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Couples Therapy Marriage Relationships Therapy November 12, 2018 By Stephanie Insko, Ph. D 0 Comments

Marriage Counseling: More Than Just a Last Resort

Marriage counseling. What do those words bring to mind? Impending divorce? A last-ditch effort? Couples often do seek marital therapy when the relationship doesn’t seem like it can possibly continue. But marriage counseling can also serve to strengthen healthy relationships that have simply gotten off-track somewhere along the way. Every marriage is different, and many different relationship dynamics create tension or outright conflict between spouses. But couples fall into lots of common traps that, with some understanding, don’t necessarily have to mean the end of the road for the marriage.

Different marriage templates

Think about the kind of relationship dynamics you witnessed between your parents. Were they outwardly affectionate with each other? Did they argue in a healthy way? Did they nurture their marriage with date nights or getaways without the kids? The kinds of patterns you observed as a child all contributed to your understanding of what marriage looks like. Healthy or not, their relationship became your template for marriage. After all, how many others did you observe so closely for so many years?

When couples marry with very different examples of what a marriage is, they bring with them assumptions about what the role of “spouse” entails. And often, those assumptions don’t mesh. For example, let’s say one spouse came from a family where the parents spoke several times by phone during the day. And let’s say the other spouse had a parent who traveled for work and only called home once during those week-long trips. If expectations about frequency of communication are not discussed, misunderstandings and hurt feelings can result. This is just one way that different marriage templates can create conflict. But understanding them can open up a couple’s discussion and negotiation about what they want from each other and the marriage.

Differences in problem-solving styles

Problem-solving is another area in marriages where interpersonal differences often go unnoticed. Think about what you need the most when you have a problem. Some of us get a lot out of simply being heard and having our feelings validated. But others only feel better after they’ve arrived at a solution. Understandably, a spouse who just needs to “vent” about a problem may feel frustrated by their partner’s suggestions about how to “fix” it. But if each had known the other’s needs up front, that frustration could have been avoided.

But what about when the problem is between the spouses? Differences in conflict-resolution styles can make problem-solving even harder. For example, one spouse might discuss problems calmly and rationally, whereas the other might bring heated emotions into the mix. Or one might prefer to address only the current concern, with the other bringing up similar concerns from the past. Identifying a couple’s differences in problem-solving styles can keep conflict from escalating into something beyond the original issue.

Difficulty adjusting the marriage to the season of life

Another trap that healthy marriages often fall into is failing to keep up with life-cycle transitions. This is a very common concern, and is often what brings couples into therapy. Dating and marriage take place during one snapshot of a couple’s life. And when their individual or joint life circumstances change, they often forget to reassess how the marriage will also shift. These transitions are often related to children, careers, or finances. Change any of these things, and most likely there will need to be adjustments to the day-to-day workings of the marriage. We’ve all heard of empty-nesters who wake up one day and realize that they devoted so many years to raising a family that they scarcely know one another anymore. But think about other life-cycle transitions. Previously-childless couples who now have an infant must reevaluate how to maintain relationship-nurturing habits like date nights and sexual intimacy. Or a new job that requires lots of travel will probably mean a renegotiation of household and childcare duties. The constantly-changing nature of life demands marriages to keep up, and when this doesn’t happen, there can be bumps in the road.

The good news is that all of these concerns can be worked through with the help of a trusted professional. Sometimes it just takes an unbiased third party to facilitate discussion and negotiation, and to enhance communication skills. Contact us to find out more about how the therapists at Brentwood Counseling Associates can assist in getting your marriage back on track. A bump in the road doesn’t have to mean the end of it.

Relationships September 18, 2018 By Stephanie Insko, Ph. D 0 Comments

Finding Deep Connection in the Age of Surface Relationships

by Stephanie Inkso

It’s all so easy. Swipe, like, love, share. All with the touch of a finger. We make quick judgments of current and potential friends and intimate partners based on one post or photo. And when we’re on the other side, we have the luxury of presenting our best selves to the world. Sure, these virtual interactions ensure much less risk of being rejected. But that risk is a natural component of human relationships, and by removing it, we have also robbed ourselves of the richness that deep interpersonal connection can provide.

In my work with teens and young adults over the past few years, I’ve heard over and over about the longing for a true relationship, including all the ups and downs, the good times and the bad. Clients talk about “surface” friendships, in which accomplishments are shared, but not missteps. It’s as though the online presentation of the perfect self is playing out in real life. Intimate relationships are being kept “surface,” too, but in name only. These no-strings-attached relationships have all the components of a committed dating relationship, but without the actual label. This trend is leaving many young adults hurt and confused, and unfortunately, often less likely to want to go down that path again. But with so many young adults wishing for more meaningful connections with others, what’s keeping them from doing so?

Sure, it’s truly easier to interact with others virtually instead of in reality. But I would argue that it actually makes it harder and harder over time to start using those one-on-one, in-person skills again. Think about a depiction of two older gentlemen sitting in rocking chairs passing the time of day. What in the world do they have to talk about? And how do they stand to sit in silence, should there be a lull in the conversation? I wonder if we’ve lost the ability to be comfortable in the presence of others without the distraction of technology to occupy our minds? Are we using our phones as protection from the potentially difficult feelings that are an inevitable part of true interpersonal connection?

Further, we can gain so much from the nonverbal interactions that occur when we spend time being present with others. Shared smiles and laughs. Eye contact. Facial expressions and body language that indicate being in sync with each other, or that something is wrong. These experiences all have so much more depth and meaning when experienced in person rather than through emojis. Sure, being truly present with another person opens us up to potential criticism, and even rejection. We see more in each other than the best selves that we usually present online. But the practice of being real with each other increases our comfort with the vulnerability that leads to deeper connection.

If you’re tired of surface relationships, counseling is a good place to start. You can examine the fears that hold you back, and practice being vulnerable with a trusted professional in a supportive space. One of us here at BCA would be more than happy to join you in this process. Sometimes we even offer interpersonal process groups, in which you can practice that newfound vulnerability with others who are also looking to deepen connections. Give us a call if there’s any way we can help.

Anxiety Depression Teens September 18, 2018 By Stephanie Insko, Ph. D 0 Comments

Anxiety and Depression in Teens and Young Adults: When is it Time to Talk to a Professional?

by Stephanie Insko

You may have heard about the alarming increase in anxiety and depression among college students. I have seen this concerning trend firsthand in the couple of decades since my first job in a university counseling center. Sure, I worked with a lot of students who were dealing with depression and anxiety back then. But the majority of the students seeking counseling were simply struggling to adjust to the newfound responsibilities, decisions, and relationship dynamics that came with college life. In other words, they were in the thick of the learning curve of becoming adults.

The challenges of adjusting to adulthood have not gone away in those nearly 20 years. But they are inherently more difficult for the average young person to navigate while also struggling with untreated anxiety and depression. Therefore, it’s more crucial than ever that young folks address any mental health concerns before they’re on their own, trying to perform in college or on the job. But how do you know when it’s time to seek the help of a mental health professional?

Clinical anxiety and depression can sneak up on us, and may go unnoticed until functioning is affected. In teens and young adults, this often shows up as a decline in school or work performance. There might be a lack of interest or motivation to improve, and problems concentrating might make it nearly impossible to do so. Social functioning might change, too, with increased isolation from friends. A loss of interest in previously-loved activities is another warning sign. Other signals that this is more than a “rough patch” include changes in appetite, sleep, and overall energy levels.

If you’ve noticed any of these signs, it might be time to consult a therapist. Anxiety and depression in teens are manageable concerns, and therapy is a collaborative effort to develop a plan to do so. Maybe you’re a parent noticing some signs that worry you as you send your child off to college. Or maybe you’re a young adult struggling to balance depression or anxiety with the demands of school or a job. Whatever the age or stage, a good relationship with a therapist can help you figure out how to manage it all.

Uncategorized anorexia • Anxiety • chronic anxiety • insecurity • maturity • self-acceptance July 19, 2016 By Jim Kelly, LCSW 0 Comments

Self-Acceptance: The Cornerstone of Maturity

by Jim Kelly

The following is an excerpt on the significance of self-acceptance drawn from the book, How to Be the Adult in the Room, authored by one of our therapists, Jim Kelly. You can purchase this book through Amazon. This book is also available for purchase in our office.

In the privacy of my office, even highly successful people regularly admit deep insecurities, which rob them of peace and happiness. In fact, in many cases their achievements are driven by the desire to prove themselves. Yet, their achievements never satisfy the deeper need to feel whole for just being who they are.

When I work on the issue of self-acceptance with clients, I help them identify and validate aspects of who they are in the following areas:

Inherent personality traits
Natural abilities
True interests
True values and principles
Honest thoughts and feelings
Direction and purpose

Deborah was in her late twenties and struggled with chronic anxiety and anorexia—a very complex issue. In my experience, anorexia is usually symptomatic of a few predicable themes—perfectionism, achievement, and control, though what I typically find at the heart of the problem is an undeveloped sense of self. This young woman, who was a nurse, exhibited these patterns. Her compliant personality oriented her as a child to take her cues from other people and to try to please them. Her parents divorced when she was young, and she lost close contact with her father. She grew up longing to feel closer and more loved by her father, which undermined her self-worth.

Deborah’s personality also predisposed her to strive to be in control. As she grew up, these factors coalesced to work against her. Along the way, she became deeply insecure, and her maladaptive response was to try to be perfect to win outside approval and validation. She always made straight A-s in school and graduated at the top of her nursing class. Yet, she never felt good enough. She was an excellent nurse, but constantly compared herself to peers and would look for evidence to find herself lacking. On the outside, she appeared to have it all together. On the inside, she was a train wreck. This is where anorexia came in. Like many women in our culture who feel insecure with themselves and out of control internally, she focused on controlling and perfecting her body to gain a sense of self-worth and control. The psychological reward gained by achieving this essentially unhealthy thinness is, of course, fleeting, illusory, and never satisfying.

The only real solution was for Deborah to decide that who she was had little to do with her body, her achievements, and the approval of others. While she was gaining an awareness of the elements of who she was, she had to learn how to accept, listen to, validate, be guided by , and trust her true self—not a simple process. She had to completely re-orient herself from taking cues from others to finding and trusting her own center. As she developed a more authentic sense of her own identity and learned to trust and accept herself, she began to feel more secure internally. This internal sense of control allowed her to start shedding, little by little, the need to be perfect. She began to accept her own flawed, limited, imperfect human nature, including her body. Her anxiety began to resolve as she was able to validate her own competency, stop comparing herself to the other nurses, and enjoy her work. Deborah must continue to practice this higher consciousness, but she’s clearly on the path.

ADHD Children Teens ADHD • Family • Kids • Parenting • Self-Regulation • Teens June 28, 2016 By David Elkins, Ph.D. 0 Comments

Parenting ADHD Kids and Teens

by David Elkins

To Understand

ADHD is not just an immature, overly active child; a passive, defiant middle schooler; or an unmotivated, lazy teenager. ADHD is a neurobiological condition that presents with deficits in self-regulation (attention, focus, over-activity, or impulsivity) starting in early childhood and at times may create impairment in school, relationships, or daily activities.

ADHD is a continuum disorder, not yes/no or black/white. The Executive Functioning area of the brain (prefrontal cortex) is not fully developed until mid 20’s. The “ADHD brain” often lags several years behind.

ADHD often co-exists with other behavioral, learning, and psychological concerns (e.g., learning disability, cognitive processing deficit, anxiety, depression, substance abuse, low self-esteem).

ADHD is a lifelong challenge with Age/Stage Implications. ADHD kids and teens often

Take the scenic route
Display “quick twitch”
Act like “knuckleheads”
Act clueless and don’t make connections
Are high maintenance, high risk, and high reward

…and where do you think this comes from? (Whose family tree gets “credit”?)

To Remember

The system is the solution (develop a program-e.g., points for positive behavior)
Surprise is not your friend (plan ahead and tell them about the plan)
Kiss the third request goodbye (one or two is enough)
Being right is highly over-rated (power struggles miss the point and will not work)
Keep your mental illness to yourself (control your emotions and language)
If it is not written, down, it doesn’t exist (lists, notes, charts, technology)

To Try

Behavioral/Psychological – Environmental/Life Style

While there is no magical parenting formula, parenting ADHD kids and teens needs to be more proactive, more intentional, and more thoughtful in their approaches. These strategies apply to parenting all children; however, they are especially helpful with children who have issues of inattention, impulsivity, and over-activity.

First, get their attention (eye contact, prompts)
Structure, structure, and more structure (routines, consistency)
Catch them being good #1 (to reinforce positive behaviors)
Talk and fuss less, behave more (clear expectations, clear consequences)
Run for your life! (or walk, swim, kick, jump, climb, move, exercise)
Teach “executive functioning” skills (study strategies, organization)
Catch them being good #2 (to build confidence, self-esteem)
Find the best school fit, then advocate (504, IEP, Learning Services)
Offer academic tutoring (to build basic skills)
Seek counseling or coaching (for you and your child)
Catch them being good #3 (to shape your behavior)
Teach emotional self-control (don’t assume it)
Don’t over-schedule (to provide down time, rest, and sleep)
Catch them being good #4 (to help break the negative cycle of behavior, punishment, anger, avoidance, loss in self-esteem, depression, acting out)

And finally…

CELEBRATE THE GOOD NEWS OF ADHD (intelligence, creativity, independence, out-of-the-box thinking, “quick twitch” athleticism, sense of humor, energy, enthusiasm)

Books

Taking Charge of ADHD, Taking Charge of Adult ADHD, 3rd Edition, Barkley
ADHD Workbook for Parents, Parker
Spark, Ratey
The Gift of ADHD, Honos-Webb
ADHD in Adolescence, Robin & Barkley
Smart But Scattered, Dawson & Guare, and Smart But Scattered Teens, Guare, Dawson & Guare
Give your ADD Teen a Chance, Weiss

Websites

Anger Management balance • human nature • narrow our reality • seek intensity • violence June 14, 2016 By Rick Taran, Ph.D. 0 Comments

Violence and Human Nature

by Rick Taran

The past years have seen increased incidences of violence in the schools, in public, and in the workplace. The aftermath is the same: shock, grief, looking for answers. In our search for answers, we tend to blame our pet peeves as the cause for senseless violence. Of course there is not just one cause, but rather a complex interaction between human nature and our environment.

There are three tendencies of human nature which are important pieces of the puzzle to explore. Knowing about them could possibly prevent further school, public, and workplace violence. These are the tendencies to alter our consciousness; seek intensity; and narrow our reality. These tendencies are natural to all people, yet when exaggerated in the context of addictions, poor judgment, alienation, illness, and denial, they can lead to violence.

Altering our Consciousness

The first of these tendencies, altering our consciousness, is seen in small children who love to spin around making themselves dizzy, or peek through their legs to look at the world upside down, or giggle or scream loudly for no reason adults can easily see. Adults also have a natural desire to alter their consciousness, as seen in altered states induced during some religious ceremonies, sporting events, overeating/vomiting, daydreaming, a bad temper, cutting, road rage, and sexual activity, to name a few.

Seeking Intensity

The second natural human tendency is to seek intensity. Examples of natural periods of low intensity include boredom, routine, deadened emotions, and depression. We will then create situations to lift us out of the low intensity state and into the realms of feeling “very alive.” It feels better to feel alive. Most addictions are exaggerated attempts to keep intensity going or to lift us out of boredom/routine/deadened emotions/depression. Intensity is built into news stories, video games, TV, advertising, political rhetoric, and movies as a way of engaging our interest (we are drawn toward intensity and drama)

Narrowing our Reality

The third natural human tendency is to narrow our reality. This relates to taking a small piece of our world and focusing on it to the exclusion of the bigger picture. We do this to gain a sense of control over our lives, since dealing with many of life’s issues all at once can seem overwhelming. The more a person feels disenfranchised, powerless or out of control, the more one tends to narrow one’s world. Some of the more problematic examples we frequently see are, being overly focused on violence, religion, sex, work, drugs, money, or relationships. This will eventually lead to an unrealistic view of oneself and the world, and intensify feelings of anger, frustration, fear, and alienation. Narrowing one’s reality to a small area of life is part of the addictive process and may be one of the purposes behind most addictions. Certainly, violence has an addictive quality.

On closer look, what seems like senseless violence eventually does make sense from the violent person’s perspective, as psychological autopsies have demonstrated. Most of us are not prone to violence because we learn to balance the natural tendencies to alter our consciousness, seek intensity, and narrow our reality. Some less intense imbalances, yet still self-destructive behavior, can be seen in sabotaging relationships, under-achievement, and poor health habits. Our goal should be to understand the need for, and the skills required for balance, so that we do not become destructive to ourselves or others. Internal balancing of our thoughts, emotions, and behaviors is a prerequisite for a healthy life.

My observation is that those who are violent in schools, in public, and in the workplace are significantly out of balance, but could possibly be identified in advance by applying the three human tendencies listed above. Perhaps the violent individuals get “high” over planning their and others’ destruction (altering their consciousness), felt very alive in carrying it out (intensity), and were removed from most thoughts/behaviors not related to their destructive plan for some time (narrowing reality).

By understanding what to look for, we may be able to prevent further acts of violence. It is important to stop blaming specific issues (usually our pet peeves) in society for a person’s violence, such as gun ownership, lack of religion in schools, Hollywood movies, or even poor role models. Human nature and the environment are constantly shaping each other over time, yet the outcome of that interaction is ultimately the individual’s responsibility.

Stress chronic stress • fight or flight • heart attack risk • high blood pressure • IBS • Irritable Bowel Syndrome • rest and digest • stress • stress management • stressors June 14, 2016 By Jay Tift, LPC-MHSP 0 Comments

The Science Behind Stress

by Jay Tift

What is Stress?

Simply put, stress is the way that we respond to the stuff that happens in our world. The things that are happening are called stressors. I think it’s important to mention right here at the start that stress is not necessarily a bad thing. Really, it is how we think about it and respond to it that can get tricky. Stress can actually be a great thing. When we’re engaged, motivated, excited, energized, etc., we are appropriately stressed. Of course, when we generally think about stress, when we say “I’m stressed,” we mean we’re overwhelmed, anxious, exhausted, and burned out. Think about it on a spectrum, when there is not enough stress then we’re bored, disengaged, unmotivated and uninterested. When there is too much stress, we’re overwhelmed and “stressed out.” We want to figure out how to get into that sweet spot where we have the right amount of stress and are feeling energized

Fight or Flight vs. Rest and Digest

So let’s talk about what’s happening physically when we’re on the overstressed end of that spectrum. Most people have heard the term “Fight or Flight.” The fight or flight response is governed by the activating half of the part of our nervous system, called the Autonomic Nervous System (ANS), that handles many of our automatic processes. The other half of the ANS handles the recovery response or “Rest and Digest.” Really these two halves of the ANS can be thought of as the gas and brake. When we’re on the overstressed end of our stress spectrum, we’ve got the gas pedal stuck on the floor. Blood pressure and muscle tension go up, digestion, immune system, and ability to think go down, and we start to wear out. Think of it this way: your body is responding to danger. As far as it’s concerned, you’re being attacked by a lion. If you’re actually in danger, this is a great response. So, you’re almost run over by a car, a building is on fire, somebody jumps you in a dark alley…that’s what it’s there for. However, we tend to turn on the same response for relationship problems, excess work, financial problems, etc. What’s worse, we keep it on for long periods of time, and it’s really not meant for that.

Chronic Stress

The problems with stress come when the excess/negative stress becomes chronic. At this point, a number of pretty unpleasant things start to happen. Chronic stress can have a negative impact on our sleep, appetite, mood, immune system, digestion, relationships, memory and ability to learn. Over a long period of time it can lead to high blood pressure, reduced heart health, increased risk of heart attack, and functional digestive problems like Irritable Bowel Syndrome. Essentially, our bodies start to fall apart from the wear, and our ability to reach out to others for support falls apart. What’s worse is that it becomes a cycle. We get overstressed, so we are less able to deal with excess stressors, which makes us more stressed, etc.

How to Deal

So what the heck do we do about it? Life is stressful, are you saying to get rid of stress in your life? No. That’s not reasonable or even useful. The goal is to learn how to manage it effectively to keep yourself in an energizing state of positive stress, which can actually counter many of the negative effects I mentioned above. The good news is that stress management does work…if you actually use it. What is important is to learn what works for you that you can effectively incorporate into your regular daily life.

In future posts, I will talk about the many ways one can approach stress management in order not only to reduce chronic stress, but to fully engage positive stress in an energizing way.

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