Teenage Substance Use

Photo by Rawpixel on Unsplash.

Photo by Rawpixel on Unsplash.

What is Adolescent Substance Use Disorder?

Many people think that substance use issues are defined by whether or not a person can stop using.  While this is certainly a factor, it is not the most significant one.  As clinicians we are looking to see how a person’s substance use has infiltrated and impacted different areas of their life including school, work, family life, friendships, extracurricular activities and more. 

“Control” can be a highly misinterpreted word when attempting to understand addiction. One of the strongest motivating factors for a teenager during this phase of development is individuating and having the freedom to make their own choices and do their own thing. When a normal teen is faced with the loss of freedom as a consequence for using drugs and alcohol, their response will be to clean up their act.  They will likely do this with a fair amount of ease. 

When a teenager is willing to sacrifice or compromise their freedom in order to protect drug or alcohol use it can indicate a larger problem with substance use. This is how loss of control manifests itself in Substance Use Disorders.

Is this normal teenage rebellion or something more?

So many parents become twisted and tormented by confusion and unanswered questions about their child’s behavior.  This angst is often laced with bits of denial as well as a lack of education about addiction, greatly hampering their ability to be objective about the situation. Fear is not a foundation for effective decision making. Turning to a professional at this point can be critical in impacting the outcome of the situation for the entire family system.

Parents often show up with a laundry list of different behaviors they have witnessed in their child over the past several months.  They are able to recognize the acting out or rebellion, but often fail to see the underlying pattern of substance use that coincides with these behaviors.  When the use of drugs or alcohol in any context (using, seeking, being around a friend that uses, selling, etc.) becomes a common denominator, it is an indication that it may be time to seek outside help.

What influences adolescent substance use?

There are many factors that can influence adolescent substance use.  Culture plays a significant role as a factor influencing substance use.  The very first thing I usually ask parents is what the teen’s friendship circle looks like.  Who are they spending most of their time with and what are they doing during that time? A teen that is not using drugs and alcohol, in general, will not want to spend most of their time with friends that do.  Are they involved in sports, hobbies or extracurricular activities of any kind?  What they do and who they do it with, in large part, creates their culture.

The younger a person is when they start using substances, the higher their chances of addiction.  According to the National Institute on Alcohol Abuse and Alcoholism individuals who “begin drinking before age fifteen are four times more likely to become alcohol dependent at some time during their life” compared to those who have their first drink at twenty or older. According to the National Institute on Drug Abuse teens who “begin using marijuana before age eighteen are four to seven times more likely to develop Marijuana Use Disorder” than those who were introduced after the age of eighteen. 

Genetics also play a big role in influencing substance use disorder’s in teenagers.  If there is a family history of addiction of any kind, an individual is approximately fifty percent more likely to develop a substance use disorder at some point in their life.  It is very important to remember that addiction is a biologically based disease.  Informing a teen of their family history and their potential vulnerability to the disease will be to their advantage.

Parenting as a Protective Factor

The point of presenting to your child as a united front cannot be stressed enough. The relationship between parents, whether married or divorced, serves as the underlying foundation for the entire family system. Any crack in that foundation will be recognized by the child as instability and weakness.  While power is struggling with a kid is never encouraged, maintaining our personal power and our role as the parent/parents is dire.

Focusing on how we are showing up in the relationship rather than on the content of what is happening with the child is key. It’s very tempting to get hooked into the details of the drama that is going on with the child. This will get us nowhere.  In general, it’s not about what you were interacting with your child about but rather, how you are choosing to respond.  

It’s so easy to get triggered when dealing with a teen that is acting out. They know exactly how to push our most sensitive buttons. The minute that anger starts rising up within us is also the minute we begin losing power. Children, and particularly teenagers, do not respond to the words that come out of our mouths but rather, to the energy behind them. Once we recognize this we can start making choices that will affect a different outcome.

As parents, we want to recognize a cry for help from our child. Adolescents communicate differently than adults and may not come forward with a direct request for help. It’s important to read between the lines and trust our instincts. Realize that they are the kids and are relying on us to be the adults. If all signs are pointing toward a problem then don’t wait for more evidence to stack up. Not reaching out for help will always be more regrettable then reaching out unnecessarily.

To schedule an appointment with Jobi Weinstein MA, LPC, LCDC, contact jobi@jcounseling.life or call 970-391-6058.

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What To Tell Your Therapist

Photo by Meraki Creative Co on Unsplash

Photo by Meraki Creative Co on Unsplash

“How do I tell him/her?”

If you have ever been to therapy before, there is a possibility that the question above popped into your head at some point. If you have never been to therapy before, but are considering it or have been thinking about it, this blog post will explain the importance of addressing difficult conversations with your therapist or future therapist.

Handling expectations and finances

Just like many other things, therapy is an investment of time and money. Many people erroneously think that that their lifelong struggles can be over in just two therapy sessions. This is just not realistic for several reasons. The first one is that your therapist doesn’t know you. Maybe you talked to him or her on the phone before your first session, but he or she will have to continue to assess many variables (especially in the first few sessions) in order to get to know you. 

The second reason is that you have probably been engaging in some sort of pattern or behavior for quite some time (think dynamic with your partner for instance). Maybe you both decide to seek couples therapy because you have felt disconnected for a while or have been fighting intensely for months. One or two sessions will probably not change the way you have been relating to each other these past months. Therapy is a process and for that reason, you need to feel comfortable with whatever fee you and your therapist agreed on. Some therapists will work with you based on a fee that you can afford, while other therapists have a set fee, so it will be up to you whether or not you want to work with that therapist. Nevertheless, it is very important that you speak up if the fee is inconvenient for you. Therapists will either work with you or talk about other options (e.g. referrals).

“My therapist did not understand what I was trying to say.”

Do NOT stay quiet about this. If you feel like your therapist did not get you, let him or her know. As therapists, we are trying to figure out what is going on in your life. The reality is that we can be spot on, but we could also get it wrong. It is extremely important that you let us know if that is the case, so that we have a clearer picture of what your experience is like. You can simply say something like: “I don’t think that is what I meant, what I meant is….” or “Actually no, it is more like this…” Please correct us! I cannot emphasize this enough. Don’t think that you will hurt our feelings or disrespect us by correcting us.

“My therapist said something that triggered me.”

No therapist is a divine, perfect, human being. This could happen, either early in therapy or maybe a few months later. If something that your therapist said triggered you and made you feel uncomfortable, sad, frustrated, annoyed, disappointed—whatever it is—tell him/her. If you really like and trust your therapist, explaining what happened inside of you as he/she said X, can be very powerful. I encourage you to try it before dropping therapy and leaving. It is normal that close relationships experience some sort of rupture, but repair can be possible and practicing it can turn out to be good experience. Ruptures are opportunities to strengthen a relationship. Also, examining what triggered you is part of the therapeutic process, and there is a lot that both the therapist and client can learn from that.

“I am ready to finish therapy, but I don’t know how to say it.”

Sometimes, your therapist might be the one bringing up the idea of termination; other times you might be the one thinking about it. If you had already made a decision or are contemplating it, tell your therapist. Your decision could be based on finances or on simply feeling like you are ready to move forward on your own. Whatever the reason is, it is always a good idea for both you and your therapist to be on the same page, and to have at least one “termination” session. Usually, this is where you both can talk about what you learned from the process, form each other, what shifted or changed, and things to keep in mind for the future.

Trust your gut, and if you ever want to say something but are too shy or afraid to say it, take a deep breath and try to express it. Therapists will not criticize you for opening up about your internal experience.

To schedule an appointment with Stephanie Paez, LMFT-Associate, contact stephanie@thepracticeatx.com or call (512) 910-4052.

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The Power of Adaptability

Photo by  Rachel  on  Unsplash

Photo by Rachel on Unsplash

Overcoming the Unknown

Some people make it look easy, while others struggle when faced with the possibility of entering into the “unknown”.  Whether it be a new job, relationship, or the little day-to-day speed bumps, adaptability is a key player in handling new situations without feeling stressed and overwhelmed. 

Learning how to become more adaptable can help us become more resilient and confident when facing change or challenging situations.  But first, we must have a thorough understanding of what adaptability is: Adaptability can best be explained as a person’s ability (which can be made up of their disposition, motivation, and their willingness) to adjust or change to accommodate a different social situation, a change in surroundings, or a new endeavor.  In today’s fast-moving and changing world, this is an important component of good mental health.

The Inner Strength of Adaptability

Think of adaptability as an inner strength that can help prevent you from experiencing negative emotions like fear, worry, or even hopelessness, when dealing with change.  So how do we do that?

First of all, studies show that the highly adaptable person has close relationships, meaningful interactions, and fulfilling activities that they engage in.  So, increasing your social circle (or establishing a tribe) is one way. People that have this support network are better equipped to handle change.

Cultivating Adaptability

In addition, the following is helpful when faced with change or ambiguity: 

  • Simply identify and acknowledge your situation.  Trying to accept the situation you are in will allow you to move forward.   You don’t have to like it, but accepting it goes a long way toward a healthier outlook.  

  • Try to see the possibility of change moving forward.  Decide if and how you can take control of the situation, even in the smallest way.

  •  If your struggle involves another person, try to look at things differently from their perspective, or change your approach.   

  •  Recognize that sometimes, being flexible is necessary and easier than fighting change – particularly if there is some good that can come out of it.

  •  Try to remain optimistic.  Many times, the changes we fear actually end up being a positive force in our lives.

  •  Do your best to manage your stress.   Make sure you are taking adequate time for self-care.  Try to continue engaging in activities you enjoy, so you’re not fully immersed in this one facet of your life. 

We all need more resilience in our lives.  Being resilient allows us to adjust well when faced with trauma, big changes, stress, or life’s day-to-day speed bumps.  Remaining flexible will allow us to maintain our focus to best handle a situation.  This will allow us to remain steadfast and strong, reserving our energies to best solve our problems, instead of the difficult emotions that can arise when faced with change or uncomfortable situations.

Sounds good, doesn’t it? 

If you don’t have it, there’s hope.  We can improve our psychological strength to become more adaptable, flexible and resilient, so we can be stronger in times of change or difficulty.

To schedule an appointment with Simon Niblock, LMFT email connect@simonniblock.com or call (512) 470-6976.

Blog References:

Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1).

Mental Health America (2018) Mental Health for Men, Info Graphic. Accessed: http://www.mentalhealthamerica.net/infographic-mental-health-men 

Winerman, L. (2005) Helping Men Help Themselves. APA, Monitor on Psychology, June 2005, Vol 36, No. 6. 

World Health Organization (2018) Suicide Rates. Global Health Observatory (GHO) Data. Accessed: http://www.who.int/gho/mental_health/suicide_rates_male_female/en/

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What Can Eighth Grade Teach Parents?

Photo by  Ant Rozetsky  on  Unsplash

As a parent, what do you see when watching Eighth Grade?

As a parent, watching *that scene* in the movie 8th Grade (Spoiler Alert, for those who haven’t seen it, and want to), it’s terrifying to think that your child might find themselves in the same situation. For those who haven’t seen it, the scene I am referring to, shows 13-year-old Kayla being escorted home by an older teenage boy, who she just met earlier in the evening. He pulls the car over, proceeds to invite her into an uncomfortable game of Truth or Dare, and then shamelessly tries to pressure her into removing her shirt. Thankfully, for everyone participating and watching, Kayla denies his advances; but she is left feeling guilty, devalued, and embarrassed.

What makes this scene so shocking for parents?

The reason this moment is so frightening for parents, is two-fold. First of all, you would never want your child to find themselves in this situation as the female or the male participant. While the term “peer pressure” is a little cliche, it can play a harsh role in the life of a young teenager, especially if they aren’t able to trust their gut. In order to lessen the likelihood of a situation like the one described, teaching your child to be vigilant and outspoken about their discomfort is important.

The second unsettling piece of this scene, is the notion that your child might not tell you if they were assaulted, or someone attempted to assault them. Kayla comes home from her evening, and she is clearly distraught, but never tells her dad what happened to her. A bit of distance is fairly common between teens and parents, but having open communication is important, especially if a serious situation like sexual coercion occurs. Remind your children that they can speak freely with you.

How do you teach your child to push back against peer pressure?

There is a big difference between a situation that makes you feel a sense of thrill and one that makes you feel a sense of unease. It is that moment, when we realize the transition between excitement and fear, that is most important to recognize. Most teenagers allow peer pressure to get them much further into a situation before pulling the plug, ignoring their own instincts, just to keep from looking uncool. Kayla may have begun to feel a nagging sense of discomfort and low-level of fear as soon as the car started pulling over, but she was never able to vocalize this.

I realize the movie was mostly trying to tell the story from the perspective of a lost and awkward-feeling young woman. Because of this, there was no exposure to the forethought of her father. He clearly cared about her and was there giving her positive reinforcements throughout the film (as most parents do). What is lacking here is clear directives. Tell your child exactly what to do if they find themselves in over their heads --e.g., take a deep breath, say "no", and text or call immediately. To teach your child to trust their instincts, you must give them the resources to make in-the-moment decisions.

As far as keeping your child from being the pressurer, talk to your children at every opportunity about real life situations. Talk to them about boundaries, accepting ‘no’ and use examples that they can relate to. If you are comfortable with it, share about some of your own experiences (in an age-appropriate way) with friends and old romances.

Beyond sexual coercion, what else is scary about this, as a parent?

As mentioned earlier, feelings of guilt around rejecting someone can be very overwhelming and confusing.

“Why wasn’t I able to live up to this person’s expectations? After all, they were charming and attractive, not to mention they were doing something nice for me. Will they hate me, and possibly tell other people about what happened?”

Thoughts of self-harm and worthlessness can surface. In a worst case scenario, rumors in a school can circulate and be crippling for a young teenager, especially if an assault did occur.

A parent with whom they can trust can be invaluable in these situations. Sexual assault can occur at any age, so even if it feels too soon, talking about sexuality and consent openly, and with specificity, will encourage your child to approach you if they find themselves dealing with a situation like Kayla’s.

To schedule an appointment with Rebecca Neufeld, LMFT-Associate contact rebecca@thepracticeatx.com or 512-900-1590.

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Falling In and Out of Love with a Narcissist

Heart Hanging on by a Thread / Kelly Sikkema

Heart Hanging on by a Thread / Kelly Sikkema

“My partner is a NARCISSIST!”

I hear this a lot. The term narcissist is used, and sometimes misused, to describe an unbalanced relationship or a person that is selfish and mean. Oftentimes in therapy sessions a client will label their partner in this way, but that person probably wouldn’t actually meet the requirements to be diagnosed with Narcissistic Personality Disorder. Like many things, narcissism exists on a spectrum, and in western cultures where individualism and high achievement are valued greatly, it’s no surprise that we all have some mild degree of this. Healthy narcissism helps inform us of our own self-worth and self-esteem. Narcissistic tendencies are typically only problematic when they become extreme.

The traits that define narcissism include a lack of empathy and compassion, as well as blatant disregard for the feelings, boundaries, and needs of others. A person who demonstrates narcissistic tendencies projects an image of superiority, entitlement and grandiosity. He or she may appear self-absorbed, by interrupting and monopolizing conversations, while offering their views as indisputable. This person tends to exaggerate their knowledge, talents and achievements, seeking accolades and elevating themselves while putting others down. Those on the extreme end of the spectrum have highly developed narcissistic traits, and usually don’t believe that rules were meant for them to follow. They may lie frequently, disregard the promises they made, ignore social norms or even break the law without conscience. Typically, there is little or no remorse for their own wrong-doing or the for pain that they inflict on others.

Am I in a relationship with a narcissist?

Being in a romantic relationship with a person like this is really difficult. The partner with the narcissistic traits is often charming and romantic – especially in the beginning of the courtship. Once the relationship has formed and the hierarchy has been established, this individual will turn on his/her partner, using the charm and romance to manipulate every situation so that they remain in control. They expect total adoration, loyalty and attention to their needs. Clients who are on the receiving end of this behavior often ask me if they’re “crazy” to be caught up in this roller coaster relationship. They tolerate the mood swings, the put-downs and the broken promises until they just can’t take it anymore.

How do relationships with a narcissist end?

Getting off this roller coaster isn’t easy. This ride might actually feel more like loop de loop, with no end in sight. When the partner with the narcissistic traits feels that the relationship is in jeopardy, they may become passive aggressive, offering the silent treatment and withdrawal when he/she doesn’t get their way. When confronted about a grievance or a lie, they’ll typically use emotional warfare including blaming, criticizing, guilt-tripping and gaslighting. Then they may counter that behavior with generosity, romance and kindness to further manipulate the outcome so that their partner relents and agrees to give him/her one more chance. It’s hard to extricate oneself from this type of relationship. The end usually happens in one of two ways. The partner that has endured this behavior finally sets and maintains firm boundaries with consequences, or the one with the narcissistic tendencies realizes that to stay in the relationship will require that they behave differently and accept responsibility for their actions.

Feeling stuck in an unbalanced relationship is an unpleasant place to be, but there are ways to improve the situation, and to tip the scales of power. With therapy, change is possible, and that change may happen for both the partner with the narcissistic traits, as well as for the one that has endured these circumstances. Breaking the cycle in these toxic relationships requires time and effort, but restoring balance and self-esteem make it all worthwhile. Today is a good day for a good day.

Call or email Katey Villalon, LMFT-Associate for a free consultation at 512-537-6339 - katey@thepracticeatx.com. Katey will also be hosting a group this November 2018 - More details below:

Breaking the Cycle of Unhealthy Relationships

Are you feeling that the relationship you have is unbalanced or even toxic? Do you wish that your partner was more supportive and showed you empathy and understanding? This 8-week women's group will help you to find your voice and validate your needs.

Learning Objectives:

1. Understand why some women seek out or stay in relationships with selfish people.

2. Learn how to communicate assertively and to ask for what you desire.

3. Recognize the differentials between healthy and unhealthy relationships.

4. Identify the key factors that lead to consistently happy relationship dynamics.

5. Develop greater self-esteem and a positive self-image.

When: This group begins on Friday, November 2, 2018 and goes consecutively for 8 weeks (no group on 11/23)  

Cost: $40 per group session; SAVE $5 per session by paying for this series in full by 11/1/18! Total due with discount applied is $280 and may be paid by cash, check, credit or debit card.

Requirement: 30 minute consultation (cost $40) before 10/15/18 is required to be admitted to this group. Call Katey at 512-537-6339 or email katey@thepracticeatx.com to schedule this meeting.

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Men’s Mental Health Stigma: Empowering Men to Seek Help

Photo by    Blake Connally      on    Unsplash

The stigma around men seeking support for mental health is very real.

We are told that ‘’real men’’ don’t cry. The reality is, a harrowing amount of men are dying from the modern health epidemic of the 21st century. Suicide rates are only increasing and statistic show a significantly higher number of males than females are ending their own lives.

An existing cultural barrier is preventing men from getting help. ‘’Real men’’ are told to be strong, not soft. To ‘just get on with it’ or ‘stop feeling sorry for yourself’, no one wants to hear you moan and if you’re a man you are expected to be tough and resilient to any of your emotional worries. For many men talking about their mental well-being equates to a loss of masculinity, and the thought of seeking professional help is impossible. The daunting thought of being viewed by society as mentally ‘weak’ is simply, unthinkable. The truth is, being a strong man doesn’t mean you should suffer in silence.

Let's break down the barriers for seeking help:

Everyone has bad days, and we all go through hard times. But when do we listen to ourselves and understand what to do when things get a little too much? Breaking down the social stigma is possible, but first, allow us to discover ways we can help men open up about mental health conditions  

How can men recognize emotions?

It is incredibly important to try to explore inner feelings and acknowledge own emotions.  We all go through tough times, whether it’s work stress, a traumatic life event, a breakup, losing your job, low self-esteem, or comparing yourself to others and feeling like a failure. It can even be a build up of lots of small things others may deem as insignificant. Recognising emotions and worries can be the first step in the right direction to getting help. Admit that it is okay to feel these sad and stressful emotions, any battle you may be going through, big or small, needs thought and attention in order for them to be understood and solved.

Start talking about mental health

When talking about mental health, there is nothing to be ashamed of. The more conversations we have about mental illness, the more open society will become with the idea that men struggle mentally. You know what they say—a problem shared is a problem halved. It can be a real challenge opening up to someone; it takes time and sheer bravery to talk about your innermost deep thoughts. However, as we talk more openly about mental struggles you will be astonished at the number of men who will also be struggling with the same emotions.

Finding your community

Most men will struggle in opening up to their social circles, friends, families, and colleagues due to the existing stigma with the aim to preserve their masculinity. Surrounding yourself with a community of people who will listen to you, such as a family member, old or new friends, or a colleague that you can truly open to and express your thoughts to. This can take time to find that one support group who will be attentive and understanding. Ensure you don’t give up on finding someone to confide in, you will be surprised at the number of people who are fighting the same mental struggle.

Many men find that opening up emotionally to a stranger can be a liberating, as it doesn’t always have to be a close peer, regardless of who the person is there is always someone ready to listen.

Talking openly about mental health can save lives. Understand that men aren’t going through mental issues alone, one simple conversation can shift the shameful attitude, put a stop to the stigma and can lead to men making the life-changing decision to seek professional help and start their journey of healing. 

We can prevent lives from being lost to mental illnesses by empowering men to ditch the social expectations of them being the tough guy. Instead, start a discussion about their emotional struggles and encourage them to reach out for help when things really do get tough.

If you know someone who needs reassurance that their mental emotions are valued and need to be listened to then call Simon Niblock at (512) 470-6976 for a free phone consultation.

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Why You DO Need to Talk about Emotions.

Pixabay/CC0  Author: Stephanie Paez, MA, LMFT-Associate


Author: Stephanie Paez, MA, LMFT-Associate

Imagine that the fuel light in your car turns on. You have a pretty packed week, juggling work, appointments, and social life. The first thing that comes to your mind is, “Why now?” You decide to test your car and see how far it will go. “Maybe I’m able to finish my errands,” you say. You’re able to go to places, and it feels good. “Yes, I’ll make it! I really have no time to stop right now… I’m sure it can wait until tomorrow.” Then, all of a sudden, your car stops. The first thing that comes to your mind is “Why? Why didn’t I stop when I knew I needed gas?” If your car stopped in the middle of a busy highway, or at peak traffic hours, then you can picture the amount of anxiety that comes next…

Denying the fact that you needed gas clearly made things worse. Something similar happens when you deny your “negative” emotions, or those emotions that feel uncomfortable. The reason why I put quotation marks around the word negative is because there is no such thing as “good” vs. “bad” emotions. What could be potentially negative are behaviors that are implemented in order to deal with the uncomfortable emotions, but anger and sadness per se are completely normal responses.

Denying emotions is extremely common; most people have engaged in this behavior at some point. There might be a temporary relief from pushing emotions aside and not having to deal with them. However, if you push those emotions aside on a regular basis, you might end up paying an emotional price… similar to the one experienced on a busy road with no gas.

Why is denial worse in the long term? Because every day you spend avoiding the real issue is a day you spend not taking appropriate action to deal with the situation.

If emotions are bottled inside of us, they could manifest later in different ways. For example, Mark absolutely hates his job situation, but does not know how to address it with his boss. He decides to wait several weeks to see if the situation improves. He realizes that nothing changes and feels angry and hopeless. Mark then begins to notice that he gets very irritable when driving. He completely withdraws himself from interacting with co-workers, even the ones he enjoyed being around with. He also has found himself lashing out at his family after coming home from work.

Denial keeps people in unhappy situations, day after day, or even year after year (I’ve worked with individuals with unresolved issues from 20+ years ago). Confronting the truth or uncomfortable emotion after a long time might even feel more overwhelming, as there are now added layers or a bigger issue than the one you started with. If the accumulation of emotions or crises were never addressed, in some cases the result might end up being an addiction, an eating disorder, a suicidal attempt…  in order words, a cry for help.

What can uncomfortable emotions teach us?

Emotions such as sadness, anger, fear or despair can provide the opportunity for addressing the root of the issue. For example feeling fearful could lead to the opportunity of working through a previous traumatic experience, or feeling sad could lead to finally addressing emotional disconnection in couples therapy. In the example above, feeling angry and hopeless can be an opportunity for Mark to address the issues directly with his boss. Which could then lead to deciding whether or not the job is a right fit for him.

Don’t be intimidated by uncomfortable emotions, let them be and let them tell you and show you what potentially needs to change in your life. 

To schedule an appointment with Stephanie Paez, MA, LMFT-Associate, call 512-910-4052.

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Besides Medication, What Else Can I do About Depression?



Author: Diana Walla

You know that feeling. It’s hard to get off the couch, even though you have a million things to do. Sleep either swallows you up or seems elusive. Your appetite is non-existent, or it is ravenous, demanding food as though starvation were right around the corner. Things that used to be fun hold no appeal.

It's depression, and it is one of the most common mental health issues.

According to the Anxiety and Depression Association of America, it affects 16.1 million adults in the U.S, or 6.7 percent of the population age 18 and above. That’s a whole lot of us. It is safe to say, if you don’t suffer from depression yourself, you know someone (probably many more than one) who does.

So, first in the treatment line-up is medication; psychiatrists typically treat these symptoms with chemical antidepressants. Research shows, though, that medicine should never be our only attack on serious depression. There are many other options currently under exploration by researchers all over the world.  Many of these other options are strikingly effective. For milder forms of depression, they might be enough to keep things from getting worse.

In an interesting new book, Johann Hari, an award-winning journalist with a lifelong familiarity with anxiety and depression, travels the world in search of the latest research into the causes and treatment of depression (and depression’s loyal sidekick, anxiety). In Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, he describes nine contributing factors and proposes remedies for each. We’ll discuss three of those factors.

How Disconnection from Meaningful Work Contributes to Anxiety and Depression

The first cause explored by Hari is disconnection from meaningful work. In Great Britain, he interviews researchers who are looking into the world of work, and are finding a link between dull or repetitive work and people’s mood and psyche. As our work environments change in response to automation and new technology, some people find themselves in jobs that offer little intrinsic reward. As one researcher told the author, “the notion of what constitutes stress at work has undergone a revolution. The worst stress for people isn’t having to bear a lot of responsibility. It is having to endure work that is monotonous, boring, soul-destroying, where…their work touches no part of them that is them.” These researchers are also zeroing in on specific work environments, such as those where no matter how hard one works there is little recognition or reward. These are also big culprits in bringing on despair. So whether you need a different job or a new boss, if you find yourself bored or frustrated with work and also depressed, it might be worth looking at your options.

Disconnection from Other People as a Contributor to Depression

Another cause of depression is lack of connection to other people. We are relational beings. We are social by nature, even if there are differences among us in just how social. Researchers at the University of Chicago are studying the effect of our social connections on mood, with a special focus on how technology, from social media to video games, is contributing to isolation. Their results are startling. Being deeply lonely, they have found, is as stressful on the body as being physically attacked! Also, just being around people is not the only answer.

For relationships to be helpful, you must feel you are sharing things that matter to those people. Significantly, the research is strongly supportive of actual, face-to-face connection; so sharing your life on social media is not the answer. As the author states in regard to how much we have allowed technology to isolate us, “we – without ever quite intending to – have become the first humans to ever dismantle our tribes. As a result, we have been left alone on a savanna we do not understand, puzzled by our own sadness.” One of the best ways to really connect with someone else? Reach out and help someone. Being community and spending time or money for someone in need communicates – to them and to you – “we are a group, we belong together, we take care of each other.” And those things are healing.

Disconnection from Meaningful Values

Which makes you happier: a promotion, expensive car, newest phone, and great new outfit? Or spending time with family, doing things to make the world a better place, and helping other people? If you have stayed with me this far, Dear Reader,  you know the answer. These results are clear and compelling: “Twenty-two different studies have…found that the more materialistic you become, the more depressed…and anxious you will be. Similar studies…in Britain, Denmark, Germany, India, South Korea, Russia, Romania, Australia, and Canada – and the results, all over the world, keep coming back the same.” The healing comes from stepping back from materialism and the quest for more stuff, which is easier said than done in our consumer-driven culture. But that is not enough; you have to replace this with people and activities that support more meaningful values, like relationships and personal growth and contributing to the wellbeing of others.

Other factors addressed by Hari include disconnection from childhood trauma, disconnection from status and respect, disconnection from the natural world, disconnection from a hopeful or secure future, genes and brain changes. It is a helpful read, since it gathers information from so many countries and so many fields. If you are interested, pick up a copy and let us know what you think!

To schedule an appointment with Diana Walla, LPC-S, LMFT-S, call 512-596-2924.

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Failure to Connect: How Social Media are Changing Human Communication



Author: Kendall Campbell, MA, LMFT-Associate

In the last 25 years, we’ve made some of the greatest technological advancements in our history. One of which, the internet, has allowed us to freely and effortlessly exchange brilliant ideas and funny cat pictures via whatever device we want, whenever we so desire, through social media. The internet and products of the internet like Google, Facebook, Twitter and the like, have revolutionized our society and the way we connect with others on a day-to-day basis. Just think about how many times have you learned something about someone else – their interests, hobbies, birthday, etc. – without ever speaking to them?

The irony however is that despite social media’s ability to aid us in communicating and connecting with others we are more alone, isolated, and stressed out as a society than ever before.

Social media are nothing more than tools. They can’t create genuine connection with others, but they can create the comfortable illusion of connection.

Do social media create a false sense of connection?

By our very nature we need other people. We have an innate desire to connect to and be understood by something or someone else. So, it makes sense why we use social media. I go to someone’s facebook or Instagram page to discover information and/or pictures about their new cat or the vacation they came back from and I instantly feel connected to their experience.

Unfortunately, that connection is one sided; I’m aware of them but they’re not aware of me. It’s this weird – slightly creepy – lack of true connection that leaves us feeling lonelier, more isolated and stressed.

Social media is limited in how different platforms create a connection experience. First, they have evolved into a system of short bursts of communication: statements rather than conversations (e.g. snapchat with its 10 second video capture length and twitter with a 280-character limit).  This makes genuine connection even more difficult, especially if these short bursts of communication are hard to interpret or be interpreted by someone else. Sarcasm, abbreviations, and/or poor punctuation are just a few ways interpretation can become difficult. 

Second, there’s a delayed response. It might be a second, an hour or a day before you receive a response from another person and even then, that reply might be a ‘like’ or a ‘retweet,’ which doesn’t communicate anything of true value.

 Finally, posts and replies can often lack authenticity or at the very least be perceived as lacking genuineness. Think for second… When was the last time you were literally laughing out loud when you posted to someone the abbreviation “LOL”? Chances are that “LOL” elicited only a small smile or simple “ha.” Additionally, people tend to post about amazing and awful moments in their lives and very rarely about the in-between – Have you seen anyone recently post about eating a bagel or going to the doctor without a modifier attached (e.g. “best bagel ever!” or “Doc gave me some terrible news today.”)

Are social media changing how we communicate?

want you to imagine going on a date with someone and having a conversation with them where all the points mentioned above were present throughout your conversation; They spoke to you in an exaggerated fashion, using/making unclear language/references, in short quick bursts, and making vastly more statements than asking questions. That sounds terrible right? My guess is you might be hard-pressed to find a reason to go back for a second date. Yet, this is the type of connection that’s being formed with another person via social media. Let’s change that.

Get out of a social media communication mindset

Put down your phone. Seriously. The next time you go out with a friend, go on a date, take a walk with your kids or visit your favorite part of the city, intentionally put your phone down. Social media is a way to communicate an experience, but it was never intended to capture how you felt when you were in that experience. That can only be accomplished through mindful communication. Let yourself breathe in the moment mindfully without diving int your phone.

Stop telling stories and start asking questions. Social media have created an environment where we are more assertive and less curious. We are more than happy to send a photo of the most edited perfect picture of that trip we took, but that doesn’t allow us to be curious about another’s experience. Try to break the habit of talking about yourself and ask, instead, about someone else.

These are just two simple tools to help steer us all back toward authentic communication. Social media are tools, but no app or medium will ever be able to replace meaningful human interactions.

To schedule an appointment with Kendall Campbell, MA, LMFT-Associate, call 512-920-3654.

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Why Men Should Go to Therapy.

CC0/Bruce Mars

CC0/Bruce Mars

Author: Simon Niblock, MA, LMFT-Associate

We all know that when you throw the gauntlet down, most men are up for the challenge. Consider these examples:

Are you ready to tackle the next ‘Tough Mudder’ in record time?

Sure! Let me show you who’s boss!

Ready to dismantle the kitchen garbage disposal, blindfolded, with dinner guests about to arrive?

Easy mate, I can do that, while still juggling the BBQ!

How about changing the nappy of your child, while in an airplane toilet stall at 30 thousand feet, while experiencing turbulence? 

Come on, that’s old school dad stuff! Would you like me to land the plane too?

How about coming to therapy?

You’re bloody joking right?!

So… we struck a nerve then?

Why the adverse reaction? Why do some men suddenly develop an acute phobia when presented with the idea of seeing a counselor or a therapist? In my professional opinion, I suspect there are three reasons.

1. Society has expectations that men must be independent, bulletproof, and have the world in the palm of their hands.

2. Men are not taught the language of verbal, emotional expression.

3. The counseling and psychotherapy profession has not fully accommodated the therapeutic needs of men.

Because of these reasons, many men are willing to sit in their pain, while hoping they can push through it, using the same old tired tactics. Most of this is an attempt to show the world that they have both the answers and solutions and that they will fix themselves by the end of the business day.

Let’s explore these reasons a bit further…

Society has done a wonderful job in shaping how men should view themselves. Men are labeled in so many different ways these days, whether it’s trending or not, the story that many guys portray isn’t necessarily their own. Think of stereotypes or labels like; the toxic masculine, the metro, the sportsman or jock, the action hero, the buffoon, or the ‘strong silent type’. Many of these social narratives are placed heavily on men’s shoulders right from a young age. These labels are created to reinforce our expectations of men and how they should think and behave towards themselves towards women, with their children and other men.

If society says that men must think of themselves as untouchable and indestructible - then naturally men aren’t going to seek help when they really need it.

The stigma of reaching out for help is both internalized (there’s no way that I will admit that something is wrong) and externalized (he better not fall off his horse and crash). That is an incredibly powerful force in shaping our ideas about masculinity and how we think about ourselves.

As a consequence, many men are never taught (or even expected) to be able to openly express themselves or experience their emotions.

When men are asked to ‘express themselves’ they come up short. Because they haven’t had any real training in this action, they don’t necessarily have the right type of vocabulary to communicate what’s really going on inside. Now, that’s real pressure. In many circumstances, this is viewed as avoidance or resistance and as a result some men are portrayed as ‘emotionally void’ or even just ‘bumbling idiots’. What’s important to recognize is that it’s not a situation of unwillingness but a simple lack of capability.

Subsequently, men struggle to express what’s really happening behind the kimono and the cycle of shame and despair is perpetuated; their needs get buried deeper, problems never get resolved and their relationships suffer.

What can we do to help men help themselves?

Offering gender-specific services, practices, and environments that honor the diverse needs of men is a practical way of engaging more men in therapy.

Services that address the typecasting or labeling that has commonly deterred them, using language that suits men's thinking will help minimize the uncertainty and misconceptions of therapy and open the door to endless possibilities. Hopefully, men can then come out of the trenches and live authentically without fear of reprisal or isolation. If men were confident that this was available to them, then more might actually be willing to engage in services that create a meaningful, healing experience.

To schedule an appointment with Simon Niblock, MA, LMFT-Associate, call 512-470-6976.

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Parenting While Living with Cancer



Author: Robyn Strelitz

Those with cancer know that life throws its most unfair and unexpected surprises without your permission.  Most parents have ideas for how they want to parent.  They have hopes and dreams for the experiences and adventures they will have with their family.  But life can get tricky and you can be thrown a curveball that nobody saw coming.  Or maybe you got the curveball, but you still went for it anyway; you took on the most awesome job—you became a parent.  Here are some things to consider if you are facing cancer while raising your children:

1. You may understand cancer, but your children don’t. 

Children often think that what is going on in their home, is going on everywhere.  This is particularly true the younger they are.  As they move forward, they start learning about the outside world, but their young minds are still developing and perspective-taking is a work in progress.  You have years of life experience to fall back on and your cancer probably feels like a major curveball.  But to your children, especially younger ones with shorter memories, it may seem normal.  Keep in mind that as they grow and when they are grown, they will better understand your struggles and appreciate your tenacity.

2. Talk to your kids about cancer.  

Life is fragile, but for those facing cancer, the fear of letting your children into your medical odyssey is extremely painful.  Cancer reminds us of an ultimate truth—that there are so many things out of our control.  It is a daunting task to talk to your children about your illness and possible prognoses.  Parents have a strong biological urge to shield their children from pain.  Part of the delicate job of ushering our children in the world, is the painful awareness that at some point they will be introduced to the uncertainties of life. 

Our children are smart and they usually know, maybe not with words, that something is wrong.  This can cause them to feel anxious and rightfully so.  For most battling cancer, there is likely a lot of adult talk that happens in front of children.  Facing cancer can mean that our children hear and witness things that we would prefer they never had to face.  This can leave children trying to put the pieces together, and this can be scarier than being armed with the facts. 

3. Sometimes you need to hit refresh. 

Children grow up, but sometimes we forget to update them on an age appropriate basis.  Maybe you were diagnosed when your children were too young to talk.  The one constant in children’s lives is change.  So, what happens if you were diagnosed with cancer prior to or just after having children?  Many times, it means that unless you plan for it (in the midst of treatments, surgeries, hospital stays, side effects etc.), they miss out on learning and understanding what is going on with their primary people, their parents.  So, from time to time, it’s important for you, your partner, or a trusted loved one to sit down with your children and provide them with age appropriate information about what is going on in their family.  Give them time and space to ask questions and process their feelings.  This can be especially painful for parents; not only personally confronting your illness, but watching your children do the same.

4. Access cancer support networks.

You have options and you are not alone.  The Flatwater Foundation is an organization that covers the cost of care for therapy and counseling for you and your family. They cover the cost of providing support to you, your spouse, and your children.  You can learn more about this service by asking the social worker at your medical or social facility if they're connected to the Flatwater network.

Places like Wonders and Worries are designed to help your children process your illness on an age and timing appropriate basis. There are books that help explain illness and loss.  Take all the help you can get.

5. Enjoy the beautiful moments.

You never know when connection and joy will strike—grab them and savor them.  Take the cuddles on the couch, naps, and times when you feel well enough to play with your children.  Your children will have these no matter how your illness unfolds—they will learn the beauty of living in the here and now. 

Mostly remember that your diagnosis does not define you.  Yes, you are facing remarkable challenges and odds, but you do have some control: control to leave nothing left unsaid and control to manage how your children learn about your illness.  And whether you face remission or the unthinkable, your children will know deep in their soul that you showed up for them, were passionate about them, and that you did the very best you could for them despite the hand you were dealt.  

To make an appointment with Robyn Strelitz, call 512-434-0868.

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How to Avoid the Valentine's Day Blues



Author: Jessica Worthington

Valentine's day is just a few days away and has many of us brainstorming ideas and scouring the internet for ways to show our significant other how much they mean to us. But even the best-laid Valentine's day plans have the potential to backfire. It's not uncommon for couples to experience a post-Valentine’s day argument that leaves them feeling discouraged and disconnected. Below are some of the most common reasons we can have the blues after a day colored in love, and what we can do about it. 

There's no such thing as mind-reading on Valentine's Day.

Telepathy is high on the list of superpowers I'd like to have (it would make my job and personal life a lot easier). However, in real life, many of us operate with the assumption that our partner should just know what we want, what we're feeling and what we're in the mood for. We may drop hints, or make vague comments alluding to what we're trying to communicate. Our subtle belief in mindreading is universally hard on relationships. One partner is left feeling unloved, and the other partner is left feeling powerless and confused as to why their partner is upset with them.

When challenging the concept of mindreading, the responses I often hear are "We've been together for so long, they should just know" or "If he/she really loved me, and really knew who I was, they would know what makes me feel loved". Instead of assuming your partner "should just know" what you're hoping this Valentine's day will be like, resolve to make it special by starting a tradition of talking explicitly about your hopes for the day, ideas you have and what would make you feel loved.

Don't let Valentine's Day be a relationship test.

Culturally, we put a lot of pressure on this holiday. Therefore, any discrepancy between what we're hoping and our reality has the potential to derail the entire day. Instead of using this day as a test for how much your partner loves you, commit to using this holiday as an opportunity to get to know one another a little better, share more deeply and marvel at the way your beloved changes through time. Make room for imperfections, and use this holiday to co-create a relationship that you can celebrate the other 364 days of the year. 

To schedule a consultation with Jessica, call 512-537-5977.

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Why it's so Hard to Change.

Author: Jeanene Smith, LMFT-S, LPC

New Year’s resolutions are hard to keep when the weather is cold, the gym is far away and the cookie box wielding minions of doom commonly known as Girl Scouts are still laying out on the coffee table where I left them last night. What really happens to those promises to change? Does one misstep begin a shame spiral or does the action of change idea never start due to fear?

Why Is change so scary?

What is your first reaction when you start to think about a major change you want to make in your life? Do you scream "NO!" Do your arms magically cross, your forehead scowl while declarations of “I hate change” are made?

When did change become something negative instead of exciting, adventurous and plain old fun? Was it learned at home or was it the result of a change that didn’t go well? As toddlers we were constantly faced with changes, and we were encouraged to embrace them. What if, instead of reinforcing screaming no’s, crossed arms and declarations, the first thought would be YES! The first idea would be “that’s interesting?“ What if your body's first reaction, was to lean in to change? All life on earth is constantly changing and evolving, what makes humans resist? Is it fear?

Our bodies are constantly changing.

When John Mayer sang, ‘Your Body is a Wonderland” he wasn’t kidding. The heart pumps on average 72 beats a minute. Every second two million billion bits of information move around the brain.

A team at Harvard in 2014 successfully achieved brain-to- brain verbal communication in humans for the first time. Not using a voice box, but just two brains. When the body senses fear either by a visual cue or thought impulse, breathing accelerates, goosebumps may appear, heart rate increases and in extreme conditions stress can override the control of the bladder.

As we sense fear, we turn inward and assess whether we need to take action. So changing requires the courage to take a risk, a deep breath, a small step forward, and the beginning of a changed attitude that walks toward change rather than remaining resistant. By doing so, you make a fool of fear and change transforms from a mountain to a small hill.

Change will happen without your permission.

While we resettle the mind with new thoughts, breathing deeply and pushing forward, we  also battle our egos. An ego person’s sense of self-esteem or self-importance. No one wants to look or feel stupid, foolish or fail. But if the idea of change leaves a cold sweat happening because in 2nd grade you peed your pants in front of the class and vowed to avoid all change, will you avoid opportunities that could change your life because of fear?

Many of us are victims of change we didn’t want. An accident, a death, a loss. Each of those change us forever. But are we courageous enough to not let that one moment of anguish shadow hundreds of other moments of joy, laughter and accomplishment?

How to take a first step toward change

I recently had to embrace a new change: I moved my full time practice to part time, and I joined a new group of younger therapists.


What if I'm too old for them? What if I get embarrassed because I don’t know all the new technology they use? On day two I was shown a new trick to my iPhone. I have never used anything other than Apple but I didn’t know that one. I had to laugh at my ego, breath through feeling foolish, tell my mind that I may not know all the new, but I am still smart and good at what I do.

Then I took a forward step into my new office.

To schedule an appointment with Jeanene Smith, call 512-578-8255.

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When the Holidays Aren't so Jolly


As the holiday season looms, many of us turn our thoughts to family and friends.  This can be particularly difficult when you are grieving the loss of a loved one.  It can trigger sadness, loneliness, loss, and anger.

Planning and preparing for the holidays requires a lot of energy. Be aware that grief can often drain you of that energy.  Sometimes we feel a pressure to “do” the holidays, the way we have always done them.  Bear in mind, it is absolutely okay to do things differently—it might be just for now or it might not.  The number one thing is to be gentle with yourself.

Decide as a family or on your own what would make these 2017 holidays meaningful. Be aware of the pressures and demandsand realize that you are under no obligation to do what others expect.  Consider planning some “down time” to regroup, as needed, but be careful not to isolate yourself.

Here are some ideas to cope with the holiday season and navigating your grief.

You can take care of yourself:

• Try to remember what you have as well as what you have lost.

• Take note that the anticipation and worry about the holidaysis usually worse than the actual day itself.

• Plan for what you want to do and what you don’t want to do…it is your choice. You do have some control.

• If you are planning for your family, decide what is right for you all NOW…talk about how it can change next year if you all choose for it to.It can help to stay focused on the present.

• Start a new holiday tradition. It could help symbolize moving forward.  It could also be an acknowledgment of the depth of your loss.

• Make a list or two: remember when you are grieving, your memory and concentration may still be impacted, so use the tools you have to compensate.

• Remember that tears and sadness for the lossare to be expected, but it does not have to ruin the joy that can also be experienced. It’s just more complicated.

• Express to others what you want or need during the holidays.  They likely want to help, but don’t know how.

• Share holiday tasks and responsibilities.

• Do something for someone else…perhaps honor those you grieve with a charitable donation. This can help you get unstuck at times.

Take care of yourself around the holidays:

• Get plenty of rest

• Get plenty nutrition

• Get some kind of physical activity or exercise daily

• Avoid excessive alcohol or drug use

• Stay connected with others

• Allow yourself to laugh

• Breathe

• Remember, just because you always have, doesn’t meant you always have to.

Here’s an event this holiday season that could help, hosted by us and our good friends at NAMI:

Coping With The Holiday Blues: December 7th by NAMI

to schedule an appointment with Robyn Strelitz, LMFT, call 512-434-0868.    



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What Cheesecake Taught Me about Gratitude.

Modified Pixabay/CC0

Modified Pixabay/CC0

When I was in the fourth grade, I learned an enduring lesson on gratitude. At the time, I was only interested in two things. Television and food. As you can imagine, that meant that my physique left much to be desired, but luckily, I wasn’t too concerned with that at the time.

I went to a private catholic school and my homeroom teacher was Sister Theresa. She was kind and loving but she sure as hell didn’t take any lip. It was the last day of school before the Thanksgiving break and we were having our very own feast! I don’t want to get all George R.R. Martin about it, but there was pizza, chips, soda, cookies, candy, and, most importantly to young Joseph, cheesecake! I had been fantasizing about this cheesecake all week and I anxiously watched as Sister Theresa made the rounds placing a piece of cheesecake on each student’s desk.

When she finally stood before me and placed my cheesecake upon my desk, my heart sank. It was not the glorious slice of creamy goodness I had envisioned, but merely a small bite sized morsel. Sister Theresa saw the look on my face and immediately asked what was wrong.

“It’s just a bite size piece.” I said.

Without a moment’s hesitation, she grabbed my slice of cheesecake, placed it back in the box, and continued distributing to the rest of the class. Eventually, she sat back down at her desk and beckoned to me. As I walked up with my head hung low, I noticed that sitting on her desk sat one solitary piece of cheesecake. My heart skipped a beat.

She asked, “Do you know why I took back your piece of cheesecake?”

I nodded while trying to hide a smile because I just knew she was going to give me back my cheesecake when she was done chastising me for being ungrateful.

She continued, “There are people in this world who don’t ever get dessert. They don’t even have time to worry about cheesecake because they are busy trying to figure where they are going to sleep and how they are going to afford their next meal.”

I began to cry.

“I want you to go back to your desk and think about all the things you have to be grateful for this Thanksgiving.” She concluded.

Then I walked back to my desk in shock. I couldn’t believe she didn’t give me the cheesecake! I don’t know when exactly I grasped what she was trying to teach me that day. But, today as I try my best to raise two young boys and help addicts find new life, I often think back to Sister Theresa and can’t help but smile because today I understand.

Why is gratitude so powerful?

Today, I understand what gratitude is all about. You see, I am a person in long-term recovery. Nine and a half years ago, I was dying of a severe addiction to IV heroin and found my way to a treatment center to be separated from alcohol and drugs for the last time.Every day I wake up grateful to be safe and sober. I am grateful for those that came before me and all the amazing people that have come into my life. I am grateful to have my family of origin back. I am grateful for my wife, the two boys we are raising together, and the little baby girl that is on the way. I’m also grateful to be working in a field in which I get to help other people change their lives as well.

I am a Licensed chemical dependency counselor and the president of the Austin Chapter of the Texas Association of Addiction professionals. I am also the Director of Outreach for an amazing program that helps people recover from addiction. It’s called Recovery Unplugged. Recovery Unplugged takes the best practices in addiction treatment and combines them with music and music therapy to facilitate a deeper emotional understanding, emotional expression, and recover!

Today my life is so full of things to be grateful for that I am often at a loss for words.

But, I still think about that cheesecake sometimes…

We are grateful to have this guest article written by Joseph Gorordo, a Licensed Chemical Dependency Counselor in Austin.  


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The Power of Intention



We can all benefit from being a bit more intentional.

Intentional in our thoughts, intentional in our actions and intentional with our relationships. I recently wrote about how saying no more often could be a benefit to you and your family. Intentional thinking is like that. It takes the notion of saying no a little further.

Being clear and direct with your intentions is setting a personal boundary that is about self-care and living authentically. We will always be challenged by life’s obstacles and the pace at which we live.

I have to constantly work to be intentional with my thoughts, actions and energy. When I don’t take the time to check in with myself I find that I am living for other people’s intentions or accommodating someone else’s value/belief system. I have to ask myself, what kind of mom do I want to be today? next week? How do I want others to respond to me? What can I do better? What are my hopes for my family today and in 10 years? Are my husband and I taking enough time to focus on our relationship? I know many people that do daily guided meditations or devotionals, some use their yoga practice to set intention and stay grounded, others use various forms of mindfulness (intention is arguably a facet of mindfulness, depending on who you ask or what you read). Figure out what works for you. I’m still trying to figure out my own work-life balance as a new (ish) mom, between logistical time constraints and navigating new roles in our family I haven’t found a yoga practice, daily devotional or mediation that I can stick with. What works for me is taking a couple of minutes, alone, every morning to set my intentions. My intentions are simple, Lead with love. Practice patience and practice gratitude. When I remind myself to do these three things, my perception of everyone around me changes. I’m more centered.I have more empathy for others and am less hard on myself.

 So why is intention important?

Because it can keep you grounded. Grounded in your values, goals and hopes for the future. Our culture revolves around constantly tackling goals and meeting milestones. Not to mention the large cultural discourse that is constantly placing unsolicited expectations on us about what defines professional success, healthy adjusted children, relationship “goals,”  and a life cycle timeline of when its appropriate to realize certain milestones — just to name a few!  Using intention as a daily part of your routine can keep you grounded and rooted in what is important to YOU- not everyone else. The power of intention is also that its a reminder to focus on what you can ACTUALLY change.

 Is there a difference between intention and mindfulness?

Define intention anyway you want, I think it’s a notion that applies across a number of contexts. Intention is action. Mindfulness is awareness. Mindfulness is about more awareness than action. I feel more authentic and grounded when I can count on myself to act and to act intetionally. I allow intention to ground me, I allow it to simplify my energy and create space for emotional experience and relationships.

 How can intention impact my family?

In a highly reactive culture it sometimes feels like we don’t have control. Intention is controlling your responses and the energy you put into relationships. Sharpening your intentions and becoming more thoughtful in your interactions can directly impact your family and relationships. Clear and direct intentions create an emotional climate in a family that welcomes the full range of emotional expression. A supervisor once asked me what my goals were for the summer. I said, “Work on my marriage, start eating healthier and exercising, grow my private practice, start trying for a baby, take three trips, train my dog to be a service dog, and run a marathon.” He laughed— good luck! His advice was to simplify my goals and be more intentional; he also had the idea that in general, we can only be great at a handful or less things at once. We simply don't have the resources to excel at everything, all the time. You can only do so many things at once. So, I decided to focus on three things instead of a bucket list of things. Simplifying my intentions allowed me to focus on what I could realistically accomplish and accomplish well. We can’t do it all- and if you're trying to, it might be at the expense of the feelings of those around you.

Find the three things you can focus on for the remainder of the year. Do those things well. Then reassess. Practice intention and make it a habit.

Lead with love. Practice patience and practice gratitude.

To schedule an appointment with Caroline Harris, LMFT-Associate, call 512-915-3063. 


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                              Where change begins.  

There's No Place Like Home for the Holidays


Perry Como sings us his classic Christmas song each year, “Oh there’s no place like home for the holidays...la la la la...”bringing us all into to the holiday season and spirit. Christmas music fills the radio stations, holiday themed shows occupy the major networks, and shopping lists are being built. The Santa station was set up in the mall evenbefore Halloween to remind us to GET READY because it is that time of year again, the holidays!

In my conversations with my clients it is clear the holiday may bring warm feelings of happiness, as many know that it is a time to spend with family and friends. Some find themselves using this time of year to look back on all of the accomplishments from the current year and then looking forward to the upcoming year. The holidays are often seen as the time to shop all the good deals, eat all of the good food, and watch all the good holiday classics. For some, however, the holidays may start out this way, and then they go home for the holidays. Or even just the thought of the holidays immediately causes anxiety!

Many people find that their separate life from their family is balanced and orderlyonly until they return home to their families. There is something about walking through that front door that triggers old feelings of angst with family members (or with yourself) causing you to feel like the confidence you once had is now uprooted. Now that balance has turned to emotional chaos and anxiety, stress, and overall unhappiness can be the result. It is not uncommon for all of those unresolved issues to suddenly resurface just in time for when the turkey is to be served or the presents to be opened. The emotional stressors you have been trying to avoid are staring you and that turkey right in the face.

If you are connecting with this, you are not alone. Manyof my clients struggle with this and we talk about the a concept of “going home again.” This is a concept from a family therapist that reminds us that there are ingrained issues and differences from our families that we can overlook when we are on our own as individuals but they tend to resurface when going home again. Maybe there are old unresolved issues, challenging family dynamics, insecurities or just general differences that you are able to overlook when rolling solo, but not so much when around family.

If you feel like every holiday season creates similar obstacles for you I think approaching this holiday with this motto may help:

Don't react. Respond. 

So what’s a good way to react? The good way to react is to not react at all! I love this passage from the book, “Boundaries”by Dr.Henry Cloud and James Townsend:

When you react to something that someone says or does, you may have a problem with boundaries. If someone is able to cause havoc by doing or saying something, she is in control of you at that point ad your boundaries are lost. When you respond, you remain in control, with opinions and choices.

Start to plan ahead 

Think about what potential triggers may exist when you go home for the holidays and have a game plan for what you are going to do if you’re feeling the inner turmoil or urge to react. I think the most helpful tip is to step away from what is triggering you to find a place to calm down. I think it is good to look inward and focus on all you are proud of versus all you aren’t during this moment.

Staying around family when triggered may unfortunately lead to your family members causing you to say or do something you really hoped to avoid- which only violates your separateness. Now isn’t the time to solve all the family’s issues or differences, rather it is a time to be together (but as separate individuals) celebrating the holidays.

When you react, they are in control but when you respond, you are in control.

Oh, there’s no place like home for the holidays…with all the good and all the bad...so now it is time to return home being emotionally prepared for what home may bring. Start setting those emotional boundaries now!

To schedule an appointment with Mandi Roarke, LMFT-Associate, call 512-537-0995


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How to Live with Loss.



I recently experienced a loss that was hard to shake. Because I felt it, I had to go through the typical steps that, because I’m a therapist, I know to go through. But it still hurt. I’m supposed to know how this goes. I’m supposed to have it all together, but that’s not the way life works. Regardless of what your loss is – person, place or thing – the way we experience loss can be powerful and it’s important you know how to handle it.

For this reason, I thought I'd share some of the important lessons I've learned in coping with the grief that loss creates.

Acknowledge what was lost and what it meant to lose it.

I lost a job. It sounds silly (even to me), maybe even ridiculous that I’m choosing to talk about a job loss rather than what some might have expected – the passing of a loved one or the ending of a relationship – but to me this job had a greater significance than just a place I went to punch a clock (if people even do that anymore). This job afforded me close and personal friendships, daily experience into a field of psychology I now love working in, financial stability for my wife and I’s future plans and a sense of pride – because dammit I was great at my job. So, naturally when I was informed that I was being let go I was a bit shocked (and sad, angry, anxious, scared, excited, discouraged, distressed, embarrassed, and about fifty other emotions).

I didn’t know what to do. I’m a therapist, yes, but I’m also human and in that moment my training and education went out the window and suddenly all I saw was my insecurities and fears – I was a failure, I was weak, and I was letting the ones I love down. Not a particularly fun ocean of thought to play in, especially if you stay in it for too long it can start to feel like you’re drowning.

Open yourself to others and allow yourself to feel/grieve

After the initial shock of loss there is a tendency to do one of two things: sit in the middle of the metaphorical ocean slowly drowning form an overwhelming number of emotions and thoughts left in its wake or bury those emotions deep down and tell yourself to get on with your life. I tried the former, attempting to disconnect from my emotions through the guise of logic, thinking my focus needed to be on finding a replacement for the things I lost. I made it my mission to occupy my time with meet-ups, interviews and/or anything that would keep me busy (aka distracted). I knew better but again, I’m human. It wasn’t until my wife made a comment – about how well I was handling the job loss – and then asked how I was really feeling that I realized what I was doing. Of course, after a meeting with a few friends… therapist friends… the following day doubly confirmed that I needed to do what I do for my clients; take a few days/weeks to work through all the emotions I had neglected and reach out to others when I needed support or started to feel overwhelmed.

Living with loss is simple, but very difficult.

Acknowledge it, feel it and talk about it. That’s it. I don’t intend for that to sound easy, because I know it’s not. To use the ocean metaphor again, loss comes in waves and just as I described before; at first it can feel like you’re drowning but, as you begin to open up and talk about your loss those waves will hit you less hard and less frequent. The last thing I want to leave you with is something that absolutely needs to be said.

There is no timeline to understanding, acknowledging and living with loss. There is no manual, book or person that says you need to be at that shoreline by a certain date or time. As I’ve already said, loss can be a powerful influence on your life and it’s important that you take the time you need and reach out to the people you trust to successfully work through it.

To schedule an appointment with Kendall Campbell, LMFT-Associate, call 512-920-3654.

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Six Boundaries that Can Change Your Life



Why are boundaries important?

Last month, my colleague, Caroline, shared with you the purpose and benefits of saying “no” and it’s absolute importance when setting healthy boundaries in her blog post, "When Saying No is Actually Saying Yes." She helped us recognize and acknowledge our feelings around setting effective boundaries and in the process sparked additional intrigue for me…how do we know what healthy boundaries are and how do we know how they’ve been crossed?

To help us build this emotional intelligence and self-awareness, it’s helpful to explore the moments that you are feeling that distress to discover what boundary violations are occurring. Understanding these six types of boundaries will help us establish healthier boundaries with others and cultivate a healthier sense of self overall.

What kinds of boundaries are there?

1. Physical

These boundaries include personal space and physical touch. Has anyone ever rummaged through your purse without asking or hugged you after just meeting them? Do either of these examples make you squirm? That reactivity is your body telling you a physical boundary, whether it’s your personal body space or your personal environment, has been violated. You’re likely to welcome a hug from a long-time friend over a stranger on the street, just as you are likely to be more comfortable allowing your daughter to grab your phone out of your purse than you might be with a passerby in the store. Healthy physical boundaries include an awareness of what’s appropriate in varying settings and relationships.

2. Emotional

These boundaries refer to our feelings, including our expressiveness of them. These can be violated when we are criticized or invalidated. Has anyone ever said to you “there’s no reason to be upset” or “you’re making a big deal out of nothing.” Even if they’re trying to console you, this can feel damaging and leave us feeling unheard and dismissed. You’re likely to be more vulnerable and confide in a friend who has been through multiple life transitions with you compared to a blind date that you’re meeting for the first time. Healthy emotional boundaries include personal limitations we set for sharing personal information, which includes when this information is shared and with whom.

3. Intellectual

These boundaries are slightly less obvious, yet likely happen more often than we think. Intellectual boundaries refer to our thoughts and ideas and are often violated when someone dismisses or belittles them. Have you ever had an idea you were excited about that was quickly shut down by someone you shared it with, leaving you feeling like you wanted to hide in a hole for weeks afterwards? Or maybe you’ve shared some insight on a political topic (who hasn’t these days) and been berated about it from an opposing party? It happens all the time. Healthy intellectual boundaries will include respectfulness and a willingness to understand not only one’s own ideas and values but others as well, even if they are opposing of our own.

4. Sexual

These boundaries compile the physical, emotional and intellectual aspects of sexuality. What does this mean? Essentially any unwanted sexual touch, ogling from others, sexual comments, or pressure to engage in sexual acts can qualify as a destruction of a sexual boundary. Curious about what the #MeToo movement represents? This is it folks – violated sexual boundaries. Healthy sexual boundaries will include consent, mutual agreement, respect and understanding of limits and desires that have been discussed between intimate or sexual partners.

5. Material

These boundaries refer to personal possessions. Does someone you know always ask to borrow money but never pay you back? Or maybe you lent your friend an iPad and they returned it broken? When someone pressures you to give or lend them your possessions or steals, damages or destroys your possessions, the boundary has likely been violated. Healthy material boundaries include limitations on what you choose to share and with whom.

6. Time

These boundaries reference how we use our time. These boundaries are a bit trickier to notice but are very apparent all the same. They are often violated when someone demands too much of another’s time. Do you find yourself always setting aside your own plans because a friend constantly wants to hang out instead? Or maybe your partner gives you grief for trying to take time for yourself or hang out with friends? Healthy time boundaries can be implemented by setting aside time for the various facets of our lives including work, hobbies and relationships in consideration of your values and priorities.

How to establish boundaries

These boundaries can seem tedious when we reflect on just how many variables cultivate our initial reactivity. But there’s a notable difference to negotiate. The dynamic of the environment or relationship for each is important for us to note in order to help us set clearer healthier boundaries overall. But how do we do this?

You know your body better than anyone else and if you are experiencing distress, it’s likely that a boundary is being crossed. Your boundaries are unique to you and they’re going to likely look different than others around you based on your comfort level with varying relationships, environments and culture.

Listen to what your body is telling you, be curious about the situation that’s evoking the overwhelm and as Caroline reminds us, “check-in if you’re emotionally exhausted or over-committed…slow down and re-asses.” Tune into your feelings, practice assertively addressing your limits, and take care of yourself along the way. This awareness will go a long way with helping you implement healthy boundaries for a happier and healthier sense of self.

To schedule an appointment with Alyssa Cornett, MA, LMFT-Associate, call 737-226-3803.

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Arrested Development: When Adult Children Depend on Their Parents



Differentiation is the process of becoming different.

In psychology, differentiation refers to the process of becoming different than our parents and independent of our family of origin (so far as independence is dictated in each specific culture). This process takes place from birth to young adulthood—often hitting some rocky moments in adolescence.

We’ve all seen or experienced a young girl wanting to do everything her mother does until that same young teenager suddenly decide she hates everything mom likes, only to have that young adult settle in with a distinct identity, one that is allowed to both identity and disagree with mom, unlike the earlier phases which could only do one or the other. This emotional differentiation allows us to become our own people—separate from our parents.

But emotional differentiation isn’t the only thing we need to be happy, healthy adults.

We must also grapple with the increasing freedom and responsibility that come with growing up. It means that, yes, while getting to drive your own car is an exhilarating milestone, so too is the less-enjoyable milestone of paying for your own car insurance. Parents and society alike generally participate in the differentiation process by balancing increasing privileges with increasing obligation and accountability as children grow up.

When this process occurs, the adult child becomes independent from his parents. He or she “launches” and becomes a responsible contributor to society, solving problems on their own, and often forming their own family units.

What happens when adult children don't differentiate?

When this process doesn't occur as it should, adult children depend on their parents physically, financially, or even emotionally. This dependence can take many forms. At times adult children may still live with their parents and be unable to hold down steady employment. They may live by themselves and rely on parents to pay their bills or arrange their affairs (such as doctor’s appointments, etc.).

When adult children become emotionally enmeshed, an adult child may be financially independent but continue to be overly dependent on the intervention or control of a parental figure. Think of a father’s demand that a son behave a certain way or lose his place in the family business, or a mother that demands through guilt trips to be the center of her adult child’s young family.

It's hard to know exactly why children struggle to differentiate, because each story is unique. But it's likely that one of two dynamics is at play:

(1) there is an emotional need in the parent that inadvertently drives them to keep their child dependent; or

(2) there is a disability, illness, or behavioral problem that prevents the child from scaling the normal ladder of titrating freedom and responsibility, leaving parents to perpetually care for them well into adulthood.

When parents have an emotional need for enmeshment, we often see a parent that “needs to be needed” and afraid or ill equipped to face what will be destroyed or left should the adult child stop needing them.

For some parents, they are afraid to be alone; for others, they have developed such a strong identity of being a caregiver, teacher, and manager for their children they have long forgotten how to be anyone else. Therefore, when their adult children no longer need their care or guidance, they feel lost and empty. In extreme cases, a parent may have a disturbing need for power and control that would be lost if their children were independent of them, or a parent may suffer from a mental health issue that demands a constant need for extreme closeness or involvement with their adult children.

What about illness or trauma?

When a child experiences an illness, disability, or behavioral problem that necessitates care, the easiest example would be a mentally or physically disabled child who cannot physically care for themselves. This places the parent in the eternal caregiver role. This is neither right nor wrong, good nor bad. In some cases, these adult children will always need care, and as long as the parent is maintaining their own life and health there is nothing inherently unhealthy about their child’s continued dependence.

Even in the case of a disability, a parent may depend more than they need to. Such is the case I encountered once of a mother who was still caring for her daughter who was on the spectrum. The daughter was relatively high functioning but still at the age of 26 lived at home, did not work, and accompanied her mother everywhere. It seemed to me that she believed her child to be less capable of independent life (or at least some aspects of it) than she truly was.

Finally, when behavioral health challenges stunt a child’s normal ascent into responsible adulthood, the entire family (but especially the parents) can become trapped in a vicious cycle. This cycle is one in which their fear of the now-adult child’s inability to act responsibly prompts them to take care of all of the adult child’s responsibilities for them. This, unfortunately, has the effect of preventing the adult child from the normal balance of freedom and accountability that actually teaches the responsibility he or she lacks. Simply put, we learn to pay our car payment when our car gets repossessed; we learn that bills are serious when our lights are turned off; and we learn to stop being an asshole when we discover that no one wants to be around an asshole. 

So what do I do?

If you are a parent struggling with allowing your children to become independent, the best thing you can do is seek out quality counseling for yourself. Identifying what may be driving your participation in the arrested adolescence of your adult child is the first step to ending the cycle—and truly helping your child. If your child suffers from addiction there are a multitude of programs, many of them free, that can help you establish healthy boundaries and learn tools to help your adult child become independent.

Resources for families:

·      Free documentary on how families deal with addiction.

·      Support groups for families dealing with addiction via Families Anonymous.

·      Confidential individual and family counseling.

This article was written as a guest post by KC Davis, LPC-Intern. Contact KC at 972-900-9001.

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