Family Life and Choosing Yourself
written by Jordon Evander Williams, LPC-A
Recently the former iCarly child star, Jennette McCurdy released a memoir titled “I’m Glad My Mom Died”. In it, she discusses abuse suffered at the hands of her mother. She appeared on Jada Pinkett Smith’s show Red Table Talk to discuss the complicated relationship she had with her mother and read an email that her mother left her before she passed. In the email, her mother berated her, commented on her body size, and told her she had wasted her life all before asking for money for a new refrigerator.
This may bring up thoughts of wild, and over-zealous Hollywood parents like Joan Crawford or Joe Jackson who pushed their children to their limits but ultimately get dismissed as a microcosm of a town as known for its scandals as for its glamor. However, not taking contentious parent-child relationships seriously or seeing them as something that can only happen to some “other” family would be a grave mistake. I have counseled a few people who have been thinking about what family means to them and what it would be like if they weren’t in contact with their blood family and even for some of my most emotionally independent clients it brings up anxiety.
American social values dictate that one should be beholden to the family that they are born into, bound to them in good times and bad times for as long as all parties shall live. This structure could work if you like your family and enjoy being around them but if you don’t then what? Some of my clients have discussed having nothing in common with their families and not even particularly liking them but feeling that if they pull away from them, they would be consumed with guilt. The social pressure to show up at Thanksgiving and give gifts at Christmas, to be able to answer the question of “How’s your father doing?” is so great that these people struggle to move away from relationships that have ultimately become hollow.
I have also observed that people find it easier to pull away from family members who resemble Mary Jones from the 2009 film Precious. Outright abusers who are unambiguous in their abuse tend to be easily identified as “monsters” who have to be broken away from. The journey is still difficult, but the task is clearer when people present themselves that way. The decision to break contact with a family or family member who doesn’t behave in a textbook abuser way can be more challenging for some. Some people may not even realize that they are in a negative relationship with their family if it doesn’t look like the way we’ve seen those relationships dramatized on screen.
It is important to begin to check in with yourself by asking questions like “How do I feel once I’ve left an interaction with my family?” “Is this person nice to me?” “Does this person like me?” “Do I like them?” Doing this allows you to examine your family relationships honestly and lets you see where there may be problems that go unnoticed and behaviors that are hidden red flags or maybe even yellow flags that need to be addressed.
Choosing oneself is a powerful and scary thing to do, especially when the choice is you or the people you have known since you were aware of the world. I wholeheartedly believe it is necessary though; if you have a family that loves you and uplifts you and makes you stronger after being around them then that should be cherished but if you don’t then you must strive to make those connections in other places. Keep in mind that family can be what you make it, what and who you choose. I would urge those who read this to consider what their lives are like in their family units. Every family has disagreements and arguments so the existence of tension in your family isn’t inherently a bad thing but if there’s no love, no levity, if there is only tension and no enjoyment of time spent, if the relationships only exist out of obligation it may be time to reevaluate them. Start by asking this question, “If I met these people today, would we be friends?” The answer to this may help to start a serious process and lead to some personal evolution.
Anxiety and Depression
written by Rachel Froehlich
In this generation, many people don’t think of the significance of depression. Some even make jokes about the subject. Most of these jokes make this condition sound light-hearted and laughable but in reality, it is a very serious mental condition. As stated in the article, “Facts About Depression”, published in 2014 by Chris Iliades, “depression affects more than 23 million Americans every year and it is the most serious brain disease in the United States.” The World Health Association also estimates that around 264 million people globally are affected by depression as stated in their article titled “Depression” published in 2020. If there’s anyone here that knows someone personally who struggles with this issue then you should know what a toll it can put on someone’s life. If you don’t then I’m here to tell you more about it.
Today I want to show the real effects of depression and inform you of the hardships that this condition brings. The three main points I’m going to be focusing on today are self-doubt, irritability, and health issues that come along with depression. As said by Tartakovsky in “How Depression Damages your Relationships,” published in 2014 when dealing with depression “many people experience self-doubt, which can affect their everyday relationships.” The deterioration of relationships proves that depression doesn’t just affect the person dealing with it but the loved ones around them. You’re probably thinking that everyone experiences self-doubt throughout their life, and although that is true when dealing with depression self-doubt isn’t just every once in a while it’s a constant feeling. Self-doubt makes it hard to stay or become motivated to do any sort of tasks that normally wouldn’t be an issue. It also makes you feel as if you’re constantly at battle with your thoughts, thinking, “Am I good enough?” “Am I worth it?” This can cause someone to isolate themselves and not reach out for help causing a downward spiral in their health. When this occurs it can cause the person to lose people once close to them because they unintentionally push them away. Although self-doubt may seem like something that everyone goes through it is also a common sign of depression and should never be ignored. Along with self-doubt, a sign of depression is irritability. Even though feeling irritated is a normal occurrence for anyone, it is also a sign of depression. When a person is struggling with their mental health feeling irritable is a constant struggle that many tend to brush off. When a person is feeling irritable, small things that usually wouldn’t bother them causes stressful situations that can lead to a spiral in the worst direction.
The Article Depression Basics published in 2014 from, “The National Institutes of Health”, states that men tend to show the irritable trait more than women do cause them to feel angrier towards small mishaps and very tired throughout the day. When feeling irritable when depressed the person tends to be angry with themselves rather than the people around them this usually starts from childhood coming from traumatic events. Men tend to misread their symptoms as something different and never realize that they could be experiencing a depressive state leading to what could turn into an even more serious condition. Depression doesn’t only affect a person’s mental health and emotions. Long-term undiagnosed or noticed can cause physical health risks that could be very serious and life-threatening. According to Nancy Schimelppfening in her article, “7 facts you should know about depression”, published in 2020, Depression is caused by an imbalance in the brain also known as neurotransmitters that regulate moods, including dopamine, serotonin, and norepinephrine. Dopamine is known as the “feel-good” hormone, it’s what makes us feel pleasure and satisfaction. Serotonin is another key hormone in the human body, it regulates our moods and feelings of happiness. Lastly, norepinephrine is the hormone that contributes to increasing the heart rate and blood pumping from the heart. The theory stated is that having too little or even too much of these neurotransmitters can contribute to depression. Since depression is such a complex issue within the brain when it goes untreated or even unnoticed it can cause your physical health to decline. Information from the Center of Disease Control and Prevention (CDC), provides that people struggling with depression for a long period can experience increased heart rate, high blood pressure, and reduced blood to the heart. Over time this can lead to heart issues such as heart attack, strokes, and heart failure. with all of that said, from the very few symptoms I’ve talked about today including self-doubt, irritability, and health issues, it proves that depression has true hardships that come along with the condition.
Margarita Tartakovsky, M. (2014, July 04). How depression damages your relationship & what you can do. Retrieved February 08, 2021, from https://psychcentral.com/blog/how-depression-damages-your-relationship-what-you-can-do#1
Depression basics. (2016). Retrieved February 08, 2021, from https://www.nimh.nih.gov/health/publications/depression/index.shtml
Iliades, C., Parch, L., Marks, J., Hurley, K., Seitzer, M., & Rauf, D. (2014, August 5). Facts about depression: Who’s at risk? – depression center – everyday health. Retrieved February 08, 2021, from https://www.everydayhealth.com/depression/facts-about-depression-whos-at-risk.aspx
Schimelpfening, N. (2020, August 03). 7 facts everyone should know about depression. Retrieved February 08, 2021, from https://www.verywellmind.com/depression-facts-you-should-know-1067617
Heart disease and mental health disorders. (2020, May 06). Retrieved February 08, 2021, from https://www.cdc.gov/heartdisease/mentalhealth.htm#:~:text=People%20experiencing%20depression%2C%20anxiety%2C%20stress,and%20heightened%20levels%20of%20cortisol
Depression. (2020, January 30). Retrieved February 08, 2021, from https://www.who.int/news-room/fact-sheets/detail/depression
Women that Inspire me: Reaching for the Stars
written by Gloria Froehlich
I came from a divorced family and was raised by a wonderful mother along with 4 strong sisters. Each has their own unique gift and they all have taught me in their own ways.
My mom handled her divorce all those years ago and didn’t let hatred enter her heart. She raised me with Catholic faith and forgiveness and gave me the gift of compassion. She still loves going to church, reading about her faith, and still continues to guide her children in the right direction, to reach for the stars!
My oldest sister, Grace, has always inspired me to reach for the stars and gave me the gift of ambition. She had knee and shoulder surgeries, an early pregnancy, traumas and challenges with little money, and, yet, still strived to do great things. She now is a wonderful role model, mother of 2, owned and sold her own business, and is a successful doctorate in pharmacy.
My middle sister, Gina, has always inspired me to look outside the box and my inner self and gave me the gift of strength. Many would think the opposite of strength is weakness, but for me it was fear. The fear of striking out. She too had her own battles: divorce, trauma and not knowing where she fit in, what would actually make her happy, and doing what she loves. She, too, reached for the stars and now has a wonderful husband, 5 step kids that love her, a masters of science in clinical counseling, and a successful business. She taught me inner strength can move mountains.
My younger sister, Gabrial, inspired me to have balance and she gave me the gift of happiness. You’ve heard the expression, “All work and no play makes Jack a dull boy.” Well, actually when I was younger, I was more play than work. But, that’s another story. Gabrial knows how to find balance in her life. She has handled many adversities and without a college degree became a successful businesswoman and is the breadwinner of her household. Besides working hard, she takes care of her 4 kids and the household but still makes time for herself.
Last but not least, my daughter Rachel. Even though I am her mother and still her teacher/parent, she gives me the gift of unconditional love. Guiding her and watching her grow up to be a smart and beautiful woman is a blessing. I told her, too. to reach for the stars! She is off at college and I love that she calls, texts, and FaceTimes me all the time about her lows and her highs. Unconditional love – I love her and want nothing more than her happiness! No strings attached! She is exceeding in all that she does and made honor roll her first year! Truly an inspiration.
I am proud that I have strong and passionate women in my life that in so many ways have taught me compassion, ambition, strength, happiness, unconditional love and to always reach for the stars!
Adult ADHD Relationships and Hope
ADHD can impact both individuals in a couple, leading to negative patterns that damage the relationship and each other. Treatments and solutions from coping skills to addressing key life areas can help repair these patterns. Effective solutions touch on life areas pharmacological, educational, therapeutic, emotion regulation, stress management, support groups even health and physical fitness.
ADHD affects individuals in inappropriate inattention and/or hyperactivity-impulsivity deficits that disrupt our everyday work and life, in approximately 70% of previously diagnosed children, and up to 5%. Issues related to negative coping often appear in childhood or young adults as behavioral problems, substance abuse to risky behaviors and promiscuity even addiction issues.
Executive function is greatly impacted and can show up in different life areas such as emotional intelligence or emotional impulsivity adding difficulty to our romantic lives. Adult ADHD deficits are notable, for instance marked increases in impatience, ease to anger, high levels of frustration, emotional overreactions or chronically overstimulated. The impact can be felt in career, emotional stability, health/sexual health to financial wellbeing. Social impairments can lead to poorer relations and greater rates of inappropriate sexual liaisons, separations, and divorce. Struggles with issues of self-esteem, achievement, anxiety, learning disabilities and depression are common. The good news is higher rates of success occur where ADHD and other life area issues are addressed together.
Relationships, romantic, sexual, and/or social issues start in our teens, can show up by what age when begin dating, severity of social and romantic rejection, frequency of romantic relationships, negative impact of early sexual activity, greater levels of intercourse, promiscuity and risky sexual behaviors.
ADHD is often accompanied by additional issues, or comorbidities and a sensitivity to negative influence. Comorbidities affect around 75% of adults with ADHD, in forms such as learning disabilities, anxiety, personality, sleep and mood disorders or a variety of addictive behavior i.e. substance, sex, gambling and more. Negative influencing factors includes stress, hostile environments, relationships and families with high emotionality or friction/conflict exacerbating ADHD traits and deficits. ADHD partners are likely to have conflict with romantic partners when self-control resources were depleted, or effective coping strategies are insufficient, common for untreated ADHD.
Examining and addressing life areas lead to improvements and relationship recovery from the sometimes-caustic effects of ADHD. ADHD symptom management raises functional satisfaction in the individual. Increasing these and areas such as Emotional Intelligence increases relationship satisfaction levels.
Romantic relationship improvement and maintenance is aided through positive interaction and open dialogue to address the negative patterns that may have built up. Couples are often depleted, stressed, rife with fear, hopelessness and denial, often chronic.
The use of Psychoeducational groups, to educate couples about the effects of ADHD on social, romantic, educational, career, stigma and environmental, aimed at reducing symptomology is highly successful.
Successful strategies abound for managing time and attention through tools, processes, and accountability. Physical exercise, sleep and nutrition produce consistent positive impacts. Couples and families including walking or hiking together where conversations are encouraged, taps into neuroscience and brain change, proving highly beneficial.
Managing stimuli and attention issues in amounts and types at work, home and socially is important. Managing symptomology through medical (medication or Neurofeedback for instance),, behavior, therapeutic and/or coaching, and strategy interventions are highly effective, recommended for both ADHD and non-ADHD partners to aid change and relationship recovery.
Addressing the impact neurological issues in relationships i.e. poor social and communication skills, emotional and/or hypersensitivity, including couples therapy, models like Gottman, Emotionally Focused Therapy (EFT), Imago Relationship Therapy (IRT). Developing stronger listening skills, improved self-control, deeper understanding, and problem-solving strategies. Specific tools added to the ADHD toolbox such as: The Couples Dialogue, Mirrored listening, Validating, Empathizing and many more. Therapeutic works to dispel myths, halt shame/blame cycles, disable triggers and improve relating, boundary setting and maintenance. Addressing these negative relationship patterns, repairing misunderstandings, resentments, and wounds both individually in couples/family sessions brings clarity and hope when all parties engage in change.
Getting control over the worst of symptoms, allows relationship repair to proceed more smoothly, but many years of hurt, loss of trust, cycles of blame and shame will take time to heal. Each partner needs to rebuild their own strengths, address wounds and resentments, so we can give each other the “benefit of doubt” that will be needed to rebuild and build our new relationship!
A Partial Book list:
- The ADHD Effect on Marriage by Melissa Orlov
- Driven to Distraction by Hallowell and Ratey
- You Mean I’m Not Lazy, Stupid Or Crazy?! By Kelly and Ramundo
And many more very good books are now available
What the Virtual F2F?
written by Alexis Hyde-Washmon, MS, LPC, LMFT, BCBA, LBA
I walked into a classroom last week. A teacher and two para-professionals (paras) sat six feet apart from one another staring at their computers. A shadow of sunlight disturbed the solemn mood through the windows at the top of the outer gray classroom wall. Desks sat in order, in rows, as usual. I wondered, “It is lunchtime.? Is there a fire drill?” Silence lingered as noise. Emptiness defined the soul of a living organism once filled with light, sound, and blessed, organized, frenetic chaos. A tear went to the corner of my right eye and sat trying to decide if it wanted to make an issue with my mask. I swallowed before I moved and spoke an inch. It was business as usual.
Having worked as a counselor for school districts, clinics, and other venues for many years, I’ve become accustomed to faces, voices, raucous, rowdy, and calm thoughts. Where did they go?
I finished my assignment at the school that day, signed out, and walked to my car. As I sat, sort of catatonic with my hands on the steering wheel, I pondered, “What just happened?” I found myself wondering, “What the Virtual F2F?” In simple words…what the virtual face-to-face? I questioned, “If I’m feeling this way, out of sorts, then how and what are the parents, the children, and the teachers feeling?”
As a counselor, behavior analyst, and human being, in this blog I am presenting compiled feedback from an interview with several parents since the “re-opening” of schools and the virtual and tangible impact on their family system from a parental perspective. I provide a summary of the parents’ responses to this monumental change, as well as possible tips in managing stress related to the upheaval. In this, I hope to present a view of how parents are feeling and adjusting with a humble interpretation. The following areas were explored in questioning and tips that may help in the various areas: balancing work and school, basic struggles in transitioning to a virtual learning platform, challenges with scheduling, and accommodation in the home environment.
Parental challenges in a virtual versus face-to-face world (an interview):
How have things been going for you and your children at home together (all day) when balancing their education and your personal work?
It’s been stressful because we’ve had to work; we’ve had to be parent and teacher. There have been things that we’ve had to do to maintain the house after balancing work and school for our kids. As a parent, things pile up too…laundry, cleaning, cooking, taking care of daily hygiene for all of us, just living in a healthy way. We are on the computer with one child from 7:00 a.m. to 12:00 p.m. and 1:30 p.m. to 6:30 p.m. with the other child. They get a break at noon, but there’s no break for us as parents, because we must make sure that not only schoolwork is done, but we are working and trying to maintain an income at the same time.
What are the basic struggles you have endured transitioning from a face-to-face platform to a virtual platform?
When you have multiple children of different ages with varied skills, they have different subjects in school. They have different “apps” on the computer that they use and we, as parents, must be the ones who figure it all out. We must learn and then teach them how to sign on and they forget…so it’s a repeated process. The biggest fear is that they are not learning. It doesn’t seem as if they are receiving a “real” grade. We receive packets to complete and some of us do not have the skill. We are not teachers. The children are not socializing as they normally would. They are not engaging in outdoor activity, exercise, or group activity with their peers. We have become their peers. Exercise is a struggle as the basics have taken up most of EVERYONE’s time and exhaustion the rest of it.
What are the struggles that you have had to face with scheduling?
Preparing for school has been different based on whether parents maintain a regular schedule (e.g., require children to wake up, get ready, be fully dressed, eat breakfast, and follow the same routine as if they were going to school), schedule with modifications (e.g., be awake, partially dressed, and sign in on time but having slept later), or just get it done (e.g., wear pajamas, wait to eat breakfast if any is eaten, and if a class is missed, it’s made up later, even if at night). Our kids ask why their friends are wearing pajamas? Our children are distracted being on their computer or phone. They want to play games and engage in social media during class and we parents are the constant mediators for redirection and maintenance of attention to the lesson. Sometimes there’s make-up work for the kids which can vary from working five hours per day to eight hours per day. This does not seem ‘fair’ under the current conditions or based on age or ability of our children.
Have you made environmental changes in your home environment to assist in making life easier during this change?
We are sharing space with our children (e.g., kitchen dining table) all the time. They interrupt our work schedules with their schoolwork or breaks. We can’t really trust them to be in their own rooms because they want to do anything but class on the computer. They play with toys, run off, cut in and out, etc.
Tips for balancing work and school in a virtual world:
- Keep a structured routine AS A FAMILY
- Wake up together at the same time Monday through Friday.
- Eat breakfast together at the same time Monday through Friday.
- Work together.
- Be ready to engage the day in peace.
- Establish a special moment acknowledging joy and strength (e.g., prayer, dance, blessing the animals, etc.).
- Logging on (place passwords where they are readily accessible with step by step instructions).
- Breaking for lunch (make it a family decision, decide the night before, take time to be playful).
- Prepare snacks and lunches ahead of time enlisting family input
- Working on offline work (establish specific times, not willy nilly).
- Resting, relaxing or playtime (establish specific times).
- Completing homework (establish specific times).
- Make sure your child knows what they need to be doing and what you need to be doing at specific times throughout the day.
- Utilize visual supports for scheduling your and your child’s time (e.g., calendars, whiteboards, timers, sticky notes, text message reminders).
- Set up a dedicated learning space with all the supplies and equipment you and your child needs and make it comfortable (e.g., lighting, comfortable chair, table, water, light snacks).
- Check in on your child during your scheduled work breaks (you should be taking breaks anyway!).
- Establish rules for interruption and what circumstances warrant interruption.
- Teach waiting.
- Touch base periodically about what is working and is not during virtual learning; problem-solve ways to improve if needed.
- Make your home a place where work is defined as a contribution to a happy state of being.
THE NEXT STEP:
What are parents feeling about their children returning to a face-to-face setting based on this interview?
In conclusion, when parents were asked how they felt about their children returning to school, there was an overwhelming response of “YES!” The primary reason for this voluntary movement has been attributed to families and children having been “stuck at home” since March. Many parents and children are ready to return to school and life, even in the face of a pandemic. There has been an enormous financial and emotional burden on the family system that has not yet been moderated or nor has found a new homeostasis. Parents admit to being afraid to send their children back to school due to possible viral infection; however, they are committed to being “careful,” meaning taking safety precautions as required by the schools, society, and the CDC.
“Meet the Therapist” with Sarah Gerber
1. How would you define counseling?
I believe counseling provides an opportunity for individuals to explore their feelings in a safe environment allowing them to gain insight and understanding into the nature of their struggles. I strive to create a safe place with tools and knowledge for my clients to utilize for their personal healing and growth.
2. What do you look forward to most in your work with clients?
I believe my clients can become empowered to create meaningful change in their lives. When they begin to realize the strength within themselves, they shift their perspective to a more healthy and balanced way of living their lives. Witnessing this shift is one of the most rewarding parts of this work.
3. How did you get into Equine Therapy and how does that inform your work with clients?
I became familiar with horses when I was young and was introduced to Equine Assisted Psychotherapy at a conference early in my graduate education. Natural Lifemanship is the original Trauma-Focused Equine Assisted Psychotherapy and emphasizes the importance of relationships with ourselves and others to bring about healing and growth.
4. What have horses taught you?
The horses have taught me to show up. In order to understand the work which occurs with horses, we must be willing to lean into our discomfort and be present even when it is difficult. The horse is a prey animal, and we are natural predators. While this relationship can cause stress for the horse and the human it can also bring about significant insight into the nature of our relationships.
5. Where were you before you came into counseling, and what prompted the switch?
I am the mother of four adult children and pursued my graduate degree later in life. I believe we all search for answers which are not always evident and require some intervention. I expected to focus my work with adolescents due to the challenges faced by this population and have since found meaning in trauma informed care for all ages.
6. Do you have a favorite quote and why?
“Be the change you want to see in the world” Gandhi
I believe we each have a responsibility to look inward and ask ourselves what we can do to make a difference. It is always easier to find fault in others while not recognizing our own responsibility to show up and be present. We all must be accountable for change.
7. What are some lessons you’ve learned from the people you’ve counseled over the last 21 years?
Vulnerability looks different for different people
Determination is as important as information
Laugh at and with yourself
Never give up
Love, love, love
8. What can we find you doing in your free time?
Working with horses, hanging out with family, loving on my rescue pups, reading and listening to music
“Meet the Therapist” with Deborah Feinsilver
How would you define counseling?
REVEAL: Get to the core of what is problematic or causing the problem/s.
RELEASE: Forgive others or forgive self in order to move forward.
REPAIR or RECONSTRUCT: Replace behaviors that are not working with those that better serve.
What motivates people to come into counseling?
RECOGNITION that life shouldn’t be so difficult or that there must be something else.
Can you tell us about how your journalism background influences counseling?
I want to explore the story, and the stories behind the story.
How did you transition into counseling?
Quite simply I did a RE-WRITE or edit of my own life. As I matured and experienced my three children maturing I knew there was a better way to use what I had learned.
Do you have a favorite quote and why?
This is one I often discuss with clients. I don’t know where I found it, and I don’t know the author, but I think it speaks to all of us . . .
Courage doesn’t always roar . . . Sometimes courage is the little voice at the end of the day That says . . . I’ll try again tomorrow.
What are some lessons you’ve learned from the people you’ve counseled over the last 21 years?
Ahh . . . people are infinitely resilient. And have so much courage. Maybe that’s why I love that quote.
What can we find you doing in your free time?
I like to be with my family and friends. But also fee that my creativity can be my best friend, too.
Body Dysmorphic Disorder
Thea is a 14 year old who was recently diagnosed with social anxiety and depression. Her symptoms started about 6-months ago when she became increasingly anxious about going to school and other public places. She is overly concerned about the size of her nose, and believes it is larger than other people’s noses. She goes to extremes to camouflage her nose by wearing oversized glasses and trying to cover her face with her hair. She is convinced that other people are staring at her nose and she feel disgusted with the way she looks. This is a fictional case for illustrative purposes only.
Body Dysmorphic Disorder (BDD) is a body-image disorder with unrelenting and intrusive thoughts about imagined or slight defects in your appearance. The mild blemishes and/or imagined defects leave you feeling ugly, abnormal and/or deformed. BDD occurs equally in all genders and affects 2-3% of the US population, or as many as 664,000 individuals. BDD can make you feel anxious, embarrassed, even ashamed and you may avoid social situations. You may spend hours checking your appearance in a mirror or asking others for reassurance about your appearance. This can cause significant distress and negatively affect your ability to function on a daily basis.
Experts do not know the causes BDD, like other conditions it may result from a combination of things, such as family history, abnormalities in the brain (serotonin), personality traits, and negative life experiences such as child trauma. Typically, the age of onset is during the early teenage years.
People with BDD may fixate on one or more areas of their body, including the skin and hair. People with BDD may engage in compulsive and time-consuming behaviors that appear to be similar to OCD compulsions, such as constant grooming and reassurance seeking. Sometimes individuals with BDD will seek cosmetic surgery in an attempt to correct the perceived flaw. However, BDD is a neurobiological disorder not a physical defect. Cosmetic procedures do not cure BDD and can often make the symptoms worse.
The most common and effective treatment for BDD is Cognitive Behavior Therapy (CBT) with Exposure and Response Prevention (ERP). CBT is a type of therapy that helps identify distorted and harmful thoughts and behavior patterns, improving emotion regulation and distress tolerance. ERP is a type of CBT that can help the person with BDD learn to reduce the compulsions that cause so much distress in their lives. Additionally, Acceptance and Commitment Therapy (ACT) is a type of CBT that focuses on making room for, or tolerate negative thoughts and symptoms, rather than trying to change or eliminate them. Finally, perception training (or visual training) can help individuals with BDD learn to be nonjudgmental towards themselves and their reflection in a mirror.
If you suspect you or a loved one has BDD, consider talking with a therapist for an assessment and to discuss treatment options. The therapies listed above can help you reduce your symptoms and learn to manage BDD.
If you are feeling suicidal, thinking of harming yourself, or are in crisis, please call the National Suicide Prevention Lifeline. It is a free, 24-hour hotline (800) 273 TALK (8255).
Disclaimer: The content in this publication is intended to serve as educational purposes only and is not a replacement for therapy. For treatment-related questions, please ask a licensed therapist. If you do not have a therapist and would like to talk to someone about therapy, call
Francesca Beilharz, David J. Castle, Andrea Phillipou, & Susan L. Rossell. Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial. Pilot and Feasibility Studies, (2018)
Amy Harrison, Lorena Fernández de la Cruz, Jesper Enander, Joaquim Radua, & David Matix-Cols. Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review, (2016)
Anxiety and Depression Association of America. www.aada.org
International OCD Foundation, Body Dysmorphic Disorder page. www.bdd.iocdf.org
Christine Block PhD, LCSW
Marriage and Family
Mother Theresa once said, “Love begins by taking care of the closest ones – the ones at home. If you want to change the world, go home and love your family.”
Some may ask, why say … go home and love your family?
Babies, whose mothers hold them close, cuddle them and consistently respond to their needs, develop a trusting relationship and a healthy attachment to the caregiver. This sets the stage for the child to have healthy relationships with other pe“ople and experience and express a full range of emotions. Conversely, when this bonding does not occur, the ability to form healthy relationships is greatly affected.
The family/home is the child’s first teacher. Ideally it is here we are taught the dynamics of how to navigate relationships. Children’s sense of who they are is intimately associated with their relationships – both with other people and the context in which they live. When relationships do not give them what is needed, they lose their sense of comfort and confidence. Powerful psychological processes then come into play. Much distress/mental illnesses are as a result of these processes.
Many people have children without fully realizing the Herculean task they have undertaken. Parents have a duty to provide and cater to the physical, emotional, intellectual and spiritual development of the child. This entails helping them inculcate sound morals and values, giving praise when warranted, knowing when to say “No” and consistently enforcing established rules. Talking to children and taking an active interest in their lives and the things that matter to them is also necessary, however, it is crucial that parents lead by example and practice what they want children to emulate.
The statement above, lends itself to the topic of marriage and relationships. As a therapist who has been married for the past 35 years and offers marriage counseling incorporating the Gottman principles, I can safely say that marriage requires HARD WORK to be fulfilling and lasting. People get married as a way of expressing their love and devotion to each other. It is necessary to keep that love alive because neglect and time can cause the strongest of marriages to decline. What once seemed like heaven can be later perceived as hell and bondage.
I do not know of anyone who is happy all the time, but when couples come into therapy, I sometimes ask, “Do you still love each other? How do you feel when you see each other at the end of a workday? How do you show your love for each other?”
The answers are not usually what one would expect. Many couples are frustrated, disconnected and sad. Partners often feel invisible, not validated or have unmet needs. They live like two business partners who are taking care of children and other chores, instead of two people who are connecting, loving, appreciating, forgiving and supporting each other on a deeper level.
When couples are hurt, bitter, angry and frustrated, there is a ripple effect which is often easily visible in their attitude at work, the way they drive, react to daily challenges or interact with others. It may manifest as arguments with hurtful words, fights with partners and many times, abuse directed at children, which begins the destructive cycle of dysfunction.
This cycle does not have to be perpetuated. We all need to help break this vicious cycle which can be achieved if we make the choice to work on ourselves. Some can do this without external help, but many of us need to enlist the support of therapists and other qualified professionals. We owe it to ourselves and to future generations to do the work on our relationships while there is still hope and a desire to stay together. When we make our homes a refuge of peace, it gives us a place to lay our burdens down, refuel, find comfort and reenergize to face another day.
Make that choice today to create peace in your home, so you can help paint the bigger picture, which is, the change you want to see in the world.
Liz Malcolm, M.Ed., LPC.
Podcast Interview with Dr. Bob Beare with DeepWaters Recovery in Austin Texas
Episode 32: Parenting, Recovery, and Spirituality with Bryant Packard
Change, Transformation and Recovery
Change, true transformational change comes to everyone eventually. You may find the need for change thrust upon you from recovering from addictions, traumas, new or childhood or simply from leading an unsatisfying life. Getting to long lasting positive change, requires a toll, building upon your resilience, growth in unexpected ways, and need to create a sense of deep self-acceptance. The good news is at some point you may realize you are worthy and begin living a life that you love, maybe even being a person, you can love.
Often our life experiences and the tools, walls, coping skills we developed over time to protect ourselves become the very things that keep us stuck, slowly killing ourselves. These things now starving us from meaningful connections to not only our spiritual selves, but others and ultimately the one that needs us most, our wounded inner self!
Recovery is a great point from which to begin the journey of self-discovery. In fact, I often find I recommend people to participate in 12-step programs. One that I find effective for so many regardless of your identified issue is ACA or Adult Children of Alcoholics and Dysfunctional Families. At its core it focuses on the need to learn to “reparent” ourselves. If we pause here, I would imagine not one of us could not find some sliver of ourselves where an appropriate level of acceptance or nurturing would not have aided us in developing a greater maturity? Some of those areas can be so significant as to leave us nearly incapable of sustaining relationships, sobriety or just plain having a life I want to be living.
Deep transformational work is a must if I want to change the root cause of the things that keep me stuck. Keep me using. Keep me hurting those around me. Keep me hurting those inner parts of myself that really need light and being seen and loved. For many those first steps are just the beginning. ACA for instance says right out loud, if you need help with your drinking, go to AA, if you need help in other ways hire a therapist. Recognizing that my best thinking got me “here” and that I am not likely to get out unscathed on my own, it is time to find help. There are many fantastic and powerful organizations and people out there that can help me create meaningful and lasting change and finding that life again I can enjoy and is worth living. Even the bible states that starting to plow the field is fifty percent of the work. That first step is the hardest in the world because it will take half of everything you have left in you to take it. The rewards in this work are exponential and profound because you have no idea who that beautiful person you are, will be, as you continue to evolve and unfurl your wings! Fly my friend!
Bryant Packard MS., LMFTA, PMP
Elizabeth Malcolm MEd, LPC.
Current international trends almost dictate that we make an effort to understand the differences in each other, in order to foster a climate of acceptance and peace.
Many people are wounded because they are “the other” and different. Different is at times seen as being distasteful, foreign, dismissible, not in our social class or less than. Different is “not like us” and so we cannot understand “them” and don’t bother to try because “they” are foreigners, disabled, poor, Arab, female, gay etc.
In a country that was built by “different” immigrants, how much do we really know about Culture and Acculturation?
Culture has been defined as the attitudes, habits, norms, beliefs, styles, customs, rituals and artifacts shared by group members and passed on over time.
Culture does not only apply to people from a country. It can refer to people from a particular state, town, company, group or ethnicity.
Acculturation refers to the meeting of 2 different cultures. It has been thought of as an individual’s socialization into a different group’s ways. It is referred to as a second – culture acquisition.
Through Acculturation individuals take on some of the manners, speech patterns, dress, values and tastes of the culture to which they are exposed, while maintaining some of their original culture’s expression and norms. It has been noted that the majority culture also adopts elements of the minority culture which is why we enjoy Texmex, Chinese food, pizza etc.
Each year many people leave their country of origin and make the decision to migrate to another country in search of better opportunities for themselves and their families.
Being an immigrant in any country can be daunting. It requires strength, resilience and tenacity in order to succeed. As an immigrant myself, I have lived through this challenging process, which can be ongoing.
According to studies, there are many ways that immigrants navigate the acculturation process.
Some immigrants place very little importance on maintaining their original culture. They prefer to be absorbed into the new culture and no longer identify with their original culture.
Others maintain their own culture and do not embrace the new culture. This is common in racially segregated societies.
There are immigrants who place no importance on maintaining the old or adjusting to the new culture and these people often become marginalized by society. This is seen in cultures which make integration difficult.
Many immigrants who live in multicultural societies have opted to retain their original culture yet embrace the new culture and they navigate comfortably through both.
There is yet another method of acculturation where there is value placed on both the original culture and the new culture. In this process, the cultures are fused and a third culture is created.
Despite the method used in the acculturation process, moving from one country to another is not as easy as many envisage. The excitement soon wears off and is replaced by reality. Many immigrants never discuss their struggle with the loneliness they endure when they leave lifelong friends, family and support system behind to move to a country where they know no one and the lifestyle and customs are different. They never openly acknowledge their fears, apprehension or anger they feel, when they are judged as “different” and sometimes ostracized because of the way they look, dress or speak. These acts of unkindness and rejection increase the daily challenges that face many immigrants.
Each day every one of us has a choice. We can choose to be different and improve the quality of our interactions with the people we meet and make a difference in their lives.
Some ways we can do this is to:
Be aware of your prejudices and make an effort to challenge them when they surface.
Be cognizant of how your own culture impacts your choices, values, biases, manners and privileges.
Be comfortable with cultural differences.
Realize that each of us has a duty to question the status quo, to examine the morality of power and to work to make every society more just and equitable.
Let’s all strive to create a culture of inclusivity, so our children can live in peace with each other.
THE BENEFITS OF NEUROFEEDBACK
Using neurofeedback your actions are an active part of the brain’s healing process. Whether you play a fun or competitive video game, interactive sounds or music using just your brains focus this play brings long-term change.
The setup: a read-only system attaches electrodes to your head measuring the electrical activity your brain is producing. Next you play games that require a balance of concentration and relaxation. Your brains activity influences the games performance, the clinician monitoring output can aid you in interpretation and alterations. Facilitation pattern changes in engaging some patterns and decreasing others.
The good news is that effects and benefits of training are long lasting to permanent once training has been completed. You have effectively retrained your brain, creating more efficient and optimally performing patterns, new pathways, and better self-regulation.
What our patients report is decreased anxiety and developmental trauma, enhanced memory and focus, decreased impulsivity, improved mood, better quality of sleep, better mental clarity and organizational structure, migraine reduction, among others. Not only is neurofeedback effective without side effects, while you may be targeting to improve one thing, the effects are far broader, accomplishing more than one change.
Professional athletes and executive coaches work with optimal performance enhancements to accomplish competitive advantages, visualization, attention regulation, greater insights into self and organizations, better risk management.
Multiple studies illustrate the effectiveness of neurofeedback to improve conditions such as:
- Autism Spectrum / Asperger’s
- Bipolar Disorder
- Chronic Pain
- Developmental Trauma
- Headaches and Migraines
- Memory Issues
- Sleep Quality
- Traumatic Brain Injury (TBI)
Neurofeedback not only heals it can be fun!
The Brains Chemicals
Human suffering is ubiquitous. It occurs across cultures and continents and no one is immune from suffering, in one form or another. In a sense, suffering is the one absolute thing all humans have in common. Some theories on human behavior suggest our brains are hardwired for pleasure seeking and pain avoidance. Certain chemicals in our brain, or neurotransmitters, have even been identified as important in pain avoidance or pleasure-seeking behaviors. GABA, for example, appears to influence pleasure-seeking behavior. Glutamate, on the other hand, is known to be involved in trauma and fear response, and glutamate pathways are particularly strong. Substances, like drugs and alcohol, affect these neurotransmitters, increasing the effects of GABA while decreasing the effects glutamate. Therefore, it should come as no surprise that archaeological records indicate the presence of psychotropic drug use in the earliest civilizations. Humans have an ingrained drive to avoid negative emotions and increase positive emotions; ancient drugs may have been used to induce euphoria while repressing anxiety or depression, much as they are today. The nature of addiction is not based on free will alone, but has biological, psychological, and social roots. Traumatic experiences, particularly in childhood, are known to contribute to drug and alcohol use and repeated exposures to toxic stress reinforces use, leading to a spiraling cycle of addiction.
Do you think you may be addicted to drugs or alcohol? As yourself:
- Has your drug or alcohol use negatively affected your relationships with others?
- Have you ever used drugs or alcohol to improve or numb a negative mood?
- Have you ever lied to friends or family about your substance use?
- Do I have a history of traumatic experiences?
If you answered yes to any of these questions, you may have or be at risk of developing a substance use disorder. Recognizing that you have a substance use disorder is the first step; getting help is the most important. When you are ready to move forward, we are here for you.
How does Love play into it?
Love…one of the most used, abused and misused words in our vocabulary. As we approach Valentine’s Day, many people focus on love and on the exchange of material tokens as a symbol of love. This then begs the question…What is love? What is the standard by which love is measured?
Whenever these questions are asked, regardless of one’s religion, I think of 1 Corinthians 13, which tells us that love is kind, it is not easily angered, it protects and trusts, it keeps no record of wrongs, it is not self-seeking and love NEVER fails. In a world where so many people equate love with money, lust and control, this passage gives us a new criterion we can use as our standard, both in giving and receiving love.
How many of us have ever loved or been loved like this? This is the pinnacle of unconditional love. Many would say that to love like that is not humanly possible, but most of us have goals, because goals give our lives purpose, it gives us direction and something to strive towards. I therefore challenge you, to use this standard for love as the goal towards which you aspire, and when in any relationship, debating whether it is love, use this criterion to determine your answer.
LIVE with LOVE.
Elizabeth Malcolm MEd, LPC
Trauma Sensitive Yoga
We are Glad to Announce…
The Center for Authentic Healing and Counseling
Is Offering Trauma Sensitive Yoga (TSY),
Beginning March 24, 2020, Every Tuesday Evenings from 7PM- 8PM.
This mind-body movement is designed to help traumatized people to begin to release negative symptoms and find a safe place within their bodies.
Our Massachusetts Trip
Our AHC team of Gloria Froehlich, Yoga Teacher, Deborah Feinsilver, LPC, LMFT, Gina Baiamonte, LPC and owner participated in a weekend long intensive the month of February, 2020, through the Trauma Center-Trauma Sensitive Yoga at the Justice Resource Institute in Brooklyn, Massachusetts.
“We had a great time connecting with mental health practitioners and yoga instructors around the globe and experiencing Boston’s local eateries including enjoying Beverly Massachusetts, Hamilton, MA and Salem, MA. We are looking forward to sharing more of our experience with you and some research and information below about TSY.”Gina Baiamonte LPC, Owner The Center for Authentic Healing and Counseling
Yoga has become a rapidly growing practice in the United States, with millions of people enjoying and experiencing connecting with a community and awareness to their bodies. Yoga is an intricate practice comprised of diverse elements that include, but are not limited to, physical poses, breath work, meditation, spirituality, inward attention, knowledge of the self, and focus (Park, Braun, and Siegel, 2015). Yoga increases one’s ability to balance the autonomic nervous system (ANS) by calming the sympathetic and
parasympathetic systems, augmenting one’s ability to self-regulate emotions through self-soothing techniques (Simpkins & Simpkins, 2011).
What is Trauma Sensitive Yoga and How it Helps
TSY is a recent program jointly developed by psychiatrist and premiere trauma researcher, Bessel Van der Kolk, and David Emerson, a yoga teacher, with the intention of helping war veterans who have returned from war recover from trauma (Emerson & Hopper, 2011). Specifically designed to help complex trauma survivors who have endured multiple chronic traumatic events on an interpersonal level recover. TSY is a structured body-oriented yoga practice that serves the objectives of cultivating self-awareness, facilitating self-regulation, and developing a compassionate relationship with the body (Emerson & Hopper, 2011).
The Science Behind Trauma Yoga
According to research through the Trauma Center at the Justice Resource Institute in Brooklyn, Massachusetts, yoga has greater beneficial effects in alleviating traumatic stress symptoms as the best possible prescription. In 2014, study showed with a group of women who had suffered domestic violence, and were exposed to a 12-week trauma sensitive yoga course of one class a week, showed a reduction in severity of PTSD symptoms and frequency of dissociation symptoms, and gains in vitality and body attunement.
Based on the emerging neuroscience research, a vital ingredient of trauma
recovery is to develop sensory awareness (Van der Kolk, 2014). Yoga is an evidence-based process for traumatized individuals that develop such awareness as it invites them to notice and approach a sense of their bodies. This developed sensory awareness helps traumatized individuals navigate a shift away from their traumatic experience and redevelop a compassionate relationship to themselves and their inner world (Van der Kolk, 2014).
Body Sensory Awareness – Interoception
The TSY instructor will use verbiage that will be non-directive, giving the participates choices in their movements or while helping each person to be more interoceptive. The definition of Interoception is a lesser-known sense that helps you understand and feel what’s going on inside your body. People who struggle with the interoceptive sense may have trouble knowing when they feel hungry, full, hot, cold or thirsty and or connecting their physical emotional sensations to their bodies.
Sensing our bodies is the experience of embodiment, understanding where we begin and another person ends; we are more than just thoughts, feelings and responses. We have a physical self that responds to the environment to protect and nurture us. People who have experienced developmental trauma or other negative experiences may be living inside bodies that feel unsafe and untrustworthy and attending to visceral sensations and noticing their bodies may provoke fear. TSY helps us feel safe and back in our body’s – giving us presence in the now, develop freedom and self-autonomy, reclaim self-concept and identity, being proud of oneself and one’s appearance, cultivating inner peace and tranquility and optimism for the future and a safe place to live in our bodies and re-connection with the community.
This group will include our Authentic Healing and Counseling clients, as well as their family and friends! Please, invite all who would like to benefit!
Peace be with you!
Gina Baiamonte, MS, LPC, EMDR Certified
Owner of Authentic Healing and Counseling