Healing the Heart Through Art and Music

Art and music can both be excellent mediums to help you access and process memories, feelings and experiences. I was reminded of this while working with one of my counseling clients recently who is learning to cope with a family member's life threatening illness.

Music can be a universal resource. It can help an individual who is grieving to process the loss, perhaps by evoking memories of music that reminds you of the beloved. A chill playlist on your phone or tablet can be the perfect way to calm down for 20 minutes when you are stressed, flooded emotionally and need to cool down so you don't lash out at someone you love. Then, when your cooler head prevails, you can productively discuss the issue with the other person involved.

Music is also a creative parenting strategy. Trying to help engage preschoolers with assisting you in cleaning up? Dealing with a grumpy, tired preteen or teenager in your car after school? Looking for subtle ways to lift your mood in the morning? Wanting to create a warm, loving atmosphere at home? Creative use of music can fit beautifully in each of these scenarios. Teens love to school parents while in the car commuting about what kind of music they like, and this is a great way to build a bridge to them emotionally. If little ones are squabbling, drown them out with the score to Hamilton. Music is also a beautiful part of a bedtime routine for parents and younger children.Think outside the box on your selections.

Music reaches us in amazing and deep ways. I can remember as I began my counseling career working with hospice patients, their families and a wonderful music therapist in a hospital and on home visits. Some patients were unresponsive until the music therapist brought out her auto-harp and played hymns or songs they loved as children. Patients who were unresponsive began to move a little or respond in ways that hadn't been seen in days.

I often use art---drawing, painting, collages and art projects--- while working with children and some teens who like creative activity as a way to help them relax and be able to access feelings in counseling sessions.It can make children and  teens less self-conscious while they are sharing.

We know that art, like music, can take you into a deeply relaxed state of mind where you can free up your ability to feel and express emotion. There are places that art and music can take you that words cannot touch. Here's a little art experiment to try on your own for using art to heal.

Find a quiet place where you can work uninterrupted with some paper or canvas art board and some acrylic paint in multiple colors.

Pick two colors to work with to express your feelings.

Paint one area of the canvas to represent something that is negative or difficult in your life now, and that you hold some upset or angry feelings about.

With the second color, paint a place that represents who else is involved in the situation that is upsetting you.

In another place on your canvas, paint about the consequence of this situation that is upsetting to you or that you are holding on to anger about.

Next, consider something in your life that brings you happiness, joy or light in your life right now. Think of something or someone you are grateful for. Paint a section to represent this positive element, person or situation.

If you wish, you can either reflect on what shows up in your painting, or share it with someone you trust.

Both art and music allow us a path into our interior life and access to emotions that might not be reached just with words. In the words of Victor Hugo,"music expresses that which can not be said and on which it is impossible to be silent." Painter Georgia O'Keefe wrote of making art that, "whether you succeed or not is irrelevant, there is no such thing. Making your unknown known is the important thing." Think of creative endeavors with art and music as a tool and a resource to explore what you are feeling, process emotions and help you shift a mood when necessary, in a healthy way.

Family Therapy: Still Effective After All These Years

Times change, but family therapy has stayed relevant for families over time. Family therapy is empirically supported and clinically effective. Clients report marked improvements in relationships, functioning and emotional health. In the April 18, 2016 issue of Time Magazine, one reporter shares her own recent experience in family therapy. Read the Time article here.

Why Sooner Is Better For Couples Counseling

Men can be reluctant to come in for counseling. Often it's their partner who talks them into coming. Men can be depressed and not want to talk about it. Sometimes women start the conversation about getting couples counseling, and men can drag their feet until the marriage is at a breaking point.

It makes me sad as a couples therapist to see people delay and let a relationship deteriorate without getting professional help. Divorce is expensive and emotionally difficult for both adults and the children involved. Why ignore the signs of relationship tension, your distress or your partners? What if you wait too long and it's too late to save things?

What if we shifted the paradigm to working on couples or individual concerns when they are still small? I think we could prevent a host of relationship cancers developing. Even a tune-up, a couple of sessions with a couples therapist can help you get things back on track, more connected and communicating better. Sooner is better!

What are signs a couple should get some counseling, because there are couples issues developing?

1. One or both partners feel unappreciated.

2. Physical affection is tapering off or stopped. You don't hug, kiss, hold hands or have physical intimacy. You can't talk about your physical needs and preferences with your partner comfortably.

3. You are completely consumed by your children's needs and there is no energy or time left for you as a couple.

4. You can't recall your last date night with each other.

5. You are sleeping in separate bedrooms, or different places in the house.

6. You feel misunderstood on a frequent basis.

7. Your partner won't listen.

8. You can't solve problems together.

9. You're not having any fun together.

10. You don't feel respected by your partner and/or you don't respect them.

11. You or your partner are not emotionally available for any reason: working too many hours, alcoholism, substance abuse.

12. Your parenting styles conflict. One of you always has to be the bad cop.

13. One or both of you shut down, pout, threaten divorce, swear, rage, scream or otherwise make communication impossible. You can't fight fairly.

14. One of you doesn't set appropriate boundaries with others: your family or friends of the opposite sex.

15. There are difficult conversations you need to have with your partner, but you don't feel safe to have them.

Any of these relationship issues is so much easier and quicker to fix sooner rather than later. While counseling is a cost, you must consider what your happiness is worth. If your relationship isn't satisfying, not much else in life is enjoyable. When it comes to solving couples, family or individual counseling issues, recognize the value and intelligence of a tune-up rather than waiting for the point of no return. Why suffer with a mediocre relationship, when you can co-create something much better with some coaching and effort? Life's too short not to go for the marriage you really want. It makes me so happy to be a part of making that happen for couples.

Choosing a Therapist and Making Therapy Effective

In a recent issue of the Wall Street Journal (9/25/14), they ran a helpful article by reporter Elizabeth Bernstein in the Health and Wellness section about how to choose the right therapist. It got me thinking about how important it is for patients to be active in the process of choosing a therapist, and then to actively participate in therapy in order to get the highest benefit from it.

Choosing a therapist is a very personal choice. You need to select someone who you can feel comfortable with, and open up with. You may not know where to start the search. Here are some things to consider:

1. No therapist is an expert at everything. Most therapists have a scope of practice. Ask potential therapists about their areas of practice. Do they see adults? Teens? Children? Couples? Families? In general, MFT's (marriage and family therapists) have special emphasis in helping with relationships. Psychologists do testing as well as individual counseling. Psychiatrists assess for medication. Social workers have special training with linking to community resources, and LCSW's have experience doing counseling as well. Find out how many years they have been in practice. Make sure they hold a state license in their field.

2.Ask people you trust for referrals. You can get names from friends, family members, co-workers, your child's school counselor, your family physician, the pediatrician, your Ob/Gyn. Think about whether your preferences (gender, age, language). Even if you are bi-lingual, most people feel more comfortable speaking about feelings in their first language.

3. Check the therapist's website. It should give you some ideas about their background, experience, training, specialties and office location.

4. Call several therapists. Start by screening them by phone. You should get a call the same day you call if it's a weekday, unless their message says they are out of the office. Responsiveness is important. Ask about their office location, availability, how far out you have to book an appointment, how long their appointments last (this can range from 45-60 minutes). Ask about hourly fees. Find out if you can pay by cash, check, debit, or credit card. Ask if they can bill insurance or provide receipts so you can submit them to insurance for reimbursement. You may want to ask if they are in full-time private practice, or part-time. Ask if they offer a brief complimentary meeting, so that you can meet with  a couple therapists in person, and determine the best fit. The therapist should ask you some questions too, to determine that it's an appropriate fit.

5. Meet in person. They should be on time, and have an office that makes you feel at ease. The office setting should be private and quiet.

6. Good therapists are good listeners. Make sure you feel comfortable with their style. Do you feel like this individual would be someone you could let in more deeply over time?

7. The best therapists are curious about you. They don't box you in or act like they know it all. They want to understand you in all your complexity. They don't jump to conclusions.

Once you select a therapist and begin treatment, stay involved. You will maximize the effectiveness of therapy if you:

1. Ask questions. Ask them to clarify if you're not following them.

2. If you have had previous therapy, the clinician should ask (or you can volunteer) what has been helpful and not helpful in the past. In the first few sessions, the counselor should take a thorough history.

3. Together with the therapist, define what you want to accomplish. Set goals. Within a few meetings, the therapist should be able to give you the diagnosis they have made, and what the treatment plan is. They need to explain how they can help.

4. Don't edit yourself in therapy. You need to be able to talk freely about anything that's on your mind. You need to speak up in counseling, because your therapist can't do therapy without your involvement. Anything is okay to talk about in therapy. There are no limits.

5. Good therapy is collaborative. It's a journey to understand yourself and to grow emotionally, and you and your therapist are on it together.

6. Try to do some of the constructive action your therapist asks you to. They should have your best interest at heart, but if you don't incorporate some of their suggestions you may be missing some of your potential growth.

7. Therapists need feedback. I try to always encourage my patients to give me some. Share positive and negative reactions. It may be critical for moving your therapy forward, as the therapeutic relationship between therapist and patient needs to be a safe place to learn about yourself in relationships, and how to express yourself and develop your voice. Therapist make interpretations, and we can be wrong. It's okay to feel angry with your therapist. Let them know and work it through.

8. Discuss with your therapist if you want to change the frequency of sessions, or need a change. Sometimes you can only do part of your journey with one therapist, and your therapist should be open to helping you work through making a change if you need it. They shouldn't be defensive. Therapy doesn't go on forever, so it's important to talk about when therapy will end, and how you can continue to grow after it terminates. It is a great joy for me when my patients complete therapy and then call later in their lives to come in and check-in and perhaps work on a different life stage.

9. A good therapist should challenge you to grow. They should care about you, but they aren't your friend. You should be continuing to learn new things about yourself. They shouldn't JUST be listening, you also want feedback.

10. No therapist is an island. They should be networked with other helping professionals, so that they can make referrals for you as needed, for educational testing, career testing, medication evaluation, dieticians, support groups, parenting classes, divorce recovery programs and more.

Choosing the right therapist and actively collaborating with the therapist you choose can be the beginning of greater self-understanding, insight, healing and  healthier relationships. It might be one of your most important decisions.

Bring the Family: How Family Therapy Helps

I love doing family therapy. Some pretty amazing things can get unstuck and moved forward when we have more family members to work with.

About 20 years ago, I remember watching family therapy pioneer and psychiatrist Carl Whitaker do a demonstration of how he worked with the whole family in mind. He began the session on stage with one adult client. As they began talking about the issues that were upsetting for the client, Whitaker invited other family members to join them to help solve the problem. One by one the other family members appeared on stage to join in the session: mother, father, spouse, child, grandmother, grandfather, etc.

The effect of Whitaker's demonstration made the audience full of mental health professionals laugh as the session got bigger and bigger, but the point was made effectively. There are some concerns that can be very effectively treated by bringing in other family members to help.

Whitaker felt that the therapist needs to always consider the family as the client, not just the individual. While I do individual therapy as well, I agree with Carl Whitaker that the family you live with now, and the family you grew up with, may hold a great deal of information about why individuals struggle. Most people carry some wounds from childhood. Until you're a parent yourself it's hard to fully understand how hard it is to be a "good enough" parent while also staying married, supporting a family financially, and dealing with other life challenges.

Traditionally, family therapists believe most families have an IP or identified patient, who may be seen as the one who has a problem. Part of family therapy is shifting a family out of negative or blaming patterns, and not having an IP. In treating children and teens, I often see that they are the symptom bearers for other things that are going on in the family. Children can really struggle when a parent has cancer, an eating disorder, a chronic illness, or alcohol or drug issues. Children and teens are often painfully aware of marital conflict between their parents.

Family therapy has evolved over the years. I don't always have all the family members in the consulting room with me at the same time. I like the freedom to call in different dyads from the family as I can tell that it is needed . For example, I am currently seeing several teens who are depressed and including some work with their parents to improve their parenting skills, and some work with the siblings and my patient to increase their mutual support. Involving the family strategically can really speed up the course of treatment and improve results.

Got some things to work on in your life? You can work on it alone. You might also want to consider involving your family. Your family is the source of part of your own story, your past, and how you learned to be in relationships. Some of those scripts get reenacted until they get rewritten.

"When you look at your life, the greatest happiness is family happiness."
-Dr. Joyce Brothers

"The family: we were a strange little band of characters trudging through life sharing diseases and toothpaste, coveting one another's desserts, hiding shampoo, borrowing money, locking each other out of our rooms, inflicting pain and kissing to heal it, loving, laughing, defending, and trying to figure out the common thread that bound us all".
-Erma Bombeck, humorist