remember that therapy creates a safe environment in which everyone can benefit. Many people seek therapy for a variety of reasons - perhaps it's to rebuild after a trauma, to tackle anxiety or simply to find a new way to live life more authentically. Therapy creates the lens that allows us to take a more truthful look at ourselves and it provides a guide to help you navigate unknown areas. Similar to using your GPS app when you travel out of town (or around town for some of us), it can give you the instructions for you to drive in the direction you desire.

I would estimate that less than ten percent of our nation actually sees a therapist on a regular basis.  I am confident that more than ten percent of the population is experience challenges with their mental health including understanding changes in their job, relationships, finances, or family.  This leads me to conclude that there are people out there who are facing these problems alone.  Often times when we feel like we are alone it leads to further worsening of symptoms. 

Some of the signs that might indicate therapy could be helpful in your situation include the following:

• Feeling sad and unmotivated. If you have had feelings of hopelessness, decreased energy, sadness, irritability, thoughts of suicide, feel overwhelmed and unable to cope, or are no longer finding pleasure in activities you used to enjoy, you may be dealing with depression and may benefit from talking to a professional.

• Excessive worry. If you feel as though your anxiety is interfering with your ability to do normal activities and/or you are unable to sleep at night due to ongoing rumination about your difficulties, you may want to consider seeking help.

• Trauma or abuse. If you have experienced any type of traumatic event or abusive relationship, coming to terms with your experience by talking to an empathic other can be extremely helpful. Trauma and abuse can leave long-term scars that, if left untreated, can negatively impact your life, relationships, and ability to experience joy or happiness.

• Relationship problems. If your relationship has become unfulfilling and you feel you are no longer able to communicate effectively with your significant other, seeking out couples counseling can be a helpful step in getting your relationship back on track.

• Difficult life transitions. We all face difficult life situations at times–the loss of a job, a move to a new city, a divorce, or the loss of a loved one. When difficulties such as these arise and you find it difficult to move on, talking with a therapist can be an effective way to process your feelings and work through any lingering grief.

• Addictions. If you are struggling with any type of addiction—substance abuse, an eating disorder, gambling, or sex addiction—this could be a sign you are trying to cope with unresolved issues or feelings in unhealthy and inappropriate ways and may obtain benefit from professional help.

• Obsessive or compulsive behaviors. If you are spending too much time double checking to make sure you have turned off the stove, obsessively washing your hands, or are consumed by compulsive thoughts, receiving therapy could be extremely beneficial in getting your life in order.

• Children excessively acting out. If your child or children have been misbehaving and you are at your wit’s end trying to figure out what to do, talking with a professional who has experience with children’s issues can be helpful. A therapist can frequently provide you with some additional parenting tools to make your life easier.

In addition to helping with the issues above and others, obtaining professional help may provide you with more insight and awareness. Although it can sometimes feel scary to take the first step to reach out, reducing your symptoms and learning to cope in healthier ways can make doing so more than worthwhile.

Is Play Therapy Right for My Child?

Therapy with youth and adolescents is often very different from adults.  Many types of therapy emphasize talking and thinking about feelings and experiences, which can be particularly challenging for kids. When working with children, part of the session includes discovering how a child likes to communicate. Including using therapies that will allow your child to express themselves non-verbally, such as play therapy, sandtray therapy and EMDR.

Play therapy allows a child to use toys, pictures or books to help express their emotions. This approach is highly effective with most children and allows the therapist to interpret emotions and experience through their play. Similarly sandtray therapy allows a child to create scenes in a sandtray with a variety of toys. This provides a blank canvas for children to reenact or interpret life experiences. 

By using non-verbal forms of therapy, children benefit by increasing emotional vocabulary and intelligence.  When families increase communication about emotions it automatically increases the families ability to solve problems in a healthy way.  Parents are highly encouraged to attend therapy sessions together with their child as therapy can be a safe space in which to address the thoughts, feelings, and emotions experienced by all members.

Reasons to seek play therapy treatment include, but are not limited to, temper tantrums, aggressive behavior, non-medical problems with bowel or bladder control, difficulties with sleeping or having nightmares, and experiencing worries or fears. This type of treatment is also used with children who have experienced sexual or physical abuse, neglect, the loss of a family member, medical illness, physical injury, or any experience that is traumatic.

In my experience only about 20% of children who need play therapy are actually participating in some form of structured therapy.  All too often we fall into the trap of completely relying on medications to treat symptoms such as impulsivity, anger, hyperactivity, lack of focus, depression, anxiety, oppositional behavior and many other forms of emotional instability.  Research has proven that medication in conjunction with therapy provides much greater impact than medication alone.

_______________________________________________________________________________

Play therapy addresses psychological issues and would not be used to alleviate medical or biological problems. Children who are experiencing physical problems should see a physician. Likewise, children who experience academic difficulties need to receive an in-depth psychological evaluation in order to clarify the presence of a biologically-based learning disability. In both of these cases, psychological problems may also be present, but they may not be the primary problem. Alternatively, evaluations may show that medical or biological causes are not evident, and this would be important information for the parents and therapist to know.

Seasonal Affective Disorder

Daylight change can trigger Seasonal Affective Disorder – by Mitch Shaw

Standard Examiner - Monday, November 14, 2016

As the days grow increasingly darker, colder, shorter and less colorful, the chances for one to encounter a bout of seasonal depression spike.

According to University of Utah Health Care, depression in the form of Seasonal Affective Disorder strikes most often during the fall or winter as less daylight can trigger a chemical change in the brain and cause depressive symptoms.

According to the Mayo Clinic, the most common symptoms of SAD include the following: irritability; increased desire to sleep or low energy; problems getting along with other people; hypersensitivity to rejection; oversleeping; appetite changes, especially craving foods high in carbohydrates, weight gain. 

Nick Call, a clinical social worker and therapist in North Ogden, said SAD symptoms can also mirror the severe symptoms of general depression, including thoughts of suicide and death.

“It can be very serious for some people,” Call said. “In a lot of (serious) cases, it co-occurs with another issue, like drug and alcohol abuse or prior depression and anxiety.”

Call said SAD typically begins around the time daylight savings ends, but can also occur during other times of the year.

“Sometimes it’s the first snow, sometimes it’s January when it’s been cold and dark for a while and you body begins to react (chemically),” he said.

The Mayo Clinic says some people experience opposite patterns, with symptoms flaring up in spring or summer.

Call says people should start to pay more attention to how their feeling as winter sets in.

“Knowing it’s happening is a huge thing,” he said. “Being able to recognize it is key.”

Once diagnosed, Call says patients can heal through a large spectrum of treatment options. The disorder can be diagnosed through a mental health exam and most often treated with light therapy, therapy, and antidepressants.

“There are a lot of things you can do,” he said. “Mindfulness exercises, diet and exercise, medication.”

Call said people with SAD should be encouraged to seek the help they need.

“Often times there can be this irrational belief that someone will have a negative opinion of you if you take medication or seek (professional) help,” Call said. “The stigma is there, but sometimes that’s exactly what a person needs to get better.”

http://www.standard.net/Health/2016/11/14/Daylight-change-can-trigger-Seasonal-Affective-Disorder.html

Depression in Men - A Hidden Epidemic

Society has come a long way in recognizing this difference, but one stereotype remains: Men are looked upon as weak if they become emotional. This stereotype has played a role in many men deciding not to address their depression.

This untreated depression has directly led to the death of at least one man I know, and he is certainly not the only one to take his own life because “life just wasn’t worth living.”

According to the National Institute of Mental Health, “In 2012, an estimated 16 million adults aged 18 or older in the U.S. had at least one major depressive episode in the past year. This represented 6.9 percent of all U.S. adults.”

Although women are nearly three times more likely to experience depression in their lifetime, the men who do experience depression are much less likely to seek help. Statistically, men are much more likely to attempt to “self-medicate” or “tough it out on their own.” This leads to men committing suicide at a much higher rate than women. Imagine waking everyday with nothing to look forward to, feeling like everything is a hassle and hopelessly trying to figure out why.

Many things can cause depression. It can be a chemical imbalance in your brain, an ongoing problem at home/work or a combination of the two. The symptoms of depression vary greatly; change in appetite, change in sleep patterns, constant feeling of impending doom, anger, aggressiveness, and restlessness. These are just a few of the more common symptoms in men, but the one many can relate to most is a lack of desire for life. Depression is more than just a decrease in mood caused by a bad day. Depression is a persistent sadness that makes it hard to function and enjoy life like you have in the past.

When I talk to men about depression, I use an example of a man in his early thirties, married with two kids, a good job, nice house and all the toys for the family to enjoy themselves with. His weekend begins on Wednesday when he begins to look forward to the camping trip with the family. They are going to the mountains to camp in their trailer and ride four-wheelers with friends. He begins to plan the trails to ride and which peaks they want to visit. He wakes up early Friday morning to pack the trailer and get the four-wheelers loaded. All this time he loves what he is doing; he looks forward to time with family and friends and willingly prepares for a weekend of fun.

Now look at this same man in his late thirties. He's still married to the same great woman, and both kids are doing well in school. He has the same job, same house and still owns all of the toys. His wife asks if they are going camping with friends this weekend. At this point in his life, he is deeply depressed due to a chemical imbalance caused by age. He doesn’t think about the weekend of fun the same way. Instead, he is overwhelmed with the hassle of getting everything ready to go. He has to clean the trailer and get the four-wheelers ready. All he can think about is how much hassle this trip would be; how much work it will be to prepare.

There is only one thing that has changed in this example. The man is depressed. His depression has caused him to have a different perspective on what normally would be a fun family activity. His depression causes him to view everything as a “hassle” and to consider it as “work.” This is an example of depression and the impact it can have in our lives.

When things get to the point that you no longer find joy and happiness in the things you once loved, things can get pretty hopeless for us men. I think this is when most of us consider a way out. I beg each and every one of you reading this to ask for help if you are depressed. If you know of someone who is depressed, help him. There are solutions; the thing to remember is that you don't have to live with depression. If you have a loved one you think may be dealing with depression, don’t wait until it is too late.

Published on KSL.com Sept. 18, 2014      http://www.ksl.com/?sid=31535229&nid=1010&title=depression-in-men-is-a-hidden-epidemic&s_cid=queue-19