Book Recommendation: Hold Me Tight

Hold Me Tight by Dr. Sue Johnson is a friendly, structured tool I recommend for couples looking to enhance their relationship. The book includes seven conversations designed to enhance your understanding of how you show up in your relationship, and how you “dance” with your partner. It covers the three common ways people fight, why some interactions feel so hurtful, how to really work toward forgiveness, and keeping your relationship alive over the long haul.

Who should read it?
Any couple who has been struggling with fighting, feeling distant, or wants to build understanding of themselves and their partner.

Will it be full of all that psych jargon?
I love this book in part because it is so approachable. Dr. Johnson gives clear descriptions and examples to help us understand the common patterns in relationships and ends each chapter with questions to ask yourself and your partner to tie it all together with your own experience.

What if my partner and I start fighting while we’re reading it??
A very common reason for couples to avoid therapy is the fear that shining a light on problems will make them worse. Totally understandable! It can definitely feel safer to stay in the problems you know, rather than risk things escalating. In my work with couples, I’ve found that most of us have the capacity to handle tough conversations, and actually long to share “the hard stuff” with our partners. Sometimes, however, our experiences make it feel impossible to verbalize our feelings to the one we love. If you notice this happening for you I’d recommend seeking out a trained counselor to help you navigate these conversations and walk with you through these painful parts.

Who should we contact if we need help?
I strongly recommend seeking out a therapist trained in Emotionally Focused Therapy. EFT was developed by Dr. Johnson and utilizes the theories she writes about in Hold Me Tight. Reading this book can be a great jump start to therapy and help you prepare for the work you’ll be doing.

What if I hate reading?
No problem! It isn’t a requirement for couples counseling. Also, there are Hold Me Tight workshops lead by trained therapists across the country. This can be a meaningful and fun way to connect with your partner and grow in all the areas covered in the book.

Please reach out to our office for more information or to find out if couples counseling might be a good option for you!

Managing Stress from Social Media and News Outlets

Managing Stress from Social Media and News Outlets

In our world today it seems as though our attention is always being pulled towards a screen. Whether it is a news station telling us the latest updates or social media telling you all the tips and tricks to stay healthy, the constant flow of information can be daunting. Many people who are working from home or trying to follow stay at home guidelines are constantly watching the news to know the latest updates for themselves and their family. However, when everyone can post their opinions it is hard to know what you should consume and not pay attention to.

Here are some tips to help cope with stress from screens and media: 

Limit the Amount of Time Spent on Social Media

This is beneficial because if you are on social media for too long you will be constantly exposed to new stories that can create worry that isn’t necessary.  Examples of limiting time on social media could be not logging into social media sites or apps, setting time limits, leaving devices in another room or charging device in another room.

 Make Sure Your Source of Media is Coming from a Verified Source

How often do you see news sources that are biased towards one side or the other?  Everyone on social media has a personal experience and opinion but what you allow yourself to consume should be factual. Finding credible news sources will allow you to know the information is true so you don’t have to compare it to a contradicting family friend on Facebook.

Connecting With Others Through Technology

We are designed to connect with others.  Connect with friends and family outside of devices.  So much of our screen time is spent on social media that we forget we can stay in touch with family and friends even while we are apart. If you need to use social media or technology to connect video calls, text, email, games are all great ways to connect with one another and keep ourselves from feeling alone. 

Focus on Yourself

Unplug, put your device away – focus on yourself for a set amount of time each day.  Spending too much time in front of screens and getting too wrapped up in media will leave you stressed and unsettled. Self-care is such an important act that many forget when they are overwhelmed.  Little things like physical activity, reading, and meditating can all help lower stress about the world around you and help you feel like you are in control.  

 

Even though there is a constant flow of information coming at us, filtering that can help us not feel so overwhelmed. Tips like these are helpful to live by constantly, finding a balance between news and social media vs real life experience is crucial to keep yourself less stressed. 

 

Therapist versus Friend

Does this sound familiar? “I really need to talk to someone.”  Or this one: “is it worth it to see a therapist?”

How about: “why can’t I just talk with my best friend? What will the therapist offer me that my friends won’t?”

Well, there are some differences between therapist and friends.

A therapist:

  • is trained (usually has a master’s degree) to listen without judgement or interruption. They’re trained to recognize shifts in emotions that need to be addressed, and to do so in a way that does not belittle or cause harm to you
  • makes you the sole focus for the duration of the session; for that 45-55 minutes, it’s all about you
  • provides objective feedback
  • comes into the therapeutic relationship with no preconceived ideas about you (your character, attitudes, beliefs, etc.)
  • won’t disclose what is shared (unless you tell them that you plan to harm or kill yourself or someone else, or you share knowledge of abuse or neglect of a child or vulnerable adult, or that you yourself are the victim of abuse); information shared in session will remain confidential and will not be used to harm you
  • helps you to make connections between your thoughts, feelings, and behaviors
  • provides a safe place for you to express your emotions without fear of reprisal or ridicule

A friend:

  • will likely listen to formulate a response and will most likely give their opinion throughout the duration of the conversation
  • doesn’t always recognize when your emotions are shifting, and if they do recognize the shift, they are often unsure of how to react
  • can’t always guarantee and that they’ll be able to provide you with of time needed to work through your problem
  • may be unable to remain objective; they may share opinions about what’s going on because they are actively involved in a personal relationship with you
  • sometimes (though it may be unintentional) inhibits your ability to be completely open and honest for fear that we will lose acceptance or be judged for what we say
  • knows your behavioral patterns, so they may not be able to listen without judgement or saying “I warned you about…”; their reactions and responses are usually based on the familiarity of your relationship
  • No matter how good a friend they are, there is no guarantee that what you share will be kept between you; whether on purpose or inadvertently, your thoughts and emotions may be shared with others

If you’re still unsure about seeing a therapist, remember that we are here for you. We see you and accept you as you are. We don’t tell you what you should and shouldn’t do; instead, we provide guidance to help you reach a healthy decision.

Written by Sherine Chambers, Stepping Stones Therapist

Mindfulness and ADHD: How to Curb the Impulsivity

There are three primary symptoms of ADHD, and their presentation is different in each individual. They are inattention, hyperactivity, and impulsivity. As you probably know, impulsivity is the tendency to act without properly assessing the consequences beforehand. For those with ADHD, increased impulsivity appears to be the effect of an under-stimulated prefrontal cortex, which is the area of the brain that controls the so-called “executive functions.” Hyperactivity often functions as a means to sufficiently arouse the prefrontal area of the brain, so that the person with ADHD can give sustained attention where it is needed.

But there is another way to curb the impulsivity. Those with ADHD can work to slow down their thinking, applying mindfulness to a situation. Here, I am speaking of mindfulness as the ability to become increasingly aware of what is going on inside of and around us. For instance, mindfulness can be as simple as taking an inventory of the objects in our direct vicinity, or as complicated as learning how to identify specific physiological sensations in the body. However it manifests, mindfulness tends to be characterized by slowness and an increased awareness of what is occurring in the moment.

The application for impulsivity is pretty straightforward: Slowing down and deliberately thinking of what is occurring in the moment protects us from making impulsive decisions. Instead of allowing our brains to run around in fifteen different directions at once—which prohibits reflection, we can center ourselves on a specific thought, or direct our attention toward a specific object or task. Over time, the idea is that our brains will become more proficient at doing this sort of thing, which means it will require less effort. Instead of our attention being automatically diffused, such that we cannot think through something, our minds will be settled and more attentive.

Impulsivity can be a major issue for people with ADHD. However, there are steps we can take to try and introduce protective factors against the frequency with which we act impulsively. This will reduce regret, and also lower our vulnerability to anxiety and depression. As we begin to observe more positive outcomes, we can grow more confident of our ability to make competent decisions.

Restructuring the Narrative: How an ADHD Diagnosis Can Change the Story

Excited about the prospect of solving a cold case, the newly appointed detective opened up the box of long forgotten evidence. He knew that the process would be tedious, but he also knew that a disciplined and thorough approach could pay dividends. Perhaps he would find something someone had overlooked, or maybe there is a piece of evidence that could now be submitted to more sophisticated testing methods, uncovering clues unavailable at the prime of the investigation? Whatever the case may be, if there was something new, they would have to reinterpret everything.

For some, they spent their entire childhood not knowing they were suffering from a treatable condition. Perhaps they didn’t draw enough attention to themselves to be noticed, or evaluated, as they remained firmly planted in the range of what was considered acceptable or expected behaviors? Or maybe they had an intuition that something was not quite right, but they never thought it necessary to pursue further investigation? And so, they developed a sense of identity around their functioning and interactions, drawing what seemed to be obvious conclusions. “My relationships tend to be unstable, mostly because I can’t handle my emotions.” Or, they said, “I’m not really that smart of a person. I haven’t ever done well in school.” Of course, these messages have implications, as they inform the person’s decisions, sometimes selling them short on what is possible.

But then, some of these folks get a diagnosis. This changes things for them. Drastically. Any time a new and significant piece of information comes to the forefront, we’re forced to reevaluate the case we once made. That is the connection between diagnostics and the forensic introduction I gave in the first paragraph. Sometimes a missing piece of the puzzle is uncovered, and this revelation becomes a catalyst for new and transformative developments. Old parts of the story can now be measured against a new standard of evaluation, which changes the conclusions drawn. For instance, the man who believed he was “no good at school” can reframe his understanding, replacing it with the more reasonable observation: I struggled because I couldn’t keep all the details together. That makes a difference.

Some of us react to the idea of a diagnosis with fear. We avoid even the acknowledgment of the possibility, because, to us, it somehow represents giving up hope—or waving our white flag to the possibility of a better future. To say it means it’s true, and if it is true, then it is also over. (Or so we tell ourselves). But we don’t have to take this approach. Instead, we can view it as an opportunity to reinterpret, and subsequently restructure, our personal narratives. As we gain knowledge about ourselves, we can update the storyline of our lives to better reflect the relevant facts. This can give us significant hope and reassurance—and hope is what keeps us coming back.

Sometimes a diagnosis, ADHD or otherwise, is like finding an overlooked clue in a cold case. It connects all of the formerly incoherent pieces together, creating something meaningful and redemptive. It can clear the record, exonerating us from the false allegation of “not being good enough.”

 

 

Adult ADHD and Communication

ADHD and Communication

The ability to communicate effectively is integral to the maintenance of long-term relationships. However, communication can be inherently difficult. This should come as no surprise, given we not only tend to have different communication styles—but we also tend to ascribe idiosyncratic meanings to our words. For instance, what does the term “good” mean in the context of the statement, “I had a good day?” The meaning depends upon the individual making the statement, and clarity depends upon us being able to contextualize what they say. That is, we have to ask questions, so as to get to the bottom of things.

If we have ADHD, or we are in a relationship with some who has ADHD, then the inherent difficulties with communication can be exacerbated. For instance, someone with ADHD might struggle with forgetfulness or inattentiveness. These characteristics can manifest in the way the person communicates with others. In the course of listening to us speak, for instance, the person with ADHD might have an attentional shift—being drawn away from our words, which results in missing out on key pieces of information. Or perhaps they initially received the information, but weren’t able to recall it. Then, when they respond, it can seem like they haven’t heard us, leaving us to assume that they weren’t listening, and perhaps didn’t even care about what we were saying. If that’s the implicit message we internalize, then it can negatively affect our future interactions with the person. Maybe we’ll choose to minimize our interactions with them, for instance?

What to do?

As the person speaking to someone with ADHD, one thing we can do is to make sure to keep the communication in context, accounting for the characteristics described in the previous paragraph. For instance, when we feel we are being neglected, or not listened to, we can remind ourselves, “Maybe they’re unable to recall what I said?” This may lead to the realization that we’re saying too much at once and perhaps contributing to the problem. If that’s the case, we can change our own behaviors to help the situation. As the person with ADHD, we can attempt to find ways to be more attentive during conversations. Perhaps choosing a specific place and time to talk would be conducive to attentiveness, because we could exercise more control over the environment. For instance, we could choose a place with less distractions, or a time when we our minds are not overwhelmed with one hundred other things to do.

The important thing to remember is that communication is a two way street. If we are committed to the betterment of our relationships, then we need to be willing to make whatever adjustments we can to help facilitate more effective communication. Better communication is a protective factor for the health of the relationship, increasing the probability of greater intimacy with the other person. We’ll never be perfect, because communication is too complex and varied. However, through increased knowledge of communication patterns, we can better insure productive exchanges, even if a person has ADHD.

Anorexia Nervosa in Adolescents

It’s that time of year again, swimsuit season! Imagine you have a “girls’ day” planned with your teen daughter complete with lunch, manicures and shopping. You’ve noticed your teen has lost some weight recently but attribute it to her time competing in cross country. But the glimpse you get in the department store mirror tells a different story. As you crack the door and hand her more suits to try, you are confronted with a shocking sight; a gaunt, emaciated, unhealthy adolescent stands before you. How did this happen? How did you not know?

Anorexia Nervosa can be very difficult to detect in the teen population. Young people that suffer from this disorder are usually adept at hiding their maladaptive behaviors from parents, teachers and trusted peers. Many problem behaviors leading to AN are acted out in isolation, making detection extremely difficult.

Anorexia is not just a diet. It is not a choice or a phase an adolescent will grow out of. It is not found solely in females; males are also at risk.  Anorexia Nervosa is the restriction of intake relative to the energy requirements needed for the teen. AN presents as extreme weight loss, or an inability to maintain a healthy weight. Those that suffer from this disorder value low weight as his or her primary source of identity and self-worth. This is accompanied by an irrational fear of weight gain or loss of control of eating. These adolescents have an extremely negative and distorted body image that impacts many areas of their lives. Many view an eating disorder as a way to establish a feeling of control and manage anxiety.

What are some signs of Anorexia Nervosa? Parents and teachers should look for rapid weight loss in their students and loved ones, even if the teen is above a healthy weight. The teen may refuse to eat certain foods or have odd food preferences. Some adolescents with this disorder have a high need for control and seem like perfectionists. Take note if the teen skips meals, won’t eat in front of others, or escapes to the bathroom immediately following a meal. Ask questions if your teen has stopped menstruating. Those that suffer from AN may enjoy cooking, watching cooking shows and vicariously watching others eat without partaking themselves. Dieting is the leading behavior associated with the development of Anorexia.

Anorexia has two main types. The restricting type involves limiting calories by diets, fasting or over-exercising. The binge eating/purging type involves purging by vomiting, diuretics or laxatives. Both types of anorexia can lead to life threatening electrolyte shifts, cardiac problems, bone loss, loss of cognitive functioning and damage to vital organs. Some are genetically vulnerable to anorexia nervosa and life changes or transitions (even positive ones) can trigger these behaviors.

Early intervention is crucial when diagnosing anorexia nervosa. These interventions enhance the chance of favorable outcomes in adolescent populations. When a child is diagnosed with cancer, what happens? Family and peers encircle the sick individual. Friends accompany the patient to chemotherapy and doctor appointments. Support is usually ample and constant, and the child is not left to fight the disease alone.

The same attention is needed when treating eating disorders. Hope can be restored with the aid of parents, teachers and clinicians. Family therapy is preferred as the entire family unit rallies around the teen suffering from AN.  Family Based Treatment (FBT) is an evidence-based treatment plan proven effective with anorexia nervosa. It utilizes parents as a resource and teaches adolescents that food is fuel.  Recovery is possible, and a multidisciplinary team approach is usually best including parents, physicians and mental health providers.  Treatment outcomes for adolescents are significantly better than for adults; there is hope for teens suffering from anorexia nervosa!

Resources for those that would like more information on eating disorders:

moeatingdisorders.org.

https://www.psychologytoday.com/us/basics/eating-disorders

Journal of Clinical Sport Psychology Special Issue: Eating Disorders and Body Image in Sport and Exercise, December 2018.

This information was in part compiled and consolidated from a lecture given by Laura M. Huff, Ph.D for The St. Louis Behavioral Medicine Institute.

 

 

Tis’ The Season for Increased Organization

The holidays are fast approaching, which, for many, means an already overloaded schedule is about to take on even more complexity. For those living with ADHD, the extra stress can have a cascading effect. Even more things to do often leads to even more things left undone. It becomes an ever increasing feedback loop.

 

What are some things a person with ADHD can do to help alleviate these circumstances?
First, write things down, or make an electronic note of some sort. Those with ADHD lack the internal structure necessary to organize daily tasks. Hence, creating and implementing external structures, such as written notes or setting reminders on their phone, helps to compensate for the losses. These act as both records and reminders, aiding in memory related issues.
Second, prioritize. Writing things down helps. But there needs to be a specific order of action. Often times, the complexity we face is due to neglecting more important things. If we can keep the most important things in the forefront of our efforts, then the lesser things often resolve themselves. This can help to alleviate the overall stress.
Finally, act as soon as you have the first opportunity. Many people who have ADHD struggle with procrastination. Putting things off until later, however, multiplies the amount of things to do in the future. And, of course, this can create anticipatory anxiety, such that it reinforces the procrastination. This can become another feedback loop, keeping us from ever doing what needs to be done. But if we can begin immediately, even doing a small portion, it can be a catalyst for more action.
The holidays don’t have to be more hectic than they already are. Keeping these few steps in mind as you go through the season can make things more manageable.

World Kindness Day

Whenever you turn on the news these days chances are it is not covering a very happy story. It’s likely about something involving violence, hatred, anger, tragedy, or disaster. For whatever reason people tend to latch onto what makes somebody different, with the impression that different equals less. That can make it feel like the world we live in is a pretty sad, desolate place. There just doesn’t seem to be enough positivity or happiness to outweigh all of the nastiness and disgust. Sometimes it feels like there is a lack of kindness.

If you dig deeper, however, there isn’t a lack of kindness at all. Rather, there is a lack of awareness of the kindness we encounter on a daily basis. There doesn’t appear to be a true appreciation for those people that share and exude kindness on a daily basis. So, how can we remedy that? Where do we begin? Well, November 13th is World Kindness Day, so perhaps we can use that as a springboard to bring kindness back into the spotlight. Here are a few suggestions.

Keep it up. If you’re somebody that already shares kindness with those around you, don’t stop! Although it can be easy to feel discouraged, the world needs your positivity and caring nature now more than ever.

Initiate. There may be an opportunity to share a moment of kindness with someone but you don’t necessarily want to stand out or draw attention to yourself. Don’t be afraid to be the person to share kindness! Chances are there’s somebody else that is watching and needs to see your example.

Notice. Look around you more often and obverse the random acts of kindness. You may be surprised by how many caring people you encounter without even realizing. That awareness will open your eyes to the beauty of kindness.

Defend. It’s typically people that are marginalized in society that are on the receiving end of hatred, violence, and anger. If you see someone that can’t protect themselves or is viewed as “different”, be their defender. Stand up for them and help them realize that they are in fact valued and loved.

Nudge. Sometimes people need a gentle reminder that their actions are wrongfully motivated or are outright harmful. Push those people back in the right direction by reminding them what true kindness looks like.

Empathize. Put yourself in the shoes of people that are different than you. Instead of responding with judgment try and understand their situation in life and how a simple act of love can be just what they need.

Support. Kindness can take many different forms. It can be an outward act of giving and caring. Sometimes, however, it’s just being a simple ear to listen to or shoulder to cry on. Be the supportive presence in the lives of those that are struggling.

Seek. It’s one thing to be more generally aware of opportunities to share kindness. It’s another thing to actively find and create those moments. Don’t just be complacent with acknowledging the kindness around you – be somebody that makes it happen for other people to notice.

You may think that kindness has vanished from the world. Depending on where you look there may be some truth to that. However, kindness still exists. It’s still present. And it still makes an impact. Instead of letting negativity, hatred, and despair dictate how we view the world, let’s flip the script. On World Kindness Day, on in the days to come, let’s view the world through a lens of kindness.