Category Archives: counseling

For Those Mourning a suicide

If you have lost someone to suicide, my sincere condolences:  peace be upon you in these incredibly difficult times.

I have been involved in grief counseling for a long time. I began volunteering as a grief support group facilitator about 20 years ago. Grief is always painful – the Irish language word clumsily translated into English as “Troubles” actually means tearing apart.  Losing someone to suicide is definitely a tearing apart, and one that carries particular burdens.

  • They are even more likely than other mourners to look backwards and try to reinterpret events to make sense of what happened. We humans like for things to “make sense,” even things that can’t be understood. Looking back can lead to a lot of unnecessary suffering – self-blame, recrimination, guilt.  Our culture pretends we can control just about everything, but we cannot. Through the lens of grief looking backwards, even a passing sad day years before can seem like a sign that was “missed,” and the perfectly normal little disagreement turns into the possible cause. Every memory is scoured for warning signs. The lists of warning sides of suicidality are helpful, but not all people have them. In reality, about 70% of suicides are impulsive acts – there are no real warning signs or markers, beyond the events of life that many people experience without becoming suicidal:  relationship struggles, financial struggles, legal struggles, job loss.  Some people will show some of the warning signs but are not be suicidal at all, such as someone who is enthusiastically minimizing their possessions in order to downsize. Please try to refocus on something else, even a small physical task, when you find yourself looking back to try to see what you “should have” seen: you are at risk of burdening yourself with unnecessary guilt.
  • Those whose loved one committed suicide are likely to hear even more of the hurtful things people can say to those grieving. Granted, most people’s hurtful remarks to mourners are well-intentioned, and yet incredibly unhelpful, such as the dreadful, “You’re still young…you’ll have other children,” or, “You should be glad they’re not suffering any longer.”  There are some people, though, who say truly, intentionally horrible things about those who commit or attempt suicide, and this leads mourners to lie about the cause of death and/or isolate from others.  Avoid these people; seek the company of those who are compassionate.
  • Those who have lost someone to suicide are especially likely to avoid going to grief support groups, or will only go to those about suicide.  I encourage going to a general grief support group, too; it can be a place to learn a lot of skills and strategies that are helpful to all mourners, and can be that first, safe place to talk about what really happened and get support as you manage the tangle of terrible emotions. You will find strategies and support for how to take one step at a time into a world that seems to no longer make sense. Please do not isolate out of pain, unnecessary shame or unnecessary guilt.
  • See your primary care doctor, avoid any mind-altering substances, and try your best to follow medical guidance – even though you will often not feel like eating right or exercising.
  • Seek individual or family counseling to help with the grief process as needed.

And, of course, as this is not psychological guidance or advice – just information and encouragement – reach out for help if you are struggling with suicidal thoughts or fear for someone else. Besides your health care provider, the local emergency room, or 911, you might call the National Suicide Hotline at 988 or the 1-800-273-TALK (8255) National Mental Health Hotline.

If you are reading this and thinking of someone you know who has lost someone to suicide, please reach out with compassion. Be present; keep reaching out. Invite for simple things; offer specific help (with chores, for companionship, to go with them to a grief support group because going is, at first, absolutely terrifying). Please do not ask a lot of questions about the death; if the person is open, instead ask about the person: the happy memories of the past. Ask if you can help and don’t be surprised if you hear, “I’m fine,” or, “You can’t bring them back,” or, “I don’t need anything.”  In that case, come back another time with specific offers (“Can I come by sometime and help with the lawn?” “Are you up for a cup of coffee at the park?” etc.).  Be gentle with people who have been torn apart.

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.

Cutting off Mom and Dad, Part 1

We were talking about families, generally, over breakfast.

“I don’t know why family therapy isn’t held in greater esteem,” my husband commented. “Look at what things are like for families…people are really struggling.”

I agreed with the struggling. And, yes, it would be nice if family therapy were more respected. It is rich with the integration of lifespan development, evolutionary psychology, personality, temperament, and culture. Family psychology and family therapy seem to be the neglected child in the world of mental health. Yet every theory of development, and most personality theories, see the family and early life experiences as foundational to the development of the adult person.  How we attach to others, the ease of trust, our expectations of the world, are all rooted in life experiences, particularly those early life experiences most often lived in the context of family.

Well, of course, if we emphasize family then we are saying family is important, pivotal, vital. And that, it seems, flies in the face of much of the mainline culture.

I will take one small slice for now: the bizarre movement to cut off parents who were not, and are not, abusive, neglectful, cruel, or so otherwise dysfunctional that remaining in active relationship with them would be endangering to one’s safety and/or sanity. There seems to have been, over the past few years, a growing movement in this regard. I have spoken with people, and read books by professionals, on both sides of these issues: the grieving parent and the disgruntled adult child; the professionals who attempt to help parents bridge the gap or, if that is impossible, to heal from the grief, and the therapists whose main lens is the toxic relationship that will only hurt you until you extricate yourself.

Are there cruel, abusive and destructively manipulative parents? Yup. And, likewise, selfish, cold and manipulative adult children, too.  And my somewhat limited professional experience (I’ve been in this field about 30 years) is that sometimes children who cut off parents did not have abusive, cruel parents. Sometimes, people cut off parents who did not do what the child wished, did not read their minds, did not feel obliged to agree and praise everything their child did.

And here we come to a piece of the culture guaranteed to undermine the family: the demand that people validate and accept whatever one thinks, feels, and does as indisputably “okay” because it is how we “feel,” etc. Well, now we have a problem that any family therapist could easily explain.

Mommies, generally, give children the majority of early care.  They provide unconditional love and approval because, as Dr. Jordan Peterson often points out, infants are “always right.” If the baby is crying, the baby is right: something needs attention, swiftly, lovingly and gently! That loving care must come even if baby is colicky, pukey, poopy, or otherwise quite disagreeable.  The baby is, after all, always right. However, this stage of life passes, and then Daddy’s influence increases: Daddies specialize in unconditional love with conditional approval. “I love you, and the room is a mess. Get going on it, kid. Here, I’ll give you a hand.”

This coordinated approach works great: it prepares children for the real world, where people have expectations and you can’t just do “whatever” and then complain it’s how you feel, and have everyone act shame-faced, shrug and say, Oh, OK. If that’s how you feel. Whatever.  Children benefit from the solid backing of both parents’ love, and the experience that disapproval of how I behave does not mean I am not loved. It means my behavior probably needs improvement.

The world, or the part of it to which children and young adults are often exposed, plays another tune. The modern message is that the relentlessly approving gaze of a nursing mother ought to be the perspective of parents forever, across all circumstances. That is a set-up to disrupt and undermine the family.

And it appears to be working terrifically.

A child goes off to college and is enlightened about…it matters not.  Politics, nutrition, whatever. They realize their parents are abject idiots. Worse, their parents may be bad and ill-intentioned because, look! A younger sibling is being raised in a religious/liberal/conservative/omnivore/vegetarian/whatever home. Big sibling becomes disrespectful towards the parents, dismissive, and undercuts them in an attempt to rescue little sibling from the fate of growing up in the same family.

Or, a young adult who is apparently sliding along, perhaps in perpetual adolescence, shifting from goal to goal, engaged with street pharmacology or alcohol, resents the parent who dares express concern and perhaps even the intent to turn off the money tap. Anger, resentment, and accusations flare; the young person demands parental fealty, blames the parents, and the parents, afraid of losing the relationship, are tempted to cave and pretend that a ten-year cycle of major changes in undergraduate school is just okay. It wouldn’t be okay even if the young person was the one financing it with their series of so-not-serious jobs; it would still be a waste of talent and youth.

In short, the mainstream culture offers the illusion that new-mommy bottomless approval is what is normal for adults. Do parents contribute to the problem of parent/child alienation? Absolutely; and that will be a story for another day.

What’s up with that?

Why do you do what you do?

No, seriously. Why do you do what you do, whatever it is that you do?

Could you get a bit obsessive about this question? I suppose so. But it is worth asking, over and over again.

You got out of bed at whatever time it was. Why? For what purpose?

Why did you eat and drink what you ate and drank? Or, why did you choose not to eat?

What did you put on your body to wear out into the world, to tell other people about you, your tastes, and your intentions?  Why those messages, and not some other messages? Why are those the messages you choose to give to the world?

Why did you go to work? Why did you choose that work?

Why did you behave that way, and not some other way, towards whatever persons you encountered along the way?

Why, why, why, why.  Sometimes it is important to take a step back and ask that defense-raising question of yourself, repeatedly, digging in.

Well, why, you might ask, and it is a worthwhile question.  Asking ourselves “why” is very important, because, if we drill down far enough, we come down to whether or not we have decided upon a central principle, a guiding ethic, a core belief that allows us to direct our behavior with cohesion and authenticity towards our purpose.  If you don’t have a “why,” you are less focused than the average toddler. A toddler can be remarkably determined in pursuing her goals, despite an inability to clearly articulate the “why” for coloring on the walls or giving Teddy Bear a bath in the toilet. 

For religious people, the central “why” comes down to a covenantal relationship with the Lord and, for Christians, a relationship with Jesus, the Christ.  That is the “why.”

Why get out of bed on time? Because an orderly life (ordered to what is best) requires self-discipline and routine, and honoring one’s legitimate commitments to others.

Why be kind to the barista, the cashier, the slowly shambling person in front of you on the sidewalk? Because they, like you, are a child of God and your rooted relationship with Him requires you to treat others as His children, too.

Why be honest with someone when you know it will be ill-received – the student whose work is apparently plagiarized, the employer asking you to do the unethical, the adult family member who is drinking in excess? Because it is important to be truthful, to not allow dishonesty to muddy the waters of relationships and to let yourself slip into that mud out of fear of conflict. Because your relationship with the Lord requires you to act honestly, justly, and with love.

Wishing you a new year full of the joy of discovering beautiful “why’s” in your life!

When God Speaks

“It just seems awful convenient that whenever my dad prays, it turns out God tells him to do whatever he wanted to do in the first place.”  The teenager was slouched, watching me sidelong through floppy bangs, waiting to see how I, the Christian counselor, would respond to his cynical appraisal of his father’s approach to prayer.  I nodded slowly and asked for examples…examples that seemed, I thought to myself, to at least support the child’s misgivings about prayer in particular, and religion in general.

My experience is that, more often than not, what I experience as God suggesting a course of action is precisely what I do not want to do.  Whether this is because I am by nature and habit a worse person than this boy’s father or I am more honest about not liking to do some things, I cannot know.

If you are not a person of religious faith, no doubt this all sounds pretty crazy.  Perhaps you suspect that Christians are hallucinating, or pretending to do so, in order to fit in with the group.  Who know; perhaps that happens.  What a non-believer may not know is that when Christians talk about discerning a message from God, we are likely talking about one or more of these experiences:

  1. The thought that pops up, unexpected and persistent.  For example, I had the thought pop up to call someone with whom I hadn’t spoken in a year or two. The thought nagged at me. “I really should call ‘Beth.’”  It turned out that ‘Beth’ had just had a death in the family, and other trials, and needed some friendly encouragement.  A non-believer thinks of that as a coincidence; a believer attributes it to God’s Spirit at work in and among us.
  2. The events of our lives: the series of experiences that are, perhaps, unexpected and beckon us to pay attention to a pattern. Perhaps we have been ignoring that pattern; perhaps the busy-ness of our lives has fogged our attention. This might also include
  3. The people around us; their words and actions may plant seeds. They might speak truth to us, including truth we don’t like, such as confronting us on a bad habit or poor choices.
  4. God’s Word: Scripture speaks across the centuries. For example, consider how quick many biblical persons were to rebel and give up when the going got tough – despite all the good they had experienced. How different are we, and what could we draw out of these examples to be more persistent in times of trouble?
  5. Through beauty:  nature, art and music, literature.

There are others, of course, but these are perhaps the most common. I have known two people who claimed to have heard a booming voice speak to them, but mostly, when people talk about messages from God, it comprises one or more of the above categories. They do their daily scripture reading, and then encounter a similar message in a song, or a news story. A friend shares an experience that echoes that theme, and a thought pops in, unbidden and somewhat surprising, “Perhaps I should…” or, “I really need to…”

If you are a non-believer, you might attribute all this to coincidence, or some vague power in the universe. A matter of quantum physics, you might shrug, imagining a little particle in “Beth’s” brain synchronizing across the miles with its partner in mine. It seems that the most elemental grasp of what is suggested by quantum physics should quell any urge towards atheism.

Anyhow…that’s a mini-explanation of what believers often mean when we talk about hearing from God. I hope that clears up any silliness about mass psychosis.  As my young client noted, it might be discernment, and it might be a convenient little personal excuse; that is inevitably our human nature.  We see what we want to see, except when we unexpectedly encounter a mirror. But that is a story for another day.

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.

I could tell you, but you’re not going to like it: Anxious Youth

As you know, this column isn’t intended as psychotherapy or professional advice. It’s information and entertainment, and, I hope, the spark for some conversation with someone who can help with a problem. The problem here is anxiety in all its forms.

According to the Anxiety and Depression Association of America, about 31.9% of youth have some sort of anxiety disorder.  This would include diagnoses such as generalized anxiety, separation anxiety, panic disorder, and trauma disorders. It’s hard to believe this is accurate; if it is, then as a culture, things have gone horribly wrong. 

We know a lot about what works, and what doesn’t work for anxiety.  Isolation, the vortex of doom the internet can be, the misguided or malevolent support of random strangers online, endless social networking, and a sedentary, sleep-starved, junk-fed existence don’t work.  Overscheduling doesn’t work. Avoidance doesn’t work. Irresponsibility doesn’t work. So do the opposite.

Get off the devices except for schoolwork.

Get enough sleep. Go to bed at a set time, get up at a set time. Every day, even weekends.

Cut down on activities.

Read real books. Learn about other people’s interior lives via good fiction (that’s a primary reason that we read classic literature in school; to understand more about how other people think, feel, and respond to life’s events). Then talk about them. That means parents should read them, too.

Get physical activity.  A healthy young person needs at least two hours of activity a day, and ought to be standing, moving around, and active a big chunk of the rest of the time.  

Learn useful skills.  For example, everything it will take to manage one’s own money, car and home.

Socialize in person, often while doing something purposeful (whether that’s a sport, volunteering, or other activity).

Spend a lot of time in nature. If it can’t happen just about every day, plan a four- or five-hour chunk on the weekend.

Have chores and responsibilities for young people.  No, “school is not their job” and therefore nothing else is to be done around the house. How are they going to learn necessary life skills? Plus, who wants a spouse or roommate who thinks going to work covers them for any contribution to home and family life?

Learn mindfulness meditation skills, to slow down the stress response and “step back” from anxiety-provoking thoughts. This facilitates the cognitive restructuring of cognitive-behavioral therapy, in which new ways of thinking and behaving are identified and rehearsed.

…and try cognitive behavioral therapy (CBT), preferably with at least one parent learning, too, to be coach and to help the parent. Anxious parents tend to teach their children fear-fueled ways of thinking and behaving, and anxious parents are apt to facilitate avoidance.  Avoidance is like jet fuel for anxiety. Find a licensed mental health professional who will work with you as a family to teach the skills. Keep in mind that CBT will work much better if the other parts of life are in healthy, working order – proper sleep, nutrition, exercise, etc.

To expand on an earlier point: parents, often your anxiety feeds your child’s anxiety. If you are behaving as if the world is a terrible, dangerous place, do not be surprised if your child responds the same way.  Making changes together to have a healthier, less anxious lifestyle will help the whole family.

I could tell you, but you’re not going to like it: Why doesn’t she leave?

Hint: whatever the reason is, odds are, she’s not “codependent.”

Your much-loved friend, your sister, your cousin – someone precious to you – is in a hellish relationship. Not a call-the-police violent relationship, but something similar: a toxic, gaslighting, crazy-making mess of a relationship that whirls up and down and around like a psychological roller coaster from Hell.  One day she’s fine, the next she’s a weepy, shaky, self-doubting shadow of her usual self. Over the days, weeks, or months, you’ve watched her change from confident, funny and insightful to anxious, depressed, maybe even physically ill. You can tell the problem is her partner; everyone can. Why can’t she?

I’m using the female pronouns because, although the torment can flow in either direction, research and the experts in the field indicate the pattern tends towards the victims being female and the dark-triad partner being male. 

Dark triad types – more often male, with antisocial, narcissistic, and Machiavellian traits, and often sadism thrown in – prey on victims. They assess the prey and find the way to quickly gain her trust.  The typical prey makes this easy, because it is her positive personality traits that will now make her vulnerable to this predator. The relationship started out fast – intense, a burst of attraction and an amazing number of similarities. In retrospect, you think, too amazing. The “too good to be true” turned out to be, well, untrue.  The cycle of drama – accusations, fights, threats of abandonment, and, ironically, your friend seeking forgiveness sometimes – keeps her off balance, on the ropes, without enough peace to think things through.

Very often, the women who find themselves in relationship with manipulative, emotionally and psychologically abusive, and often financially exploitative and sexually manipulative men, are the people you’d love to have for a good friend. They are high in the personality traits comprising the primary traits of Agreeableness and Conscientiousness.  Agreeableness includes traits such as friendliness, honesty, a willingness to put others first, and nurturing.  Conscientiousness includes loyalty, perseverance, and dedication. These people are often great parents and wonderful friends. These traits bite them in the butt when a predator exploits those very strengths to draw the woman into, and keep her in, a chaotic relationship that never settles down enough for her to have time to reflect and figure out what might be going on. Sometimes, her best hope is that she starts feeling like she’s going crazy and seeks therapy…and finds a therapist who sees, not codependence and a victim’s participation in the dysfunction to meet some unhealthy psychological need, but a person whose strengths have, in this unusual situation, become a trap.

Maybe you wonder, reading this, how good traits can be a trap…just think about your own history. Were you ever the team-member, at school or work, who dutifully did your share and more, while others slacked off and still got the shared credit? Has your loyalty been exploited by a “friend?”  Have you loaned money to a friend or family member on a word and a handshake – only to be avoided, and unpaid, later?

Part of the trap for your friend will be, ironically, compassion for the predatory partner, who has probably included in his story a carefully curated tale portraying him as a noble and heroic victim.  Her compassion, nurturing and desire to be helpful (those great-mom, great-friend characteristics) now propel her into fix-him mode.  His anger at her can all too easily be interpreted through the lens of his pain and frustration. Out of care for what she believes is a suffering fellow human being, she gets tangled in self-blaming, guilt and confusion. She easily believes his supposed distrust of her that seems to erupt out of nowhere is due to his attachment wounds, and buys into a notion that patient endurance and reassurance will heal him. And yet…sometimes he just lashes out, apropos nothing, and then denies anything even happened.  He berates her and tells her later she’s exaggerating, overreacting, imagining things. Stop making up lies about me, he rages.

So, if she wonders, half-rhetorically, on the few times you manage to see her alone, if she’s “going crazy,” don’t agree. Don’t accuse her of being codependent.  Listen, actively.  Gently question her: is it okay that he keeps texting while the two of you, who have known each other forever, have a cup of coffee? Does he do this a lot? Share your observations and concern for her (not criticism or blaming). Ask what keeps her in the relationship and, if she admits to feeling trapped, be kind and firm in your assurance that she has people to help her. She is not trapped, no matter how stuck she might feel.

The manipulative partner creates so much emotional turmoil and distress that it becomes almost impossible for the victim to think clearly.  Part of this is because of the cognitive dissonance the victim feels: the confusion and distress of holding conflicting thoughts of this magnitude: On one side are the “good” beliefs about the partner because of their seemingly perfect match and on the other, the anguished, distrustful, terrified thoughts because of the confusion of demands, accusations and threatened abandonment.  Your friend probably can’t think straight – for now – but, again, it isn’t because there is something “wrong” with her.  She is in the midst of a prolonged trauma.

Thus, the most obvious (to you) parts of a solution may seem overwhelming or impossible.  Moving the abuser out of her place? Not impossible.  Moving her out of the abuser’s place? Not impossible. While she may feel unable to cope with the finances, her pet rabbit/dog/cat/bird, and the task of moving possessions, her concerned friends and family can easily help slice this problem into manageable pieces.  Someone has a guest room or garage apartment or mother-in-law suite; someone can foster her pet at their home while the dust settles; someone has a truck for everyone to gather and load up so she doesn’t have to face the process alone; someone can coach her through changing all her passwords and un-merging her phone, etc., from the partner.

This situation is heartbreaking to endure. Keep reaching out; do not give up on your friend/family member/cousin.  Maybe it’s even worth having a little movie night – without her partner – to watch the classic film, Gaslight, starring Charles Boyer and Ingrid Bergman.

I could tell you: Bryce Canyon Therapy

I could tell you, but you’re not going to like it…there’s no way to defeat fear without going through it

I am afraid of heights.

Not, “Eew, a little squeamish standing on the observation deck at the Empire State Building” afraid of heights. I mean, heart-pounding, sweaty-handed angst when faced with the open stairs in your typical outdoor, three-story-ish observation tower. I come by it honestly; I apparently took a few hard tumbles down long flights of stairs as a toddler. Hence the reality that “falling can and does happen, and it’s bad,” is hardwired in.

The thing of it is, avoidance works perfectly if by works you mean, never feel that afraid. It also means missing out on things, standing around at the bottom of things feeling slightly foolish when everyone else goes up and looks out over scenic vistas that I will see as a thumbprint on their cell phone screens.  The only way to reduce it, or at least have the experience that fear will not be what kills me, is to go through it.

Enter our long-planned, long-saved for vacation earlier this year to Utah, where we joined a small group tour hiking and camping and taking in five of the national parks: Arches, Bryce Canyon, Capital Reef, Canyon Lands and Zion.  The first day, we set up camp nearby and drove over to Bryce Canyon to see the canyon at sunset and see the trail we would take on the next morning just past sunrise – a narrow path down the cliff walls, through the varying terrain of the bottom, and back up the narrow path along the cliff walls.  I spent half the night in turmoil, crying with fear, and woke up knowing if I did not do that hike, I would regret it for the rest of my life. Meanwhile, of course, my amygdala were trying to convince me that the rest of my life would be short because I would certainly fall off a cliff and die.

I did hike the trail, sometimes in tears, sometimes trying to melt into the cliff face away from the edge (sorry, everyone who had to pass me; I disobeyed the rules of foot traffic on that).  By the end of vacation, I was navigating through elevations with much less fear. I am not a fan of heights, and probably never will be, but I know I can feel afraid and still do reasonable things.

Sharing this tale with friends, one shared that he, too, is afraid of heights and that’s why he decided to apply to and go through jump school in the military (as in, jump out of perfectly good airplanes). He didn’t expect it to cure his fear of heights – it didn’t – but it did do what he hoped, which was convince him he could handle scary things, something he wanted in his pocket before being deployed to war.

The purpose of this rambling set of tales is to illustrate what’s happening when we therapists annoyingly insist people face their fears, even one small step at a time, if the fear is keeping them from doing the normal, necessary things of life and/or barring them from their goals. Whether it’s elevators, public speaking, or driving over bridges, only taking the small, often agonizing steps forward works. Thinking about it, waiting until you’re magically not afraid, or postponing only convince your emotional, instinctive brain parts that the situation in question merits that level of fear. In other words, avoidance doesn’t reduce fear, it increases it. Every time I started up an observation tower, freaked out and sat down on the steps and then crept back down before reaching the top, I didn’t accomplish anything except making my fear worse.

So when, as the therapist, I encourage you to plan out, with me, and begin taking small steps towards conquering the fears that block you from living as enthusiastically as you’d like, I am not being mean or insensitive. I am not failing to understand how gut-wrenching fear can be. I get it. Really. As in fear-sweat drenched, heart-pounding, climbing that narrow path in and out of Bryce Canyon on a hot day getting it. 

(Un)Social Drinking

4th in a series: I could tell you but you’re not going to like it: Social Drinking often isn’t.

Yet again, I am stepping into the fray to offer the kind of information that can be helpful but feel quite unwelcome. In this case, it’s the raw fact that, for many people, Social Drinking…isn’t.

Social drinking is one of the terms for the use of alcoholic beverages in disciplined moderation, with others: the glass of wine at dinner, the single drink at happy hour.  It means the person is not an alcoholic, and everything’s under control…but as the term is used, perhaps not.  The American Psychiatric Association has established a low bar to meet the criteria for mild Alcohol Use Disorder: these are two of the many criteria, and perhaps these two will resonate with some social drinkers:

“Alcohol is often taken in larger amounts or over a longer period than was intended” and

“Continued alcohol use despite persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of alcohol.”

In other words, if someone often drinks three glasses of wine when they meant to have just one, or plans to have “a drink” with a friend that turns into a three-hour hangout with multiple drinks, that is a marker of a potential problem. If someone uses alcohol, and then becomes argumentative with friends and/or family, or zones out in front of the television and, yet again, neglects chores or short-changes the dog’s evening walk, the so-called social drinking isn’t just social drinking. Stir in failing to get up on time for work due to a hangover, or having the alcohol cause headaches, belly aches, acid reflux or blood sugar issues, and there is a storm coming.

So, perhaps, unless your physician advises otherwise, you might do a bit of an experiment if you are a social drinker. The experiment is, no alcohol for a month; six weeks would be better. Fighting a habit takes time. Then see what happens.  If you discuss alcohol with your physician, please be honest: the health professionals’ unofficial guideline when people tell us about alcohol use is, double it, or perhaps even triple what the person tells you.

Evening alcohol use disrupts sleep; people may fall asleep more quickly but will often have sleep problems a few hours into the night.  Alcohol impacts the brain in a host of ways: it impairs balance and spatial judgment, slows physical reaction time, weakens impulse control, and interferes with cognitive functioning. It also interacts dangerously with a host of common medications, including but not limited to medications for pain, anxiety, depression, OCD, ADHD, allergies, and more; if you are on any medications, over the counter or prescription, check with your pharmacist about using alcohol with these medications.  Mixing alcohol and medication can be deadly. Perhaps during your alcohol-free weeks, you will find yourself more motivated to get up and get that morning walk or workout in; perhaps you will have fewer unproductive arguments with the people you love. At that point, it may seem that social drinking may not be social, after all.