“C”ommunicating with Our Teenagers

We cannot NOT communicate. – Ray Birdwhistell 

Everything we do communicates something. It has been estimated that between 67-94% of our communication is nonverbal. What is non-verbal communication, you ask? It is everything except the words. It could be a grunt, a smile, a sigh, our smell, our jewelry, our clothes, whistling, the way we comb our hair, tattoos, the way we cook our food, piercings or the lack thereof, our posture, the nuances and history of a relationship, a stare at our son, a gaze at a pretty girl, the way we walk, our mode of transportation, hand gestures, or making googly eyes and funny sounds at a baby. We may say something, but our true intentions frequently will leak through our nonverbal behavior.  

The tone, the attitude behind the words when you ask your son to do something, communicates a whole lot more than the words that you verbally say. It is the attitude that he will respond to, not merely the words. Everything communicates. That is why the “C” in the title of this article is so large. Everything communicates something. We cannot NOT communicate. 

Even a dead person communicates. They communicate deadness.  

It is what is not being said that we pay attention to; this is why sarcasm is so dangerous. With sarcasm, there is a contradiction between the verbal and the nonverbal. Sarcasm is typically cutting. In fact, the word means, “to tear flesh.” For children, sarcasm can be very confusing.  

If you were to attend a communication seminar on learning “Effective Communication Skills,” you might come away with skills such as: having good eye contact, sitting on the edge of your chair, nodding and other non-verbal behavior to indicate you are listening. You might also learn about the importance of reflective listening. All these skills are important, however, do you suppose it would be possible to perform all these behaviors and not really listen in a caring way? And, if a person didn’t really care, do you think other people will be able to tell?  

Of course they can. 

“There is something deeper than behavior that others can sense – something that, when wrong, undercuts the effectiveness of even the most outwardly ‘correct’ behavior.” i  This thing that is deeper than behavior is something philosophers have been talking about for centuries. Carl Rogers called it “Way of Being.”ii  

Martin Buber explains that there are two fundamental ways of being, two ways of seeing another person. The first way is as a ”Thou,” a person with hopes and dreams and struggles similar to your own.  The other way of seeing a person is as an “It.” This is where one objectifies a person. “If I see them at all, I see them as less than I am – less relevant, less important, and less real.”iii This is then also about you and your perspective. There is always a good chance that a person does not see things the way they really are; that person may be missing something. We must be willing to honestly look at ourselves and see what part of the problem is our own. “Might I be provoking the other person without even knowing it?” 

When we talk to our teenagers, we sometimes ask them questions.  We must understand that they do not merely answer our questions; they are answering a relationship. Our conversations don’t happen in a vacuum. They happen in the context of a historical relationship.  They are answering a person, and with that person, comes an accumulation and history of their interactions. They answer according to the quality of their recent and remote relationship. 

For example, you might ask your daughter, “Would you take the dog for a walk?” She could respond in a variety of ways. She could ignore you. She could say, “of course.” She could tell you to eat rocks, or yell out while leaving, “maybe later.” On the other hand, if your daughter’s best friend (having a different relationship) said, “Let’s take the dog for a walk?” Your daughter may happily agree to take the dog for a walk. The relationship determines the interaction. 

In his book ”7 Habits of Highly Effective People,”iv Stephen Covey speaks of an emotional bank account we each have with our children. We must have enough positive interactions, thus building the relationship in our “emotional bank account,” before we can safely make a withdrawal (correction/discipline) without damaging the relationship. After all, we do not want to bankrupt the relationship.  When the emotional bank account is healthy, your child can take correction, knowing that it is coming from a place of love. 

The quality of the relationship determines our ability to be effective parents  

and our teenager’s willingness to allow us to influence them. 

 The moment a parent has a nasty verbal exchange with their teenager is not the time to try to immediately solve the problem. There are too many hot emotions for anyone to think clearly. If the relationship is generally good, waiting for a few hours, or perhaps a day to address the problem is wise. Time allows the parents and teenager space to see the situation clearly without the corrupting influence of these distorted and self-justifying thoughts and emotions.  

If the relationship has been rocky, time is needed for the relationship to heal. Part of healing process is deliberately working on developing trust again; another topic for another day. 

Originally published on http://utvalleywellness.com/

 

 

Medication Management and Mental Health

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/

 

 

Cleaning Out your Marriage Closet: Couples Counseling

People are often worried about drudging up the past with their loved ones. There is controversy as to what is healthy for the relationship. People certainly don’t like to bring up an old fight when everything is going well. The issue is that we all have a closet of sorts where we hide everything that “isn’t worth the fight.” At first this closet is empty and the intention of putting things in there is good, you intend to talk about it later, it’s just not the right time.

The problem is that you enjoy the times you’re not fighting, who wouldn’t! You soon forget about what you’re storing in the closet, and you continue to throw everything “not worth the fight” into the closet. Your closet becomes full, and when you try to fit one more thing in there everything topples over. This is the fight of all fights, this is when you seemingly “loose it” out of nowhere about nothing and everything. This fight happens at a time when something was already “not worth the fight” and you were trying to put it in the closet. Therefore, you are probably not up for resolving everything in that closet either. It’s like if your junk closet toppled over just as company is coming over, you’re going to scoop everything up and stuff it back into the closet because you don’t have time to sort through it. This fight leaves everyone upset and confused and often nothing is resolved in this fight.

So how does one clean out this closet? Well its much like spring cleaning, you are going to take everything out and you begin to sort everything into categories. You evaluate if it is something that only happened once and will never happen again, if this is the case it truly isn’t worth the fight and can be thrown out. If it is something that continues to happen you need to address it, you will be bringing up the past not as a weapon against the other person, but as a justification for bringing it up as an issue. It is absolutely necessary that cleaning this closet is done at a time when your calm and you remain calm to be able to assess what the core of the problem is, what does their behavior tell you about your relationship with them. For instance, If someone is always late, how does their behavior effect you, why does it feel disrespectful to you and how does it create distance in your relationship, what is the message you receive about their feelings toward you. As opposed to judging their behavior as something you wouldn’t do and lecturing them about how it affects them.

When you clean out the closet you are transferring responsibility to the people it will be useful with. You will find that the cleaner your closet becomes the more clarity you will have in your relationships. Your intent in cleaning out the closet is not to change other people’s behavior, it is meant to change your relationships. You will find that some people will choose to become more distant because they are unwilling to make changes, but the relationships that become closer and the internal peace will be worth the distance in others.

Written by Madison Price, MS, LAMFT – therapist at Holladay Center for Couples and Families

Shared originally by the Holladay Center for Couples and Families

Latino and Hispanic Mental Health Care

There are many trials one might face in this lifetime, and finding proper mental health care should not be one of them. Specifically, there is an issue for Latino and Hispanic persons to be able to receive the proper care that they need. Throughout this article, I will be using both the terms ‘Hispanic’ and ‘Latino’ interchangeably to describe members of this beautiful population, while meaning no disrespect to those who identify by either Hispanic or Latino.  

Currently, there are over 400,000 Latinos living in the State of Utah (Roughly 14% or 1 in 7)1. According to the National Alliance on Mental Illness (NAMI), 46% of Latino women and 20% of Latino men have struggled with depression2. However, less than 10% of Latino individuals suffering mental illnesses reach out to mental health care specialists. Additionally, Hispanic students between the 9th and 12th grades are more likely to commit suicide than their black and white peers3. Furthermore, first and second-generation Hispanics are more likely to experience depression than immigrants. 

Stigma/Cultural Differences 

There is a stigma surrounding mental health issues in most cultures. Within the Latino population, there is a fear of being labeled as “locos” (crazy) that can cause shame and fear to seek out the treatment that they need. Approximately 1 in 5 people are affected by a mental illness2. This statistic is no different for those within the Latino population.  

Understanding that there are few differences in regards to those who can be affected by mental illnesses, it is important to note that there are some differences in the way mental health treatments should take place among different cultures. I personally have visited and done humanitarian/therapeutic work in many countries, including: Spain, Costa Rica, Chile, Perú, and México. I understand that each of these countries have their own unique culture as well as do the other countries and cultures within the Hispanic and Latino communities. Finding a mental health care professional that can understand the cultural differences and possibly even the language is a big challenge and something that needs to be taken into account when looking for someone who can help you the best.  

Uninsured and Undocumented 

The fear of finding affordable health care is a real struggle if you do not have insurance or proper documentation. I have spoken to many individuals who do not seek out mental health care out of fear deportation. If this is a fear for you, it is important to seek out clinics and providers that care for all persons, regardless of legal status.  

Resources 

If you are uninsured, the Affordable Care Act is a resource available to you to see what you can qualify for. To learn more, go to https://www.cuidadodesalud.gov/es/ 

According to NAMI’s website, you can go to the website: findtreatment.samhsa.gov or by calling the National Treatment Referral Helpline at 800-662-HELP (4357). If you do not have papers, contact local Latino organizations that might be able to help or provide a referral. Additionally, you can search NAMI’s Compartiendo Esperanza to learn more about the importance of mental health awareness within Latino communities. 

 

1-US Census, 2015. 

2-National Alliance on Mental Illness 

3-Centers for Disease Control and Prevention, 2015. 

Originally published on http://utvalleywellness.com/

What to do if you are on a path of divorce – Couples Counseling

Marriage is never easy. Have you ever wondered how so many people seem to look so happy in theirs? Well – they might be, but chances are, they struggle too. The difference might be how you handle the struggle as a couple that can bring you happiness or not. It’s important to know that how you argue with your spouse matters more to the life and longevity and healthy of your marriage than the simple fact or presence of arguments in the first place – according to marital researcher John Gottman. Learning how to argue or fight fair is crucial to building a relationship that lasts. John Gottman outlines several important types of fighting that can harm your marriage. The first is criticism. This is where you directly complain and nitpick at your spouse. The second is contempt. This is harsher than criticism because you start to attack the character of your spouse instead of just what they are doing. The third is defensiveness. This is where you react with a defensive posture to things that your spouse does or says. Lastly, stonewalling. This is where you cut your spouse off emotionally and don’t engage in any way. John Gottman found that when these types of interactions are present in your marriage, that it’s in trouble. Come to counseling to find out what to do if you are engaged with your spouse in these ways of fighting. They can help fix and turn things around.

Couples Counseling with an expert

Couples counseling, if done right, isn’t a refereed fight in a therapist’s office. A trained therapist will help you to identify underlying, unmet emotional needs after helping you to deescalate from the tension and fighting you have been experiencing with your spouse. The problem is that most couples come into therapy years too late and it is difficult to change course – to learn a new way. It is possible, however! John Gottman, a world-renowned researcher on marital stability and satisfaction, has found that it is not the presence of argument that causes divorce, but rather it’s how a couple argues that causes divorce. Knowing this, couples don’t have to ignore what they are feeling, but rather they can communicate it differently and in a healthier manner.

Marriage and family therapists are trained to do this type of work. This is a specific degree and license type that focuses on relationships between people (husband and wife; father and son; mother and daughter, etc…) as the point of intervention rather than just focusing on fixing symptoms (depression; anxiety, etc…). Its important to alleviating depression and anxiety and its crucial to build relationships that help someone deal better with anxiety and depression in the first place.

Pornography Addiction: An Epidemic

Pornography is a big business. Americans spent 97 billion dollars on pornography over the past five years. The monetary cost of this epidemic is only a part of the real cost of this problem in our country. Over the past decade, increasing attention has been given to the damaging effects of pornography on the brain and, by extension, the lives of individuals and families. The accessibility of pornographic material and the multitude of technologic means by which it comes into our lives has brought this issue increasingly into the spotlight. In fact, you may be reading this because pornography has impacted you, personally, or someone you love.  

There has been controversy in the psychiatric literature about whether those who struggle with pornography are “addicted.” Whether or not it is formally designated in the professional literature as an addictive disorder, it certainly has been shown to affect the brain and the lives of its users in ways consistent with other addictive disorders. As with any addiction, an understanding of the process is key. Let’s start with how the brain responds to pornography. Our brains are designed to catalog our experiences with the end goal of preserving life and eliminating threats to our safety. Essentially, our brains are effective at remembering what feels good and what doesn’t. While this process is complex, a basic understanding of a few key brain chemicals is critical. 

The brain responds to pornography by releasing a powerful chemical called dopamine. Dopamine is released whenever we have pleasurable experiences. The release of dopamine and another powerful chemical called epinephrine (adrenaline) floods the brain in connection with pornography. With repeated exposure, a neural pathway in the brain is created that links arousal and associated neuro-chemicals dopamine and adrenaline with pornography use. As pornography exposure and dopamine release increases, dopamine receptors are eliminated. This “flooding” of the brain creates habituation or tolerance, resulting in the need for even greater stimulus (more explicit and “hard-core” pornography, novelty and intensity) to achieve the same effect.  

Dr. Donald L. Hilton, Jr. MD, a neurosurgeon at the University of Texas, has written extensively about the effects of pornography on the brain. His research and other reviews conclude that the effects of pornography on the brain are comparable to potent drugs, such as cocaine. He also explains that when the body orgasms, the brain produces a particular neurotransmitter called “oxytocin” which creates bonding. Oxytocin is also secreted in the brains of babies and moms during breastfeeding. So we are literally bonding to pornography (a digital image) when we reach climax. In an article published in the Harvard Crimson, Dr. Hilton states that “pornography emasculates men—they depend on porn to get sexually excited and can no longer get off by having sex with their women alone. What happens when you are addicted to porn is that you crave it. Real sex even becomes a poor substitute for porn, and you lose interest.” ¹ 

A final neurophysiologic effect of pornography is the damage created to the impulse control center of the brain, the pre-frontal cortex. With constant flooding of the brain with dopamine and epinephrine, there is a reduction in size and control of this area. Essentially, the ability to self-regulate and exercise impulse control is reduced until, ultimately, the addiction drives appetites, desires, and behaviors. As individuals fall into the grip of this addiction, they often experience other effects, such as isolation, depression, anxiety, sexual dysfunction, and relationship distress, among others – all of which spiral the individual away from resources that can lift and help them toward recovery and healing.  

As awareness of this issue increases, so do resources aimed at educating and assisting those affected by pornography addiction. A relatively new campaign called “Fight The New Drug” (www.fightthenewdrug.org) is an excellent resource for those seeking more information regarding the impact of pornography. There are also many religious/spiritually-based programs available², many of which are based on the twelve-step program utilized by Alcoholics Anonymous (AA).  

Pornography Counseling

Pornography addiction is becoming more prevalent in our society. Organizations like Fight the New Drug do a great job of educating the public on the harmful effects of pornography. What do you do if you struggle and can’t seem to find a way out? For many, the way out seems elusive and unobtainable. It’s difficult to find how when you have tried so many things, only to have this problem keep coming back. Many that come into counseling have already been before and are discouraged that they just can’t ‘get over it’. Knowing how to use the power or education and relationships is part of the answer. A good therapist can help you access both in your efforts to let go of this addiction. At the Center for Couples and Families we specialize in relationship therapy in regard to pornography use. Knowing how to communicate with your loved ones about this difficulty is an important part of the process.

An Ethic to Live: Building Barriers to Suicide Around Ourselves & Those We Love

In cities throughout the world, notable high buildings and bridges increasingly have additional fencing built atop of them with the specific purpose of preventing suicides. Suicide fences tend to work because research has shown that suicidal actions are frequently impulsive, hence such fences serve to forestall that impulse and buy individuals precious time to further think about their decisions. In studies of suicide fences, it appears that individuals don’t leave such barriers to go look for another bridge or tall building to end their lives from, but instead return to the business of living for yet another day.  

Presently suicide is the leading cause of death among young people ages 10-17 here in Utah, and over the last decade, it’s also doubled amongst adults in our state. As concerned friends, neighbors, and parents, how do we help our community build more barriers to suicide; protecting and empowering those we love? Over the next year, I’ll be writing a series of articles in answer to this question; offering my perspective as both a therapist, who has stood on sacred ground in helping others walk back from suicidal thinking, and as one who’s felt and ultimately rejected the dark pull to end my life amidst heavy times.   

Perhaps you’ve already noted that there’s no way to build suicide fences everywhere or to somehow block all of the endless ways in which someone might consider ending their life. Sound public policies on prevention and physical barriers like suicide fences are only some of the important ways to help. So in addition to these forms of prevention, the focus of my writing will be on how to build barriers to suicide directly into the thinking and values of individuals, and into the culture of our community as a whole. In this first article, I want to introduce how we help foster an ethic to live within ourselves and in others as a key barrier to suicide.  

An ethic to live means valuing our lives and holding a commitment within ourselves to continue living — even when we’re unsure of how we’ll cope or move forward. In my experience, helpful conversations about consciously building an ethic to live, begin by first taking care to turn our attention to the reality that to live is to be vulnerable to an array of difficult life experiences, with the potential to evoke within us the thought to end one’s life to escape them. Throughout human history, individuals and peoples have had to confront extremely painful and unjust challenges which have overwhelmed their sense of being able to continue on, and it’s important to acknowledge that when we confront such considerable pain, it is the most human thing in the world to want relief from it. This is real; excruciating human suffering beyond one’s current sense of how to reduce or stop it is real, and in these concentrations of pain, we may find ourselves having suicidal thoughts.  

When we acknowledge and honor that such excruciating life experiences do show up for many of us, it’s then that we can locate where we need to begin building internal fences to prevent suicide. It’s here that we recognize the need to develop a strong ethic to live even though there are times that we might not yet fully know how we’ll cope or be able to see brighter ways forward. It’s also here that we find the need to define as individuals what makes life worth living with specificity to our own life experiences, as well as the need to find a listener who we can turn to and voice what’s going on inside of us. 

As you navigate life’s difficulties, no matter how hard things may get, make the commitment now to live and identify your personal reasons to do so. Additionally, identify suicidal thoughts as a  sign to find a listener who you feel safe enough to talk to. It’s worth thinking about right now who it is you might feel comfortable turning to during your hardest times. By doing so, you’ll begin to build your own internal fence between you and suicide as well as have greater insight as to how to help others you care about to do the same.  

* If you or someone you care about is currently having thoughts of ending their life, caring help is available 24/7 by texting 741741 from anywhere in the USA or you can call 1-800-273-8255 to speak directly with a Counselor from the National Suicide Prevention Lifeline. 

Bio: Laura Skaggs Dulin holds a master’s degree in Marriage and Family Therapy from San Diego State University. She currently sees clients at the Spanish Fork Center for Couples and Families and at Encircle LGBT Youth and Family Resource Center in Provo.  

How You Can Create a Happy, Healthy New Year in 3 Simple Steps

Life Coaching is the favorite part of my job. I love sharing personal stories and real-world experiences as I help clients overcome addictions to food and other substances. When they understand that challenges with food are just symptoms of greater core issues, often related to emotions, they begin to overcome them as I teach how to change the behaviors for good.  

I was a cake decorator for over thirty years. This was my life’s passion, but it ultimately ruined my health. Giving this dream up was a huge sacrifice but one that led to greater health, energy and joy in my life. From this experience and others, I understand what it feels like to be an addict and the behaviors associated with it. I also understand the emotions and fears that come when giving up comfort and an artificial kind of love.  

Food is meant for fuel, nutrition and energy but we take it a step further and use it for comfort, love, and numbing out so we don’t have to feel what is truly going on inside. Emotional eating creates health challenges like addiction, obesity, fatigue, mental instability, and eating disorders of all kinds. It is fine to derive pleasure from food, but that should be a secondary result of making healthy food choices. 

We know now that scientists have engineered processed food to increase our cravings and desire to keep coming back and purchasing their products. Sweet tastes, for example are what we are biologically programmed from infancy to gravitate toward. Mother’s milk is sweet and toddlers often choose fruit over vegetables. High fructose corn syrup is added to many products from ketchup to cereal to satisfy the cravings for sweets. The unfortunate consequence of eating it, however, is that it turns off the mechanism in our brain saying we are full, so we continue to eat until we are stuffed or feeling sick. Processed sugar feeds candida and causes a host of health problems if eaten regularly over time. 

So, we are not completely to blame for our addictions, but there are things we can do to change our behaviors around food and make wiser choices that will reap greater benefits. As we enter a new year, I’d like to give 3 suggestions to help you make better decisions before going into the kitchen. 

  1. CREATE A PLAN: People who fail to plan, plan to fail right? Look through your recipe books and decide what to make for breakfast, lunch, dinner and snacks. Go shopping and get the ingredients needed.  
  2. PREPARE AHEAD:Prepare your mealsahead and refrigerate or freeze them for use throughout the week to save time and money.  
  3. ASK YOURSELF QUESTIONS: Sometimes we eat because we’re bored or tired and we aren’t even hungry. Here is a series of questions you can ask yourself before going to the refrigerator or pantry for a snack.
  4. What do I want to eat?
  5. Is it something that will give my body nutrition,fuel and sustained energy?
  6. Why do I want it?
  7. What emotion istied to thisfood? 
  8. Will _____ serve me for the better or worse?
  9. What physical symptoms will I feelafter eating _______ ? 
  10. Is it worth it?

 

Asking yourself these questions will help you become conscious of your decisions and help make better ones. If you want to eat it, just because, then own that and don’t make yourself feel bad. Good habits are learned as we practice over time. Taking baby steps forward will help us see and feel the progress. Create a Happy New Year!