Tekulvē is joining the CCF team in Utah County. He brings with him 10 years of experience as a licensed marriage and family therapist. Check him out here.
Tekulvē is joining the CCF team in Utah County. He brings with him 10 years of experience as a licensed marriage and family therapist. Check him out here.
When you’re trying to create boundaries with people they will be tested. It’s like when cows enter a new pasture, they will knock their shoulder against the perimeter a few times to check out where their boundaries are and how strong they are. Cows are strong enough to take down barbed wire if they really wanted to, but they aren’t really testing if they can get out, they are testing if they are safe from the external world. Once they know that the boundaries are consistent and stable they feel safe and they graze in the middle. If the cows don’t have that consistent boundary they will rely on the cowboy to tell them when they have gone too far. The cowboy, however, doesn’t have consistent boundaries, they will only correct the cow when they notice the cow has gone too far, which doesn’t create a feeling of safety. People are the same when they have never experienced consistent boundaries, or they are experiencing new boundaries. People will test boundaries, not enough to break them but enough to trust that they are there to stay and to trust that they are there to keep them safe.
A lot of young adults who never experienced boundaries, because their parents wanted to be their friend. They have a great relationship with their parents, but they will tell me that they feel like they grew up as an orphan because they don’t have a secure home base. but they will tell me that they are afraid to explore and take risks as an adult because they can’t trust that they have parents who are watching out for them, to make sure they don’t make a mistake big enough to ruin their entire life.
It’s important that people are given the space to grow and find their own solutions within appropriate limits. When your setting limits the goal is not to get a specific outcome, rather the goal is to prevent a specific outcome. It is quite spectacular what people can come up with when their possibilities aren’t limited, but just the same we don’t want anyone hurting themselves or others in the process. Limits are set to prevent irreversible and/or irreplaceable damage, while still allowing people to learn how to cope with and improve from mistakes.
When cattle are being herded they have the instinct to turn around when they feel blocked, which can be disruptive to the flow and requires more work to redirect them back into the flow. To redirect a cow, you want them to feel pressure on their shoulder. If you are in front of them when you apply this pressure they feel blocked, if you are beside them when you apply this pressure they will simply turn a bit from where they shouldn’t be. People are the same, when they are told to stop doing what they are doing (and they don’t continue trampling over you) they will do a complete turnaround, even if this wasn’t your intention. If you’re only wanting a slight redirection from a no-go zone you want to adjust your approach to let them know that you understand that they want to move forward, and you want that too, but you want them going forward in a slightly different direction.
Written by Madison Price, MA, LAMFT – therapist at the Holladay Center for Couples and Families
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
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 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 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.
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.
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.
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!
The term behavioral health has gained exposure and popularity more recently, particularly among medical providers and those involved in healthcare reform in the United States. Burg & Oyama1 define behavioral health as, “the psychosocial care of patients that goes far beyond a focus on diagnosing mental or psychiatric illness… [encompassing] not only mental illness but also factors that contribute to mental well-being”. This is the first of a series of articles which will introduce essential concepts and goals for integrated behavioral health treatment. Why is this important? The correlation between comorbid mental health and medical issues has mounting evidence for impacting healthcare cost, treatment outcomes, and patient satisfaction. Comorbidity in this sense refers to the presence of two co-occurring issues influencing the progression and prognosis of either condition. Well researched comorbid conditions include diabetes & depression2, asthma & anxiety/panic3, and chronic pain & psychosocial issues4. The good news is we are learning innovative ways to effectively treat comorbid conditions concurrently, thereby increasing the likelihood of successful outcomes and improved quality of life for patients.
The sustainable future of healthcare in the U.S. will likely require efforts to improve consultation/communication, cross-discipline competency, and collaboration among clinical teams. Traditionally, mental health specialists (i.e. psychologists, LMFTs, LCSWs, LPCs, CMHCs, etc.) have operated in relative isolation from the medical community. Aside from psychiatrists, who are primarily trained as Medical Doctors (MD), many practicing psychotherapists have minimal training in the biomedical model of treatment. And the inverse is true as well, wherein medical practitioners often have limited understanding of psychotherapeutic theory, psychosocial problem etiology, and effective behavioral intervention. This is exceptionally problematic for the patient because practitioners involved in treatment may have dramatically different, and often conflicting, beliefs about mental health problems and their respective solutions. Sperry5 suggests, “the goal of health care integration is to position the behavioral health counselor to support the physician… bring more specialized knowledge… identify the problem, target treatment, and manage medical patients with psychological problems using a behavioral approach”. The future of medicine may very well be found in systems which prioritize such supportive collaboration, encourage patient-centered policy, and deliver on whole-person treatment options.
Hopefully this educational introduction to behavioral health integration can serve as a starting point for further interest and exploration of the topic. While this is a relatively new concept, I predict we will see a dramatic increase of integrative efforts emerge over the next several years as clinicians, administrators, policy makers, and third-party payers (i.e. insurance companies) recognize the cost-effectiveness and clinical efficacy of interdisciplinary collaboration. We do not live our lives in a vacuum, and our problems are rarely isolated conditions in themselves. Therefore, we will need innovators across various disciplines to create efficient and effective systems which benefit all parties involved with the daunting task of healthcare reform. As patients, we can empower ourselves with education about how the biopsychosocial model might positively influence our role and options in treatment. So, the next time you are at the doctor’s office and they ask you questions about mood and/or behaviors, and you think, “What does this have to do with my medical problem?”, now you’ll know.
1.Burg, M.A., & Oyama, O. (2016). The behavioral health specialist in primary care: Skills for integrated practice. New York, NY: Springer Publishing Company.
Every now and then, most of us feel down or blue – this is different than depression. Situational sadness comes and goes with whatever is getting us down. For example, if you don’t get recognized for something you worked hard at, you will probably feel sad. After time, your sadness will start to disappear. It isn’t as sad over time. This is situational. Depression, on the other hand, seems to last beyond these events. Even when something potentially sad has come and gone and if there is seemingly no reason to feel sad, you still might feel sad. This can especially be true in the winter. The days are shorter and colder. This causes most of us to stop moving as much, and to stay inside. We then lack exercise and sunlight. On top of that, with the Halloween, Thanksgiving, Christmas and New Year’s, we tend to eat food that isn’t as healthy. We eat more sugar. This all contributes to feeling sad when we don’t seem to have anything to be sad about. Seasonal Affective Disorder (SAD) is what happens to many people during the winter months. Most people don’t realize they have this type of problem, they just think that they are down or blue. It is more than just having the ‘winter blues’. It impedes you in your daily life and interferes with your functioning. Recognizing that you have SAD will help you know what to do to overcome and let go of it. Some of the symptoms include: feeling sad, losing interest once enjoyed, change in appetite, change in sleep (usually sleeping more), loss of energy, restless activity, feeling worthless or guilty, trouble making decisions, and thoughts of suicide or death. If you think you might have this type of depression talk with a therapist today.
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