In an ever changing, fast-paced world, the demand for mental health professionals is growing. We have noticed an increase in more and more people reaching out for help to get through difficult times. While it is not easy to know that there are more and more people in need of help, we are happy to be here to assist people through it. Because of this, we have been expanding our clinical staff. There has never been a better time to book an appointment with us. We have day and evening appointments and our new clinical staff come from a variety of backgrounds and have many years of experience. Call today to schedule an appointment with one of our new clinical staff.
Jill Camm, LCSW-C
Milton, Hawkins, LCSW-C
Arlene Levinson, LCSW-C
Martha Monaghan, LCSW-C
Sarah Simpson, PhD
Karey Skinner, LCSW-C
Susan Tangires, LCPC
Marilyn Yunk, LCSW-C
There are many therapeutic models for helping couples having trouble in their relationships.
The model I have found most successful is a communications model. This approach begins with the assumption that problems in relationships begin when the couple stops communicating well. Poor communications can take the form of distorted messages or simply the lack of any message at all.
I like to compare it with the Rorschach inkblot that is sometimes used in psychological testing. The inkblot is deliberately ambiguous and this ambiguity allows the person being tested to project their own fears and imaginings onto the blot. The couple has a relationship field of information consisting of daily micro-encounters with each other. They include the words they speak, their gestures, their body language, their comings and goings, and even things as seemingly as trivial as where they sit in the family room to watch television. If this field is ambiguous, that is if there is little communicated meaning, one or both members of the dyad are free to project their own meaning onto it. If these projections are not reality tested, they are assumed to be true and over time build up a critical mass. Since us humans typically fill up information voids with “monsters,” the result can be ever increasing resentment and hostility.
The communication model assumes that poor communication is self reinforcing within the relationship. If one member, for example, starts to become resentful about her partner working long hours and not spending much time with the family, she may assume that he does not want to spend time with the family. In reality, he may be trying to make extra money for the family’s economic security or may simply be acting out an old work ethic he inherited from his family of origin. Her assumption causes her to be more distant, feeling that she is no longer loved. He picks up on her coolness and assumes that she is less invested in the relationship and begins, based on this assumption, to stay away more and more. Thus the cycle, which I refer to as a toxic dance, is set in motion and neither member knows how to call attention to it.
I encourage couples to start to notice the toxic dance and understand how it got started and how it built up its momentum. Thus, we will frequently go back to a time when communication was better and do a history to understand how it deteriorated. Frequently, it is some stressful event that the couple did not handle well: the birth of a child, an economic setback, the death of an extended family member or the chronic illness of a child. These events cause stress fractures in the relationship and frequently begin a cycle of non-communication, resentment, and distancing.
We may also visit the couple’s own family of origin to look at communication patterns each brought into the relationship. Did either come from a family that was conflict avoidant, or had trouble talking honestly about feelings, or used shouting or even violence to settle conflicts? Did one member come from a family that favored strictness and routine in raising their children while the other came from a family that preferred a more casual and lenient approach? Was sexuality a taboo or difficult topic in one family and not in the other? Did one family emphasize frugality in spending and the other more spontaneity and a “live for the moment” approach? Did one favor a hard work ethic and the other allow for playful spontaneity? These differences inevitably are brought into the marriage and create conflict. Frequently, the couples I see have been unable to communicate with each other about them so have been unable to reach a middle ground, have given up, withdrawn, and harbor a lot of resentment.
Under the communication model, infidelity is seen as a symptom of an underlying disease. Just as a physician would not treat a patient’s dangerous fever without looking for the underlying cause, so I would not help the couple work past the infidelity without looking for the underlying cause of the affair. Frequently, it is an increasing lack of intimacy caused by growing resentment driven by poor communication. (This is not to excuse the infidelity but to give a reason for it, and I will not conduct marriage therapy with a couple while an affair is continuing). In my experience, most couples are able to come to an understanding of what caused the affair and their relationship actually becomes stronger.
The therapy will thus emphasize honest and direct communication. In session I will insist that both listen carefully to the other without interrupting, whether or not each agrees or disagrees with what is being said. I will look for ambiguous exchanges between the two and ask for clarity. I will note non-verbal communication in the session and inquire what it means. I will note asymmetries in communication such as one member talking much more than the other, and attempt to readjust the balance. I will constantly reality test what is said if I think there are hidden meanings, innuendos, sub-plots, or subtle put downs, I will demand clarity. The session becomes a practice for the couple. The goal is for the couple to learn honest and direct communication and thus immunize themselves from future problems. The goal is described in the old saying, “Give me a fish, I eat for a day. Teach me to fish and I eat for a lifetime.”
In the vast majority of cases I have found that this approach brings relief to the couple in a reasonably short amount of time. However, certain characteristics of one or both members of the couple may impede progress and cause me to recommend individual therapy before the MT can proceed. In these cases I will suspend marriage therapy and refer one or both partners to a provider I believe can help them.
Substance abuse. When one or both members are chemically dependent, progress in marriage therapy is impossible until the substance abuse is treated. This is true because for the person dependent on alcohol or drugs, the focus is on the substance and not on fixing the relationship and the whole relationship is conditioned by the addiction..
Narcissism. A person is narcissistic if he or she must erect and maintain a grandiose persona that needs constant affirmation. This persona, which is a defense against feelings of worthlessness, cannot abide criticism, no matter how gently or constructively offered. Improved communication often cannot penetrate this need for constant stroking as it operates on a subconscious level and the narcissist has little insight about its function as a defense mechanism.
Passive Dependence. A person adopting a stance of extreme passivity and dependence creates huge problems in the relationship. This person is not able to adequately assert and verbalize their needs as they are always deferring to their partner. Thus, an asymmetrical dominant/dependent relationship is maintained. Individual therapy is often needed in this case, both to uncover the origin of the dependency and to work on assertiveness.
Perfectionism/Control Issues. If one partner demands perfection of the other and insists on rigid control of their behavior, communications training alone often cannot help. Frequently control issues manifest as excessive neatness, an ongoing effort to make their partner over into what they view as a better person, or unreasonable jealousy. Often, this characteristic comes from early trauma. Individual therapy is required to uncover the origins for the need for unreasonable control and to practice letting go of it in ordinary life situations.
Borderline Features A borderline client has little sense of a self and desperately clings onto their partner in what I call a Velcro relationship. There is little room left for the partner to be an individual. Small disappointments and short absences are treated as disasters. Feelings about the other switch rapidly and tend to be absolute, that is, the other is vilified or idolized. Individual therapy is required to retrain the borderline person to tolerate reasonable separateness and to modulate their “roller coaster” feelings about the other.
submitted by: Jerry Lawler, PhD
The National Center for PTSD has designated June National PTSD awareness month. PTSD has become a household acronym in the US but do we have an understanding of what it really is? Let’s talk about some history. Post-Traumatic Stress Disorder (PTSD) gained notoriety during the Vietnam war in the 1970s when the phrase was coined, but symptoms were being detected in military service men back during the second World War where people classified it as “shell shock.” It was not until the 1980’s when the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) classified it as a diagnosis. Since that time research has taken off and in the recent years it has gained more attention.
Here are some basics:
PTSD is a stress reaction to a traumatic event lasting longer than 3 months causing impairment in home or work life. Many people report reliving the event and the feelings of the event, hypervigilance, anxiety, nightmares, poor sleep, avoidant behavior, difficulty concentrating, and dramatic changes in beliefs or feelings. Although PTSD is more frequently seen in military population, many other people who have suffered a trauma can be living with it. Many people seek counseling and medication to help overcome the symptoms. Learn more about PTSD at the National Center for PTSD. If you or someone you know is struggling with PTSD and are ready to start counseling, please contact us today. We have therapists who work with individuals with PTSD.
submitted by: Steven Plummer, LCPC
I read an article on Psychology Today that talked about being “emotionally contagious.” What does that mean, you might be asking? In essence, what you express through nonverbal communication can influence others around you. You might be able to conduct a little “experiment” yourself around your office at work or even at home with your family and notice this very quickly. If you are happy and your body language shows others that you are happy (smiling, upbeat, open posture) you might notice that the mood of others around you improves. The inverse of this is likely also true. If you are having a bad day and you shut yourself down (poor eye contact, folded arms, low energy) you may notice that people will start to reflect some of that behavior. You may be thinking, “wow, how full of yourself do you have to be to think that the way you act influences people that much?” But it’s true! Much of who we are as humans relies on our interactions with other humans and sometimes if we are down or are having a bad day, having that one or two people around you that can brighten your spirits can dramatically change that. This is also a good lesson for us to take a look at our own behavior and what we put out in the world. Many times we choose to let bad days ruin our mood. Making a positive choice to have a good day or positive attitude can not only improve your mood but the mood of those around you. I try to make every effort when I can to examine myself during the day to see what I’m putting out in the universe and how that affects my clients, coworkers, friends, and family. I hope that you will take some time each day to reflect and say to yourself “how am I really doing today?” If the answer to that question is more consistently, “not well” consider talking to one of our dedicated professionals who are here to help.
submitted by: Steven Plummer, LCPC
April is National Counseling Awareness Month!
April is National Counseling Awareness Month. This time is set aside to not only honor those professionals who do the work, but to help people understand what counseling is and how it can benefit them. There are lots of benefits to going to counseling and yet some people still do not reach out. So let’s talk some basic facts. What do you know about counseling?
What is the difference between a counselor, a social worker a psychologist, and a psychiatrist?
Each of these professionals provide some form of counseling and differ just slightly in their training and/or amount of time they spent in their training program:
Licensed Psychologist (Ph.D. or Psy.D.): Doctorate in Psychology; 4-5 years of school and at least 1-2 years of post-doctoral experience providing counseling and/or psychological testing.
Licensed Clinical Professional Counselor (LCPC): Master’s in Counseling and minimum two years post masters providing counseling.
Licensed Certified Social Worker – Clinical (LCSW-C): Master’s in Social Work and minimum two years post masters providing counseling or clinical social work.
Psychiatrist (M.D.): Medical Doctor with specialization in psychiatry; often prescribes medication. Psychologists, Counselors, and Social Workers cannot prescribe medication.
What is counseling?
A collaboration between a professional and a client to work towards a common goal of relieving stress or lack of coping by addressing problems that often relate or influence relationships, work, or other areas of functioning.
I thought only crazy people needed counseling…
Counseling is still very stigmatized in our society but the truth is that most people at any given point in their lives can benefit from having someone that is not their family or friends to help with a problem.
How does it work?
In general, you meet with us once a week and talk about some of the problems on your mind. We will listen to you and work with you to find out what is going on and how to best help you. Many people feel anxious or worried about coming to counseling for the first time. This is normal. The important part is to remember that we are here to help and not to judge.
These are just some basic facts. If you’d like more information, Check out this fact sheet published by the American Counseling Association.
If you were thinking about going to counseling, there is no time like the present. We’re ready to support you!
submitted by: Steven Plummer, LCPC
We sometimes hear from clients “I tried therapy once and it didn’t work.” or “Having to go to therapy is a sign of weakness.” These are preconceived ideas that therapists run into on a daily basis and often have to work with the client to dispute these perceptions. We often ask clients what their idea of therapy is to gauge what the client’s understanding is of what we do. I often explain to people that therapy is a place for people to talk about their problems and help get ideas about how to address these problems so that they can begin feeling better. This of course, is a very general statement about what goes on in therapy. Therapy can be a powerful tool that allows people to explore many aspects of their lives, their backgrounds, and goals for the future. I came across an article that made me think “I wish anybody considering therapy would read this.” The author addresses 10 things that, through her experience, she wanted to share with the public about therapy. She highlights the importance of trust in a therapy setting, dispels some of those preconceived ideas that people have about therapy, and what some of our feelings are about what we do with clients. I hope that if you are considering seeing a therapist that you will read this article and it will help you make your decision. I also hope that if you find yourself wanting to begin therapy that you will contact us so that we can help start that journey with you.
submitted by: Steven Plummer, LCPC
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