Mindful Monday: Be Yourself

Happy Monday. Here is a thought for you to contemplate.

Be Yourself

What does it mean to be yourself? Can you recognize and celebrate something unique about you? Even if others deem it different or “weird“?

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#TBT: Childhood Wounds

Sometime people worry that therapy will be all about blaming others, especially parents. Instead, it is about understanding how your early experiences have impacted you. Important people can wound us without intending to, and if unaddressed those early wounds can have lasting impact.

Childhood Wounds: Understanding Yourself in Context

Why talk about your childhood experiences in therapy? What does that have to do with you as an adult?

What role did your childhood experience/parents play in the development of your depression? anxiety disorder? eating disorder? relationship problems?

I was prompted to write this post by a recent online conversation I observed.  A therapist writing about family  contributions to the development of eating disorders sparked quite the controversy and received some vehement opposition.  It reminded me that that which I take for granted as a given is not shared by the public at large.  Namely, that it is just about impossible to escape our childhood unscathed.  Along  the path to becoming an  adult often lies wounding great and small.  By that I mean, even families with the best intentions will experience empathic failures and disconnects. They will succeed in many ways and they will at times fall short of the mark.  There are countless daily experiences of frustration and separation  which in addition to times of  feeling understood and connected  combine to make up who we are.   Secondly, that the understanding of this within ourselves and the acknowledgment of this between parents and adult children can be powerfully healing.

We all (hopefully) get that overt types of trauma such as childhood sexual and physical abuse impact the developing child.  I almost added emotional abuse too, then realized how that gets defined and understood is much more nebulous and can be harder to grasp. The issue of intent can also be confusing. And painful. It can be difficult to realize that even parents with good intentions can respond in ways that negatively impact their child’s development and self.

Examples of less obvious childhood experiences that can have a negative impact include but are not limited to:

  • parental perfectionism
  • high levels of competition
  • family prohibition against expressing certain feelings (for example sadness or anger)
  • witnessing violence
  • parentification of child: child acts in an adult role, for example in single parent families or with many younger siblings
  • child used as confidante by parent
  • child as caretaker of parent: common in families where a parent is alcoholic, for example
  • emotional unavailability of parent due to own depression, anxiety, unresolved trauma history  or physical illness
  • attitudes about gender: for example, shaming a feminine son or tomboyish girl
  • attitudes about sexual orientation: expressing belief that anything other than heterosexuality is inferior, sinful, pathological impacts the developing self of a non-straight child
  • attitudes about weight and body image: directed at yourself and your child
  • boundary issues: too distant or too enmeshed can be problematic
  • not allowing any privacy: for example reading a child’s diary, listening in on phone calls
  • conditional love: expectations about what a child will do in terms of hobbies, careers, interests.  Approval conditional on meeting parents’ expectations

As a psychodynamically trained therapist, I am operating from the belief that much of who we are is formed early and within the context of our primary family/care taker relationships. As a trauma informed therapist I am aware that traumas (big T and small t) can actually impact and change brain structure and chemistry.  So in the great nature vs. nurture debate within the field of mental health, I am much more apt to focus on the nurture side of the equation. I see the individual and her/his psychological problems as more often than not created within the context of early family dynamics.

Sometimes this gets misunderstood as an attempt to find fault or place blame upon parents.  I see it instead as about seeking a broader understanding of the individual in the context of the family and early experiences. With understanding can come more compassion for yourself. Too often I see clients presenting feeling  “crazy”, as if something in  them is inherently bad or flawed.  Putting their lives and experiences into context can be empowering.  In fact, I firmly believe that  knowledge is power.

In my view,  we develop a healthy self when our parents/caregivers provide  “good enough”  responsiveness to our critical emotional needs. What is “good enough” varies depending on the individual child. This is where I see some “nature” stuff like temperament playing a role. Some children do indeed seem to be more highly sensitive than others from day one.  This may provide more challenges in attunement for certain types of caregivers.  For example, a parent who is not  comfortable with his/her own range of emotions may not be able to empathically respond to the child’s. The child may then grow up feeling they have to deny or split off certain feelings in order to be loved.

Of course I get why many resist this approach.  It is incredibly painful as a parent to consider that you may have contributed to your adult child’s psychological problems.  I understand the denial and defensiveness may spring from a need for this to not be so.  However, I have seen what it can do for both when a parent can listen non-defensively and acknowledge the ways he or she inadvertently wounded their child.  One of the greatest gifts parents can give their adult children is to be able to tolerate this and model the awareness that none of us are perfect .  That includes parents.  Successful relationships of any kind are not about being 100% empathically attuned and connected, but about how we do the repair work when there are inevitable ruptures.

How have you grappled with these questions in your own healing work?

Kathleen Young, Psy.D.

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Mindful Monday: Plant Seeds

Mindful Monday is here! Check this out and use the 5-step mindfulness practice if you so choose.

Mindful MondayWhere are you starting your healing journey? Or this next phase of growth?

What do you have that you can use? (if your answer is “nothing”, check in with a trusted other for help…we all have strengths!)

Honor that you did what you could…and that is no small feat because it helped you survive to this moment!

How are you planting seeds for your future growth?

 

 

 

 

 

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Mindful Monday: Self-Love

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#TBT: The Therapy Relationship

Here are some thoughts from the archives on choosing  a therapist who will be a good fit for you.

The Therapy Relationship: What Makes a Good Fit?

Research shows that the quality of the therapeutic relationship is an important component of successful therapy, along with the training and experience of the therapist. I would go so far at to say that it is the foundation of therapy and the context in which healing occurs.  Certainly, without a working relationship in place, no techniques are likely to be very effective!

Those who have experienced trauma( Big T or little t) in the context of relationships are thus faced with quite a dilemma.  Relationships in the past have led to wounding:  abandonment, betrayal, unmet needs.  Now a relationship in which to heal must be sought. It makes sense that in the aftermath of  trauma  there are a host of responses that make connection difficult.  As I have written previously, childhood trauma can cause the disruption of basic developmental tasks such as self-soothing,  seeing the world as a safe place,  trusting others,  organized thinking for decision-making and avoiding exploitation.

Does it ever feel like a double bind? To seek to feel safe in the therapeutic relationship when relationships in general feel dangerous?

How have you navigated that?

As a potential client, what cues do you look for to feel safe enough to begin therapy?

Do you start assessing even prior to the meeting? I have had some clients give me feedback that even tone of voice on a therapist’s voice mail message can factor in.

As a therapist how do you address the issue of safety and the relationship?

I find it is important first of all to name the dilemma. I acknowledge all the ways starting therapy can be a challenge.  Sometimes taking that first step is one of the hardest parts! I also believe and express to potential clients that I see trust in me and the process as something that will develop over time.  I strive to earn trust by being trustworthy: authentic, consistent, matching what I do to what I say.  I also believe that a good therapeutic relationship is not free from empathic ruptures or miscommunications. There is no perfect relationship, not even in therapy. Instead, what matters is how we address disconnections and  how we do the necessary repair work.

I’d love to hear input from both sides of the therapy relationship.  Below are a list of factors that come to my mind. What about you?

How do you try to assess a potential therapist? What makes for a good enough fit?

  1. Ease of access: How can you contact the therapist? Do you prefer phone,  email.  How quickly does the therapist respond?  Does too much phone tag turn you off?
  2. Location: I am always surprised at how many clients pick a therapist based on location alone! How far are you willing to travel? Do you want in person therapy or would some form of online therapy work for you? Do you consider the type of office space? How accessible it is by public transportation?
  3. Availability: How soon can you be seen? What hours and days are appointments available? Is the therapist available for more than one session a week? In between scheduled or crisis contact if needed?
  4. Credentials: Do you have a preference for a psychologist? A social worker? Does the type of degree or training matter to you?
    Information on types of therapists
  5. Identity Demographics: Do you want to have certain things in common with a therapist? Do you have a preference for a particular gender, age, race, ethnicity, religion,  sexual orientation? Some of these may be initially apparent, others not.  Do you want a therapist to disclose some identity information? Therapists: are you comfortable/willing to do this? How much is too much? Sometimes people from marginalized groups (like the LGBT communities) want to seek LGBT therapists.  Is it enough to know that your therapist is knowledgeable and affirming about your culture or do you seek a shared identity or background?
  6. Areas of expertise: Is the therapist experienced with the issues you present? How do you know? Is the therapist licensed? Do you know how to access that information? What is the therapist’s theoretical orientation? Are they trained in specific techniques like EMDR, found to be effective in treating trauma? Does the therapist practice trauma-informed care? If treating dissociative disorders, are they aware of the Treatment Guidelines developed by the ISST-D?

Pragmatics like location and availability as well as a therapist’s professional training and expertise are all important factors to consider. But what about the sometimes more subjective factors? I truly believe that therapy is as much an art as a science. The therapist’s self (as expressed within appropriate ethical boundaries) factors into the equation. Being authentic, consistent, insightful, able to model expressing emotion, the ability to be present with hearing unspeakably painful truths, conveying warmth and understanding,  humor can all factor  into the healing relationship and show up in different ways in each therapist.  A therapist who is a great match for one client may not work for another.

Interviewing potential therapists to ascertain goodness of fit is crucial! You may want to write out a list of questions or concerns in advance, to make sure you cover all your bases.Dr. Bessel van der Kolk suggests that trauma survivors also consider their experience of the potential therapist: “Pay attention to whether the therapist really wants to hear the troubles you have to tell.  Ask yourself, ‘Do I feel validated? Is the therapist really listening to my story?’”

Trust your gut and intuition, but also work to sort out past triggers.  Is your gut telling you this therapist won’t work for you, or are you feeling scared of therapy in general? Can you determine that in one session or do you need several to make an informed choice? Unless there are huge red flags( unethical behavior,  lack of education regarding trauma,  homophobia/transphobia,  for example) I really encourage potential clients to share their misgivings and concerns with the therapist.  How this is addressed will tell you a great deal! It is important that any therapist listen to your critiques with empathy and non-defensiveness.

What do you look for when seeking a therapist? And how do you know it when you see it?

I’d love to hear your thoughts and experiences!

Kathleen Young, Psy.D.

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