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.

The Practice ATX

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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.

The Practice ATX

512-861-4131

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.

The Practice ATX

512-861-4131

What is Addiction, Really?

Image by Airpix on  Flickr

Image by Airpix on Flickr

What is addiction like?

Addiction is like the matrix. You remember Morpheus, sitting in front of Neo asking him to take the red pill, or the blue one? People who suffer from addiction eventually feel like whatever substance their addicted to becomes their entire world. Heroin. Cocaine. Alcohol – all of these substances become the world pulled over their eyes to blind them from the truth. What truth? That they’re in pain. Or that they’ve experienced trauma. Or that life outside of their substance is very, very hard. Put simply, addiction is a process that occurs when a person becomes dependent on a substance to self-medicate emotion, pain, loss, stress, trauma boredom or other challenges.

We often talk about addiction and it's relation to drugs, video games, gambling, food or sex. Some would say you could be addicted to any of those items and others might disagree.

Regardless of what form you believe addiction takes, one fact will always remain; Addiction sucks. It’s an epidemic in our country and affects the lives of millions of people. Surprisingly, we tend to avoid talking about it. Sure, you hear about addiction on the news and see addicted people in movies and TV but when it comes to everyday conversation, we don’t talk about it, because maybe…we don’t know what to say.

Why don't we talk about addiction?

Like other forms of mental illness, it’s a stigma. We don’t talk about addiction because it often hits too close to home and brings up feelings of hurt, guilt, shame and sometimes embarrassment. But when we avoid talking about addiction, we isolate the people who need to be heard and we continue to create silence where we should be creating connection. There’s an estimated 23 million people battling drug and alcohol addiction in the United States alone. That’s about one out of every 10 people and damn close to the total population of Texas. T

o be honest, until I started working as a therapist at an addiction treatment center, I didn’t realize how far-reaching this illness spread, nor did I have a comprehensive understanding of how it affected addicted persons’ support systems.

Addiction needs to be discussed and normalized so that those affected by it feel safe to seek comfort from their friends, family and those around them when they need help. As a society, we can help bring addiction to its knees if we simply take a few minutes to educate ourselves about it.

What does addiction look like? Who does addiction target?

Addiction looks like a disease; like HIV, diabetes or cancer. While researchers and medical professionals are still unsure whether addiction should be classified as a disease, it seems to operate like one. Just like diabetes, addiction may be genetic, meaning your family history may increase your risk of addiction.

Like HIV, there is no magic pill or vaccine to cure it, only ways to manage it. Like cancer, treating addiction early is best to prevent worse outcomes. And finally, like any of the diseases mentioned already, anyone can be affected. Addiction does not discriminate between race, gender, religion, sexual orientation, economic status or even astrological sign. Addiction can affect anyone.

Why addiction is NOT a choice

No one chooses illness. This is true of addiction, just like it's true for other health challenges. While addiction usually begins with someone choosing a substance, the powerlessness over that substance isn't something anyone wants for themselves. It's a mental health challenge.

For someone in addiction, that first use stirs something up within them. It begins the phenomenon known in the 12-step community as the mental obsession.

The mental obsession is the notion that you have just found something [a substance] that has solved the answer to all your questions. Experiencing chronic pain? Here, take this, viola! All better! Tired of feeling alone, disconnected, awkward, anxious, fearful, angry, misunderstood, victimized, abused and/or unwanted? Not anymore you’re not. Suddenly – if only for a short time – you’re fixed!

But there’s a problem. The “fix” is only temporary.

Even when another option is provided, like therapy or medication, and problems start to disappear, an addicted person still poses the question of “Okay this is working, but what would happen if I drink now?”

How bad can addiction get?

When it gets really bad, drugs and alcohol become more than just a substance to be put in the body, they become the person’s identity; one, which overrides all other priorities like friends, family, and loved ones. Sometimes, the addict will still hear pleas to stop and calls of action to seek help, but feel powerless to do anything about it. This is because at that point the substance is no longer pleasurable, but rather it’s just a means to avoid, distract and/or numb problems and survive.  

The vicious cycle only begins to compound itself. Addicts will start to feel emotions like shame, guilt and misery even when using, knowing as well that the substance that once saved them, the substance that became ingrained into their identity, is now killing them and they have no means to stop it.  

It's at this point (hopefully) that they become, what those in recovery say, desperate for the psychic change. But it doesn’t have to be this way. Treatment can start sooner.

What else does addiction impact?

There’s so much to consider when it comes to addiction. Over the next month, I’ll be going more in depth about addiction and answering questions like, how does Addiction impact the family? How does Addiction affect marriage? And most importantly, how is Addiction treated? I hope you all enjoyed this post and I look forward to seeing your reactions and comments.

To schedule an appointment with Kendall Campbell, LMFT-Associate, call 512-920-3254.

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The Practice ATX

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