Category: Couples Therapy

Attachment Styles

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Attachment Styles

              As we know, every individual person has had a unique life experience. There are people who grow up in the same environment yet their personalities and relationship dynamics can be quite different. Some may wonder why that is. One reason for this can be found in Attachment Theory. The theory of attachment was founded by John Bowlby and was furthered by Mary Ainsworth, who theorized that emotional issues within relationships can be tied back to early attachment related experiences with a child’s parents (Cassidy, Jones, Shaver, 2013). The common types of attachment are identified as Secure attachment, Anxious attachment, Avoidant attachment, and Anxious avoidant (Disorganized) attachment.

              What do these different types mean? Let’s begin with Secure attachment. Secure attachment is best understood as an individual having trust in their caregivers responsiveness and availability. When it comes to romantic relationships, an individual may feel comfortable with their partner and able to communicate more easily about their emotions. Next, let’s look at anxious attachment. This attachment style is caused by the child experiencing a caregiver who is unreliable or inconsistent during childhood. This might then impact an adult who has fear of abandonment or rejection, seeking validation from their partner.

              Avoidant attachment is yet another component of attachment. Avoidant attachment is caused by a child who does not consistently receive care and attention that they need from a parent. For an adult, this may come out in your relationships by recognizing that you struggle to trust others or open up to them. Lastly, anxious avoidant or disorganized attachment shows a mixed attachment style for an individual. They avoid intimacy and close relationships, yet also fear abandonment. An individual may want to be independent yet when a partner is unavailable, they begin seeking constant validation from them.

              Our bonds are relationships and they are developed during times of distress (Olufowote, Fife, Schleiden, Whiting, 2019). Now that we know what the attachment styles are and briefly how they can impact relationships, now what? Many people feel stuck when it comes to this. They wonder if they’ll ever be able to “shake” these patterns of behavior. While it can be hard to challenge these patterns, the good news is that we are able to work through these reactions. Understanding our attachment styles is an important cornerstone to understanding our interactions with others and how they might change (Olufowote et al., 2019). A lot of research has been done and continues to be done on this topic. Positive attachment changes are possible, some scholars call this “earning security” throughout an individuals life (Olufowte et al., 2019).

            One way a person might begin to “earn security” includes working on having more flexibility with ones cognitions (i.e. how they view themselves). Cognitive challenging helps reshape ones thought patterns and shift from a more rigid view of themselves to one that allows a person to slow down and have more grace for themselves within relationships. Another way to challenge these attachment patterns is through therapy and surrounding yourself with secure individuals that help build that security within yourself (Saunders et al, 2011). While more research should be done on this, the literature states how the these interactions can increase a persons ability to challenge and change their attachment patterns.

            In the end, our attachment styles are not the end all be all of who we are as a person. It does not define our worth or our ability to love or be loved within relationships. Attachment styles help us understand where we come from. It’s what we do with the information that matters.

Works Cited

Cassidy, J., Jones, J. D., & Shaver, P. R. (2013). Contributions of attachment theory and research: a framework for future research, translation, and policy. Development and psychopathology, 25(4 Pt 2), 1415–1434. https://doi.org/10.1017/S0954579413000692

Dansby Olufowote, R. A., Fife, S. T., Schleiden, C., & Whiting, J. B. (2020). How can I become more secure?: A grounded theory of earning secure attachment. Journal of Marital and Family Therapy, 46(3), 489-506.

Saunders, R., Jacobvitz, D., Zaccagnino, M., Beverung, L. M., & Hazen, N. (2011). Pathways to earned-security: The role of alternative support figures. Attachment & Human Development, 13, 403–420. https://doi.org/10. 1080/14616734.2011.584405.

“Attachment styles help us understand where we come from. It’s what we do with the information that matters.“

 

Anger in Kids (Relationship/Systemic Factors)

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Anger in Kids (Relationship Factors)

        Anger in kids is complicated as it can stem from the history of the child, genetic and developmental influences, and environmental/systemic factors. The focus in this post will be about the environmental/systemic factors to anger and aggression for children. Family therapists know that we are influenced by others, we influence others, AND children are the most ‘influentiable’. When looking at relationship factors for anger in kids, it is helpful to first explore how the behaviors are serving the family or system rather than attempting to simply extinguish the behavior. In this post, we will discuss the possible underlying causes for a child’s defiance, anger, and negative behaviors from a systemic/relational perspective.

        Salvador Minuchin is the developer of structural family therapy (SFT). This form of family therapy is very effective and has become the foundation of family therapy across Pennsylvania. Minuchin worked as a child psychiatrist before developing SFT and he recognized that the child was being consistently influenced by the family. A professional needed to intervene at a family or systemic level in order to create change for the child that would be significant and long-lasting. *’Systemic’ refers to there being various factors working together and influencing a situation (similar to gears turning; if one gear came to a complete stop, it would effect the other gears).

        The top 3 tenants of Minuchin’s SFT model includes: Boundaries, Hierarchy, and Closeness/Distance. If we look at a child’s anger from a SFT perspective, we need to examine those three areas and determine how the family as a whole influences the child’s behaviors (in both positive and negative ways). In many families, for example, the child has too much power in the family (hierarchy), there are boundary issues (either too rigid boundaries or too loose boundaries), and there is either too much closeness (people constantly feeling like they are on top of each other) or too much distance (not enough contact with one another). Generally speaking, all three of these areas usually need adjusted if the child is showing extreme forms of aggression.

        Here is a classic/traditional example: A child is showing severe aggression through breaking objects and threatening others while being constantly defiant towards the parents. The mother is overwhelmed by her attempts at helping her kid with little success and feels unsupported from her husband. The husband/father spends a lot of time outside of the home and isn’t usually present when the child is aggressive. For this short example, a systemic family therapist may believe that the child is actually taking the father/husband’s role in the family. This is due to the father frequently being outside of the home thus leaving a role in the home open (the husband/father role). So the child steps into this role automatically and in doing so, perceives that he has gained a lot of power/status. When the mother tells him what to do, it may filter through his head as “Who is my mom to tell me what to do, I’m one of the leaders of this house!” Additionally, the disconnection between the father and mother (too distant) generally leads to an overconnection between the mother and child (too much closeness). This turns into inappropriate boundaries between both the father-child and between the mother-child. Since all of these areas are problematic (hierarchy/power, boundaries, and closeness/distance), this leads to an overloaded child who needs to prove he is an adult and the aggression becomes an attempt to get this burden off of his shoulders. 

        One of Minuchin’s findings was that aggression in kids can arise (or at least intensify) when the parents have tension or have poor relationship quality. This is not to say that all of the aggressive behaviors are due to the parents’ relationship. It is to say, however, that parents form the foundation of a family and if the foundation is shakey it can cause instability for anything on top of it.

        Take Brian and Kelly, a married couple of 15 years. Their child was behaving very aggressively for the past 2 years. They came to family therapy looking to change their child’s aggressive behaviors. When assessing all of the relationships in the home, the therapist noticed that Brian and Kelly’s relationship was distant. If they happen to interact with one another, it was cold, argumentative, and one-sided.

        After extensively assessing the family’s situation, the family therapist pointed out that one of the reasons the child may be behaving aggressively is to bring the parents closer together. In other words, when the child would escalate, the parents would come together, work together, and plan on how to deescalate him. Their relationship became better the worse the child behaved. Part of this realization came from the therapist asking what would happen if the child stopped behaving aggressively. After the parents initially responded with “It would be peaceful..” they began describing how everyone could just go about their lives. Well this is the dilemma for the child. If “everyone goes about their lives” then the parents remain disconnected and tense with one another leaving the home feeling anything but peaceful. 

        To reiterate, when looking at relationship factors for anger in kids, it is helpful to look for how the behaviors are serving the family or system rather than looking to simply extinguish the behavior. The behaviors may be the last-ditch effort towards connection. The relationships are often not the only source of the overall problem but it is important factor to consider if you are seeing anger and aggression in children. 

“Only the family, society’s smallest unit, can change and yet maintain enough continuity to rear children who will not be ‘strangers in a strange land,’ who will be rooted firmly enough to grow and adapt.”

-Salvador Minuchin

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Anger in Kids and Adolescence (Part 1)

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anger in kids

(Part 1)

        10-20% of youths (15 million children in the US) meet diagnostic criteria for a mental health disorder. Among those, only 20-30% receive specialized mental health care. This statistic is even worse for those youths from low-income families in the juvenile justice and child welfare system, ethnic minorities, and those with substance abuse problems. Bradshaw (2010) found that poorly managed anger in adolescents was linked to: increase in verbal and physical aggression, peer rejection, school dropout, juvenile delinquency, and later adult criminal behavior. This post will discuss a child’s development and how to manage their behavior to ensure safety. Part 2 will begin discussing genetic and relational reasons for why the behavior began and lingered.

        There is a variety of reasons why anger and aggression can be prevalent for children. Trauma, developmental disorders, and environmental factors contribute to a lot of aggression seen in kids and adolescence. To show the impact of trauma on kids, one study found that children exposed to family violence show the same pattern of activity in their brains as soldiers exposed to combat. For the developmental reason, we need to understand that most children and adolescence go through an egocentric phase. We hope this is a phase and not an everlasting condition. This phase is very important, however, and needs to be gone through. Babies are the most egocentric species out there. Cry when they are hungry, they get food. Cry when they are tired, get put down for a nap. Their life begins by having having tantrums and these tantrums lead to getting their needs met. Gradually they begin to become more independent and responsible for meeting their own needs.

        A 9 year old male client, let’s call him Ron, showed severe aggression to his family members. He would attempt to punch his mother in the stomach when she was pregnant (other posts will talk more about the relational component to these types of behaviors), bully his younger sister, and break doors and windows frequently. This child had a developmental disorder and a painful past. Therapy needed to respond first to the safety issues. Uncovering the pain and healing Ron and the family can only happen when safety is present. Ron, like a lot of children his age, had a egocentric view of the world (the universe was either all about him or all against him). He wanted things immediately and a lot of difficulty waiting. He was sensitive towards any perception of unfairness and became easily frustrated when told no. We can view kids like Ron as acting out in a functional way, meaning their aggression is to get their needs met but the way they are trying is unacceptable.

        The first step towards helping Ron and the family regain safety in the home was to empathize with Ron’s emotional experience while giving calm but firm directives. Having a sense of empathy doesn’t mean you agree with the child’s view (this is true for being empathic to anyone!). It means that we realize and show compassion towards the experience of the child that feels trapped, hurt, enraged, needing to control out of fear of being hurt again, etc. Starting there will have the child feel seen, heard, and not judged. Then we needed limits and clear boundaries for Ron. Many parents can understandably get fed up with the child’s behaviors or feel disrespected that they begin to yell at the child or begin pleading with the child. This is why it is important to have both a calm and firm tone when giving directives. The calmness shows empathy and it doesn’t add any fuel to the fire. The firmness shows clarity about the expectations and lets the child know that it is something he needs to listen and adhere to. Within a month, the parents felt safe and felt they didn’t have to walk on eggshells so we were then able to begin the longer process of healing the child and family. 

        Often children don’t know how to control emotions like anger and frustration and don’t know how to use words to express their feelings but use tantrums instead. Another male client, a 16 year old boy who we will call Jeff, would become severely fixated on getting what he wanted and would become dysregulated to the point of pulling out knives and threatening others while breaking objects in the home. Similar to Ron, Jeff had a developmental disorder and a painful past. Along with being empathetic towards Jeff’s emotional experience and being clear/firm, we used distractions to help Jeff become unstuck from his fixations. This could be distractions that were completely random or they can be something we knew would interest him in the home. After he became un-fixated for about 5 minutes, we would give him 2-3 options of what he would like to do that were acceptable by the parents. The parents were then able to apply these strategies with the child to create the safe environment consistently. 

        To recap, children’s anger often comes from a misguided attempt to meet their needs. So a good first step is to empathize with their emotional experience (imagine being as scared of being hurt as Ron or imagine being as fixated on something as Jeff and how that trapped/desperate feeling may eat you up). Then we need to provide calm (not aggressive, tense, etc.) but firm (assertive) directives to the child for them to be clear about the expectations without adding extra tension/frustration to their emotional state. Adding distractions and 2-3 options can help to get the child “unstuck” and help them refocus on the 2-3 options rather than the flood of emotions/thoughts they may have. These strategies are not an end-all-be-all. They are not going to resolve the pain and relational factors. We will talk about those in other posts. These strategies, however, can help redirect the child, begin rebuilding a safe environment, and give more opportunities for the child to express their needs in an appropriate way. 

“Therapy needs to respond first to the safety issues. Uncovering pain and healing the child and family can only happen when safety is present.”

 

Gratitude

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Gratitude

        Gratitude is often neglected and ironically unappreciated in therapy and psychological literature. It has only recently been realized as a significant force to happiness and well-being. Being in a state of gratefulness deters depressive symptoms, entitlement, and many other unpleasant or negative emotions. It is nearly impossible to be in a state of gratitude while in a state of negative emotion. Gratitude builds appreciation, thankfulness, and encouragement. How is gratitude tied to our well-being and how can we use it to grow our enjoyment?

        Often our pride and anger can block our appreciation of life’s little gifts. Some get locked into a state of: What is done well is because of me and whatever is negative is because of someone or something else. This neglects gratitude and simultaneously grows anger and blame. Gratitude is an agent of well-being and it buffers against negative emotions and negative mental states. 

        Gratitude can be described as having a warm sense of appreciation towards something or someone. When we have gratitude, it becomes difficult to get bogged down by misfortunes. More and more research is coming out about how gratitude can counteract depressive symptoms, anger, and anxiety. Gratitude brings with it a sense of goodwill towards that person or thing. This goodwill helps us in our self-image (see ‘Trust’ post) and becomes contagious with those around us. 

        One client, a woman now in her 50s, was in a tragic car accident when she was 16 years old. The car had been hit by a tractor trailer that was hauling propane gas. She was able to escape out of the vehicle but as she turned back to get her parents and sister, it was too late. She watched helplessly as her parents and sister were trapped in the car fire. Talking to her about this memory was shocking. She was able to attend to her painful memories with compassion and love. Love for those she lost and love for being a survivor. To this day, she is grateful for understanding the fragility of life and the importance of never taking time or people for granted.

        A core characteristic of people who are entitled is their lack of gratefulness. To be given privileges, good fortunes, or even breath on your next day is ultimately out of your control. Many people find this very difficult to admit. It takes vulnerability and an admittance of some form of dependability on the things we cannot control. To admit we are in debt and ultimately dependable on life is a bitter pill to swallow—at first. However, this bitterness can turn into giving thanks each day because none of us deserve the next moment—we are given it. 

        There is a village in Nassau that many volunteer workers in Pennsylvania go to annually. This village has very little water, if any at all. They have two outhouses in a village of 40+. 10 or more people often stay in one home which is the size of an outdoor shed. The food is scarce and good hygiene is nearly impossible. So try an exercise to look at what you have and for this exercise don’t mind the things you don’t have. Become skilled at paying attention to the positive/pleasant aspects and fortunes that you have “earned” or have been given. This could be honoring what another person has done, giving recognition to what you have or benefits you have received, undeserved merits, or anything you possess. One way to look at gratitude is no matter how hard you have worked for what you have, it was ultimately given. Practicing gratitude will build appreciation for the “small things”, help in being more welcoming to experiences, and grow positivity with yourself, others, and everything around us. 

        One woman in her late 60s had a childhood and adolescence full of trauma. When she was a child, she was abused emotionally, sexually, and physically. When she was an adolsecent she lost her sister to drugs. This woman had every right to be resentful and angry. But she wasn’t. In fact, she was grateful. She described her trauma as helpful in her journey. She was grateful for what her pain had taught her and how it helped her become resilient. She said it helped her learn how to have strong and healthy bonds, boundaries, and deep connections with others. She was, and still is, an expert at weeding out snakes. She believes her trauma gives her a form of strength that other people essentially cannot possess. She knows others cannot injure her soul because she had to deeply learned who she was at a young age. She is, as she describes, her best self-who she wouldn’t be without her past. Talk about grateful?

 

Stress and Headaches

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Stress and Headaches

        Stressors can come from all areas of life: general life stressors, interpersonal conflict and relationships, and/or social rejection, etc.. These stressors can result in negative moods while making acute and chronic pain worse. In fact, migraines and other chronic hypertension problems are correlated with negative childhood experiences and post-traumatic stress.  The frequency of stressful events are positively correlated with tension headache frequency. This post will discuss how stress and chronic tension can lead to frequent headaches and give you first steps towards relief and prevention. 

        47% of the population qualify for a headache disorder diagnosis and at least 3% have chronic headaches (defined as occurring at least 15 days per month). One young adult woman was unaware of the chronic tension in her shoulders and neck but she was very aware of having frequent headaches. Throughout her time in therapy, she was able to be more aware of the tightness in these areas. Initially she was convinced that the stress came from the brain and therefore NEEDED to relieved through the brain. This can helpful. However, it can lead to an exhausting cycle of stressing about stress. During sessions, she was willing to practice specific body relaxation techniques with the therapist. She mentioned afterwards that the techniques not only helped with relieving the tension and provided energetic relief (energy was tied up in these tension areas) but recognized that her stress about other circumstances in her life decreased. This is a trap many people fall into: The source of the stress is often the perception/beliefs/thoughts/brain so we MUST start in those areas. What often happens, however, is that the body becomes activated and stores this sense of stress so that it becomes more difficult to think clearly and continues a cycle of perception–> stress–>body–>stress. 

        We know stress contributes to headaches AND we know suppressing negative emotions appears to augment pain. Due to this, we need interventions that directly reduce stress-induced physiological arousal and negative emotions. Becoming more attuned to our body’s tension and becoming more skilled at relieving these knots is going to help us to regulate AND it can help us discover the source of the tension in the first place. When you notice the tension in your body, first begin by deep breathing (check ‘Body’ post for specific breathing techniques’) and relieving the tension. This will help you regulate and ensure that your mind can be as clear as possible. Then begin exploring what event on the outside triggered the body to contract. It may sound a bit robotic and it will likely feel unnatural at first to look “outward-inward.” What therapists know, however, is that being overwhelmed and trying to explore what causes you to be overwhelmed leads to, guess what, being more overwhelmed.

        One married woman had hypertension, back problems, chest pains, and feelings of nausea. She would talk about her anxiety, become more anxious about not understanding what she was anxious about and then continued spiraling until she felt incompetent and helpless. Once she began relieving her stress through her body she was soon able to realize that her relationships were causing her stress, her job caused her stress, and her extended family caused her stress. Before getting her body tension under control, she understandably felt that these problems were too big to try to solve. After all, she had these intense stressors while living in a body full of hypertension and chronic pain. Attending to the body first led to her very naturally breaking down the stressors on the outside to begin resolving the problems one by one. 

        In short, stress creates tension. This tension, left unattended, can causes physical problems such as heart conditions, inflammation, headaches, etc. We suggest to START by managing your arousal and relieving body tension. Relieving these tense areas can make you feel more energy and can relax your brain. After relieving these tense areas, move to your brain for understanding the stressors and triggers. *Remember, you can not simply attend and relieve tension one time. You will need to frequently attend to your body because it has likely become a master at storing stress. 

 

 

Tolerance and Resolution

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tolerance and resolution

        Without tolerance, we cannot endure. However if you solely focus on tolerance or “coping” then you will be stuck in a constant fight that doesn’t bring long-lasting relief or healing. This is one of the main reasons people come to therapy exhausted. The fact is we need both tolerance and resolution to find joy throughout our life. In this post we will talk about the first steps of tolerance and begin moving towards resolution.

        It is interesting that people with fear and pain want to resolve fear and pain due to their fear and pain. In other words, the fear and pain is the driving force of healing. It may feel as if this force is hanging above your head, forcing your hand to receive help. This help, however, won’t be from being forced. It will be from being in charge of your process.

        Unpleasant emotions are going to occur. Many talk about acceptance but what does this look like? Does it mean we approve of it? No. It means we notice and recognize what is occurring. Some get caught in a denial state. Without acceptance, fear won’t be confronted, anger won’t be seen as an emotion that can be used in healthy ways, and the body will be neglected. We need to be able to withstand and endure in the midst of stress, pain, and suffering. A goal many people used and found helpful has been “I will _________ even when feeling ________.” Fill in these blanks and take action even when at your worst. Looking for resolution before increasing tolerance is like expecting another storm not to ever come. You will encounter another situation or person that triggers you. We have the keen ability to push each other’s buttons. Often those that are hurt try to hurt. Similar is said that people who are anxious bring anxiety. We need to increase tolerance before the next wave comes our way. 

        First we need to understand that although our perceptions create automatic thoughts and then create feelings—we ultimately feel the unpleasant feelings in our body first. This means the initial unpleasant bodily sensations are likely a large part of your frustrations and stress. The tension, the aches, the pent up energy, the knots, the adrenaline, the sweating, the heart palpitations, the inability to relax, etc. These sensations cause many people to have immediate reactions. These reactions cause all sorts of problems in our life with work, family, and life satisfaction. To increase tolerance, we need to tolerate these unpleasant sensations with more effectiveness. In other words, we need to increase our ability to regulate. When you get upset, do you recognize the tightness and relieve this before taking any action? When you are afraid, you most likely feel your heart but do you know how to slow it down, do you use the rest of your body to rebalance your emotional state? Physiological regulation skills are one of most important first steps towards toleration (refer to the ‘Working Backwards’ post specific steps towards beginning this process). 

        If you solely focus on tolerance or “coping” then you will be stuck in a constant fight that doesn’t bring relief or healing. Many people come to therapy exhausted. They are constantly regulating without overcoming the source of the suffering. This is where it is helpful to uncover the beliefs, thoughts, perspectives, and cognitive states (tunnel vision, fast thinking, etc.) that trigger these unpleasant feelings. When you accept and begin to regulate, did you notice what automatic thought you had before getting the sensation. These automatic thoughts occur spontaneously without deliberation and often go unnoticed but the associated emotion is often noticed. The thoughts can be in verbal or image form. This step towards resolution is to become aware of the automatic thought that triggered the unpleasant sensation in your body. These thoughts are connected to beliefs about you and the world that we will get into more detail in other posts.

        Remember: thoughts, feelings, and behaviors are interactive and related. Changing one will have an impact on the other. Start with physiological regulation and tolerance. This will give instant relief and provide a foundation for handling unpleasant emotions in the future. Next begin to move towards being aware of the automatic thoughts that trigger the unpleasant emotions. Practicing this process will begin creating a filtering system that doesn’t allow forces out of your control to govern you. 

“Receiving help won’t be from being forced. It will be from being in charge of your process.”

 

Shame

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shame

        Shame is the sensed loss of our dignity and self-respect. When we have shame, it is not solely based on a behavior, it is more deeply personal and all encompassing. Guilt, for example, is based on a specific behavior we have done. Guilt has the sense of “I have acted wrong” whereas shame has the sense of “something is wrong with me.” Shame can lead to interpersonal problems, social anxiety, isolation, and depression. It is often masked by anger and anxiety. This post will talk about how and why shame can drive unhelpful behaviors and give suggestions on how to begin breaking the shame cycle.

        One of the most important areas to explore when it comes to shame is our morality (values, principles, standards). In shame, we have experienced a moral injury. Our values and beliefs have been deeply violated. It is no wonder why people can become enraged from shame. After all, a person may sense that their deepest core values are at stake so becoming angry and reacting immediately is an understandable response. Unfortunately, this just perpetuates the cycle as the person will then feel guilty and ashamed. If you are frequently dealing with feelings of shame, start by exploring and discovering what values and personal principles are being broken. Remember, the moral injury feels like it is entirely you who is broken, unrepairable, unworthy, but it is the principle or value you have that drives this sense of self-loathing.

        Shame creates an impaired capacity to connect genuinely. This fear of vulnerability often gets guarded by anger, blaming, or hiding. The four common responses to shame are: avoidance, withdrawal, attacking self, and attacking others. All of these responses have the goal to cover-up. The act of covering up further perpetuates the belief that we are not worthy or acceptable in the world. For people dealing with intense guilt, they need to practice forgiveness. For people who deal with shame, they need to practice reassurance and acceptance. Begin self-compassion, the antidote to self-hate, by accepting the parts of yourself that are being judged so critically. Without judgment, find the fear you have of being open and vulnerable. What may happen? Be seen as _________? Be treated as ______________? Then, if I am open and vulnerable to myself, what might I see? I may see that I am __________. I treat myself as __________. After answering these questions, it may be more clear to you what you need to do to begin gradually changing the shame cycle. For example, if you said “I treat myself as a second-class citizen”. It would be clear that you need to start taking small steps to be attuned to yourself, putting yourself first, asserting your boundaries, etc.

        Shame can stem from the threat of social rejection. In fact, it is often interpersonal. You can feel ashamed independently but the shame itself is connected to others. It is not a mystery why people who feel shame, a form of personal self-hatred, can lead to withdrawal and isolation. This self-hate can lead to anger outwards or anger inwards. The anger outwards will lead to aggression at a target whereas the anger inwards will lead to isolation and depressive symptoms. The first suggestion for countering shame driven responses is to pause (to create more space between stimulus/response), breath (relaxes the body and tells the brain no need to react right now), and externalize your shame. One man practiced this method and described himself as being the helpful and accepting friend he desired to himself. He said “Friends try to slow you down and hold you back when you are about to do something you shouldn’t.” So when he would want to isolate or withdrawal, he would connect with others as much as he could to counteract this shame momentum and then he would speak to himself as though he was around these caring people. He would say to himself: “It isn’t going to help you to crawl into a hole even though I know that’s what you want to do, it will help you to realize that no one can define your value or life other than you. You will move on and it will pass quicker than you think.” 

 

Personal Trust

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personal Trust

        Trust can be talked about in many ways and has been a frequent focus point for relationship distress. However, trust has rarely been discussed as a reason for a lack of confidence, general insecurities, or symptoms of anxiety and depression. To narrow the definition and clarify more about what trust means, we need to first start with the question of what areas do you trust or distrust? Do you trust your partner, trust in other people’s actions or intentions, trust in your resiliency, trust in your performance, trust in your follow through, trust in you doing the right thing, etc.  What situations do you enter that you naturally and automatically trust yourself and the opposite question, what situations do you enter that you doubt yourself and feel incapable of behaving in accordance to your values or standards. Trust will be broken up into two separate posts: personal trust and relational trust. This post will focus on the first aspect, personal trust, and how to take steps to begin trusting yourself.

        Research indicates that trust revolves around two main aspects: morality and reliability.  Morality involves your ethics and moral standards. Your value system (what is good, bad, right, wrong) provides a lens to judge behaviors (yours and others).  Reliability involves discipline, consistency, and dependability. If something or someone was unreliable, it would be a mistake to trust since this person would only be reliably inconsistent. 

        Before moving towards our own morality and reliability, it can be helpful to first understand which camp you typically fall into-do you tend to trust yourself too much (give yourself undue credit and expect perfection) or not enough (doubt yourself even when there is evidence of your capability). The term confirmation bias is used in psychological and sociological literature to essentially describe the process of paying attention to and giving a lot of importance to things that we already value and downplaying evidence to the contrary. For example, let’s say you believe you are not good at your job and frequently doubt your work performance. You have been promoted to a higher-paying job, receive frequent compliments from coworkers, and have been working at this company for years. The confirmation bias within you may only pay attention to the few times that you needed to adjust a work project or when your boss criticized one of your presentations. However, if you were to look at the overall evidence, it would point towards you not only performing sufficiently but there is more evidence of overall success rather than failure. When it comes to trust, explore which confirmation bias you typically have: Do you tend to trust yourself even when you shouldn’t (i.e., expecting reliability out of yourself when evidence shows a lack of reliability) or distrust yourself (expecting faults/mistakes when evidence shows reliability). We need to first identify which camp you tend to fall into because in either case, you will lose–either by setting yourself up for failure or not engaging in something you are capable of.

        Next, explore your own value system. It is necessary to have knowledge and confidence in your ethics and morality to regain your self-trust. Research indicates that treating yourself and others with moral standards of integrity, honesty, kindness, love, and goodwill grow reliability and dependability (i.e., trust). However, we are a work in progress so you may simply want to go through these moral standards and see where you fall in those categories. Remember, this is about trusting our own intentions, motives, and actions. If our actions are connected to our core beliefs then we will begin to trust ourselves and build confidence. If we don’t act in accordance to our values, we will get guilt, shame, and grow insecurities. Explore and understand your core values and in turn the rewards/consequences of acting in opposition of these values. For example, if you value treating people with kindness, you will have guilt when treating people maliciously. Many people’s problems involve a clashing of values. For example, a 27 yr old man had a value of kindness but he also valued strength. For him, when he had a sense of being “too kind” he got walked over on (and in turn, felt resentful) and when he was feeling “too strong” he had a sense of feeling domineering (in turn, guilty). This man was able to explore and discover that he wanted to be BOTH understanding (kind) and assertive (strong). Check to ensure that your actions line up with your discovered moral standards. If you notice any discrepancies, start small and gradually build towards this standard. Another example is of a middle-aged woman who had a sense that she acted dishonestly in a recent conversations (e.g., she agreed with someone to appease them but did not genuinely agree with them and felt disingenuous about this). She needed to begin small and intentionally voice her genuine thoughts and opinions on topics even if it was met with judgment or criticism. Remember, even if this is in subtle or small ways, the process of acting in accordance to your values is the important aspect to repair your trust in yourself.

        Now that we have started discovering our values, we need to be disciplined and consistent in our actions. Reliability and consistency are cornerstones of trust. If we are not reliable to do what we need for ourselves, we won’t be able to count on ourselves. The key to reliability is follow through or keeping promises (doing what you say you will do). This is the opposite of lying and deceit. It is the discipline and willpower to stick to your values even when you don’t feel like it or when it is uncomfortable. It will show yourself and others that your words and actions are lined up. It is very easy to trust someone who does what they say will do so begin small and gradually build this reliance on yourself.  A 22 yr old woman recently began to trust herself more by finishing knitting a blanket that she had started last year and promised to give someone. This “small” act of finishing the blanket proved to her that she would not let things go unfinished and she would follow through with doing what she said she would do. Again, start small and gradually build your dependability and consistency

        Lastly, ensure your trust in yourself is being determined by yourself and only yourself. We often trust others to give us feedback about certain people (ex. since John said that Nick is trustworthy and we trust John then we will be more likely to trust Nick). We can do this with ourselves– if we perceive others who we trust as not trusting us then we may be prone to not trusting ourselves (ex. we trust John, John doesn’t show trust in us, therefore we begin distrusting ourselves). The trust in yourself would be aligned with your trust in John. This will leave you tethered to John rather than putting your focus on aligning your actions with your values and gaining trust and self-confidence. 

 

Arguments

Posted on by systemstherapy

 

 

arguments

 

 

        A topic that comes up frequently in couples therapy is arguments. Is it ok to argue? One married couple proudly reported not having argued in their 23 years of marriage. It became quickly obvious that this pointed to an unhealthy pattern of avoidance and passivity more than it did a healthy and genuine relationship. Throughout their marriage, there was infidelity, secrets, and subtle threats of violence that pushed down conflicts. IF it is ok to argue then how do we turn arguments into something constructive? When are arguments helpful and when do they lead us further disconnected from our partner? This post will give 3 simple (not easy) methods to overcome harmful arguments.

        Some have said disagreements are ok but arguments are not. This can be a helpful tip but it can also cause people to surrender their attempt at exploring and discovering truth or right/wrong with their partner. A disagreement clearly means that there is not an agreeable right/wrong or truth (both partners disagree on what is right/wrong or true/false). An argument, however, can serve as a journey for both partners to oppose ideas, be ‘devil’s advocates’ and stir up deep discussions that further connect the couple. There’s no need to spend too much time with this but while some will say disagreements are fine but arguments are not, we ‘argue’ that arguments can be positive and worthwhile-depending on how they are done. 

        First, arguments can quickly become fast pace and you and your partner’s responses become more like reactions than thought-out replies. Due to the emotions becoming heightened, the reactions to what your partner says becomes quicker and quicker. The first method is going to be taking 5-10 seconds before responding after your partner finishes their point. Is this going to be awkward and lead to an uncomfortable silence? Of course but it has helped many couples to prevent reactivity. In these 5-10 seconds, breath and relax your body. The more tense our body becomes, the more the body sends signals to the brain that the current situation is dangerous. The more this happens, the more likely the brain will begin becoming more emotional (activating the limbic system) and less logical/rational (deactivating the neocortex). This 5-10 second pause to breath and relax the body will be unnatural at first so you can either show your partner this post or simply let them know that you are trying to take time before responding to prevent being reactive. 

        The second method is to change the goal of your role in the argument. Instead of trying to be the winner, try being an avid listener/reflector and a clear communicator. In other words, try making the goal of conversations and arguments to be 1) becoming more and more accurate in your interpretation of what your partner said AND 2) becoming more and more clear in delivering your message to your partner. For the first goal, we need to start with reflection. It is very difficult to have conversations spiral into pointless and draining arguments if you first start with reflecting what you heard the other person saying. Some start with “I get that..but..”. “I get that” is a lame excuse for reflection and usually sounds like you just want to get to your point plus the “but” dismisses anything you said before it. This happens very frequently when couples are told to reflect to their partner but may not be told ‘how’ to reflect. One way of practicing reflective listening is to say “So I heard you say ________, is that right?”  If you are wrong, you have to let go of what you thought they meant. There have been many situations in couples therapy that a partner will begin practicing this and say “I heard you say….” and their partner says “No, that’s not what I meant” only to be quickly cut off and told “But that’s not that what you said!”. Well there is no point in reflecting to get clarity if you are just going to cut the person off and argue about what they were trying to say or mean. “I heard you say ______, is that right?” No? Well I must be missing something can you either say it again or reword it so that I really understand where you are coming from? Remember, your new goal is to become an avid listener and reflector: this means you are trying to get better and better at being able to accurately interpret what your partner is saying and reflect it back to them to have them feel heard and understood. 

        There are a few traps people fall into for trying to achieve their second goal of becoming clearer with their message. First, they get upset if their partner’s interpretation is not accurate. Communication takes two so instead of becoming frustrated with your partner for not understanding you, re-word your message and try being more clear and concise. This takes time and practice but it helps to focus on your message and delivery rather than focus on the receiver’s errors for not understanding you. Another trap is bringing up too many points at once. Bring up only one point (AT THE MOST two) points before stopping and ensuring that your partner understands what you mean and where you are coming from. For example, a couple attempted a listening exercise during a couples therapy session and the wife began by saying, “I feel really alone and not supported with the children, I am exhausted about people at work putting so many demands on me, I’m stressed about money and our financial situation, and why were you so snappy with me the other day when I was simply asking you to watch the kids for an hour?” She was obviously overwhelmed and all of her statements are valid concerns and they need to be addressed. Bringing up 4-5 of them at one time, however, is only going to flood the listener and fog her main points. When she then tried again with, “I feel really alone and want to spend more time with you”, paused, and gave her husband time to reflect and respond to her- it led to a clearer process of attempting to resolve one concern at a time. 

        There is not only nothing wrong with having an argument or having your viewpoint challenged but it can be very healthy and helpful. There can be a way where both partners disagree and argue with one another AND feel closer to one another. A way to help this is to get away from thinking about “what you two are talking about” and look at “how you two are talking to one another”. The third method to having helpful conversations or arguments is to manage your body language. It is extremely difficult to have arguments turn into something harmful if both partners keep a calm voice and manage their body language. No this doesn’t mean you sound like a kindergarten teacher talking to children. It means you keep your volume in check, your tone softer as when you are being curious with someone, and keep your body language away from either being shut down (crossing arms) or aggressive (tight shoulders and jaw).

        How would this look if you put all 3 methods together? One way this may look: Your partner begins talking about a sensitive or touchy subject, you take 5-10 seconds to breath and relax your body, you reflect what they said (“So, what you are saying is ________?”), they say “Yes”, then you keep your volume, tone, and body language relaxed as you respond with JUST ONE of your main thoughts or feelings about the subject. It is amazing how simple these methods are and how helpful they have been to couples again and again. So don’t be like many and think, this won’t work-it is weird or our problems are more complicated than that. Remember, it often has much less to do with ‘what’ you two are having problems with rather than ‘how’ you two are attempting to resolve the problems. 

 

 

Working Backwards

Posted on by systemstherapy

“When we are flooded, stressed, or overwhelmed, our brains are having a difficult time processing, learning, and adapting. When we focus on our breathing, we prevent this flooding by redirecting our awareness and energy into our bodies.”

working backwards

        Many people come to therapy when they are overwhelmed, exhausted, and after they have tried some online psychology tips and tricks with little to no relief. Their energy is running low or they are running around in circles going nowhere. Family and friends give advice and recommendations on how to think, plan, and overcome but all this does is leave the person feeling more drained, stuck, and frustrated. For a lot of people, trying to help with ‘heady’  information and tips can just lead to more of the same stress. Our brains can only function optimally when there is a certain amount of energy (too much and you are flooded; too little and you are disinterested). In this post, we’ll talk about 3 ways to work backwards: Starting from the body (tension and feelings) before going to the thoughts/emotions/beliefs. This way we can get immediate relief from the stress and tension while creating ways to be attuned to our body, feelings, and overall experience.

        First, we need to have awareness of our body. The fancy word, interoception, is our sense of what is happening in our body. We can become so immersed in planning, solving problems, stressing about situations that we forget to feel what is going on in our bodies. A feeling is the effect of an emotion, not the emotion itself. Feeling vs emotion is often used interchangeably but it may help to separate the two. For example, “I feel afraid” is the emotion of fear and the accompanying feeling in the body (uncomfortable tension). The first step in working backwards is to locate the tension in our body. For instance, maybe your fear leads to tension in the chest and shoulders. Take a few minutes to hunt for tension in your body–even if you aren’t having a noticeable emotion. Start with awareness in your toes and slowly go through your body up to your face–locating any tension and doing nothing with it. Simply locate.

        Now that we have located some tension in our body, now what? Instead of trying to get rid of it, start by feeling it fully–where does the tension start, finish, how tense is it (1-10), are there groups of muscles tensing or one major muscle tensing, etc. It can be hard to simply relax these muscles so after you have spent some time just being with the tension you feel, go ahead and contract/tense the muscles up further. Keep it tense for 3-5 seconds and then release. Do this process with different body parts (locate, stay with the tension, then tense/release for 3-5 seconds at a time). Notice what happens with your body, does it drop down and relax into the floor leaving a little taste of relief from the ongoing tightness and stress? Most people feel slight-to-moderate relief after doing this contract/relax method for only a few minutes. 

        The third way of “working backwards” revolves around the breath. The breath is incredibly important for many reasons. First, the breath can point to our mental state. For example, the breathing pattern of shallow/fast is connected to stress/anxiety while deep/slow is connected to a relaxed/calm state. When we are flooded, stressed, or overwhelmed, our brains are having a difficult time processing, learning, and adapting. When we focus on our breathing, we prevent this flooding by redirecting our awareness and energy into our bodies. Another important aspect of breathing is that it will automatically help to bring us into the moment. With how many stressors there are in the world and the never-ending problems and demands, it is very easy to leave many moments behind. If you are focused on your breathing, you stay present with the breath (similar to a metronome) and shed some of the excess and often unnecessary stress that is weighing heavy on you. When intentionally focusing on your breath, start with deep breaths (inhale for 6 seconds, hold your breath for 6 seconds, then exhale for 6 seconds=1 cycle). After 3-4 cycles, you will likely relax some tension and you may get a sense of mental clarity.

        Lastly, like many things, positive tools can become negative tools depending on how we use them. Having more attention and attunement to our body and breath can lead to increased regulation skills, emotional attunement, and energy management. However, it can become an easy strategy of avoidance. If we have painful past experiences that lead to negative thoughts/images, the increased body awareness can serve as a strategy to escape. Be mindful, using skills to master body regulation can be powerful but check with yourself from time to time to make sure that this power isn’t becoming a magician hiding your pain.