Therapy advice to put in your pocket and take with you.

Archive for January, 2012

Money SEX and Kids (part 2)

As stated in part 1, money sex and kids are the three topics I see couples argue about the most in counseling. I addressed Money in Part 1, and will now discuss the sex details many couples disagree on.

The most common misnomer is how often couples are having sex, especially compared to how often they assume everyone else is having sex. There is no average, no number that is healthy or not. Every couple has to set their own preferences that accomodate their schedules, their libidos and their lifestyle. Some factors that can hinder a couple from agreeing on the frequency of their sexual activities can include past trauma affecting trust, safety or enjoyment of sex; biological factors that decrease libido like hormones, medication, or mood disorder; low self esteem; sexual addiction; poor communication; difference in values.

Communication is a challenge for many couples in general but especially regarding sex. But if you can’t communicate regarding what you like and don’t, what you need, what you wish, what works and what doesn’t, sex might not be successful. If you expect your partner to read your mind you will likely be disappointed. It just doesn’t happen.

People grow up with varying opinions on sexual topics. Masturbation, pornography, oral sex, open relationships: all have a wide range of acceptance from no-way to bring-it-on. If you and your partner aren’t on the same page these could be topics for hurt feelings and big arguments. Again the need for good communication.

Also beneficial is an understanding of the biological differences between men and women regarding sex. Men are often physically aroused, turned on by what they see. This is a primal reaction they have no control over (how they choose to act on that arousal IS in their power). Understanding this will help women not be so jealous if a man turns his head as a scantily clad woman walks by. Women on the other hand tend to need to be emotionally connected to be aroused. If they aren’t relaxed or they don’t trust or they are distracted or they aren’t feeling emotionally close to their partner, this could hinder their arousal. So after an argument a guy might still say “wanna do it?” and she might say “no I’m mad at you!”.

Sex is a very common topic in couples counseling. There are therapists and doctors and clinics who specialize in sex therapy. But most counselors have addressed this with couples in therapy and could help. Don’t be embarrassed to bring it up. It is more common than you think and having a healthier happier sex life could help both you and your partner in the relationship.

What if???

What if I lose my job?
What if everyone laughs at me?
What if someone I love dies?
What if I trust and my heart gets broken?
What if what if what if?

Sometimes it feels like a giant question mark is hanging over our heads, weighing us down, overwhelming us with the fear of the unknown. Feelings associated with anxiety and depression are exaggerated by a sense of powerlessness or not being in control. But WHAT IF you answered the what-if question? What if you do lose your job? What will you do? Seriously, think about it. Make a plan. Take control of it. More often than not what we fear will happen is far worse than what actually happens (Albert Ellis). We anticipate things and tell ourselves we could never handle it, it’s too much, we just couldn’t deal. And yet, truth be told, when it actually happens, we survive it. It might suck, or be painful, no fun, but we will get through it.

Remember seeing tv shows or movies with a devil on one shoulder and an angel on the other, both telling us opposite things? Our brain does that too, with rational and irrational thoughts. Usually the negative voice is the one telling us we can’t handle it and it’s going to be horrible! (That’s called catastrophizing.) That little devil is loud and naggy and relentless, not happy until we are miserable. But if you can be your own counselor in your head you can quiet that irrational voice. Talk back to it, go ahead. Answer the what-if. What WILL I do? Make a plan, write it down, stick it in a drawer and pull it out when you need it. That way YOU are in control.
Albert Ellis also said anxiety comes from underestimating your ability to handle things. Don’t fear adversity! You are a survivor. You have been through hard stuff before. Not to say you would like to do it again. But if you have to, you will. And you will survive.
You have go through it to get beyond it.

Cutting the tags from all the clothes

He doesn’t like tags in his clothes, or long sleeve shirts. He doesn’t like itchy sweaters or jeans that are tight, and gets upset if the seams in his socks aren’t just so.

She is a very picky eater. The doctor says leave the food in front of her and she will eat eventually, but she doesn’t.  She doesn’t like most fruits or vegetables, slimy foods or grainy foods, or stringy meats.  Actually most of what she eats is yellow or white or tan like chicken nuggets, french fries, cheese pizza, pizza rolls. She will practicaly eat the same thing every day, and then act like she doesn’t like it any more at all.

Noises seem to stress him out. He is hyper in noisy restaurants, he complains if the radio is too loud in the car, and he sometimes seems to have super sonic hearing, listening to something at the other end of the house.

These are just a few examples of Sensory Processing Disorder, which has also been called Sensory Integration Disorder.  All of the information we receive from our envirnonment comes into our brain from our senses.  We see it, hear it, taste it, smell it, feel it.  If you knock hard on a wooden table a message is sent from your knuckles to your brain that says ow, that hurts and your brain sends a message back to stop doing that.  But if someone has a problem with sensory processing, how that information gets to the brain is misinterpreted. So grass on bare feet might feel painful or food in the mouth might feel like it is hitting giant oversensitive  taste buds. It is a neurological mixup that is often misdiagnosed and can cause high anxiety in kids and power struggles in families.

Diagnosis can be done through an occupational therapist’s evaluation, either through a school district, a doctor referral or private agency.  Treatment is done by an occupatuional therapist who works a “sensory diet” with a child daily and can teach the parents to do so also.  This “diet” depends on if the kiddo is oversensitive or undersensitive to physical stimuli.  For example if they dislike their skin being touched, a soft brush repetitively on the arms may help “center” the nerves.  If they are undersensitive and sensory-seeking, they might need deep pressure massage. This diet is created based on the needs of the individual and may address the mouth, the ears, the eyes, movement, or whatever sensory input is relevant to the child.

I include this topic in the blog because it is more common than it is known. Kids who seem to have behavior or anxiety issues may well be helped with this intervention instead.  While symptoms can lessen over time as the child grows up gets more educated about it, they may still recognize sensory issues in themselves even as adults.

Resources abound.  An excellent place to start is a book called The Out of Sync Child by Carole Kranowitz. But you can also google this topic and find a ton of information. If you think someone you know may have sensory issues, talk to your doctor, a school counselor, or an occupational therapist.  Intervention is not invasive and can make a world of difference.

Money Sex and Kids

The three most common topics couples argue about.

Money…Turns out to be a very personal and territorial subject. People have very different philosophies on handling money. Some are savers, some are spenders. Some are checkbook balancers, some are float-a-check and count on overdraft protection. Handling money is a learned behavior and parents have great influence over what their kids learn about money. Talking to your kids about money, setting chores for money and creating a mini budget can help them learn on a small scale, and make
mistakes in a small scale (before a mortgage is involved!) Having them earn money and set priorities will help them understand the value of their savings. Your local bank may even have a fun banking system for kids.

Other things that can influence spending behavior include comorbid diagnoses. People with ADHD tend to be impulsive with money, people with Bipolar tend to be compulsive with money, people with a history of addiction may find an emotional release in spending money or gambling. Knowing these things about yourself and your partner can help you decide what help you may need to be more fiscally responsible. Understanding it instead of blaming can help create a productive plan and decrease arguing.

A spouse’s money choices can affect the other’s credit score, assets, future; hence the reason for the sensitivity and defensiveness. They are at times afraid the other person’s poor choices will cause them harm. Again, being honest about your own habits can help a couple create a plan for finances that works you both. There is no one right way. Some couples share everything, from the checkbook to the ATM card with one joint account. Some have two separate accounts and split family bills between them. Some have three accounts, his hers and ours with the joint account being used for household shared bills and each having their own spending accounts. Whatever system works best for your family to cause the least amount of conflict is the one you should choose.

There is help available for this topic. Nonprofit agencies that help teach budgeting, counselors who can help with communication, money managers who are experts in making successful money decisions. Don’t wait until its too late. Don’t let money ruin your marriage. And teach your kids well, for they’ll be taking care of you someday. 😉

Blah, just Blah.

The tree is down, the decorations put away. Nostalgic music is gone for another season. Stresses and conflicts we had late last Fall got put on hold, shoved under the rug so we could get through family holiday events without tension, but now those holidays are over. In their place are the added pounds, the holiday credit card bills, and the pressure to set a personal goal we probably won’t keep. Welcome to January.

This can be a dangerous time for mental health. People set deadlines (just gotta get through the holidays) and feel pressure to make big changes at the first of the year. Three big things I see in January in counseling are divorces filed, alcohol relapses because the vacation time at work started over, and the winter blues. I also hear about financial overwhelm from the bills, dread over not knowing what a new year will bring, fatigue and feeling unmotivated.

I don’t bring up these things to be a downer, but to point out that if you feel these things you are not alone. And you don’t have to face it alone. Help is available through counseling or support groups, work EAP (employee assistance), church groups, financial counseling, and even online support. There are books on these subjects and 24 hour hotlines around. If you feel overwhelmed, please reach out. If you have a friend or family member who struggles with mental health issues, please reach out to them. This is not something you have to face alone, and it is not something that will last forever.

Blah, just Blah.

The tree is down, the decorations put away. Nostalgic music is gone for another season. Stresses and conflicts we had late last Fall got put on hold, shoved under the rug so we could get through family holiday events without tension, but now those holidays are over. In their place are the added pounds, the holiday credit card bills, and the pressure to set a personal goal we probably won’t keep. Welcome to January.

This can be a dangerous time for mental health. People set deadlines (just gotta get through the holidays) and feel pressure to make big changes at the first of the year. Three big things I see in January in counseling are divorces filed, alcohol relapses because the vacation time at work started over, and the winter blues. I also hear about financial overwhelm from the bills, dread over not knowing what a new year will bring, fatigue and feeling unmotivated.

I don’t bring up these things to be a downer, but to point out that if you feel these things you are not alone. And you don’t have to face it alone. Help is available through counseling or support groups, work EAP (employee assistance), church groups, financial counseling, and even online support. There are books on these subjects and 24 hour hotlines around. If you feel overwhelmed, please reach out. If you have a friend or family member who struggles with mental health issues, please reach out to them. This is not something you have to face alone, and it is not something that will last forever.

I Don’t Feel Good

If you go to a cardiologist and say you don’t feel good, they might check your vitals and give you blood pressure meds. If you talk to a GI doc they might give you some stomach reflux medicine to help.  If you see a therapist, they will offer to give you counseling. All of these things may be exactly what you need.  But they might not.

If the timing in your car is off the vehicle won’t run smoothly.  The timing affects the the rate the spark hits the plugs, and the car may backfire or run rough or overheat. Without knowing it was a timing issue, a mechanic may think it is a thermostat or a fuel problem or something else.   If you just address the symptom and not the cause, the problem won’t be fixed.  Hence the need for a good diagnostic workup.

This is also true for mental health.  Someone who walks into a counselor’s office and says they are depressed doesn’t always have depression.  Someone with concentration problems doesn’t necessarily have ADD. There are so many other things that could cause the same symptoms, and just like a car, the systems of the body work together to make it run, and if one system is out of whack, you may see it in another system.  For example, someone who is irritable or fatigued may have a blood sugar issue, a thyroid problem or sleep apnea.  Someone having bad dreams may be experiencing a side effect of blood pressure medication.  If you have a decreased libido it could mean hormones, or depression, or again medication side effect.

It is your counselor’s job to do a full psychosocial history when she meets you.  He should ask you what you feel your symptoms and problems are, but she should also ask you about your family health and mental health history.  He should know about your sleep and eating habits, your medications, and your substance use.  She should know about your past traumas, how you did in school, and your current relationships.  Whether you realize it or not, all of these details can help an experienced therapist figure out the cause of your symptoms and create a treatment plan that will help you feel better now and in the future.

I have seen irritability and moodiness be caused by Prednisone.  I have seen kids diagnosed ADHD and bed wetting who actually had obstructive sleep apnea caused by tonsils.  Fatigue can be Endocrine System, absentmindedness can be medication, a kiddo’s behavior problem could be a learning disabilty or even grief.  Sometimes what you see is what you get, but sometimes not.

Why? Why? Why?

Why do bad things happen to good people? Why do the good die young? Why do some people get more than others?

If there is one thing I have learned in hearing many sad stories over the years, it’s that there is no formula for who has more bad luck than others.  There is a disproportionate number of tragic things that happen to some people compared to others, with no system for why they “deserve” these things to happen to them.  They don’t deserve them. They don’t earn them.  Con artists get away with swindles for years, the corrupt get rewarded with success… I’m not cynical or bitter. Just observing that many people feel frustrated by these things especially when faced with their own hardship. And then they ask, WHY?

I don’t have a definitive answer for why.  But I do have some observations…

The people we emulate across time, those we respect, we honor, we quote over and over, have not been the ones who have had it easy. It has been the ones who dealt with hardship and didn’t give up.  From Gandhi to Mother Theresa to Oprah Winfrey.  Job, Jesus Christ, Abraham Lincoln.  The authors who had their manuscripts rejected 32 times and published it themselves and became hugely successful.  The inventors and scientists who used failed experiments to learn from and eventually get it right and change the world.  If we all stopped when it got hard, where would the world be?

We don’t always know WHY we are going through something at the time we are going through it.  The heroes listed above probably had no idea of the far-reaching effect their words and actions would impact the world.  You don’t know how something you are going through now is setting the stage for something important in the future or precluded you from something worse.  If you are in a hurry and get a flat tire, you may be irritated and grumbling at the delay.  But what you don’t know is that if the flat hadn’t happened you might have crossed the path of a semi swerving in your lane and had it much worse.  If you smile at a stranger in line at the store, to you it may be nothing but to them it may be the one thing that kept them alive today. No kidding!

When I was a kid we had great times and not so great times.  (Didn’t everyone?)  I remember the angst of a teen, crying, sobbing, thinking things would never get better, this is the worst-thing-ever.  But now I know that the struggles I faced back then have all contributed to my helping others now, to have empathy for others and for them to feel I can connect (and hopefully make a difference). There is a common theme in literature and religion and life.  Call it Karma, or the balance of the Tao; the Golden Rule or Pay it Forward. It seems even with theoretical differences most people believe there is a higher order that keeps the universe in “balance”.  The biggest challenge is remembering that in the moment.

“Blind Faith” is an ACTION that is most challenged when we need to have it the most.  Believing that even though what I’m going through right now sucks, some day I’ll understand why.  Or if I never do, TRUSTING that it is for the best, even though it really doesn’t feel like it right now.  Being open to this concept is the first step.  The second is being open and creative enough to see the connection when it is presented.  Avoid tunnel vision and try to look at the big picture, the journey and how the little miracles all around us don’t just happen on their own, but are intricately connected to everything that came before and all that will come after.  We won’t always know why. Sometimes the answer is, Just Cuz.

You’re a rock star!

Forward-thinking.

It is what you make it.

Your life is your own.

Blank slate.

“If you build it, they will come.”

Yesterday I blogged about setting clear, objective measurable goals.  While this is the time of year for short term goals, this strategy applies also to long-term and life goals, as well as how you choose to live in your daily life.  When you tell yourself you want to be happy, or healthy, or in a good relationship, what do you really mean by that?  It’s your life, you can define it how you want.  But sometimes we don’t define it, we just wait to feel it. And the feeling never comes. Why not?  Often that’s because we don’t know what we are looking for.

Today I met with a woman who talked about concerns in her marriage and how these same patterns have gone on for years and never seem to get better.  When I suggested she and her husband talk about things, she said, oh yeah we do, but it never goes anywhere, we are just so different.  I said take some time and discuss how you would like your relationship to be.  What would it look like? What do you need from it, what does he need from it?  Stop complaining about what has gone wrong in the past and be forward-thinking, ask yourselves where do you go from here?  If you have a complaint, have a request attached to it.  Be specific about what you would like from each other in the future.  Get creative.  This is your relationship, what are all the things you would like to have in a relationship, and then discuss how to make those happen.  Her response?  “We’ve never had a conversation like that before”.

This technique can be utilized with any topic.  Do you want to be successful?  What does ‘successful’ mean to you? Money? How much? Fame? In what arena?  Do you want to be happy? What will you feel like when you are happy? How will you know? When is the last time you felt happy? What kind of things make you happy?  Breaking your goals into descriptive words can help you decide what you can do today and every day that will set you on that path, and also how you’ll know when you are living it.

Don’t limit yourself. What do you wish? Many times the things we wish for are more attainable and achieveable than we believe.  We stop ourselves because of fear or self-doubt, or just because we don’t know how to get started. 

Don’t be afraid to ask for help.  Talk to someone who seems to be doing what you’d like to be doing, a friend, a colleague, and ask how they got started and how they keep going.  See a therapist or hire a trainer.  Get books or look at a website.  Chances are whatever you are thinking of doing, “there’s an app for that.”

The bottom line is, allow yourself to brainstorm, dream big, get creative, and then break it down into a description of what it would really look like. Plant a seed, and watch it grow. Because you can be a rock star!

Change is hard, exciting, inevitable

I have heard a number of people refusing to set new year resolutions, stating, why bother…They won’t be accomplished anyway. The frustration of having set past goals and not accomplishing them can be discouraging. Here are some guidelines to help you succeed at your next personal goal.
1. Set realistic measurable attainable goals. If your goal is too vague, like “I want to be happy”, you may never know when you get there. Define what happy (or rich, or thin, etc) means to you. What will it look like? How will you feel? Is there a way to measure it, like “I will have 4 days per week when I feel like I have accomplished something.”
2. Measure it. Keep track. Journal. Sometimes we make more progress than we think, but if we don’t have an objective measure of where we’ve been we tend to minimize our success because the mountain still ahead seems so daunting.
3. Break it down. Imagine your ultimate goal and work back from there. Draw a set of stairs on paper and put the ultimate goal at the top, like Be a Doctor. On the step before that put the goal that would need to be accomplished just before, like Graduate from Med School. Then work back from there, visualizing each step that would have gotten you to the next, until you get to where you are today, like Get an A in High School Anatomy. This technique helps us see how what we are doing today really is setting us on the road toward what we want in the long run.
4. Create new habits. Change can be difficult… But not impossible. Someone once said it takes 21 days in a row to create a new habit. The point is, if you’ve done something the same way for a long time, it has become a bad habit and it will take repetition to change that habit. Don’t be frustrated if you slip up. Just catch it and turn it around, catch it and turn it around. If you are trying to stop cursing and you say a bad word, stop, notice, replace that word with a better one, and move on. Doing this over and over is what creates the new habit.
5. Reward yourself. Remember the movie What About Bob? “Baby Steps”. Set small goals and reward yourself as you accomplish them. If you are trying to lose weight and you lose 10 pounds, reward yourself with a new workout outfit or some new workout music. These small accomplishments give you something to anticipate and help keep you motivated for the long haul.
6. If at first you don’t succeed… Self improvement should be life long. We all have ways to grow and improve. If you fall off the bandwagon hop back up and start again. Look at what triggered you to slip and learn from it, using it to help you in the future. Don’t focus on the slip, keep moving forward.
7. Don’t wait. New Years and landmark birthdays and Mondays give us concrete dates to start something new. But if you have a good idea or a strike of motivation in the middle of the week or the middle of the year, jump on it. There’s no time like the present, and there are no rules on self improvement but the ones you set for yourself. It’s your life, make it a good one!

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