Wednesday, June 30, 2010

Breaking Open: Growing Through Grief

I wish there was some way to wrap yourself and the people you love in protective bubble wrap, like they use to prevent fragile things from breaking in the mail. The human experience seems to include highs and lows, and most people get a turn at experiencing loss. While the journey of grief is difficult, people can grow and be tenderized by it if they work through it completely. I notice I am often drawn to people who have experienced some loss. I respect the personal growth that can develop when we let grief break us open, rather than let it harden and embitter us.

Early in my counseling career, I provided hospice counseling for individuals who were dying, and for their families, before and after losing their loved one. Those two years, and the meaningful conversations I was privileged to have with those people, changed my life forever. Facing your own death, or coping with the death of a close family member, really puts the rest of life into perspective. I was about thirty at the time and starting my family and career. I remember sitting with several individuals in their homes and gently reviewing their lives with them; the joys and the sorrows. I recall promising myself never to get caught up in the stupid little stuff in life and lose the big picture. We are all temporary here. So are the people we love.

At work in my counseling office this week, I was reminded how much loss is a part of our lives at every age. Losing a love through a break-up at 20 can be every bit as difficult as a divorce later in life. The hardest kind of loss is the one you are going through. Comparisons don't seem to be helpful.There are other kinds of loss that impact people as well: losses of jobs,moves,financial setbacks,homes, dreams,health challenges. Emotional support at thse pivotal life moments is of critical importance. If you don't have enough, getting grief counseling can be very helpful in resolving your feelings about the loss and not staying stuck.Loss is less complicated if you deal with it as soon as possible and don't numb it or avoid it.

When we experience a loss, we need to mourn. The degree of mourning depends on the amount of attachment that you felt.It is also influenced by the timing of a loss, whether it was sudden or expected, if you were at peace with the person you lost, your coping skills and personality, and the quality of your support system. Writer and psychologist J.William Worden identified 4 emotional tasks of mourning. They are:

1.To accept the reality of the loss

2.To experience the pain of grief

3.To adjust to your environment with the loved one missing

4.To withdraw the emotional energy from that relationship and apply it to other
relationships in your life.

Resolving grief is so important, because grief, like back pain, is cumulative.It will pop up again later if not dealt with.It can be useful to understand what normal grief looks like. Feel free to contact me if you would like specfic book recommendations on growing through grief. Loss comes to us uninvited, but if we can mourn and process it on a deep level it can give our lives so much meaning, and the sweet times even more precious. People that break open to the journey of grief, and go through it, find lots of good things on the other side of that valley.

Monday, June 28, 2010

Most Effective Treatment for Depression and Anxiety

Signs of depression or anxiety are often concerns that bring people to meet with a therapist.You may be having sleep difficulties, either getting to sleep initially, or waking up in the middle of the night,and not being able to get back to sleep, or sleeping more than is normal for you. Perhaps it is hard to concentrate at work or school.You may notice that you are not looking forward to anything or not enjoying life as much as you used to. Gaining or losing weight, or having difficulty relaxing, could also be indicators.

In the July,2010 issue of Consumer Reports there is an article with survey results of their readers who have sought professional help for depression or anxiety. Here is a summary of their survey results from consumers:

1.Talk therapy helps.Those people who did participate in at least 7 sessions had as much improvement as those who took medication.Those people who did both talk therapy and medication did even better.Almost always, talk therapy is a good place to start, and that therapist can refer you on for medication if you are not improving after a few weeks.

2.Cognitive behavioral therapy is the best treatment of depression, anxiety, and those who have a mix of the two. CBT teaches you to retrain your thoughts, identify thoughts that are making you feel worse, and develop healthier behaviors and automatic thoughts.

3.Type of therapist doesn't matter. In the Consumer Reports survey, different mental health licensures( MA,PhD,MSW)all received equal helpfulness ratings.The quality of your relationship with the therapist and their knowledge of cognitive therapy and other effective methods is more important.

4.Talk therapy is a good investment in yourself. It has no side effects, and teaches you longer-term strategies for managing stressors.Individuals who stuck with talk therapy for 7 or more sessions did signifcantly better than those who went 6 or less times.

5. Some medications are better than others.Each person can react differently to medication, and side effects can occur. If medication is needed, a doctor who can closely monitor your use of it is very important.

6. Be selective in finding a therapist to treat you or a loved one. Asking other trusted medical providers, friends or family for personal referrals usually gives a better result than cold calling a therapist from the phone book.

Children can also suffer fom depression and/or anxiety, it just presents differently.
Depression and anxiety both respond well to treatment, so there is no reason not to get professional guidance. Most of us wouldn't do our own car repairs, either. I see it as a sign of strength to know what your limits are, and seek help when you reach them. You are worth it.

Wednesday, June 23, 2010

Excuse Me, While I Check My Text Messages and Other New Relationship Tests

It is a brave new world figuring out how modern technology fits into our close relationships, and learning how to turn it off at important times. The temptation to be constantly available to everyone,by cellphone,texting,blackberries, and our mobile devices is creating some strange and unanticipated results.Let us take a moment to question why we need to be plugged in so often, and what the impact is on us and on our relationships.

Interrupting a conversation to take a call or check or send a text message makes the person you are with in person feel unimportant and irrelevant. I have had children tell me they can be spending precious one-on-one time with a busy parent and feel incredibly hurt when mom or dad is distracted from their activity by their phone. It makes you feel the other person is not present. It feels bad. I can remember taking a walk through Central Park in New York city a few years ago and watching a father and son out in a boat together on the lake there on a beautiful, sunny, summer afternoon. The young boy was filled with delight, seeing a family of ducks with several baby ducklings swim close to the boat. He squealed with delight, and turned to share his find with his dad, who motioned for him to be quiet while he finished his cell phone call. Five minutes later, when dad was finished, the small boy was over it. His dad missed sharing all the joy of that moment. From my spot on the shore I wanted to cry. Or throw the man's cell phone in the lake.

In the early stages of a relationship, we make interpretations about the other persons' intent or interest in making us a priority and giving their full and undivided attention. I have heard of Generation X and Y dating experiences where one person is texting throughout the date. Check please. That is just rude behavior. If you are that busy, you should have canceled or rescheduled.Or do yourself and potential partners a favor, and get some counseling before you begin dating, to work through your lack of emotional availability.

In their recently published book, Married to Distraction, by Edward and Sue Hallowell, both therapists,they do an excellent job at portraying the modern challenges couples are facing daily to maintain intimacy in an age of constant interruption.They even have a 30-day plan of attack on dealing with this, most of which involves turning OFF the technology, talking with your loved one, asking each other open-ended questions to get the interaction going, and having some high-energy fun together. Leave the cell phones off or at home. This isn't rocket science. It is reprioritizing the important people in your life above the need to be in the know and connected at all times. Turning everything off tells the person you are with that "you are the most important thing right now, other stuff can wait".

There are some human interactions that should never be reduced to a text message. You can't get the tone or the nuances of a voice conversation or a face-to-face chat.
Lots of miscommunication can occur through text messages. It can be difficult to identify sarcasm or intent.Sometimes using a text message can be a cute little connection to your child or partner while you are apart(<3), which could be a positive,relational use of technology. I have had teens tell me about break-ups by text, which is hurtful and impersonal.Technological advances are fine, but we each need to think through situations and times when using it is helpful or destructive.

Modern technology also provides a level of secrecy and anonymity to interactions that can tempt even good people to do or say things that they shouldn't.If you are a teenager, posting critical or inappropriate things about others is unwise and gutless.Parents need to be aware, and frequently advise their teens of the risks invoved. If you are in a commited relationship or marriage and you are having secret text, email, or phone conversations with other potential or past partners, you are hurting your relationship and being dishonest. Secrets are destructive to relationships. How would you feel if your partner dishonored you in this way? Your relationship can only be as good as both people's ability to protect and nurture it.Great couples' relationships require that both people have the maturity to set boundaries that protect the sacred trust between the two. Personal integrity is absolutely the key here, and not allowing current technology to assist you in ruining something wonderful.

It is important to take some technology breaks with yourself as well.You can turn it off at certain points in your day and just be present, breathe, relax. You can notice the world around you and the way the light shines through the clouds. There is a subtle,"always on duty" mentality with being tied to any technology that keeps you keyed up. Guess what? Empower yourself. You can rechoreograph that routine. Turn it off before dinner, or on weekends,or when you need time by yourself or your favorite people.Don't take your blackberry to yoga. It is a conflict of interest.

Finally, there is a narcissistic cultural bent to feeling that any of us is so important that we can't turn off the access the world and technology have to us at times. In an era of people twittering and facebooking their day to day activities and experiences, it is good to keep our own self-importance in check. Using technology can be helpful to our relationships or hurtful. Insight and awareness about how our behavior affects the people closest to us, and how frantic it is making us, are essential. We want to use technology to enhance, not have it cheapen or hurt our relationships.I don't want you to miss life's most tender moments while you check your text messages. :)

Sunday, June 20, 2010

49 UP/ The View at Mid-Life and Beyond

I rented a really interesting DVD from Blockbuster this week called "49 UP". It caught my eye in the documentary section because it had a rave review from Roger Ebert,the film critic, who called it brillant and noted that the "UP" series of films is on his list of the ten greatest films of all time. I would recommend it highly to anyone in their 40's or beyond who is reflective and introspective about their own life and other people.

The film is by noted British director Michael Apted and is the most recent installment in a series of films which began interviewing 14 children from diverse socioeconomic backgrounds in 1964, when the children were each 7 years old. The first film was Seven Up, and has been followed with editions when the children became 14,21,28,35,42 and this film made in 2006 when they were each 49 years old. Apted hopes to follow up as the subjects turn 56 in three more years if he can keep all of the participants involved and hopefully everyone is still alive.

I found it fascinating when Apted flashes back to earlier conversations with each person at different ages. They open up about their lives, challenges, love relationships,parents, children, grandchildren, work, mistakes, vulnerabilities, hopes and dreams. Apted does a beautiful job of interviewing the people with compassion and insight, and in their home and lives. You get an intimate portrait of each person, as they move across their life journey.

The director set out to test the Jesuit belief that if you "show me the boy at 7, I can show you the man he will become". Apparently so, at least with the British people in this film. Flashbacks to earlier interviews become predictive, as we watch children at 7 explain what they care about, what they want out of life, and what their fears might be. Most interesting is how they are impacted by their parents choices,early family life,and goals or a lack of them.

The viewer can't help but to reflect on their own early childhood experiences, choice of life partner, career and decisions about whether or not to have children.
All these pivotal life choice moments, and then your own natural temperament and level of resilency, combining to make you uniquely you. We each end up writing our own life story, but as this excellent film reveals, we each start out with our own unique ingedients. We don't get any conscious choice of where we start out in life, and sometimes we only have a choice about our responses to our situation.

Recent research in Psychology shows that self-esteem drops from age 18 on to about age 50, when most people begin to feel better about themselves. I certainly saw this upswing in self acceptance and confidence in this film, when many of the subjects had been struggling with their lives, and less happy earlier at 35 and 42. By 49, people were more at peace. In her book, The New Passages, writer Gail Sheehy observes something similar, that the mid-life crisis is real for many people, and when our crisis in meaning is resolved, we feel better.

I am 49, so I look forward to that peace and confidence of mid-life arriving soon. I wonder if it arrives Fedex or UPS? This was in inspired storytelling project, and allows us the opportunity to introspect on how far we've come, and where we are each heading as we reset the course for the next part of the journey. I still have lots of fun and meaningful things I want to see and experience with the people I love, and I bet you do, too.

Thursday, June 17, 2010

Going the Distance with your Teen

Can you remember what was like to be a teenager? It is a difficult time for many people. You worry about grades, getting in to college, what friends think, if girls/guys like you, teachers, parents, choices, breaking out, first love, first break-ups, disappointments. Many adults would never want to relive it. In the long journey of raising children, hanging in there with your teen with support and compassion in the final part of the race is so important. Even when they push back.

The job of parenting changes over time, but it is so gradual sometimes that we don't notice it. Noone announces the transition. It can feel so wonderful as the parent when your young child wants to hold your hand when you are walking with them or include you in their play. I miss playing candyland and polly pockets. It felt so close and warm when they hugged you or told you everything. One day it's different, and its a new ballgame all together. Parents have to adjust, too. When parents dream of having a family, they are not usually thinking of a teenager with their own opinions whose job is individuating and pushing away from you to define their sense of self.

What can parents of teens do to go the distance with your son or daughter in the challenging teen years? Here are some tips:

1. Listen to them. Ask for their opinion.

2.Show up for their important events. Teens notice even if they don't say anything. Show up for school and sports events. Show up for choir concerts and award ceremonies. Even if they don't
say much, they will feel your support.

3.Point out their strengths. Let them know what you notice about what they are doing right. Teens are hungry for encouragement.

4. Be an approachable parent. Think of the qualities you would look for in a friend you would open up to about a problem.

5. Help your teen find an area of enjoyment or mastery outside of school. Something they can feel good about.

6. Share your life skills with your teen. Self-esteem comes from feeling capable. Make sure your teen has independent living skills. Can they manage money? Do their own laundry? Know how to apply and interview for a part-time job? Cook a few meals for themself? Drive and put gas in the car? Know the basics of how to keep the household running? Ask your teen for other skills they would find helpful. They will thank you when they get to college and are not helpless.

7.Help your teen accept loss. Part of preparing a teen for life is helping them accept that any time you take a risk, try out for something, ask someone to a dance, etc., you may get dissappointed. BUT YOU CAN GET THROUGH IT. You probably didn't get everything you wanted either. Better to learn this lesson as a teen about needing to be resilent than waiting til later in life.

8.Help your teen construct a plan for their future. Let them know how you can help them--- or find someone to help them make a plan for what they will do after high school. They will feel less alone.

9 Be watchful for changes. A change in grades, friends, sociability, eating or sleeping patterns may signal something is wrong. Ask your teen about what you are observing and consult a counselor if you are concerned.

10. Keep looking for new, age-appropriate ways to spend time with your teen, not lecturing or grilling them. Just catching up and checking in on how they are, what's up with friends and such. Your teen will appreciate that you are trying to connect and bridge the gap. Sharing a meal out together or an iced tea at Starbucks could be a start.

11. Keep the dialogue going.

12. Get to know their friends. Let them get together at your house sometimes, and be around serving snacks.

13. Avoid entitlement. It really isn't helpful in the long run to give them everything or overprotect them.

14. Keep an eye on facebook. Consider setting one up yourself and friend them. Be watchful about skype use. Go over rules for cell phone use, hours, etc. Be aware of cameras on cell phones. Teen brains are not finished developing, and they can do impulsive things that can hurt them.Pay attention and keep talking about appropriate and inappropriate use of technology and social networking. It's a whole new world for this generation of teens.

15.Keep demonstrating your values. Teens see the way you treat your spouse, your coworkers, other drivers, servers and everyone else. Your behavior, integrity, and demonstrated character is more powerful than anything you can say.

Launching teens is harder than most of us expected. As they get ready to go, they can be our harshest critics and identify need for changes in us and in our families. The challenge we have is to stay commited, caring, and present until our teens finish the race and successfully enter adulthood. We may look back at these years and smile,too.

Sunday, June 6, 2010

Have You Had Your Encouragement Today?

Most children, teens, and adults that I know could use some encouragement. Somehow, as life gets busy, we can forget to tell the important people we care most about what we like about them. This post is an encouragement to begin noticing and acknowledging---in spoken and written words---the best that you see in your loved ones.

Encouragement comes from the french root "coeur", meaning heart. So when we encourage others, we give them heart, making them fortified for the challenges they may face that day. Life has all these automatic systems for discouraging us. We may try for a goal and fail at school or at work. We assume risks in trying to make friends or build a love relationship. Everyday that we get out there in the world affords the possibility of rejection or disappointment. We each need a key person in our inner circle who points out what we are doing that is working, and reflects our strengths back to us.

One researcher found a ratio of 10 negative comments that children get from parents and teachers daily compared to each positive comment. It is understandable why this happens. In a busy classroom or hectic family life, it is the things that annoy us that pop up first. Parents may notice a grade that has dropped, a backpack left out to trip over, or whining. Catching a child being responsible, helpful to others, or showing strong effort are all welcome, positive messages that your child longs to hear. It is also a wonderful tool to help encourage more of that positive behavior, by the spotlight given by adult attention for it. Most parents underestimate and underutilize the influence they have by going for the positive whenever possible. Can't you still remember the times a parent or a teacher recognized and acknowledged your contributions?

When you encourage, it works best to be specific about the action or behavior you noticed and what impact it had on you. For example, thanking a teenaged daughter for taking the initiative to unload the dishwasher without being asked, or commenting when an older child helps a younger one with a homework problem and remains patient. Letting a child or teen know the specifics is much more meaningful than a vague or general compliment (i.e. "you're a great kid"). Noone ever has the same potential to encourage as parents do, and it has touched me over my years talking with people in counseling about how much children long to have their parents' acknowledgement as being worthwhile, valuable, and wanted.

For over ten years I taught Active Parenting classes, and one of my favorite homework activities in the class was having each parent go home that week and write a letter of encouragement to each of their chidren and leave it on the child's pillow. The feedback the following week was always so special in class. Several children saved their notes on their bulletin boards for a long time afterwards. I remember one big, burly dad who teared up when he reported that his son didn't recall ever being told or written " I love you" from him before, and it meant so much.

Don't forget to encourage your partner, either. One book I read earlier thas year about couples and personality style differences gave a cute example. A husband, married many years, told his underencouraged wife, " I told you I loved you thirty years ago, if anything changes, I'll let you know". Adults can feel wildly underencouraged, too. Be a positive reflecting mirror for your partners' strengths. Research on happy couples shows that they often see the positive in each other and comment on it. These couples often encourage their partners' strengths and bring out their best self. Happy couples more often give their partner the benefit of the doubt and see their parners' goodness rather than focus on imperfections.

Encouraging those who work for or with you matters ,too. Studies show many employees care as much about being valued as they do being paid.

Children can be taught that everyone in the family needs encouragement, and they can participate, too. Parents can use feedback from their children on what they are doing that is valued or helpful.

Go forward and encourage a couple of people you care about today!