Category Archives: communication

Why Ask Me That? Third in a series on questions in the therapy room

Someone who is struggling with anxiety just wants to feel better. It’s understandable; anxiety feels awful. The physical symptoms, so often hovering just below full-blown fight-or-flight; a mind that won’t rest, a brain that hops from topic to topic like a rabbit in a vegetable garden. Add to this the fear that so many people have when they come to therapy:  will the therapist tell me I’m crazy?

No; no, I won’t tell you that, but I am probably going to annoy you with a lot of questions that may seem to be irrelevant to your suffering. My paperwork asks about your history, decade by decade; your losses; job satisfaction; health issues; your alcohol and drug use; your prescribed medications; your exercise and sleep patterns. I ask about screen time, social memberships, supportive relationships. I ask a lot of questions, and I can tell who thinks those questions are irrelevant by who leaves them unanswered, handing me incomplete paperwork and acting surprised when I follow up on the many blank places.

All these questions are important, and here’s a short discussion on just a few aspects and the explanation.

Your sleep patterns, and any difficulties, can both contribute to, and be worsened by, anxiety, stress and depression. If you need more, or better sleep (and most people do), figuring some ways to improve your quality and quantity of sleep can help across many categories of your life: focus, memory, energy, stress level, and mood. When these improve, relationships can often improve, as you might expect when you can pay attention and be less cranky.

If you have major health conditions that are not properly managed, these may contribute to problems with sleep, anxiety, or mood. For example, poorly managed diabetes, besides being physically very dangerous, impacts focus and mood. I would refer you to your physician to see if there are problems that require medical attention.

Social isolation is a recipe for loneliness and depression. Social media use tends to make this worse – something that seems weirdly contradictory. Lonely people eventually withdraw, and this creates more loneliness, isolation and possibly anxiety and depression. We need to explore ways to enter back into activities with others.  From my guidance counselor days: children who are isolated suffer. If you ask a child if s/he has friends, and then ask him/her to name those friends, and there is a flash of hesitation, you know you are dealing with a child suffering social isolation. Just so, adults who cannot identify some supportive relationships and what is good about those relationships is an adult who is emotionally isolated.

I ask questions that make sense to me; if they don’t make sense to you, please ask why I’m asking. Thanks!

Why Ask Me That? Part 1 of a Series on Questions in the Therapy Room

“It’s a lot of paperwork.” 

Yes, I agree, it is. And all that information is helpful and useful for me in what I presume is a shared project: making positive change in some aspect – or many aspects – of that client’s life. 

The number of people who simply skip sections, as if they were optional, or not relevant, is significant. This gives the opportunity to have some conversations about those questions, and their relevance.

For example:

If someone routinely shortchanges their sleep, health problems will develop. In the short term, irritability (which tends to mess up personal and work relationships), less efficient short-term memory (ditto), distractibility (ditto) and impulsivity (mega-ditto) are possible contributors to whatever the primary complaint may be.  So maybe we should address that, too!

If you are extremely extroverted and are working remotely and living alone, you have created a perfect petri dish for restlessness, depression, and dissatisfaction. Those are psychological and emotional factors that create problems across domains. Deliberately arranging adequate real interactions with others will be essential to meeting that basic need.

If you don’t have five or six people who you can identify as part of your social support system, such as friends, family, a mentoring colleague, etc., there may be a heightened risk for depression and anxiety.  That doesn’t mean you confide personal problems with all those folks; you might have someone who provides support and encouragement in career-related areas, some people you can pray with, people who you play sports or exercise with and enjoy lighter conversations.

There are no questions on my paperwork that are not rooted in helping the client and me have a grounded understanding of the client’s strengths, struggles, and emotional resources for making positive change. Just ask me.

Cutting off Mom and Dad, Part 3



…and now we come to the final installment (so far) in my
wonderings about this strange phenomenon of parent rejection by adult children.
So far, I have tried to spread the responsibility around: the infantilization
of young adults by many institutions, the culture at large, and parents.  Now it is the young people’s turn.


It is my observation (granted, limited to some review of the
literature, professional trainings and clinical experience – over a quarter
century) that it is not usually the abused children who grow up and cut off
their parents. This seems odd, doesn’t it? If a child who was tortured decided
to cut off contact, we could understand, even support the healthy distancing.



It is much more typical for the young person who simply does
not want to be bothered to cut off the parent or parents. Quite often it seems
to be one parent; a widowed mother, typically, which makes me suspicious that
the possibility of some sort of responsibility drives the distancing.  I am sorry to be that cynical, but so it
sometimes seems.  Other themes seem to be
that the parent doesn’t just pat the child on the head for every decision, or
the parent has different political opinions, or religious beliefs.



If you are an adult, then surely you have developed the
capacity to tolerate the presence of people different than you; it appears to
be a matter of pride to young adults, especially, to be open-minded about
people’s differences, to refuse to allow even stunningly foundational
differences in values to be barriers to mutual respect. If that is the case, if
you think of yourself as tolerant, then surely you can tolerate the fact that
your parents, or grandparents, or aunts or uncles or other relatives, no doubt
have different ideas than you (and from one another). It may come as a surprise
to you that your parents, whom you may see as some monolith of monotony,
actually disagree with one another. A lot. The research indicates married
couples disagree on about two thirds of the stuff of life, or more; they just
have figured out, I hope, how to live and let live on these disagreements and
how to work with the few that are pretty significant areas. 



Are you afraid? Afraid that you cannot properly defend your
own positions, operationalizing your terms and pointing to data, rather than
feelings, and that interacting with your parent(s) will be an exercise in
losing an argument and feeling like a fool? 



Are you afraid to simply listen to try to understand more of
their opinion, meaning the information and experiences that support that
stance?



Are you afraid that staying close to aging parents will mean
being stuck with them, having to take care of them, when you are carefully
curating your life to minimize responsibility?



Are you afraid you will die of boredom if you have to listen
one more time to their ramblings about the events of their lives, which may
actually not be any more ennui-producing than your own (have you wasted a chunk
of your life bingeing a fictional series lately or playing video games?).



Are you afraid that they will keep trying to get you to
change and you are tired of explaining to them that your
job/partner/reproduction plans are not up for discussion?



Are you afraid to set boundaries, including the boundaries
of discretion? Surely you do not talk about everything with every friend; in
the same way, it can be very wise to discern what topics to discuss with whom.
If your definition of family means “people who have to accept and agree with
everything about me,” then even something as simple as dietary differences (the
omnivore and vegan siblings, for example) will necessitate cutting off a family
member when all you had to do was not rave on and on about the great steak you
grilled last weekend or stop talking about murder when you are sharing a meal.



Cutting off family without very strong grounds to do so is a
red flag. If your friends have done so, consider their reasons; if this is how
they treat the people who sacrificed for them in ways they may not yet
understand, exactly how solid is the rock you stand on with these friends? Can
you really count on them to be there, helping to clean up after you have
vomited, for the zillionth time, during chemo? To show up for you when there is
a death, or a birth, and in the long months of change and bewilderment
afterwards? To take a day off and drive you to and from having your wisdom
teeth out, or a colonoscopy, or whatever else has to happen – and the medical
office will not release you to a ride share service?



The family cut-off is a tragedy, under the best and most
reasonable of circumstances. The dangerous parents might need to be cut off,
for the sake of their children and grandchildren. It is heartbreaking that life
had to come to this, but it may be necessary. That is not something to be done
lightly, indifferently, or without serious reflection of how this decision will
play out in the decades to come.



Thanks for reading –



Cutting off Mom and Dad, Part 2

As previously explored, the culture undermines parent-child relationships. One way is the manipulation of expectations of normalcy. Young adults are frequently told to believe that anything less than absolute, craven praise and approval, of anything, is some sort of miserable toxicity and not to be borne. The relationship must be severed, even with parents.

On the flip side, many parents feel that their position as parent gives them license to offer criticism, advice, and endless commentary on their adult child’s habits, clothes, parenting, etc.  If you are financing an adult child, then I would suggest you tell your child what you will do – not what the adult child will do. You can’t make them do anything, but you can control yourself.  A self-sufficient adult who lives on their own, paying their own way, and raising a healthy, well-adjusted child does not need unsolicited advice or undermining, either.

If you’re thinking, reading this, that you jolly well can make them do something – well, actually, no, not without force.  We parents specialize in saying things that can’t be enforced, silly things like yelling at a toddler, “You’re going to get in there and go to sleep right now!” The average three-year-old has figured out you can’t make her go to sleep; and if you do anything that forces sleep, and I find out, I will report you to Child Protective Services. A three-year-old is portable:  you can pick them up and transport them to their bed, over and over, but the command to sleep is just a waste of syllables.

Sometimes, fellow parents, you may be grieving. You had your child, and you had dreams. You imagined a long future, that child’s adulthood, and the ideal fantasy of whatever your engagement with that child’s future life would be.  I was hoping for a shared private practice (we had discussed this, to be fair!) and lots of hands-on times with grandchildren and spent a couple of decades amassing cookie cutters and art supplies that seldom needed, and given away with much grief, grief not for the things but for the unfulfilled dreams. Instead, I have an adult child of whom I am immensely proud who lives many hours away, and that means her husband and their lovely child are far away, too.  I don’t get to impose my dream, or a guilt trip about my unfulfilled dream, on them. Doing so would be foolish and unfair, and reduce the likelihood I can enjoy what I have, which is far more than many people have, and a situation that those who are involuntarily childless would envy.

So…this set of posts on family cut-offs doesn’t solve anything. I don’t have any big, smart solutions or a therapy intervention that will take away the pain of alienation from the very people for whom you would willingly die. Perhaps it can open up some ideas for reflection, or conversation. If you are an adult who has cut off a parent, please reconsider, seriously and prayerfully, on whether their behavior warrants that wall of silence. If you are a parent, wondering what you have done, perhaps there is room to change the ways in which you try to influence or even make demands on someone who does not belong to you.  Perhaps there is nothing to be done except wait and pray, which comprise tremendous power in the long run.  What to pray? I do not know. I can tell you how I pray, across all relationships: family, friends, clients, students, our leaders, our enemies…that both the other party, and I, be open to becoming who God wants us to be. Amen.

Taking it to the mats

What ever happened to giving someone some grace?  Or being tolerant?

As regular readers, I occasionally page through popular magazines just to see what sort of toxins are floating around in the public sphere.  It’s less time-consuming and annoying than hours of screen time. Between what I read, and what I hear from those on the receiving end of what is often cruelty, there is a whole lot less tolerance in these self-referentially oh-so-tolerant times than in the past. Often supposedly tolerant people demand that any disagreement be taken to the mats, verbally if not physically.

To be clear, I am talking about disagreements between people where there is no violence or threat of violence. I am not talking about adopting a “live and let live” attitude about child abuse or elder exploitation or criminal acts. I wonder where tolerance and grace went when it comes to the people we encounter in nonviolent settings in our daily lives.

A simple little example was an advice columnist’s suggestion that dealing with an annoying “friend” who calls during work hours and drains your energy and time with daily drama should comprise a formal sit-down in which you express how their thoughtless behavior impacts your feelings and your work, and expect some sort of mature, measured apology.  I am practical. My guidance would be along these lines: this is your “friend.” Surely you noticed before this that she seemingly has the thoughtlessness and flimsy self-control of a spoiled tween.  You accepted the friendship under those terms; she hasn’t changed. You have. Stop taking calls or looking at texts from her during work. What kind of job allows you to chat with friends on the employer’s dime?  Call her back when it’s convenient. And, if you choose to be friends with her, accept that she is as she is. She will be immature and you will have to set boundaries. Sure, tell her you can’t be interrupted at work. But you and I both know that having a nice little sit-down with her isn’t worth the aggravation. Imagine the flood of drama, spilling and splashing all over the table at the coffee shop.

In families, people disagree. At Thanksgiving, if you are fortunate enough to have family and friends with whom you can gather, people will have differing opinions. At least one of them may have misplaced their tolerance or drowned it in some substance of abuse. What to do? You might have fun arguing. My late cousin George, who had Soviet bullet fragments in his leg from his teenage adventures helping people escape from East Berlin, would take a perspective he didn’t necessarily agree with, for the entertainment of developing and defending a position, and do it with a twinkle in his eye. You might find that stressful; your plan may be to discreetly go do some dishes because “here s/he goes again.”  You might enlist at least one ally in a plan to divert and change topics if the intolerant person who expects everyone else to be tolerant starts pontificating. You might decide to politely express your perspective. Depending on the people present, any of those may be prudent.

Some people implode relationships foolishly. I know people who were cut off on the flimsiest of rationale; because they are “too negative,” or “worry too much.”  People cut off parents because their parents do not “support” (as in overtly cheer and brag about) their adult child’s career choice, tattoos, or other decisions.  And, conversely, parents cut off adult children.  In cases where people are dangerous, or truly disruptive (the addicted adult child who breaks in and steals from the parents; the abusive parent; the family member who is aggressive and belligerent about their cause-du-jour, as examples) then yes, safety and sanity require appropriate distance-setting. This is sad, even when necessary.

I’m not an appeaser or a door mat. When it comes to disagreements, I think that freedom requires that we live and let live in peace (that’s what tolerance used to mean) until the circumstances are such that it is necessary. Necessary means that an expectation for compliance is placed upon me, a demand that I change my mind or pretend to agree with something I find false.  It is necessary when harm is being done, is threatened, or is imminent. That is when it is important to speak up, calmly and rationally, to base my position in fact and refuse to play silly word games. Speak calmly, peacefully, firmly and succinctly, refusing to pretend. That would be a way to “take it to the mats.”

Paraphrasing St. Francis of Assisi – Peace and every good to you.

Using the Right Tool for the Job

When painting, the particular tools have to suit the purpose at hand.  Pastels, my favorite medium, range from hard to very soft. The degree of hardness impacts the way they make marks and interact with the painting surface. Thus, they are used in ways appropriate to the task at hand. Softly blended colors – the distant trees, faintly blued by atmospheric effect – call out for soft pastels. The graceful lines of bare branches glimpsed through foliage are served better by a harder pastel.  Use the wrong tool for the job and it is an exercise in frustration.

Just so, the various ways in which we communicate with one another have their preferred and best-suited purposes. I write letters in long hand to some family and friends; email has its role. The humble text message is an absolute delight in its place.  Its place is best described as the brief sharing of simple data:

Writing out Christmas cards, can’t find Uncle Lew’s new address

123 Orchard Street, Apt. A, S______, STATE, ZIP.

Thanks.

Or,

At the rest stop at US 19 and I-10, should be there in about 3 hours.

Great! See you then!

Or, perhaps, sharing a quick photo: a hummingbird, frozen in flight; a child in her sports uniform, a lovely sunset.

Text messages, on the other hand, are wretchedly inadequate for important conversations and emotional expressions beyond, “Love you! Have a good day!” sort of messages. They are inadequate for many reasons.

For one, they are brief.  Unless you have the ability to reduce complex ideas to simple, yet not simplistic, expression with the elegance of C.S. Lewis, the affective concision of Yeats and the incisive observational skills of Shakespeare, give up the notion of effectively resolving complex interpersonal issues via text.  We are, none of us, up to the task.

Worse, when we misstep, believing ourselves to be abundantly clear, we cannot see, or hear, the nuances of small muscle movements, pupil changes, swallowing, breathing, voice tone and volume, that alert us to make corrective efforts. Instead, our misstep is enshrined in visible form, to be reviewed and the misunderstanding (or all-too-clear awfulness) revisited and engraved into the heart and mind of the recipient, as well as anyone with whom they share it in an attempt to justify themselves in their rage and hurt.

You might say, well, the same can be said for email (right) and for the older, handwritten letter. For the latter, until fairly recently, writing was laborious: a pen to be perpetually sharpened and wiped; liquid ink to let dry. Even now, the arm and hand movements of script engage more of the brain, slow the process, and thus allow time to reflect before dashing off a reactive and possibly toxic response.

Many clients have explored in session the dilemma of family members demanding a text message interaction to address – now! – some emotionally rich and complex issue.  I urge them, and everyone, to resist giving in to the juvenile and narcissistic insistence that something of apparent critical import be reduced to text messages.  It is quite common for people to demand immediate exchange via text, repeatedly insisting you explain yourself (or whatever it is they require). If it cannot be face to face, at least do so via voice when both people are rested, sober and have time. Audible clues of tone, volume, steadiness and rhythm can help you assess how the conversation is going. If you are dealing with a reasonable person, refuse to have serious dialogue via text. If you are dealing with someone who is unpredictably volatile, irrational, or substance-using, potentially violent, seek appropriate safety and guidance.

So, what to do? There are multiple right answers here, of course; feel free to enter into a text message discussion of why you dislike your sibling’s fiancé, or don’t want your in-laws at the birthday party, or are upset about your child’s fifth undergraduate major in three years. I’d recommend against it. I offer, as a starter set, a few options to firmly, and lovingly, employ as you refuse to play the “text message” game.

“I love you too much to have a conversation about something clearly this important to you by text. Let’s figure a time when we can both be well-rested and ready to talk.”

“This sounds like a topic best discussed face to face. When would be a good time for you?”

“I’m glad you let me know this is something we need to address. When can we discuss?”

The possibility exists that you are dealing with someone, including someone you love, who is emotionally immature. Perhaps they demand, imagining they need, immediate gratification in terms of “resolution”. By resolution, they may mean getting you to agree they are right or bullying you into capitulating in some other way. At worst, they may be willing to cancel you if you stumble through an awkward and unexpected conversation. If you love someone this immature, whether friend or partner or family member, it is a sad state of affairs.  Still, giving in and trying to have emotionally complex conversations by text message (or email) will ineluctably lead to misunderstandings that can be read and reinforced in perpetuity. Just refuse.

Because, of course, you love them too much to reduce their concerns to a mere text message.

Prodigal and in your face

The holy days of fall and winter have begun, with Rosh Hashanah and Yom Kippur behind us and Thanksgiving, Hannukah, Advent and the Christmas holidays closing in fast. The stores overflow with all things green, red and peppermint. This means that one of the dreaded markers of the season is also upon us. You might be thinking about the price of turkeys, or heating bills, or navigating the dynamics of family and politics, but I am thinking in particular of the seasonal outbreak of atheism and related forms of cynicism among adolescents and young adults. Except for the power to disrupt other people’s good times, I’m not sure why so many families experience the angry outburst, arrogant smirks or sullen refusal to participate in the traditional prayers and rituals of life just when it is most likely to hurt.  Other than the week of Passover and Easter, there is no time more likely to cause suffering, than the fall and winter holidays: the season seems to be a favorite target for unleashing pent-up bitterness over having been raised in a tradition of faith and culture.

So, if this has happened to your family, you’re not alone.  Over a quarter-century in the mental health field, I have had to see many families distressed at the verbal attacks, the rebellion, and the apparent determination to be hurtful. Fighting with the young person about it is, of course, useless.  Trying to listen calmly, refusing to participate in conversations that are disrespectful, and suggesting the conversation continue later (and then following up to be sure “later” can happen) are potentially helpful.  Give yourself time to calm down, seek guidance from other people, consider the direction being taken.  If the young person has decided that belief in God is a superstition, something incompatible with science, perhaps they are willing to explore this, including the substantial number of scientists who are convinced that there is a God. Perhaps they are willing to learn about intelligent design from non-biased sources.   When the attitude is not mere cynicism but actual anger, it is very painful. Sometimes the rage is about the perceived lack of choice, the complaint is that they didn’t want to participate in the faith from childhood and that the introduction into the faith, whether bris or baptism, was abusive and unfair.

A rabbi whom I consulted echoed the mental health professional’s perspective: look at what else is going on, what other issues are at hand.  Someone who has found clarity (as they see it) should be more peaceful, not angry. An adolescent or young adult who has decided that religion is just superstition might be annoyed at being expected to participate, but will not be enraged. Anger is the sign that the presenting assertion is merely the top layer. What else is going on? Why the sudden rage?  Is someone smart enough – smarter than Fr. Georges le Maitre, the Jesuit priest and physicist who developed the theory now called the “big bang theory,” apparently, by their own reckoning – simultaneously naïve enough to believe something just because some people who sound convincing said so on some internet platform? What other indoctrination have they absorbed with unquestioning readiness?

Of course, you won’t have this conversation at Thanksgiving, right after the young person drops the bomb of their atheism, or rejection of religion, or rage at you about their Baptism, Bar or Bat Mitzvah, or Confirmation. That’s the time to somehow find the patience to be, or pretend to be, calm, politely curious and willing to discuss this later.  The conversation may happen over weeks, months, or years; it may involve some third party – a religious advisor, a therapist, a wise friend who has been on the same road.

It won’t be a fun conversation, and we can’t control the outcome. By being calm, listening carefully, asking sincere questions and verifying that you understand, you leave the door open for further dialogue as well as for the possibility of a change of heart.

Changes of heart are hard to admit, and even more so in the world of social media.  If a young person adopts a position, there will be a host of online encouragers.  If the young person reports pushback from adults, there will be more voices, criticizing the adults, urging cutting off the relationship, etc.  But, if the young person announces a change of heart, some of these voices of encouragement can become accusing, vindictive, cruel. Backing out of a decision can always be hard; imagine telling your parents you’ve decided to drop out of med school to be a professional surfer.  Consider the people who go through with weddings because they don’t want to disappoint people. Even smart, competent adults foolishly move forward into situations they know are wrong because they don’t want the transient embarrassment and miserable, but also transient, short-term effects. How much harder it is for young people who haven’t finished developing a mature brain.

This means our first job, as adults, is to listen with compassion and find a way to keep the door of communication open.  This way, when the young person is ready to reconsider, or be less vitriolic, or simply have a real dialogue, it will not require they have the desperation of the Prodigal Son to take the first steps. Whenever the child takes those first steps towards dialogue and reconciliation, remember the father in the parable, who ran to meet the returning child.

An Echoing Silence

Does anyone ever admit that they are not exactly the best communicator around? Maybe even that they are crummy conversationalists, incorrigibly competitive, and a bossy know-it-all, too?  Probably not.

Wouldn’t that be nice to hear sometimes?  Someone freely admitting the “communication problems” are at least a little bit on their side?

Maybe you think there are communication problems – the person in question (spouse, friend, child, parent) “never talks with me.”  It may be on their side, certainly – most problems have multiple factors, and communication is no exception. However, you only have control over you – not them.  So, if the communication problem falls into the “we never talk anymore” column, perhaps the following might offer perspectives.  If it’s possible it might be you…

Are you the Conversation Hijacker?  Does every topic offer you a possibility to wrestle control of the conversation, taking over, changing direction and refusing to yield to the other people in the conversation?  They bring up the local baseball team and you take “sports” and launch into a detailed analysis of an entirely different game, the season ahead, and every stupid mistake the nearest team made when adding new players.

Perhaps you are the Professor. You don’t discuss, you lecture: expanding on your opinion, the evidence as you see it, and what’s wrong with other people’s positions, beliefs, or behaviors.  Expertise is wonderful; battering people with it is not nice.

Related to this, perhaps you become the Guidance Counselor or Coach: giving unsolicited advice, suggestions, and explanations of the person’s “problem” and the solution as you see it.  You don’t stop to be sure you have enough information to even begin to formulate advice; in your unconscious arrogance, you assume you have perfect-fit prêt-a-porté advice for every occasion.

Or, perhaps you are the Competitor.  They have a headache? You’ve had a migraine for days.  Their beloved pet died? You have three sad stories to top their heartache.  They have a muscle ache, but YOU need physical therapy.

Do you just launch into a monologue, barely taking a breath and not allowing the usual give-and-take of conversation?

Sometimes, the echoing silence on the other end of the couch is really on that end – your wife is lost in thought, your husband is anxious, your parent is depressed, or your teenager is preoccupied with stressors.  Perhaps there is some unresolved hurt between you. Perhaps, though, the person you love has fallen silent because they cannot trust you to stay in the conversation with them; they expect you to take over.