When Anxiety Becomes too Much.

Image by Ryan on  Flickr

Image by Ryan on Flickr

I don’t know anybody who hasn't faced anxiety.

Odds are you have suffered from anxiety, someone in your family has anxiety, and your friends struggle with it as well.  The truth is we all feel anxious during the day and at different times in our lives.  Sometimes it is manageable, sometimes we need help.

On any given day, most of us travel through a wide range of feelings associated with four primary feelings: anxiety, sadness, anger and happiness.  Anxiety tends to rear its head when you are going through major changes, such as moving or changing jobs, or when experiencing ongoing challenges, such as financial worries or family conflict.  Sometimes you are not aware why anxiety has arrived, but there it is.

You may notice anxiety when it comes and be able to move through it.  However, for many, anxiety is not a passing state.  It can be frequent, unrelenting, and take a toll on your life.  It can rob you of your ability to spend time with your family, perform at work, and generally engage in your life.  And everyone says the same thing.  Anxiety—It’s exhausting!  Agreed.

People often ask if they need professional help for their anxiety. There is no official marker for anxiety, no blood test we can take that tells us if our anxiety has become too much.  Odds are if you are asking the question, anxiety has taken its toll, and you could benefit from seeking help.

What does anxiety feel like?

Anxiety, in its most simple form, is a sense of fear that puts your mind and your body on alert.  Biologically, anxiety is a heightened sense of awareness so that we can identify potential threats and take care of them. This fight or flight response can ideally be engaged and disengaged as needed to deal with threats.

So, what’s the problem?  When anxiety is part of your everyday life your body simply does not turn off your fight or flight response.  Living in a constant state of anxiety can cause dire physical and emotional effects.  Long story short, anxiety is systemic: it’s in your brain and your body.

Many people who have anxiety will at some point face depression.  Both anxiety and depression are thought to stem from the fight or flight response.  This may help explain why so often people feel symptoms of both.  It’s also why the same tools that help with anxiety also help with depression.

How do I know if I have anxiety?

The National Institute for Mental Health (NIMH) reports that over 40 million people in the United State over the age of 18 suffer from diagnosed anxiety.  Bear in mind this is data for those who have been diagnosed.  What does this mean?  Millions of people suffering from anxiety go undiagnosed, which means they are not getting the support they so need.  It’s time to address anxiety—to move past shame and into the light where help is waiting.

If you have any of the following symptoms fairly regularly, you may want to consider that anxiety is on the scene:

·      Excessive worry

·      Sleep problems

·      Muscle pain  

·      Indigestion

·      Self-consciousness

·      Self-doubt

Understanding anxiety and the toll it is taking is the first step to getting help.  Rest assured: anxiety is real and you are not alone.

What helps anxiety?

Good news. You have lots of options.  There are things you can do for yourself to help with anxiety.

1. You can overcome fear, but you have to develop skills to manage anxiety.  The best thing about developing these skill is that once you identify some things that help you, you can pull them out of your tool box whenever anxiety resurfaces. Skill building happens through tools and resources. Very few people know how to deal with anxiety naturally. It's something we all experience and most of us need help along the way. So reach out to resources that can educate you or help you talk through what it's like.

2. Be gentle with yourself.  The less gracious and kind you are with yourself, the worse your anxiety will be.  What would you say to a loved one suffering from anxiety? Kristin Neff's work on self-compassion can be a tool to help you learn how to be gentle with yourself.

3. Get busy.  Have you ever noticed that when you engage in activities that require your focus, anxiety decreases?  Be strategic. This could mean taking a run, playing a game of cards, going to the movies.  Whatever works for you.

4. Talk with a therapist.  Research shows that talking with a therapist can lead to remarkable benefits when facing anxiety.  Some report immediate relief knowing they have reached out for help and started to face their anxiety.  A therapist can help you understand your anxiety and help you troubleshoot it. The best results happen when you combine therapy with medical intervention, if necessary. So don't be afraid to reach out to a psychiatrist, a nurse practitioner or holistic medical specialist of your choice.

5. Learn. Then learn some more.  Austin is full of opportunities to help you manage your anxiety.   For example, NAMI provides information, education, and support groups that can help. 

6. Tell your people.  If you’ve been enduring anxiety quietly, consider telling those closest to you.  Odds are they will be supportive.  Maybe you don’t want them to troubleshoot for you?  Let them know that the best way to support you is by being with you and lending an ear.  Who knows, sharing your story of anxiety may free others to share theirs? You could be their light.

Practice self-care.  Practice managing your anxiety.  It's a journey that never ends and you're not alone in it.

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

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I Have Depression. What Do I Do Now?

Image by Pierre Guinoiseau on Flickr

Image by Pierre Guinoiseau on Flickr

At least 16 million people ever year experience one episode of major depression.

That means that right now, either you or someone you know and love is significantly impacted by depression. If it's not you, it's your partner. Your colleague. Your friend. Your son. Your daughter. Your priest.

If it's you, then you know exactly what this feels like, even though it's hard to put into words. Language utterly fails as a vehicle for understanding the experience of depression. If you've never experienced it, then you may not know it when you see it. It's sneaky like that. In fact, one of depression's siblings is shame - convincing those afflicted with depression that they must keep it a secret.

So when you account for all those people whose depression isn't diagnosed or recognized for what it is, then the number of people who experience depression is staggering, beyond comprehension.

How will depression affect me?

If you've recently been diagnosed with depression, then you may just now be recognizing your symptoms as depression. It's hard to know exactly how depression impacts each person individually, but here are a few common experiences:

  • Sadness
  • Apathy
  • Fatigue
  • Lack of interest
  • Weight loss/gain
  • Feeling worthless

Sound shitty? That's because it is. And keep in mind that this is not a willful diagnosis. What that means is that no one chooses to be depressed. Like all things, we choose how we respond to our physical and psychological afflictions, but even that's a different story when it comes to depression.

The problem with depression is that it's the kind of experience that steals motivation. So unlike some other diagnoses, the very things you need to do to compete with depression are the very things you don't want to do. Apathy is one of the most commonly reported symptoms associated with depression, so when a doctor tells you that you need a lifestyle change - eat a healthier diet, move more, be more social, etc. - these are all things you need and they're also the last things you want to do.

That's the struggle with depression. It doesn't just afflict, it steals away your desire to heal.

How will depression impact my family?

Depression is such a personal experience. We think about it and talk about it in such individual ways that not much attention is paid to how depression will affect the people you love. But for people who experience depression, this issue is vital. Depressed folks isolate themselves to protect the ones they love from depression, despite that their loved ones don't want to be protected, they want to be useful.

Depression usually makes everyone feel powerless. That's the most common consequence. Family members, friends, colleagues and other loved ones simply don't know what to do if they're not educated about depression. The most powerful response to someone who is depressed is usually to listen and offer gentle reminders that you remain there with them despite their suffering.

Depressed persons tend to believe that they're alone in the world. So when they get gentle reminders that the ones they love still love them, will still be there with them, for them, it contributes to an environment of recovery.

The most important thing to remember is that depression will not impact your family and friends more than it impacts you. Mostly, people just want to feel useful. That's hard when you don't know how to tell them how to help you, but most friends and family can endure anything as long as they feel like they're contributing in some way that helps.

So remind them that sometimes you're not going to know what you need. And in those moments, their simple presence is enough.

So what should I do if I'm depressed?

Ah, we get to the million dollar question. First, your response to depression doesn't actually start with action, but with acceptance. Accept that depression is what you're experiencing, that's it's okay, that it's not a sign of moral or personal failure, that lots of people experience it and that you'll get through it. In fact, you're getting through it.

Second, accept that one of the things you're going to struggle with is doing the very things you need to do to compete with the symptoms of depression. This is okay. It's normal. So set smaller growth expectations for yourself than you might usually. If you'd expect to feel more motivated in a month, give yourself two. Talk to people who know you that might help you set more realistic expectations for yourself.

Here's a list of common ways folks have lived well with depression:

  1. Psychotherapy & medication - the best outcome research on depression recovery demonstrates that the best one-two punch for depression is when you combine some kind of talk therapy with medication. We also recommend that you choose a medical intervention plan that suits your own worldview. Consult with a psychiatrist or nurse practitioner who can help you make the choice that feels the best.
  2. Move - I hate the term "exercise." A part of me believes that it was invented to get us to spend more money at the gym or on supplements we don't need. I don't meant to sound skeptical. Probably I don't like the term because it means I have to do it. But I digress. I much prefer to think of the concept of movement. I can move anywhere. I can only exercise in designated spaces. But whatever term you use, you need to move. Start small. Get up out of bed a little earlier. Move around your house in ways you normally wouldn't. Stand at your desk for 10 minutes of every hour. Your body needs endorphins and your endorphins need you to move in order for you them to kick in.
  3. Socialize - You need your people. Even when you don't want to. When depression is convincing you to stay in another night. Or another day. Be around people. A small goal you may set for yourself if you work from home, for example, is to work from a coffee shop one day a week. Or perhaps start working from one of those cool co-working environments that are popping up all over the place. If you're an introvert, and you're around people all day, consider one introvert trick that most people don't know about. It's not that introverts don't like people. Introverts can actually be quite social. It's actually the nature of social interactions that either drains or gives life to introverts. So if you've been in a working environment all day, you've been "on" all day. You still need to be social in a way that feeds you. Be careful not to generalize your social fatigue to all social situations. In other words, pick your one or two friends who feed you - with whom you can just let go. Plan to be with them.
  4. Education - There are innumerable resources for you to increase your knowledge and awareness about depression. NAMI is an organization that has plenty of information that will help. And education tends to happen in public spaces like groups or seminars. Maybe you'll meet someone who knows exactly what you're going through, which can accomplish two things at once. You're learning and you're being social.
  5. Mindfulness - Finally, there's some great recent research on the benefits of meditative practices like yoga or mindfulness breathing that can really help with depression because they ground you in the present moment. Depression has a way of keeping our thoughts and feelings rooted in past mistakes or future worries. It's like time travel. Meditative practices remind us that we are in the present.  A quick google search for yoga studios or meditation practices can help you find resources in your area.

Depression impacts almost everyone. Whether you are depressed or know someone who is, no one escapes its impact. So consider yourself enlisted in your own or someone else's healing. It's an ongoing experience. It's never completed.

It's a practice.

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When A Family Member Has Cancer.

Image by A_Peach on  Flickr

Image by A_Peach on Flickr

In his book, The Emperor of All Maladies, Siddhartha Mukherjee, remembers how, during his rotation in a medical oncology clinic, he would experience his patients as a surrogate family. He laments that he would spend hours and days with his patients, and because of the nature of their illness, they would sometimes die. Mukherjee explained that every physician has to handle grief differently, but I got the feeling from reading his work that he never got used to losing people he cared for.

These are just the reflections of an oncologist who cares enough about his patients to get close to them. Imagine what it's like when a family member discloses that she has cancer. Or maybe you already know. And you're here because someone you love has recently received a diagnosis.

How can families support cancer patients?

This is a good time for us to stop and let you know about an incredible organization in town called The Flatwater Foundation. The Flatwater Foundation is an organization that pays for the cost of mental healthcare for cancer patients and their families.

In our work with Flatwater, we've experienced some of the most powerful therapeutic conversations we could have imagined. We've witnessed clients grow and change as they endure invasive cancer treatments, we've watched families struggle and thrive as they learn to live with cancer and we've lost clients to cancer, which has caused us to throw typical counseling conventions out the window when it comes to dealing with our own losses.

Cancer sucks.

There's no way around it. When a family member receives a cancer diagnosis, any cancer diagnosis, it's enough to shake the foundation of safety that many families enjoy. Patients are in shock. They're thinking about their own mortality for perhaps the first time. Families jump into action mode and start treatment planning before the patient may be ready.

No one knows what to do because there's no script.

In our experiences working with families, the first thing we do is "hold space" for whatever is in the moment without getting too far in the future. What this means is that we make sure the patient has the space to grieve, despair, be fearful or even question his own treatment. This is often quite difficult for family members who identify with a caregiver role out of their own anxiety and fear because their loved one isn't taking as much initiative in their own recovery as the family member would like.

But patients work on their own timing. And as therapists, we encourage family members to let patients work through their own decisions and attitudes as they feel is most appropriate. We usually find that patients settle into a resolve for their own health in their own time.

So how do families cope with cancer?

When patients are in this place of uncertainty about what they should do, how they should participate in their own treatment, or whether they think they'll survive, it leaves families feeling powerless. It's at this point that we suggest a strong self-care practice that can help family members wait on their loved one's timing while also feeling like they're doing something.

There's no way to ask family members not to do research, not to look for alternative treatments, not to find support groups or be proactive. But what families may consider is that they withhold that information from their loved one until she's ready to receive it. There's an emotional and mental experience that a patient is going through that you can only truly understand if you've experienced it yourself. It needs it's own schedule.

And you need to feel empowered. So do your research, seek your own caregiver support groups, find organizations like Flatwater, change your family's diet, seek alternative treatments and talk extensively to your physician, oncologist and nursing staff. Just be prepared to wait on your loved one to catch up when they're ready.

How can families fight cancer together?

When we see new clients, one of the paradoxes we have to prepare for is that clients sometimes resist their own change, or at least they feel ambivalent about it. Ambivalence is what it feels like when you're uncertain about a decision. As therapists, we struggle not to work harder than our clients. We wait on their timing and respect their ambivalence. When we push harder than clients are ready to be pushed, we usually lose them.

In this same way, families can fight cancer together by openly communicating about where each person is. Don't be surprised if you find anger as well as grief and fear. Don't be surprised to find that children worry about their parents for the first time, which may be a new experience for them.

Children need the opportunity to be afraid for their parent's life. They need to know that their fear is acceptable, that they don't have to be strong, that they can cry and that everything may actually not turn out alright. Patients need the same.

In the middle part of my years as a new therapist, I held a "caregiver support group" for family members of cancer patients. One of the things that group taught me was that it wasn't fair to assume that family members of patients were the only caregivers. As it turns out, a cancer diagnosis doesn't steal away a patient's desire to care for others also.

In fact, one of the most empowering thing a family member can do for a patient is let the patient take care of them.

This will allow your loved one to feel competent and useful. It will help them feel like they have a role to play and will temporarily relieve them of thinking so much about their illness, the next round of chemo or possibly their own mortality. Caring for another relieves the patient of the patient identity.

In our next caregivers group, I think we'll invite both patients and their families to honor the role that families play in supporting each other when one person has a diagnosis. It's a shared experience of illness anyway.

Because when one family member has cancer, its an experience everyone endures.

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What to do When Trauma Impacts the Ones You Love

Image by Mastercharz on  Flickr

Image by Mastercharz on Flickr

Do you love someone who is dealing with the impact of trauma?

If someone in your life is suffering from trauma, you may be wondering what you're supposed to do. If so, you're in good company. Anyone who has ever loved someone who has dealt with trauma has asked the same question.

Trauma is unique because it has this way of not only affecting the people who've been traumatized, but also those they love. We even have language to describe this: secondary trauma - which captures how partners, spouses, family members and friends can take on symptoms of trauma they didn't directly experience.

So if you've never endured trauma, but someone you love is counting on you for support, this post will help you understand a bit about what they're going through and how to help.

What is trauma?

In it's plainest and most basic description, trauma is a deeply distressing and disturbing experience that has lasting consequences.

Some people differentiate two types of trauma: big "T" trauma and little "t" trauma. Big "T" trauma would be what combat veterans and survivors of assault or abuse experience. Little "t" trauma might describe what it's like to be in a marriage with a neglectful partner. It's unfair to try and classify traumatic experiences, because everyone's different. There's good research to show that even fender benders in which the offending vehicle was traveling less than five miles per hour can have lifelong repercussions.

So no one's trauma should be judged based on what you or I think makes is big "T" or little "t". Instead, I like to think of trauma as any experience that fundamentally changes the way we experience life. I know that leaves a lot of room open for interpretation, but it also holds us accountable to understand our loved ones' experiences rather than rely on our own interpretation of what trauma is.

How does trauma impact the brain?

In my office is a file cabinet. It's a sturdy old thing that came out of WWII. It has a distressed wood foot at the bottom that wraps around the cabinet's cast iron to create a neat contrast. In the file cabinet are files that are neatly ordered by my clients' last names. There's also some odds and ends that I've stored in there because I need access to them and don't have anywhere else to put them.

And this is kind of how the brain works. 

When I need to recall something important, my brain fires off thousands of neurons that interact together to recall memory. Scientists don't yet fully understand how this works, but they seem to think that memory is stored in the hippocampus, available for recall when we need it. So if I asked you what you had for lunch yesterday, it's sort of like me trying to retrieve a file from my cabinet, whose job it is to store ordered information until I need it.

But for those who've experienced trauma, the brain doesn't quite work like a filing cabinet. Instead, it's more like an artist's studio. When you walk inside, you see paintings everywhere, disordered and colorful, overloaded with sensory information. Trying to find a single painting or image inside a studio is difficult. In fact, much like a painting in a studio, a single traumatic memory doesn't make sense until it's brought out of the studio and examined on its own. So when you try to talk to your friend feels triggered by something that reminds her of her trauma, it's her brain flooding her with a stress response to keep that traumatic memory disorganized, so that she doesn't have to relive it. Her symptoms serve a purpose.

Unfortunately, the brain may be working against recovery as Dr. Bessel Van Der Kolk acknowledges in his groundbreaking trauma book, The Body Keeps The Score. Although the brain may be working to keep trauma hidden so that the traumatized person doesn't have to relive the experience, the body still seems to experience trauma symptoms.

This is why people who have been through trauma sometimes have intense and volatile reactions to an environmental trigger (like relationship conflict or a hard day at work) without knowing why. Sometimes, the body remembers trauma before the brain does.

What does trauma feel like?

I once had a client tell me that trauma made her feel like she was walking around with a bomb that no one could see strapped to her back. And at any point, the bomb could explode all over herself and others without any apparent reason. The brain has very interesting ways of protecting us from trauma when we experience it. People will often describe not being able to remember what they felt or the sequence of events that led up the to the traumatic experience. I remember a moment when I played football in middle school and one of my friends snapped his arm in half. He got up and ran off the field, telling coach he was okay and could go back in.

Sometimes, the worst part about trauma is recovery.

Often, the symptoms you would expect people to feel during trauma show up in recovery even though a traumatized person can't remember those symptoms during the actual traumatic moments. The most important thing to know about how trauma impacts your loved one is that it's constantly with him and he can't predict when trauma symptoms will show up. Because of this, much of the recovery process is symptom management.

That means that in counseling, we help people become more and more tolerant of trauma triggers so that they can move forward with allowing their brain to place the trauma memory back in the file cabinet, ordered and meaningful.

You can help your loved one by not reacting to their seemingly out-of-context intense emotional reactions. Simply your willingness to remain calm in the midst of their chaos can be healing.

How does trauma impact relationships?

Most of us have no idea how to help someone who has been traumatized by an experience we've never been through. This is not a shortcoming. It's completely normal. In fact, it's such a normal part of the human experience that we have an entire industry called therapy dedicated to task of "being there" for people who've experienced varying levels of trauma.

So because we're not naturally equipped with the necessary tools to help the ones we love who have experienced trauma, we sometimes pull away from those relationships because we feel powerless to do anything useful. So this creates a feeling of isolation for us and our loved ones. What makes this even more difficult is that depending on the kind of trauma our partner or family member has experienced, their symptoms can make them difficult to empathize with. The real cruelty of trauma is that it sometimes causes quick explosions of anger or long periods of isolation.

So this is why education and empathy are like gold to people who have experienced trauma. Friends and loved ones who are willing to take the time and have the patience necessary to hold space for anger and loneliness are the greatest assets for healing and recovery.

Trauma isn't always something you can see.

Unless trauma has caused physical changes, it isn't like cancer or other illnesses that manifest symptoms you can see or touch. So people don't always know that what their friends are going through because they don't know what to look for. This may even lead to skepticism or misplaced judgment.

A friend of mine is one of the most courageous people I know. She was rear ended and endured a concussion that has had a significant impact on her emotions and relationships. She describes herself as being quicker to anger and, now, situations that weren't difficult in the past feel stressful. You'd never know it by looking at her, and even her close friends only may notice an abrupt mood change. Even if her friends noticed she'd been in a car accident, they may not be able to connect that mood change with her concussion. This has left her feeling lonely at times because no one can see what she's going through.

In order for her behavior to make sense, she has to disclose her trauma.

I don't know if you've ever been sick, but the last thing I want to do when I'm not well is tell everyone how my body is handling the symptoms of illness. It's embarrassing. I'd much rather just stay at home and wait for the symptoms to pass. But trauma doesn't always work that way. Sometimes, trauma symptoms can be resolved in a short amount of time. But sometimes, it takes a lifetime.

So how do I help?

If you love someone who has been traumatized, the best thing you can do is be patient. Gently and carefully remind them that you're there. Don't problem solve. Just be. We have a phrase in psychotherapy called "holding space." I don't usually like therapy jargon, but this phrase I like. It captures what we need from someone when we don't want them to solve our problems, but we do need them to listen.

Some other tips for holding space for the ones you love when they've been traumatized:

  1. Take small decisions off their plate. Strangely, choosing where to eat can turn into a nightmare. Take the initiative for some of the small life stuff and take over.
  2. Don't depend on your traumatized loved one to know what they need. Sometimes, holding space means sitting quietly with your hands open while they cry.
  3. Gently remind them you're there. Send a text message or leave a letter reminding her that you're just a phone call away.
  4. Be patient. Trauma recovery is a long road, and your loved one needs people who will walk through all the ways their symptoms will emerge.

If trauma has impacted your family members, friends or partners, be there for them in their time. It's hard to make sense of the internal studio of the mind long enough to know what to talk about or ask for.

And holding space for someone suffering is a sacred task.


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Why You're Actually Communicating Even If You Think You're Not.


Ever wondered if you and your partner or spouse fight a lot because you just can't communicate?

Join the club. Almost every couple we work with tell us that they can't communicate. In fact, it wouldn't surprise us to learn that the number one reason people give for finding a couples or family therapist is because they lack communication. There's just one problem.

You can't avoid communication.

Paul Watzlawick, an early family therapy scholar, was famous for saying that one cannot not communicate. It's impossible. Think about it. Remember the last time you and your spouse got into a fight? He wouldn't listen or she was being defensive. Naturally, you got so upset about not feeling heard that you stormed out of the room. For the next two days, each of you gave each other the silent treatment.

No words.

And that silence spoke more loudly than any words could have. You were communicating. You just didn't know what you were saying. You didn't know that while you were staying quiet, she was in the other room filling the silent gap between you with all kinds of words. Words like, "He doesn't care," or, "If he loved me, he'd come over here and talk to me."

We know memory is a poor measure of reality because of how the brain works. We go back and change our memories all the time to suit our preferred beliefs, emotions or moods. We're only conscious of doing this a small fraction of the time. It's mostly outside of our awareness.

So when each of you looks back on this argument, you'll remember feelings and words and intentions the way you remember ghosts.

These ghost intentions and feelings may or may not be the result of what you actually communicated during the argument. More likely, they're a result of how you felt in its unspoken moments, or at least in the moments when you read between the line. If you've ever said things like, "I just felt that you were angry..." or "I didn't say anything becasue if I did, you'd just..."

No one can feel another person's emotion. That cannot physiologically happen. We may intuit what other people are feeling and have our own emotional response to that intuition, but intuition can be wrong. So the nasty secret about communication is that it's always happening - even if you're not saying anything. Because when you storm out of a room, you communicate loudly. When he scoffs at you, he communicates loudly. When you don't understand what she's saying, she's saying things she never intended because that's what you're hearing.

This is why communication is always happening.

Even when you don't think you're communicating, you are if your partner is hearing something from the way your body is postured, from the way you shut down an argument or from the way you say nothing. So keep in mind that you're always communicating. Even if you don't think so, you are. Even if, in fact, you've left the room intentionally to avoid saying something you'll regret, you're still communicating.

So if a lack of communication isn't the problem, then what is? The question that might serve you better is, "Are you communicating how you want to?"

Now that's a totally different question.

Practicing good communication is a lifelong practice. The overall goal is to be congruent. That is, to practice speaking and expressing what is the most authentic thought or feeling you have.

Why most authentic?

Because we're humans and we're complex. Sometimes, for example, we feel sad. And sometimes that sadness is rescued by anger. What's the more authentic feeling? Certainly the anger is functional. It protects us from feeling sad, but sadness is the most authentic feeling because it's what we felt most immediately and it's what makes us feel most vulnerable.

This is just one example of how things can get confusing. And it's why we practice healthy communication. We have to be clear with our spouses and partners that what they're seeing is actually sadness or fatigue. Not judgment or apathy. That's why this is a forever practice.

Want some healthy communication tips?

1. Slow down

Almost nothing gets solved in a hyperactive, super-aroused emotional state. Take a moment to stop and breathe when you feel emotionally triggered. Emotions work best when you're able to listen to them like data points, not use them like bludgeons. Besides, when emotions get really outside your control, it's not usually because of the original reason you were upset to begin with, but because you don't feel heard. This is why conflict escalates and also why people say they often forget what started the fight off anyway.

2. Multitask

The most common reason people struggle to communicate is not because they're bad listeners. It's because they struggle to listen and manage an internal feeling state at the same time. Have you ever tried to listen to someone criticize you and remain calm at simultaneously? It's hard. Practice multitasking by inviting your partner to tell you some concerns they have about you at a time when you're already calm and not fighting. Start slow.

3. Be self-critical

We can promise you one thing. Almost every poor communication behavior (ex. not listening, being dismissive) has an equal and opposite reaction. If you're accusing your spouse of something without inviting their input on the concern, they're almost certainly going to act defensively. We sometimes make the mistake of forgetting that our perceptions are not objective reality simply because we see it, feel it or believe it. Also, if you've ever wondered why your partner is so defensive, we can almost guarantee you that she or he has wondered why you're so critical.

So practice compassion while you practice communicating. Because this is difficult work and we all need a little help along the way.

-Posted by Dr. Mathis Kennington LMFT-S

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How Does Mental Illness Start?

Image by Kristin Schmit on Flickr

Image by Kristin Schmit on Flickr

Is mental illness just in our head?

Researchers have been trying to answer this question for hundreds of years. We never even considered that the brain could be unhealthy just like every other major organ in our body until, in the early 1800s, we stopped blaming people's strange behavior on ghouls and goblins.

Once we realized that mental illness was a common experience, psychiatry found a good explanation for where it came from: the brain. It wasn't working like we wanted it to. This was the popular belief about mental illness (and still is) until relationship experts and family therapists started to challenge the idea that mental illness came only from the mind.

What about our relationships?

Is mental illness because of how we were raised?

Sociologists and relationship researchers noticed patterns of behaviors in people's families and social environments that caused people's unwanted behaviors. Conditions like poverty or abuse make mental illness more likely. Lack of quality friendships creates loneliness and isolation, which are symptoms of depression.

So, many health experts started to include social and family environments as causes of mental illness. But that still leaves us with an unclear picture of the origins of mental illness.

Where does mental illness actually come from?

Like most things, experts believe the answer is somewhere in the middle. We could be at risk for certain mental illnesses because of our genetics. Alcoholism, for example, unquestionably runs in families. But researchers don't know if this is because of learned behaviors or because of a genetic risk for alcoholism. Either way, prevention is super important because, if you have a genetic risk to abuse alcohol, there's nothing you can do about it anymore than you can change your eye color.

Except of course, to be careful with alcohol.

So no matter where mental illness begins, we should be thinking about mental health and wellness. When doctors ask us to get screened early for health risks like breast cancer or heart disease, it's not because knowing that risk will change our DNA, it's because knowing ourselves will help us create a path to better self-care and prevention.

So if you really want to know where your risk for mental illness begins, you can get genetic testing done, or maybe do a family tree. But what it really comes down to is this:

Are you taking care of yourself?

Mental illness is just like any other health challenge. You can prevent some of the major symptoms by moving your body the way it was intended, by hanging out with your friends and family (even when you don't feel like it), and by staying in the produce section of your local grocery store.

But, you can't prevent all symptoms of mental illness. That's why things like counseling and group therapy exist. Besides, mental illness is just a term we use to describe having less than our optimal mental health. 

So there's no reason to be embarrassed, ashamed or silent about mental health. We've all felt unwell. Taking action to prevent illness or intervening when you need more help is the key to all health.

Why should your mental health be any different?

-Posted by Dr. Mathis Kennington, LMFT-S

The Practice ATX