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Counseling

Couples Counseling: The Gottman method

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Couples Counseling: The Gottman method

This blog post is the email response some have received from me after inquiring about couples counseling.

My friend, Tina-Fontina Bonita-Conchita saw me with Anita, having a Margarita and mentioned you might be a good person to talk to about couples counseling. Do you do that and do you take insurance?
— Bob Loblaw

Yes, I do couples counseling and I do take insurance. I use a modified version of the methods developed by the Gottman Institute.  This method focuses on appreciation, friendship and acts of connection instead of the traditional "Communication" method still used by most counselors.  Gottman's method was developed after 30+ years of studying couples as they interacted.  

Here is Gottman talking about what the Love Lab is: https://www.youtube.com/watch?v=E94xTxEydN4

And Here is a short video about how he sees work happening: 

This is a really great overview of his process. It's a Prezi (like powerpoint) so maybe go over it with your significant other. Prezi: 7 Principles for Making Marriage Work

I don't follow it exactly (we stop at whatever stage is the most troubling and spend time focusing on cognitive changes we can do to create a new relationship with that issue) but it lays out what the process is and why it's so important to avoid the old "communication" style of counseling.  

So, here's a thought game:  I arrive home after a long day at work, park the car in the driveway and walk to the front of the house.  There in the front yard is my wife, with a shovel standing over a hole in the ground with a jet of water streaming up 15 ft into the air. 

Do I need to use proper language with her?  ("When you sever our water line, it makes me feel like you are impetuous.") 

Or do I need to love and appreciate her enough that I automatically believe she is a good person, worthy of my kindness in spite of the water line rupture?  

For those geeks out there, let's put a chart in to give the perception of scientific validity: 

Love and Connection

Our Feelings About Our Partner Predict How We React And How Much Damage or Healing We Do To Our Relationship. The numbers represent how much damage (negative numbers) or growth (positive numbers) happens to our relationship when we respond from the listed emotional states (Angry... Fond...). As our Appreciation for our Partner grows, our response becomes more positive.

This is why the Gottman method just works better.  If I have focused on how much I care about and appreciate my wife, I will automatically join with her in the problem and not blame or criticize her for the "accident" no matter how much at fault she was or how frustrated I am.  Even if she says she wanted to see what happened when she busted the water line, I will be able to still value her and be there as her partner instead of judging her, having contempt for her (lack of) intelligence, or, more commonly, use this as a validation of all the other ways I feel upset at her.  We do damage by working to push how important we are and we repair relationships by working to remind ourselves how important our partner is.  As you can see, this means we need to work together or else one partner will end up being marginalized.  This is why we need to first establish that both people are invested in strengthening the relationship instead of just getting a therapist to prove they were right all along.  

Anyway, maybe this is more a blog post than an email (and actually it will be in 5 minutes) but I think it's a fair overview of what my perspective is and what would be expected from you if you want to come in.  

Ps. This method also has been found to be more gender neutral. The "communication" method tends to favor the style of couples work that women are already socialized to be more proficient at, meaning therapy sometimes comes off as an attack on the male partner.  The Gottman method works equally well if you can figure out a way to care about your partner as they can receive it.  

Thanks for reaching out. 

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Emotional intelligence

The feelings we get are possibly more rational than the thoughts. For one, emotions exist as experience and do not need to be thought into existence, unlike many other concepts. This makes them somewhat outside the realm of rationalization. 

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We may rationalize why we have a feeling but the feeling itself, once known and named accurately, does not need further validation. The same cannot be said of theory or intellectual positions, which may change depending on our beliefs or experience. 

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Is Resilience A Normal Response to Tragedy?

For a long time the standard view of tragedy is that it only takes time for most people to get over it.  The phrase "moving on" or "time to heal" is seen as the proper way to view a situation where someone is affected by personal loss or life-altering physical status.  The loss of a spouse, of a limb, or of a child is something that we just need to go through and heal from like a cut or bruise.  

New information from Arizona State University shows that this perception may not actually apply in the majority of cases.  Up till now we thought of Post Traumatic Stress Disorder, Chronic/Prolonged Grief, or life status adjustment disorders to be the result when someone doesn't bounce back as they should. Now there is evidence that the majority of people that face large life changes actually continue to be affected by these tragedies for a lot longer and to be more affected by smaller life changes, such as unemployment.  

Used under CC license, Pixbay

The research article, appearing in Perspectives in Psychological Science, may not be the end of the conversation, but it does appear to look at the same data that has been used before and draw significantly different conclusions.  In fact it draws these conclusions by not looking for expected results.  Whereas many of the previous studies assumed that there was not a large group that were not resilient and instead looked for why or how they were or were not resilient, this study instead simply looked at how many of the people appear to be continually affected by what happened. 

What this also means is that for the many people who feel that they just aren't good enough to overcome what happened, they are not in the minority.  Losing a job or losing a husband both come with severe consequences for most of the people it happens to. This also means that the benefit of group and individual therapy is increased as it has been shown to reduce the negative impact from these events.  For those of us who are friends or family to someone who returned from deployment, lost a job or maybe has a child in foster care, it is important for us to realize that there is a good chance that time alone will not heal these wounds and that helping them find a way to unstick themselves and create meaning from it is better seen as a natural response to all such events instead of only necessary in a few severe cases. 

Building resilience is possible and it is not like eye color or height.  We can change how effective people are at facing and growing from life changes.  Our brains continue to be malleable throughout our lives, and we have developed a Neuroplasticity Retraining and Enhancement program that can help every single person through life's struggles.

Stop by or call to find out how getting to your preferred cognitive reality can help you break free from the negative habits and non-resilience your brain has learned. 

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Almost Anyone Should Start Therapy

What if the responsiblity for increasing the acceptance and frequency of counseling use is really on the community of therapists in Northern Michigan? If yoga or soccer were the best fix for depression, would we find that the number of kids and adults participating would go up dramatically? Something makes counseling harder to begin and more difficult to share with others.  This isn't just about society needing to change, it's also about therapists having to create a more welcoming environment. 

The Walk in the Woods Copay Kickback

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The Walk in the Woods Copay Kickback

Walking is wonderful therapy for both mental and physical health.  To encourage you to walk for your health, we are creating a kickback program where you receive a coupon for the value of your copay if you go for a walk, either for a walk and talk therapy session or on your own.  

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Lifetime Bonding with Adopted Children

With the flood of information regarding the extent of bonding in utero and shortly thereafter, it may influence adoptive parents to believe that they are going to struggle to create a bond that's as strong as that of a biological parent. While there definitely is a loss here, a loss of almost 10 months of physical closeness before birth and possibly weeks, months or years after birth, there are still many ways that adoptive parents can increase and deepen the bond they have with their adoptive children. So let's quit whining about that loss until you have done these concrete things to continue to strengthen the bond you do have to your children.

From Birth:

Hug them longer, and sleep closer to them than other parents do.

Bathe less and hold more. If you do wear scents or need to bathe every day, use the same, gentle smelling soap or lotion every time. Hold off on perfume if you can avoid it and go for lotions or skin creams that use non-irritating ingredients to create a mild scent.  Then mash your body against your young child as much as you can!  Let them nap with direct skin to skin contact. Hold them more than you feel comfortable doing, even after both legs area sleep. Wear them more than other parent's wear their children. Hug them longer, and sleep closer to them than other parents do.  When they take a bath, spend time drying and intentionally applying oils, lotions or other balms to their skin, not because their skin needs it (which it may) but because it let's you gently touch them more.  This also goes along with the next bonding tool. 

 Peek A Boo lets children practice looking at your eyes in a fun way.

Peek A Boo lets children practice looking at your eyes in a fun way.

Increase eye contact with your child.  Spend time on the floor with them, in bed next to them and when feeding them.  Especially as a baby, make sure you are combining gentle touch and care with compassionate and intentional gazes and eye-smiles.  Also, don't stop this even as they get older and will not lock on to your eyes for as long each time.  Make it into a game or into a special way you greet each other. As babies turn to toddlers and toddlers to kids, find ways to be silly but also meaningful, paying attention to their interests and making an effort to be imaginative. 

Let them hear you tell others their adoption story, but make sure you're not objectifying their story, them or exoticizing the concept. As the child gets older they should be able to control, limit or help share their story.  From the time they join your family, it's important to let your child hear you tell others about how they came into your family and how it was intentional, sad and also very normal. But it's also important to consider what and how you say things. A good rule of thumb is to ask yourself: Is this the kind of intimate detail I would share about myself or a friend to a perfect stranger? It's easy to accidentally objectify children in general (they're small, they don't talk much themselves yet, you know more than they do and everyone asks prying questions you feel obligated to answer just to be polite), and it's extra important not to. It's just as important for your child to hear you say things like, "You're curiosity makes sense, because our family is amazing, but we're not up for answering lots of personal questions right now. Just trying to get some shopping done!"  Remember that interactions like these are more about your child and your relationship with your child than the lady in line at Meijer.  Let your children hear you tell someone else about them, but make sure you state everything with the objective of making that narrative be the one you want your child to have throughout their life. It should not be simple and should not be without loss. It should be accurate and emotional. And above all, it should be appropriately placed and timed, just like intimate details about anyone else's life. Basically, don't gossip about your kids. But do engage in mutually intimate and mutually sharing conversations with those you know and trust.

Toddler to Pre-Teen

Play physically.  As children get older, it may be harder to spend a lot of time holding them. Reading books, helping with baths and bedtime routines may increase this, but one great way to continue to build attachment is to play physically. Mothers are not usually socially conditioned or supported in doing this but it is very important for both parents to choose to actively engage physically with your child.  Chase and tackle your kid; knock them over; hold them down; let them throw you down too.  This is one of those interaction patterns that can become very helpful as you struggle with connection later on, so make sure you set up safe boundaries and always stop when someone says "stop" but also keep things very aggressive.  Yes aggressive.  Children should feel okay grabbing you and jumping on you and tossing a blanket over your head only to pull you around the house. You can argue with me here about tactics, but I think the strategy is fair: get your children used to trusting that you are going to both be physically dominating and yet gentle with them and that they have power to control you too.  This may look different than other parenting styles, but you have a different task than many other parents so we need to use different skills. This will pay off when your 15-year-old child expects you to grab and wrestle them when they come in the house from school.

 Diversity Mask, used by CC license -  George A. Spiva

Diversity Mask, used by CC license - George A. Spiva

Paint faces. Paint your child's face for sure, but make sure they get a chance to paint your face and / or body.  It gives them a sense of creation and manipulation that helps them feel like they are able to influence you, not just be influenced.  Also it's another great way to spend a lot of intentional time very close with your child.  Look at their eyes while they paint you and get them to look into your eyes by asking them questions, making weird faces or just by trying to give them sloppy, painty kisses. 

Give your child more control. How much control do you give them now? Can you double it? Do they get to make choices about clothing, bedtime stories, bath toys, breakfast foods, the order of chores, what room to pick up first, how long it's okay to leave toys lying around?  Don't worry, being a child means being constantly reminded about who is really in charge.  This is not to say that you should let your child change your mind about things, because they also need to believe that you really do have a good grasp on this life thing. Adopted children are especially susceptible to feeling a lack of control or direct responsibility for how their life is unfolding, so make sure you aren't part of that problem by building up their sense of efficacy. 

Remember your goals. Is it to force them to bed at promptly 7pm or is it to make sure you continue to build your attachment?  Have your priority hierarchy set up and written down. Even put it right on the fridge or somewhere your child can see it.  Make sure they know that your highest priority is to be a secure family and that the other things you do are facets of this. Remind yourself of this when the times get tough and you are going to be late to work, late to school, or are just seemingly not at the same place that other parents or children are.  Daily responsibilities will get you to defocus unless you find a way to continually remind yourself of these priorities. 

Find ways to share something special. Your favorite ice cream flavor is now your child's. Learn to love it. Don't be completely false, but be strategic. Creating ways that you can have special similarities between you and your adopted child is a powerful way to remind them emotionally that they are part of you and they belong right where they are.  Does your child come out of her room with a red sock and a black sock? Go change your socks to match if you can. Wear those socks all day and giggle to each other about it.  Imagine how happy a six-year-old would be if you show up to pick them up from school wearing the same shirt as them or with a set of matching hats for you both to wear. It matters. 

Adolescents and Young Adults

Continue your touch. This is why you made family hugs, holding hands, kisses, all-smashed-into-one-chair book reading, and goodnight snuggles the norm for years. Your child and your child's friends should know that you are the touchy-feely parents. Play soccer, basketball, water tag, sardines, and other physical games to keep your kid expecting your closeness and touch. 

Reverse Roles. Let your child cook for you or pick your clothes out or take care of you when you are sick. Ask for hugs because you could use one. Figure out a way that your child can teach you something and ask to have them help you learn it and then ask them how you are doing later. Ask for their validation and approval sometimes. 

Join with them about the things they value. Going vegan, saving water, watching videos of Minecraft, whatever it is, figure out what you can do to not just encourage them but to join with them in this meaning. 

Make a big deal out of family traditions. Try to set this up earlier of course, but set your traditions and keep them.  I'm not sure what direction to go on forcing children to participate, but part of the utility about it is that your child should know to rely on them regardless of whether or not they choose to participate.  It could be the way you make pancakes, the way your family delegates responsibilities when you go shopping, or how you celebrate holidays. 

Stop your routine to bond with your child. Children need to be reminded about what is important and even as a young adult they need to see it directly.  If possible, take a day off and take your child(ren) out of school to just do something together, maybe as a response to a tough time for them or to recognize their development.  Maybe it could be for no reason at all. 

Be more and more honest as your child can accept it. Your child needs to know that they belong, even if the reasons for why they came to join your family were messy. Maybe a three-year-old can't fully understand choices about infertility, religion, opportunity, beliefs at the time, or even happenstance; but a fifteen-year-old chult (child/adult) can handle it and needs to understand it because if you don't share with them they will fill in the gaps with their own, possibly negative guesses. 

Adult Adoptive Children. 

Be honest about your failures. Maybe you should have sought to have a doctor that looked like them, or to find out more about their birth father before he died. Maybe you wish you were better at talking to their teachers while they were growing up.  Don't say "I did the best I could" because that is bullshit. We do the best we do, not the best we can. 

Help them with their search for meaning, belonging and fulfillment. Comparing them to others' achievement may be helpful or it may just be damaging.  This is not to change expectations, but, instead to base them off of a person's own abilities and past successes.  Kanye West's new album should be compared to his last albums, not what I can do with a saxophone and two hours in a studio.  


These ideas were adopted from the tons of ideas and lists in Parenting the Hurt Child by Keck and Kupecky. They are made to be informative but not declarative and may not work for every situation.  Individual experience, such as a history of abuse or other trauma may bring about a need to have other, specific skills. The one thing that is very universal is that when raising a child through adoption it is important to only slightly glance at what other parents are doing to raise their children. As an adoptive parent, you are working overtime to learn not only the nuanced layers of basic parenting, but also all of the adoption-specific nuance and skills. You are learning, potentially, to get comfortable sharing, but not oversharing; appreciating and celebrating your child's race while not objectifying or exoticizing it; wrestling with mental health issues while not letting those struggles define your child or your relationship to them; and a whole lot more.

 

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Reviews: Therapy apps

The core principle of cognitive reconstruction is to find your preferred version of reality, which is based on your own values, and then act on your brain to change how you view the world so you can change how you act in the world. 

What this looks like: I want to be less controlling of situations where my top value in the situation isn't to influence or guarantee a specific outcome.  

Specifically: When interacting with my partner, treating them like the friend I value and love is more important than picking out the right movie or making sure dinner includes the pine nuts that are specified in the recipe. 

So you can do this cognitive reconstruction or reframing with a therapist, you can practice it on your own, and you can even find an app or two that can help (which, if you're a tech enthusiast like me, is exciting). 

 The Wish Outcome Obstacle Plan is a poorly named app that attempts to be cognitive therapy in a box. It's fun to try but not to continue.

The Wish Outcome Obstacle Plan is a poorly named app that attempts to be cognitive therapy in a box. It's fun to try but not to continue.

WOOP

The first App is called Wish Outcome Obstacle Plan and is for Android and iOS.  It describes itself as : "the systematic way to motivate yourself. Through the app, you will learn the self-regulatory technique Mental Contrasting with Implementation Intentions, also called Wish Outcome Obstacle Plan".  In practice it is a decent yet incomplete method of helping you plan for and deal with the problems that keep people from achieving personal goals.  It has a lot of focus on mindful meditation and envisioning your preferred outcome. It's just not fun.  The process gets a bit stale after a few repetitions, even though you know that what you are working on is very important.  This is an interesting phenomenon.  Should change, especially self-guided change, be fun and self-rewarding? It certainly seems as if it would help. 

If you do get into the app, you will find it to be good at targeting cognitions more than behavior, which I think is a very good sign.  Behavior will change after the cognitions and emotional content change. 

 

 Just like having this guy as your therapist

Just like having this guy as your therapist

Annoyster (iOS) and Randomly Remind Me (Android)

These two are lumped together here because they effectively work in the same manner.  They are designed as reminder tools, but because they have the ability to show these reminders randomly, they can be wonderful tools as a cognitive therapy add-on or even as a self-help stand alone program. 

The basic functioning of the apps are the same. You set up a schedule by telling it how often and what you want reminded of.  I can have it remind me to spend time thinking about how I want to be kind to those I care about and I can set it to tell me 8 times during the day.  Randomly Remind Me also lets you keep track of how often you actually follow through on any prompts, such as preferred cognition repetitions or kindness gestures.  

The process with cognitive change is not complicated, but catching yourself in the right situation is very difficult because when you are agitated or otherwise stuck in a negative emotional situation you instinctively resort to older, more practiced habits.  Either of these apps have the ability to catch you in those situations and help you build new experiences.  

Personally I have had good success with Randomly Remind Me, though I rarely have more than one change active at any time.  It is really wonderful to see it pop up and to be able to make small cognitive changes right then and go back to doing other things.  

Any of these three apps can be very useful, especially if you are working with a therapist to implement changes to your thoughts.  Some therapists want you to do quite a lot of work outside the office and having a reminder tool gives you more likelihood of being able to make your practice count much more than if you set aside time only when it is convenient to you (which almost always means when your negative emotions and cognitions are not activated). 

In combination with these I have also created a practice repetition device that operates much like a prayer rosary, which brings up a very interesting conversation about what the similarities between prayer and cognitive therapy end up being once you boil each down into it's constituent parts. 

But that's content for another post. 

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The Positive Side of Anxiety

Why does anxiety exist and what is it trying to do for us?

So. First let's set aside Fear.  Fear is like anxiety but (for this conversation) fear relates to anxiety around things that are real.  Anxiety, in this conversation, concerns feelings about events, thoughts or beliefs that do not actually happen, but also do not actually NOT happen. This is the problem with anxiety: you rarely get to prove to yourself that something that makes you anxious isn't going to happen. 

The positive side of destructive, dysfunctional anxiety is that it lets you know that something isn’t going right and it motivates you to make changes that you otherwise wouldn’t make.

Anxiety appears to be an uncomfortable side-effect of our amazing ability to predict the future and plan for our best-possible outcome in that future.  But . . . and this is where it gets fuzzy . . . many articles about anxiety slip into referring to anxiety as the feeling you get before you take a test, which may be somewhat helpful, instead of the feeling that many people have just leaving the house (or insert other daily functional activity here).  

Distressing anxiety is entirely different than Eustressful anxiety.  Dysfunctional anxiety should not be confused with functional, normal, or even peak situationally-appropriate anxiety (fear). 

So if I'm not going to refer to Fear, nor non-dysfunctional anxiety, how do I talk about the positive side of anxiety? The positive side of destructive, dysfunctional anxiety is that it lets you know that something isn't going right and it motivates you to make changes that you otherwise wouldn't make.  It also helps you deflect focus from areas where your control to make change is limited.

Social anxiety and other situational anxieties do a wonderful job of motivating us to change our behavior. The problem with them isn't the motivation, it's usually the direction or object that the anxiety focuses on for the change that's incorrect.  For social anxiety, the issue may not be that someone really is that awful to have around, but it may be that the person with anxiety has to spend more time picking up on social cues that don't come easily to them or to their own need to recover and regain energy away from other people. Motivation=good. Objective=not so good. 

In my practice, I find it very hopeful to speak with someone about their anxiety, because the negative, uneasy, self-destructive thoughts and feelings that they are experiencing help keep them focussed and motivated to make changes. There are so many people in therapy who aren't ready or willing to change. But you out there with anxiety-you are motivated! Someone will come in, work really hard on their problems and even though the anxiety starts to go away, they find that working on their issues is important for their own reasons. Without the anxiety they may not have been forced to make changes. 

So. . . did I dodge the question or try to use a technicality to get out of the obvious: that anxiety isn't positive and even test anxiety doesn't help you do better. It's just a horrible side-effect of our brain not being that great and dropping a topic after it's no longer useful. 

For most anxiety, it actually limits our brain's ability to make cognitive-based decisions about situations, decisions which may lead to better outcomes because they aren't clouded by misdirected motivation. 

Enthrive North here to help sort this mess out with you.

 

 

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