In my career in healthcare, I have seen far too many patients who have been prescribed medication and continue to take that medication faithfully; Yet after a time, they are not really sure why they are taking that specific medication or if it is even helping with the diagnosed issue.
What is missing for these patients? Medication management.
Medication management is the process of following up with the healthcare provider on a regular basis to assess the effectiveness of the prescribed medication therapy, discuss any side effects that may go along with the medication, and make adjustments in order to achieve proper dosing. In some cases, the follow-up may be to change the prescribed medication therapy, if it is not providing the desired outcomes. Medication management should be an ongoing process. It should include open dialogue between the patient and provider about the effects of the medication combined with any other therapies or treatments that may be in place. This is to ensure useful data is being collected, so decisions can be made based on the whole picture; not just the medication piece.
When it comes to psychiatric and mental health services, the importance of quality medication management cannot be overemphasized. Not all people who seek psychiatric help will require medication. In some cases, amino acid therapy may be appropriate or continued therapy and counseling with regular psychiatric follow-up is warranted. If medication is prescribed, the patient should plan to see the psychiatric provider within 2 weeks (in most cases) for the first medication management visit. Continued follow-up visits should be scheduled monthly, or as needed depending on the individual case.
During these visits, the patient should plan on communicating openly with the psychiatric provider about their use of the medication, any side effects that they may be noticing, and any changes they are feeling in relation to their mental health diagnosis. At times, genetic testing can be used to pinpoint what medications are more likely to work for each individual patient. This testing can be used not only for patients who are just beginning psychiatric treatment but also for patients who have been prescribed medication therapies that aren’t working. The patient should also plan to consult with the psychiatric provider before taking any other medications. They should inform the provider of other mental health therapies being used or medical complications that may arise during treatment. The patient should expect the provider to ask questions that will direct and lead the conversation, so time is well spent and modifications can be made with confidence.
Ultimately, the key to effective psychiatric medication management is open and continual communication between the patient and provider. At the Center for Couples and Families, our psychiatric providers strive to provide thorough psychiatric assessment, follow-up, and medication management.
Originally published on http://utvalleywellness.com/
Though almost half of marriages in the US end in divorce, most people who divorce successfully transition to their new life within two years. However, about 15% of divorces experience continued litigation. These cases exhibit a high degree of hostility and distrust between the spouses, making it difficult for them to communicate about the care of their children without involving the court. Often in high conflict divorce, it only takes one high conflict person to keep the dispute from resolving. If one spouse is noncompliant with the parenting plan and unwarrantedly denies the other parent access to the children, it compels the blocked parent to fight to not only see their children, but often to defend themselves against false allegations of abuse. The accused parent has two choices: either engage in conflict, or be separated from their precious children.
If you are experiencing denied visitations and an unwarranted campaign of denigration, you are most likely going through parental alienation. Those who have experienced it say it is one of the hardest things they have ever gone through. It requires developing advanced skills in order to cope. Parents who have been successful in dealing with parental alienation have developed the following skills:
- They sought knowledge. They read about parental alienation in order to understand why it happens, and what they could do to make it less difficult for their children. “Intellectually understanding parental alienation provides an emotional anchor to help make good decisions for yourself and your children.”1
- Reframe the meaning of your child’s behavior. For example, based on your current situation you may constantly tell yourself, “My child doesn’t love me anymore and never wants to see me again.” Try altering that statement to, “My child still loves me and wants to see me, but he is painted into a corner and is doing what he thinks he has to do in order to survive an experience that is as painful for him as it is for me.”2
- Stay even-tempered and never retaliate. “A person who reacts in anger is proving the alienator’s point that he or she is unstable.”3 Avoid falling into this trap.
- Don’t live a victim’s life. Although you are experiencing victimization, don’t live asif you have no power or worth.Deliberately take care of yourself. Eat healthy foods, stay socially connected, do something spiritual daily, exercise and get out in nature. Do things that you enjoy and that rejuvenate you.
- Be proactive. Always show up to pick up your kids even if you know they won’t be there. Keep a journal, and document what happens.
- Take a parenting class. Learn how to understand your children developmentally and respond empathetically.Develop superior parenting skills.
- Reduce your children’s anxiety. Find ways to reduce their anxiety when they are with you by picking your battles and not engaging in conflict.
- Never talk bad about your ex to your children.This forces them to align with the other parent against you, and paints you in a bad light.
- Try to make what little time you have with them positive and fun. It is through having fun that you gain connection and preserve your attachment.
- Find an alienation-aware therapist, and get the appropriate support and treatment you need.
Each time you board a plane you are reminded that if the oxygen masks drop, you need to put the mask on yourself first, before helping others. The same is true of parental alienation. You must deliberately take good care of yourself first if you are going to survive emotionally.
Custody and parent-time decisions are usually made by using what is called “The Best Interest of the Child” standard. This standard is intended to guard children from conflict and abuse, and to promote stability, but because it is vague, and not based on empirical evidence, it is susceptible to influences of what Edward Kruk, a social work researcher, describes as “judicial biases and preferences, professional self-interest, gender politics, the desire of a parent to remove the other parent from the child’s life, and the wishes of a parent who is found to be a danger to the child.”1 He argues that “a more child-focused approach to child custody determination is needed to reduce harm to children in the divorce transition and ensure their well-being.”2
What does the research show about the well-being of children of divorce? That shared physical parenting is the best custody determination for children. (This excludes cases of abuse, neglect, and parents with no prior relationship.) So why isn’t this the norm in most cases? It is because of Woozles and Zombies. Woozles are myths and misrepresentations of research that are not supported by evidence, but because they keep being repeated, they are believed to be true.3 Linda Nielsen, psychologist, and expert on shared parenting, explains,
To summarize briefly, the words “woozling” and “woozles” come from the children’s story, “Winnie the Pooh.” In the story the little bear, Winnie, dupes himself and his friends into believing that they are being followed by a scary beast – a beast he calls a woozle. Although they never actually see the woozle, they convince themselves it exists because they see its footprints next to theirs as they walk in circles around a tree. The footprints are, of course, their own. But Pooh and his friends are confident that they are onto something really big. Their foolish behavior is based on faulty “data” – and a woozle is born.4
Nielsen continues, “Nobel Prize-winning economist and New York Times columnist Paul Krugman (2014) wrote about a similar concept that he called a ‘zombie,’—a belief that ‘everyone important knows must be true, because everyone they know says it’s true. It’s a prime example of a zombie idea—an idea that should have been killed by evidence, but refuses to die. And it does a lot of harm.’”5
Some common Woozles and Zombies of shared parenting, followed by what research actually shows, include:
- Children want to live with only one parent and to have one home. Shared parenting is not worth the hassle.
When adult children of divorce were asked, they said having a relationship with both parents was worth any hassle they experienced in moving between homes.6
- Young children have one primary attachment figure, the mother, with whom they bond more strongly. Given this, it is hurtful for infants to spend any overnights with the other parent in the first year of life.7
The truth is that infants form different, but strong attachments to both parents and that “there is no evidence to support postponing the introduction of regular and frequent involvement, including overnights, of both parents with their babies and toddlers.”8
- Where there is high conflict between the parents, children do better with sole custody. Shared parenting only increases the conflict and puts the children in the middle.9
Conflict remains higher in sole- than in shared-custody families. Most children are not exposed to more conflict in shared-parenting families. Maintaining strong relationships with both parents helps diminish the negative impact of the parents’ conflict.10
- Shared parenting only works with those who agree to it, and is only successful for a small, cooperative group of parents who have little conflict.
The research shows that even if shared parenting was originally mandated, it leads to better adjustment for the children and less long-term conflict between the parents.11
Sadly, Woozles and Zombies can distort the facts about best practices for custody arrangements, but the research evidence is clear and irrefutable that a shared parenting model is truly optimal for families and “traditional visiting patterns . . . are . . . outdated, unnecessarily rigid, and restrictive, and fail in both the short and long term to address [the child’s] best interests (Kelly 2007).”12
1,2,12 Kruk, E. (2012). Arguments for an Equal Parental Responsibility Presumption in Contested Child Custody. The American Journal of Family Therapy, 40(1), 33-55. DOI:10.1080/01926187.2011.575344
5 Nielsen, L. (2015). Pop Goes the Woozle: Being Misled by Research on Child Custody and Parenting Plans, Journal of Divorce & Remarriage, 56:8, 595-633, DOI: 10.1080/10502556.2015.1092349
3, 4,8,10 Nielsen, L. (2015). Shared Physical Custody: Does It Benefit Most Children? Journal of the American Academy of Matrimonial Lawyers, 28, 79-138.
6,7,9,11 Nielsen, L. (2013, Jan. & feb.). Parenting Time & Shared Residential Custody: Ten Common Myths. https://issuu.com/nebraskabar/docs/janfeb_2013/1
WRITTEN BY MICHELLE JONES, LCSW
Michelle is the director of Concordia Families – a treatment center offering services for reunification, court involved therapy, parent education classes, treatment needs assessments and professional education seminars and classes.
Originally published in Utah Valley Wellness Magazine
Each branch of the mental health profession, including psychologists, marriage and family therapists, and social workers, has a code of ethics which outlines the values and standards which should guide the treatment they offer. For example, according to the Social Work Code of Ethics, “social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people (Code of Ethics, 2017).”1 Further, most exceptions to confidentiality are also based on the values of protecting the vulnerable in the population, meaning children and the elderly.
Within the arena of high-conflict divorce, there are children who are truly being subject to physical, sexual, and emotional/psychological abuse, and at the same time, there are also parents who make false allegations of child abuse in order to gain an advantage in court. When a professional becomes involved with these families, they need to explore multiple possibilities, and see the bigger picture of protecting the children against all forms of abuse. Reflexively denying contact between a parent and child in order to err on the “safe” side is not always the “safe” thing to do. Unnecessarily disrupting a healthy parent-child relationship actually enables psychological abuse.
First of all, therapists should take all claims of abuse seriously. Their obligation is to report it to the Division of Child and Family Services (DCFS). This agency will determine whether an investigation will be made, based on an assessment of risk factors. DCFS should be able to determine if the claim should be substantiated, whether it is a chronic problem or a one-time incident, or whether there is no evidence for the claim at all.
But when a parent makes false claims of abuse and unwarrantedly induces symptoms of anxiety or hatred in the child in order to destroy the child’s relationship with the ex-spouse, this is also an abuse known as parental alienation. It has been recognized as a form of psychological abuse, and is severely damaging to the child. A research article published in 2014, called, “Unseen Wounds: The Contribution of Psychological Maltreatment to Child and Adolescent Mental Health and Risk Outcomes,”2 examined the effects of psychological abuse. The lead author, Joseph Spinazzola, Ph.D., of The Trauma Center at Justice Resource Institute, Brookline, Massachusetts stated,
“Given the prevalence of childhood psychological abuse and the severity of harm to young victims, it should be at the forefront of mental health and social service training,” (APA, 2014).3
The American Professional Society on the Abuse of Children (APSAC)4 defines psychological abuse as five parental behaviors, as measured by the PMM and CAPM-CV scales:
- Spurning(In parental alienation, a parent withdraws love from the child to punish them when they connect to the other parent.)
- Terrorizing(In parental alienation, one parent induces fear of the other parent in the child.)
- Isolating(In parental alienation the child is cut off from the other parent and most likely the whole side of the family.)
- Corrupting/Exploiting(In parental alienation the child is encouraged to engage in behaviors that are cruel, disrespectful, and immoral in order to benefit the “favored” parent.)
- Denying Emotional Responsiveness(In parental alienation, the child is punished for accepting love from the other parent.)
In the latest version of the Diagnostic and Statistical manual, psychological abuse is defined as:
“…non-accidental verbal or symbolic acts by a child’s parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child.” (DSM 5, pg 719)5
If our fundamental value is to truly protect children, who are the most vulnerable in the population, then we need to raise the level of therapeutic competency through education and training, and do assessments which consider all forms of abuse, including parental alienation. Children should never be weaponized, and intervening systems should never enable it.
2 Spinazzola, J., Hodgdon, H., Liang, L., Ford, J. D., Layne, C. M., Pynoos, R., . . . Kisiel, C. (2014). Unseen wounds: The contribution of psychological maltreatment to child and adolescent mental health and risk outcomes. Psychological Trauma: Theory, Research, Practice, and Policy,6(Suppl 1), S18-S28. doi:10.1037/a0037766
3 Childhood Psychological Abuse as Harmful as Sexual or Physical Abuse. (n.d.). Retrieved March 25, 2018, from http://www.apa.org/news/press/releases/2014/10/psychological-abuse.aspx
4American Professional Society Abuse Children | APSAC. (n.d.). Retrieved March 25, 2018, from https://www.apsac.org/
5Diagnostic and statistical manual of mental disorders DSM-5. (2013). Washington: American Psychiatric Publ.
Originally published in Utah Valley Wellness Magazine
Divorce is hard. It is emotionally and physically draining for all people involved, including children. When a divorce becomes high conflict, children are caught in the crossfire and are treated as “prizes” to be won. Parents start pressuring their children knowingly and/or unknowingly to choose sides. These behaviors can escalate to “alienation”. Alienation is defined as a parent teaching their children to reject the other parent using fear (Templer, 2). Due to limited research, professionals often mistake alienation for estrangement. This misdiagnosis can have devastating effects on a family.
One misconception about alienation is that the alienated parent is responsible for being rejected by their child, whereas the alienating parent is considered to have little to no part in why their child is rejecting the alienated parent. Discerning whether a parent has been alienated or estranged requires specialized skills and knowledge. Unfortunately, many professionals who are assigned to such cases often have little to no training in this area.
Misconceptions about alienation prevent families from getting the help they need and can even have legal ramifications. Here are some examples of harmful misconceptions:
- It is generally believed that if a child does not want to be with their parent it means they have done something to deserve it. However, the reason could be that the alienating parent programmed the child.
- It is generally believed that the child would not align with the abusive alienating parent. However, children are vulnerable to manipulation. The targeted parent often tries to enforce appropriate discipline and fill the hole left by the alienating parent. In so doing, the targeted parent is looked at harshly and viewed as not respecting their child’s wishes and feelings.
- Enmeshment (blurred boundaries between two individuals) can be confused with healthy bonding. When children feel that they are not recipients of unconditional love they can be manipulated into doing what the alienating parents desires.
Professionals who have these or other misconceptions may come to the conclusion that the alienating parent is stable, whereas the targeted parent is not; this instability, real or perceived, is often the result of depression, anxiety, and anger that’s developed from the trauma of being alienated. Another example is if the targeted parent is falsely accused of abusing their child; the parent may exhibit unstable due to the fear being jailed, losing their children, or financial pressure. The unfortunate reality is that even strong, emotionally stable individuals may become anxious, depressed, and angry when under the pressures of alienation.
Mental health professionals play a critical role in high conflict divorce cases and have the power to make things much worse or better. Given the high stakes, families are encouraged to carefully select a professional with the proper skills and training.
Written by Carol Kim, MS, LMFT. Carol is a therapist at Concordia Families, a clinic specializing in reunification therapy, court involved treatment and is parental alienation aware.
Reference: Kase-Gottlieb L. (2014, April 22). Missing the Alienation. Retrived from https://www.nationalparentsorganization.org/blog/16…/21679-missing-the-alienation
April 22, 2014
By Linda Kase-Gottlieb, LMFT, LCSW-r
Why do mental health professionals and attorneys who evaluate or work with alienated children frequently mistake alienation for estrangement?
The main reason is that cases of parental alienation are counterintuitive. That is, the brain is hardwired to misinterpret and misunderstand the family dynamics in these situations. That leads to a number of common cognitive errors (thinking errors) that, in turn, lead to serious errors in professional reasoning and decision-making. In other words, The brain is tricked by alienation cases just as it is tricked by an optical illusion. Consequently, many professionals, including mental health professionals and attorneys, get these cases backwards. Often, the targeted parent is unfairly criticized for having allegedly contributed to his or her rejection, and the alienating parent is either absolved or believed to have made only a minor contribution. Thus, unless the professional has an in-depth understanding of alienation and estrangement, cases of severe alienation are frequently mistaken for estrangement.
This phenomenon has been described in some detail by Steven Miller, M.D., a physician who studies clinical reasoning and clinical decision-making. For an excellent summary, readers might wish to refer to a chapter that Dr. Miller wrote entitled, “Clinical Reasoning and Decision-Making in Cases of Child Alignment: Diagnostic and Therapeutic Issues,” in the book, Working with Alienated Children and Families, edited by Amy J. L. Baker, Ph.D. and Richard Sauber, Ph.D. Dr. Miller examines the complexity of alienation cases, explains why such cases are so counterintuitive, even to professionals, and describes how even the most experienced mental health practitioner can succumb to a variety of cognitive and clinical errors.
I will subsequently specify some of the more common counterintuitive mistakes and biases that occur in alienation cases. But I wish first to discuss how an experienced mental health professional can be fooled in these cases and may be no better at diagnosing alienation than a layperson.
Why is that so? For one thing, professionals who are assigned to conduct custody evaluations, provide reunification therapy, or represent a child in court are usually not experts in alienation and estrangement. Parental alienation is a highly specialized area, a subspecialty within the field of family dynamics and family systems therapy. It requires special knowledge and special skills. But most mental health professionals have received little or no specialized training in these areas.
For instance, most custody evaluations are performed by clinical psychologists. And yet, the usual doctoral degree in clinical psychology does not include even a single course in family dynamics. Although I collaborate with many knowledgeable PAS-aware psychologists — many of whom are excellent, superb clinicians — they have usually gained their expertise in parental alienation through extensive practice experience, not as part of their formal training. A similar situation exists within the discipline of child psychiatry, which generally provides little or no specialized training in family dynamics. Although some degree programs in clinical social work offer the option of specializing in family dynamics and family therapy, that is only an option, and many clinical social workers have little or no background in this area. Among mental health professionals, one of the few degrees that actually require formal training in family dynamics is a degree in marriage and family systems therapy, and even those who hold that degree are not necessarily experts in alienation and estrangement.
The bottom line is that not all mental health practitioners have the required expertise to handle cases of parental alienation, and not all therapists are bona fide specialists, let alone subspecialists, in alienation and estrangement.
Thus, parental alienation is a complex subspecialty that requires special expertise. To make this point, I sometimes use the following analogy: both a tax attorney and a divorce lawyer have gone to law school, and are presumably familiar with basic legal principles. Nevertheless, each would probably be over his or her head — like a fish out of water — if he or she attempted to practice the other specialty.
The situation is even more problematic for attorneys who deal with parental alienation. As previously noted, such cases are highly-counterintuitive, and attorneys who do not have special expertise in this area can make a multitude of cognitive, legal and strategic errors — including serious errors when trying these cases in court. Although Dr. Miller has described more than 30 such errors, some are particularly important and are highlighted here.
- Most professionals believe that if a child has rejected a parent, the parent must have done something to warrant it. Few people would even think of another explanation: namely that the child had been programmed or brainwashed, just like what occurs in a cult or in the well-known Stockholm syndrome. But if one were to compare alienated children to foster children — specifically, children who had been removed from their parents due to actual abuse and neglect — the difference would be obvious. Children who have truly been abused crave a relationship with their parents. Paradoxically — and this is what makes it so counterintuitive — with few exceptions, abused children protect their abusive parents. They do not disparage, attack or reject them. I myself saw this consistently during my 24 years of working in New York State’s Child Welfare System.
- Most professionals believe that it is unlikely that a child would align with an abusive, alienating parent. What is missed here is that the child is vulnerable to the manipulations of the alienating parent, such as bribery, abuse of authority and power, and permissiveness. We know how it is generally the targeted/alienated parent who enforces the appropriate discipline to fill the parental vacuum vacated by the alienating parent. By doing so, targeted/alienated parents are incredibly misunderstood and doubly victimized by the inexperienced professional, who then labels them as too harsh and not respectful of their children’s feelings and wishes.
- Most professionals confuse pathological enmeshment with healthy bonding. To the naïve observer, the closeness and clinging seen with enmeshed parent-child relationships seems normal, even healthy. But it is not. As a result of this dysfunctional relationship, alienated children lose their individuality; must suppress their natural feelings of love and need for a parent; and are manipulated to do the bidding of the alienating parent. That is extremely dangerous and damaging to the child.
Having fallen prey to these and other cognitive errors, mental health professionals who lack expertise in alienation then succumb to other biases that lead them to conclude that the alienating parent is competent and the targeted parent is not — in other words, those professionals get it backwards.
For example, the targeted parent frequently presents with symptoms of anxiety, depression and fear. What PAS-unaware professionals fail to understand is that these symptoms are situational and maintained by the alienation and are not dispositional. As noted by Dr. Miller, this is called the fundamental attribution error. It is one of the most common and pernicious cognitive errors. Likewise, it is common for PAS-unaware professionals to conclude that a targeted parent’s anger is the result of a character flaw instead of the result of trauma caused by the alienation. This may include:
Having been maltreated by the other parent and the child;
Being maltreated by the professionals in the mental health and/or judicial systems and who have been coopted by the alienating parent;
- Being falsely accused of abusing his or her child;
- Fearing incarceration due to false allegations; or
- Being drained of financial resources or pushed into bankruptcy.
Even the most emotionally stable individual would become anxious and angry in the face of such attacks.
Another common error is to fail to adequately consider the baseline situation. If the primary problem is alienation, then, by definition, the targeted parent’s behavior was generally acceptable and there was no evidence of abuse or neglect. His or her functioning was adequate, and the relationship with the child was good or normal. Yet some professionals ignore these critical elements of the family’s history, placing too much emphasis on their personal observations and too little emphasis on the baseline relationships.
Other common cognitive errors in such cases include:
- Anchoring.As used in cognitive science, anchoring refers to a phenomenon in which a judgment is unduly influenced by initial information, and there is inadequate adjustment when additional, contradictory information becomes available.
- Confirmation bias. Once anchored to an opinion, the PAS-unaware professional can succumb to confirmation bias,which is a tendency to focus on evidence that might confirm a hypothesis while neglecting evidence that might refute it.
- Premature closure. This cognitive error ensues when the evaluator arrives at a final conclusion or diagnosis before obtaining and considering sufficient information. Factors that lead to premature closure in alienation cases include but are not limited to completing and submitting a custody evaluation without obtaining information from the targeted parent’s long-standing therapist; failing to interview all relevant collateral contacts, especially collateral contacts who have positive things to say about the targeted parent or from those who can confirm the alienation; and failure to properly assess intra-family relationships by doing semi-structured interviews not only with the family as a whole and with various sub-groups but with each individual member.
Given the immense responsibility of professionals who intervene in children’s lives, it behooves us to employ the highest standard of professional conduct and ethics. That means selecting only professionals who have adequate expertise and skill to handle such cases. Because they are so counterintuitive, many cases require a subspecialist in alienation and estrangementin order to reliably rule in, or rule out, alienation, and distinguish it from true estrangement.
Author’s notes: (1) The preceding comments about custody evaluators also apply to reunification therapists and other professionals. I have written extensively about appropriate therapy in my 2012 book, The Parental Alienation Syndrome: A Family Therapy and Collaborative Systems Approach to Amelioration. I also contributed a chapter on treatment to Working With Alienated Children and Families: A Clinical Guidebook (2012), i.e., the book previously discussed in this article. I look forward to contributing an article summarizing treatment issues in cases of parental alienation to National Parents Organization. (2) I would like to thank Dr. Steven Miller for reviewing this manuscript and offering suggestions prior to publication.
Originally published: https://www.nationalparentsorganization.org/blog/16…/21679-missing-the-alienation
New starts in life often happen when people decide to engage therapy. Whenever I meet new clients as individuals, couples, or even families, I ask them what their goals are in therapy. For some, they have not been asked about what they need, want, or even prefer in their lives for a long time. For others, it often feels that they have never been heard at all, let alone asked. What happens when you go to therapy? What type of model and style of therapy will the person you see provide? What is their level of formal training, how well attuned are they to meet your needs and do they rely on any other resources other than their self-perceived competency? Understanding how much someone knows about your particular issue(s) is a critical step in selecting the type of therapist and style of therapy you will engage.
For example, as I write this article I am thinking of the many different styles of therapy available. I can immediately think of 11 different styles: structural family therapy, strategic therapy, the Milan systemic approach, the Mental Research Institute (MRI) approach, Satir’s communication approach, symbolic-experiential family therapy, intergenerational family therapy, collaborative therapy, narrative therapy, cognitive behavioral therapy and solution-focused therapy. That’s a lot of different styles of therapy, all with empirical research associated with their model and experts in each field.
Added to this list of styles of therapy are the therapists themselves. Who are you going to see and what you are likely to experience is largely dependent on the type of education they have and the experience they have with others. There is a vast difference in the education requirements to become a life coach, mental health counselor or a marriage and family therapist (MFT). There are differences in approaches and emphasis, even within the same style/model of therapy. You and the particular issues you bring to therapy may be weighing on you. The therapist fortunate enough to have you as a client should work as hard on your issues as you do.
There are resources such as books, workbooks, films, music and other sources that might resonate with you that are not particularly useful or preferred by others. You have decided to make a new start and that new start needs the support of the developing relationship of trust you are building with your therapist of choice. That relationship is essential for discussing what you want to achieve and the ways you plan to address the changes or goals you want for yourself and your relationships. Your new journey starts with a decision about what you want to experience in the future. Often this gets accomplished by a review of the past and current life experiences you have survived or thrived from. The therapist caring deeply about your experiences and your strengths will celebrate what you have achieved and where you are going. Aspects that you bring to the therapy effort are elements of the way you might describe yourself—the many facets of who you are. When people describe their experiences in therapy, I hope they include feeling heard, challenged, respected, validated, encouraged and celebrated. Their experience should feel welcomed like a friend, with a serious focus in a nurturing manner. Sometimes people cry, reflect and reconsider critical directions or attitudes they have adopted. Sometimes they laugh and release tension in a light-hearted way. New beginnings are often encouraged by a therapist going the extra mile along side of you, so you can keep going more miles, confidently forward. Welcome to your new start.
About the Author:
David Nutter is an Associate Marriage and Family Therapist at the St. George Center For Couples & Families. His career experience includes military service, management and executive positions and international business consulting. He received his undergraduate degree from BYU and his Masters in Marriage and Family Therapy from Northcentral University, a COAMFTE approved program. David was inducted into two honor societies for academic and clinical excellence and is enrolled in NCU’s PhD/ MFT program. During his Master’s program he was mentored by Steve Allred, with a broad range of client ages and issues. He served as the SGPD Chaplain (board certified) to reduce the impact to personnel and citizens from significant trauma experiences. He is adjunct faculty at DSU. He has lived in every U.S. time zone and abroad, and appreciates diversity. David is married to his “girlfriend” Diane. Together, they call their 7 children, their spouses/partners and 5 grandchildren their immediate family.
I have counseled couples for twenty-five years. Panicking, anxiously pacing, wringing hands, couples have wandered into my office, hoping to find some peace in their relationships. In the counseling arena we explore some very principled foundation ingredients that, when mixed together, produce peaceful, passionate relationships.
There are three fundamental ingredients that all of us need to exercise for a shot at a sound relationship. My challenge to you is to sit with your lover and assess the following three principles, and set specific goals to learn a little more, stand a little more firm, and increase your skills in these three areas:
The first foundation principle is friendship. Friendship is unilateral. Increase your friendship with your lover every couple of hours. You do this by sharing information, being trustworthy, and being transparent—without conditions.
The second principle that relationships will not survive without is influence. You must accept your lover’s influence. Men seem to have a slightly more difficult time with this, but both partners will benefit from allowing influence. Think about a time when there was disagreement in direction of relationship or activity. Did you allow your lover to have influence? Did you argue until one of you gave in? Was their healthy negotiation until a mutually satisfying result occurred? The hope is always influence and no competition. Get a little better at this in 2018!
Finally, the third principle is generating a governing purpose for your marriage. This is the North Star that holds you both accountable to a result that is desirable and cherished. If you are seeking the same purpose, you won’t go after hostile results. For example, my wife and I want to travel the world. If I sneak out and spend our travel money on a new truck and lots of clothes, we won’t have resources available to travel. That causes issues. If I save and we put our travel fund together and watch it grow together, we will eventually accomplish our common goal.
I invite you all to accept this challenge: In 2018 be a little bit better in all three of these areas. Sit with your lover and map out a specific strategy to accomplish these three goals to improve your relationship.
About the Author: Matt lives in St. George, Utah where he and his wife Chris are enjoying their life with each other. Since their kids have grown and moved out perusing their dreams Matt and Chris travel the world. They want to visit 200 countries before the are done. Matt and Chris are active in their community and enjoy working out, training for marathons, and spending time participating in numerous activities with their adult children. Matt has received his PhD in Psychology. He is focused on the arena of resolving personal conflicts and improving interpersonal relationships. In addition to his Doctorate Degree Matt has earned a Masters in Marriage and Family Therapy, studied Criminal Justice and received a category I licensure with Peace Officer Standard of Training along with a degree in the Arts of Business Management. Matt is a professor at Dixie State University and hopes to be part of the positive growth of Southern Utah.
We all have those days when it feels like we woke up on the wrong side of the bed. For whatever reason we are just in a bad mood. Often times these bad mood feelings are associated with difficult or stressful events in our lives such as trouble at work, financial problems or disappointment. Sometimes these bad mood feelings last for only a few hours, but sometimes they might linger for days at a time. There are many simple strategies to improve one’s mood in spite of what it is that might be bringing us down.
Be With People
Often times when we are feeling low just being with a trusted friend or family member and talking about our feelings can make all the difference. Having a sympathetic listener or someone that can get us laughing or looking at the bright side of things can make all the difference. We shouldn’t be embarrassed to talk about our mood or admit that we need help. In fact, many times isolating ourselves can be one of the biggest culprits in a lingering bad mood.
Whether its a brisk walk through the neighborhood or a trip to the grocery store, getting out of the house can do wonders for improving our mood. Sometimes we just need a little sunshine or to breathe in some fresh air. The sights and sounds of everyday life can get our mind off of things and be a beautiful distraction.
When a bad mood strikes we might find ourselves not even wanting to do the things we normally enjoy, but doing them anyways can take our minds off of negative thoughts and often times will help us feel better overall. Think of simple pleasures like reading, exercising, cooking or baking, shopping or just watching a funny movie or show.
Talk to a Professional
Feeling sad or moody are normal human emotions that we all experience from time to time. Depression is different from these emotions primarily because depression is a pervasive feeling of sadness that impacts our entire life and doesn’t just go away even when things in our lives are good. We should not hesitate to reach out to a professional to help us understand our feelings and deal with them appropriately.
Source: Psychology Today
About the Author: Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing. Alberto has been been working as a Nurse Practitioner since April of 2013. In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program. He is currently working at the St. George Center For Couples & Families.
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