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.    



                                   The Practice ATX


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.  


                                  The Practice ATX


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. 


                                 The Practice ATX  

                              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 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 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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Addiction is the Legacy of Trauma

  Kat Jayne /CC0

Studies reveal that between 50 and 96% of substance abusers seeking treatment report experiencing trauma.

Up to 34% of people receiving substance abuse treatment have a co-existing PTSD diagnosis. That’s GIGANTIC! But it makes sense, doesn’t it?  If every breath you took came with unbearable thoughts of past traumas, you would likely do anything to ease that burden.

 How Does Trauma Affect You?

Trauma of any kind has the power to crack and skew the lens through which you view the world and yourself, making everything appear off. When I work with those in recovery I often hear a similar story; I went through hell and [insert drug/substance] was the only thing that I found that worked and kept me alive. As someone in recovery once told me, “it was drugs or death and I chose to live.” Now, not all in addiction have experienced trauma and use substances to escape that trauma, but it’s certainly a major factor that needs to be addressed in treatment.

What is Trauma and What Does it look like?

Trauma can be anything. It can be sexual assault, domestic violence, and war – each of which are widely discussed and shown through media. But it can also be the loss of a loved one, infidelity, or divorce. It’s any deeply distressing, disturbing or even embarrassing event/experience that causes a person to shift how they view themselves or the world around them.

When this shift has happened it’s not always obvious. You might know a few side effects like nightmares, flashbacks, and hypervigilance from movies like Saving Private Ryan or even Iron Man 3 (yes, I am a nerd, I need to put this here). What you might not see are some of the more subtle signs that someone is dealing with trauma; two of which I’m about to discuss.

If you read my previous article about signs of addiction relapse, I discussed the acronym AA (Attitudes and Actions) as a simple way of recognizing warning signs of relapse. Looking at someone’s attitudes and actions can also be a way of identifying trauma/PTSD.

Two subtle ways Trauma changes a person


Sometimes these shifts in mood can be obvious – intense irritability, fits of anger/rage, sadness, and/or anxiety– however the mood change I’d like to highlight is what I call the void. It’s an absence or minimized version of emotions. A feeling of being disconnected or numb. It might feel like the person is looking through you rather than at you – like a thousand-yard stare. If this mood change sounds familiar it’s because this void, or feeling of disconnection and/or numbness, can also be a symptom of depression.


The next subtle sign of trauma is isolation. This can literally be a person physically removing themselves from others – their co-workers, friends, families and loved ones – but it can also mean emotional isolation. The subtle sign is the latter of the two. When someone is emotionally isolating you might feel as if you’re only connecting with a fraction of who they are, like there’s so much more to be revealed. This isn’t necessarily by choice; trauma is powerful and even if the event/experience occurred years in the past it can still occupy/impact one’s thoughts.

Why Understanding Trauma and Addiction is Important

I started this article discussing trauma in terms of how it relates and affects those in addiction. I want to end by stating that like addiction, trauma is far reaching and affects more than people than we might like to admit. Just like addiction, trauma can impact every aspect of a person’s life, from their relationships (family, friends, significant others) to occupations (careers and school). Once again, I’d like to ask you to take what you’ve learned today and share it with someone else. By doing that, we can continue to keep the conversation flowing about mental illness and in-turn break down the barriers that limit people from getting the help they need.

To schedule an appointment with Kendall Campbell, LMFT-Associate, call 512-960-3254.

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When Saying No is Actually Saying Yes.

  Tom Hilton /CC2.0

Saying “no” might be just what you need.

It’s impossible to have CONSTANT insight and awareness to how your emotional energy is expended throughout the day and how your reactions and responses to others will impact future days. Or have your emotional intelligence so finely tuned that you are certain how your decisions and behaviors will emotionally effect professional and personal relationships and family dynamics. If you have those things dialed in, then you've mastered the ability to set boundaries and achieve a level of self awareness that never leaves you feeling exhausted, over-committed or overwhelmed. 

Most of us are powering through our days to the best of our abilities utilizing the most efficient coping skills we have acquired along the way. As the holidays approach and the calendar seems to fill up more quickly than usual, I’m reminded that saying “yes” to everything is not necessarily a good thing. In fact, it could be actually be a bad thing- not just for me, but for my family too.

First, let’s be clear about what “saying no” means in this context; I’m not referring to the “no” you say when your kid is trying to eat a crayon or cut their sister’s hair. We’re talking about the “no” that is necessary to set boundaries. ALL kinds of boundaries— the boundaries that foster emotional well being, the boundaries that support healthy functioning in a nuclear family and the logistical boundaries that have to deal with every day commitments.

How do I know if I need to say “No?”

Ever feel like you're losing control of your own emotions? Or that others are dictating how your day goes?  It’s time to say no. Recently, a client shared a story about her mother’s constant criticism and judgment of her parenting; her mother is always weighing in with an opinion about how something could be done better. My client was losing herself in self-doubt and fear that she was making decisions that would be detrimental to her children. It was time for her to say no. “No, you cannot project your own regrets and fears about your own identity as a mother onto me. No, I am a good mother and I won’t hear you anymore.” She set an emotional boundary that no longer allowed someone else’s feedback to rule her emotions despite her own ability to validate her role as a mom. If you are feeling overwhelmed, stressed and anxious - chances are good you need to check in with yourself and see if you're emotionally exhausted or over-committed. If you are feeling like you have no choice or no say in your relationships or schedule or interactions - its time to slow down for a moment and re-access.

What you're saying "yes" to when you say "no."

 Saying “No” means— I am taking care of myself, so I can take care of others. I value my own mental health. I know my limits.

While some people will take your ability to say no as a personal insult, its important to reinforce (not just to others, but also to yourself) the need to care of yourself. We live in a relational culture that emphasizes or puts a high value on active lifestyles, community and efficiency. If you're not taking of care of yourself first, it can be difficult to authentically and satisfyingly   participate in family and community. Setting emotional boundaries with the toxic friend is ok, not over-committing yourself and your kids to parties and activities so you can spend extra nights at home together is ok, deciding not to spend an hour on Facebook comparing your relationship to someone else’s is ok. In fact, it is necessary to do all of the above from time to time!

Why it can feel great to say "No."

Saying no can feel empowering, like you have control of your emotions and your time, like you have a choice. Saying no will feel different for everyone; it might feel the opposite of overwhelmed, exhausted and stressed.  It’s not just freeing your evening up from a holiday party, it is creating space for and activity or experience that feeds your energy. Saying No is independence. Saying no is permission to be you and make your own choices, free from the influence of others. Saying no is choosing you.

As the holidays approach there were be many extra curricular activities for kiddos, holiday parties and more extended family time than usual. Take some time to check in with yourself, your partner or your family. Do you need to say “no” more? 

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

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What The Harvey Weinstein Saga Can Teach ALL of Us.

Well hello, Harvey.  I keep trying to forget about you and what you represent, but for all of us, I can’t.

I’ve been reading the articles about Harvey Weinstein.  It makes me remember my early days as a woman in the good ol’ boys club of law firms and courtrooms.  Not the first time for a #MeToo, but more obvious and no attempt to be hidden.   Now, as a therapist, I am more attuned to aspects of male privilege that may be subtler, but which are still harmful.

I have competing thoughts.  I’m not surprised.  In fact, I thought I knew this about Weinstein.  I thought it was abundantly clear, as it seemed to be for many people who knew him or worked with him.  And I have to confront that it was an unspoken assumption on my part.  An assumption based on innuendo and perhaps common sense.  And it hits me (as it always does), I take part in supporting this type of male privilege.

Can we talk about equality?

 Image by  Nick Step /CC2.0

Image by Nick Step/CC2.0

At the same time, I feel anger and outrage deep in my belly.  I know this feeling.  I started noticing it as a young girl driving around with my dad.  He told me I could do anything, but I wondered about the advertisements surrounding me—they made me so uncomfortable.  It starts at such a young age—seeing the highly sexualized view of women and that we are here to serve.  It made that little girl question, where did my value lie?  That confusion and the experiences between now and then (more #MeToo’s) are not about my singular world; they are about the world we live in, the systems in place that perpetuate them, and how, yes, I unknowingly and unwittingly participate in them.  I do.  There, I said it.  And it is okay.

What is privilege?

Just so we are on the same page: male privilege is a set of social, economic, and political advantages that are made available to men solely based on their sex. And these advantages lead to devastating conclusions that men are more worthy and powerful.

Do males have privilege? Absolutely, without a doubt.  Do we all need to stand up and say, “No.  I will not live like this anymore?” You bet.  But what irritates me is that we think we need to do this only for women.  Something men need to do for us. The truth is it’s for all of us, for our collective humanity, and not “just” to support women.  Let’s be clear: addressing male privilege is for every last single one of us.  And as a society we need people supporting people.  Can I speak more about my experiences of male privilege than my husband can?  Absolutely.  But that does not make it less valuable for my husband to equally participate in and address the problem.  It is not just for me or our daughter, it is also to improve his and our son’s lives. 

So, what are some ways that each of us can work more diligently to begin to peel the layers of male privilege back?

·      TALK ABOUT IT.  Talk about bias.  We all have it.  We have all, in different ways, been trained.  No one is immune.  If we can’t talk about it, how do we confront it?  We need to think about our assumptions, be able to question them and it be okay. 

·      ASK QUESTIONS.  When things don’t make sense or something seems off, get curious.  Not to assign blame, but to truly engage in conversation.  What does blame get us?  Yes-Weinstein and other offenders like him need to be held accountable.  But in our day-to-day lives there are much smaller moments that lead to the Harvey Weinsteins and the systems of male entitlement that are unchecked.  These subtler manifestations of male entitlement understandably don’t garner the same attention that Weinstein’s egregious behavior does, but we need to discuss them.

·      ASSUME RESPONSIBILITY.  This is not up to men.  It’s not about all “those bad men.”  It’s about you and me, our co-workers, our educators, our executives, and our children.  As long as we expect change to happen elsewhere, it won’t.

On a lighter note, the other day I had to laugh.  My 10-year-old son came home complaining he was made fun of based on his gender.  After a quick check-in, I realized an old friend of his had said to him “boys drool, girls rule.”  Well, we’ve been talking…and he is thinking.  And we talked again, so I could clarify a few things, but it is a start.

Practice Conversation. Practice Accountability. Practice Change.

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

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3 Things You Can do Right Now to Encourage Your Child's Resilience

 Nguyen Nguyen/CC0

Nguyen Nguyen/CC0

Resilience is when we maintain healthy development despite our adversity. A quick google search of the definition brings up phrases like “elasticity,” “recover quickly from difficulties,” “return to previous form.” Perhaps those definitions are true to some degree, but when it comes to children and adolescents many adapt to their environment to sustain themselves, often engaging in unhealthy behaviors that allow them to survive in less than optimal conditions. One thing is for sure though, children never return to their previous form; they grow, evolve, learn and condition themselves to navigate life’s emotional difficulties.

The behavioral tools and coping skills they pick up along the way are a combination of healthy and unhealthy, effective and maladaptive, isolating and engaging, the list goes on. Our children are learning these behaviors from the vast expanse of their environments; peers, parents, siblings, social media, tv, video games, the person in the restaurant at the next table over.

True resiliency in children means they are able to weather the emotional ups and downs of life and continue to developmentally thrive. Resilient children do not always choose healthy ways of managing their emotions or anxieties, but they ARE managing them. As parents, caretakers and adults with vested interest in the emotional safety and well being of children we can all do three things right now to support and foster resiliency and emotional stability for children.

How to Build a Child's Resilience

1. Put your phone down.

Kids need to know that they are the priority over a work email or Facebook. They are taking their emotional cues from you, when you choose the phone over an interaction with them you miss an opportunity to remind them they are the most important thing in the room. Technology isn't going away, BUT YOUR KIDS EVENTUALLY WILL.

They will learn from everyone else in the world that cell phones and computers are important, your role as a parent is to ensure that your support will be given when they bring worries, concerns and questions from outside into the home. Stability supports resiliency.  BE the stable relationship in your child’s life that allows them to navigate their emotional landscape.

2. Provide consistency.

Consistency creates routine and predictability. Whether it’s the nighttime routine before bed, or the guaranteed Saturday afternoon with dad playing basketball, consistency creates a space for children to depend on. It is far easy for a child to handle the stress of a tough week at school when she knows on Thursday she will get some one on one time with her mom to talk about it. Consistency allows children and adolescents to “turn into the family” when they are having a hard time or needing support, as opposed to looking to outside influences to mitigate their stress and anxiety. Eat with your kids. Research shows it supports healthy eating patterns.

3. Talk to kids about how they feel.

Feeling is natural. No matter what, your kids will feel. But knowing how to put those feelings into words is a learned skill. Most children and adolescents walk, talk and act far more mature than their actual age. We need to remind ourselves that they are master imitators. Most children are not cognitively developed enough to fully understand and process their emotions. While it might seem that they understand what they are saying, they likely need help matching the correct words with their emotions. Anger is the easiest and most often expressed emotion in teens, it’s the most socially acceptable and accessible.

Anger is primal. It is about survival.  Anger goes hand in hand with many other emotions, and when given the language, space and opportunity to explore the other emotions can be very empowering. A safe environment for exploring emotions fosters self awareness, intrinsic validation and resiliency.

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

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How to Identify the Signs of Addiction Relapse.



Relapse is the eye of the addiction storm.

Addiction can be a heavy-handed topic, and it’s not always a pleasant conversation to have. But if you’re struggling with reading about it, imagine what it might be like to live with it. Help me spread the word; help others understand it, and help those with it so we can end it. We need to continue to better understand addiction so we know how to stay connected and supportive of those battling it.

In order to further your understanding I’m going to talk about relapse, and even more importantly, I’m going to talk about how to identify several warning signs of relapse.

What is relapse? And when does relapse occur?

Relapse is a process, not a single event. 

It's an addict’s return to the addiction cycle or worse.  Clinically, relapse is the physical act of someone in recovery putting alcohol/drugs into their body. That length of sobriety could have been one day or fifty years but when that substance enters their body the sobriety clock resets. As I said though, relapse is a process and just as anyone in addiction will tell you they didn’t wake up one day and choose to be an addict. No one in recovery just stops and says “today’s the day I return to rock bottom.”  The process can be short and in earlier sobriety it might only be a month or a few weeks but more often it’s slow with several elements occurring subtly over time.

What are the relapse warning signs?

There are several different warning signs but in order to make them easy to remember I want you think of AA. Alcoholics anonymous is most known for its’ ties with helping those in addiction fight for recovery so it’s perfect that the warning signs of future relapse can be broken down into two categories; Attitudes and Actions (AA).

1. Attitudes

One of biggest warning signs I see – especially in early sobriety – is overconfidence. It’s the string of thoughts and sometimes outright statements that imply “I know everything I need to know” and “I can do this on my own.” Don’t get me wrong, having a sense of confidence and pride in what you’ve learned in treatment and/or meetings is powerful (and needed). However, when someone in recovery stops being willing to accept the support, advice or accountability of others there should be some red flags and alarms going off.

Another major warning sign of relapse is when someone in recovery becomes emotionally overloaded. More often than not this occurs as a reaction to an event like a job loss, afamily member passing away or a relationship ending, however medication changes and existing mental illness (like depression or bipolar) can also be a cause. These intense emotional moments will look like an exaggerated departure from the person in recovery’s normal emotional state. This could look like anxiety turning into panic, sadness shifting to grief or anger becoming rage.

2. Actions

One of the biggest warning signs at any point in recovery is Isolation. For any number of reasons, many in addiction put distance between those around them before relapse; this includes family, friends, loved ones, etc. This could be subtle like missing/skipping scheduled meetings or events like lunch dates, support group meetings, or work. It might also be more confrontational like lashing out or manipulating conversation in a manner that makes you feel as if you want/need to leave.

The last major warning sign relates more to inaction than action and can best be described as a general lack of self-care. A few examples of this could be eating poorly, exercising less or not at all, and/or maintaining unhealthy sleeping patterns. You might also notice that the person in recovery has a decreased interest in engaging in the activities or hobbies that you know they enjoy. This is especially important to notice because in addition to being a warning sign of future relapse it could also be an early sign of depression.

What do I do once I've seen the signs of addiction relapse?

Whether you’ve just seen one of them or all of them, you simply reach out. There are several ways to treat addiction but each of them starts with a conversation where you offer your ear and your heart. They might not be ready to share their thoughts or feelings with you at the moment but by keeping the conversation and the support open-ended, they will know they are loved and that someone else is willing to fight Addiction alongside them.

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

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