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Why Group Therapy Works, Part 4

by Sam Bearer, PLPC

We’ve already looked at how group therapy is a great way to help individuals make changes in their lives by choose to be radically vulnerable with the other group member, fostering in himself or herself an outlook of unconditional positive regard, and allowing the very personal, negative feelings about himself/herself or others to be shared and eventually challenged by the other group members.

This final piece focuses more on how the group can invest and intervene in the individual member’s life. Following the individual work of being open, the group now has the opportunity to disrupt radically the emotional foundations underlying each member’s coping behaviors that got him or her into therapy.

As the group gently and slowly does this work of disrupting the members’ coping behaviors, the internal dynamics of personal guilt and shame frequently rise to a conscious level.  At this point, every man I have seen who comes through our groups retreats back into his comfortable style of relating. It is nearly impossible in the early stages of work for the man himself to see this happening and do anything to stop it.  Often, he can no longer differentiate his personality, style of relating, and identity without an outside perspective or help.  It is no longer a conscious choice.  He may not have even noticed it happening.  But, I am willing to bet 99 times out of 100 that some other member in the group noticed.

The group is meant to be that outside reference point.

Once again, vulnerability comes into play here, because the group member who noticed should be willing to appropriately, with unconditional positive regard, call out his group mate.  This reintroduces all the dynamics of the personal work from part one: vulnerability, maintaining unconditional positive regard, and personal investment.  It also adds to it the gut check of interpersonal conflict. The group members are doing exactly as they should when they can reflect back both the positive and negative they experience in relating to each member.  This work engages members both internally and externally at once.  This may seem obvious, but it is so important, not to mention difficult.  We do this kind of thing in our lives all the time.  However, we are rarely fully engaging our awareness of both pieces simultaneously.  It takes hard work to build up this new skill.  Like learning a new language, we have to take many fumbling attempts to communicate this new way, and we usually struggle at it for a while.  The safety created in the group should promote and celebrate these attempts as well as normalize the experience as something everyone in the group is fighting to do better.  It takes time as well as higher levels of concentration, self-awareness, and intentionality than we generally are used to.

It needs to be said here that this process, in therapy as well as practicing these skills in life, will take some time to sink in.

This is especially true when you consider there are years if not decades of reinforced acting out behaviors that a client wants to change.  It is likely to require a proportionate amount of time and effort for this new way of relating or sense of self to take shape.  Other factors that might increase the length of time and work to be done might be connected to and complicated by experiences of abuse or trauma.  Though the progress may be slower than an individual may like and expect, small changes over time add up to big changes.  These small steps along the way should be highlighted and celebrated as part of the greater changes each client wants to see in his or her life.

 

Why Group Therapy Works, Part 3

 by Sam Bearer, PLPC

Group therapy is a great way to help individuals make changes in their lives.  There are several aspects of group work that help make these changes possible. The first two I’ve talked about focus on the client’s investment in the group process. The first is for each group member to choose to be radically vulnerable with the other group members. The second is for each member to foster in himself or herself an outlook of unconditional positive regard in which it is safe to share, feel, learn, and empathize within the group setting.

The next piece focuses more on how the group can invest and intervene in the individual member’s life. Following the individual work of being open, the group now has the opportunity to disrupt radically the emotional foundations underlying each member’s coping behaviors that got him or her into therapy. This is one of the most difficult parts of group work, but as is usually the case with therapy, it is essential for change.

Each member must allow the very personal, negative feelings about himself/herself or others to be shared and eventually challenged by the other group members.

These negative feelings are both bound up in and displayed by each person’s style of relating.  Almost without fail, these negative feelings have been activated within the first few sessions of group work because of conflicting expectations, styles of relating, radical vulnerability of some members but not others, etc.  However, they most likely have not been fully expressed.

This is so difficult for many reasons. The most common roadblock is that the learned responses to emotional stressors, also known as styles of relating or coping patterns, are so ingrained and automatic that slowing the process down into separate phases or component parts can be daunting.

Individuals often identify themselves as inseparable from their comfortable style of relating.

In our next blog, we will conclude this series on why group therapy works.

Why Group Therapy Works, Part 2

by Sam Bearer, PLPC

In the first part of this blog series, we looked at how vulnerability in a therapy group is key to unlocking positive change in our group members’ lives.  The second way group therapy works is by offering the experience of unconditional positive regard of the group for each particular member, both in a single instance of intentional vulnerability as well as consistently over time.  This experience becomes an emotional touchstone for a reality fundamentally at odds with, and outside of, the negative emotional experiences that so often serve as the foundation for addictive behaviors.  If we didn’t have these negative emotional realities, or had a better way of coping with them, we would not have to resort to our numbing drug of choice. 

The trouble is that at some point we learned to survive the negative emotional storm by using something to numb, and we became hooked. 

As a result, we have lost the internal resilience to be able to handle it.  This dulls our awareness to such a degree that we are no longer conscious of the emotions that drove us to use in the first place.  One unique way that group work helps to uncover these emotions and simultaneously provide an experience of unconditional positive regard is through playing out the relational patterns and dynamics that an individual learned in his family of origin.  However, because the group is not that same environment, the members of this “new family” will respond differently to an individual’s usual style of relating.  For many, this brings up all sorts of anxiety, but it also brings the possibility of learning different ways of coping with these anxieties in the here and now.  Each member experiences the other group members reflecting on how they are affected by each other’s stories and then learns how more accurately to process, reflect, and self-evaluate openly with the group. 

A person may never have considered the questions or perspectives that are shared by others, or he may receive empathy from the very kind of person he assumed would regard him as weak or unimportant.

 The way group therapy ties both of the dynamics of vulnerability and unconditional positive regard together is a safe environment.  This is in part created by the therapist but must be maintained and reinforced by the group.  If safety is not a common value of the group, it won’t be possible to adequately support members or appropriately challenge them, which I will talk about more in the next part of this blog.

Why Group Therapy Works: Part 1 

by Sam Bearer, PLPC

There is a lot of research out there evaluating the efficacy of group work to address lots of different issues. The evidence is clear that group work is tremendously effective in helping individuals make positive changes in their lives.  But why?  For the past two years, I have volunteered with a local ministry that runs men’s groups to address sexual addiction and acting out.  I have had the chance to observe and think about what makes these groups work.  This experience has helped me identify several different components that I believe are key to unlocking positive change in our group members’ lives.

The first is choosing to be vulnerable.  Every man that has come to our group has felt ashamed, isolated, and singled out by the experience of feeling trapped in his addiction or by being exposed in it.  The terrible discomfort of this experience may be enough to get him through the door and into therapy, but it doesn’t mean that the therapy will be effective.  The work each person has to do is to risk being totally open about his struggle in therapy.

Within a therapy group context, there is little room to shade the truth or hide parts of it.

One of the easiest and most prevalent ways of avoiding vulnerability is to share only the parts of the struggle that we have shared before, or can be framed as something that we used to struggle with or happened in the past.  So often, these past struggles are also very much present ones, but by placing it in the past, it puts convenient barriers up which it is easy to hide behind.  We have all tried to hide our struggles at one time or another.

At some point in our story, we learned it wasn’t safe to share and be vulnerable because someone close to us would exploit our weakness.

Group therapy is intentionally confronting this emotional reality and seeking to do the opposite.  Again and again, I have seen group members gently confront each other about whether or not individuals are sharing all of the impact of the story or just the safe parts.  When a group member deliberately and consistently chooses not to hide in this or other ways, it becomes possible for the other group members to empathize, connect with, and enter that individual’s experience in the present.  This willing vulnerability is a sign that change is already taking place in the group member as well as opening the door to the possibility of deeper, positive change.

Cultivating Patience

Cultivating Patience

Since I started working as a counselor after getting my degree, I have realized how little patience I really have.  

Cultivating Patience

I spent a lot of time both in classes and in my internship thinking about the problems my client might have and how best to approach them.  However, with people outside of the counseling room, I find myself much more prone to aggravation and frustration when things seem to be working less efficiently than I think they should.   The other day I was having some issues with the self-checkout machine at a local store.  After a few moments, I began inwardly cursing the machine and its creator when an employee came over to help me.  Some of my frustration spilled over into my tone in talking to her about that problem.  I had intended to convey my pique with the machine, but this lady took it personally.  I recognized too late that I might have chosen better words to express myself.  She sorted out the issue, and on my walk back to the car, a thought struck me.

It was not the machine that I had been upset with at all.  I was upset because the few moments wasted standing in the store were cutting into my time on a Saturday.  

It was the lack of progress toward the next thing that was bothering me, and I didn’t even have a “next thing” planned that day.  My internal feeling of stagnation triggered a sense of minor outrage that then affected another person’s day.  But why is that feeling of stagnation or no forward progress so hard for me?  I believe it is because I get a great deal of my sense of self or identity in the things I do or how I do them.  When things don’t go smoothly, a little bit of that sense of self is challenged.  The lady was simply reflecting back to me what I was feeling, an undermined sense of self or power.

Simply put, I needed more patience to deal with the situation.  I needed not just patience with her or the machine, but patience for myself to slow down and do the self-awareness checks I so often encourage my clients to do.  It is so important for me to recognize that my agency, identity, or power, or lack thereof, is not defined by those moments when things don’t go right, big or small.  Those things are practiced and displayed in those moments.  The patience required to handle them better, however, comes from pausing and remembering. Regardless of how I handle this situation in the present moment, I am worthy of the same kind of care I seek to display to my clients.  

My impatience in these kinds of moments is likely this lack of self-care in action and keeps me from caring for others in those moments as well.  This is why cultivating patience for myself as well as others, is the way not only to becoming a better counselor, but also a better human being.

By: Sam Bearer, PLPC

Opioid Addiction and Community Support

Opioid Addiction and Community Support

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Recently I (Lianne) was asked to be a part of the Mental Health and Wellness Summits created by Missouri Care, A Wellcare Health Plan, Inc.’s Community Impact Council for the Faith-based Community as a panelist.  The first Summit was on April 7 at The City of Life Christian Church in St. Louis, MO and it addressed the Opioid Crisis within the Faith-based Community.

Thankfully the Summit was recorded because the information shared is valuable and educational.

During this half, you will learn about why opioids are so addictive and how this epidemic has grown to where it is now.  You will also learn about how Mental Health stigma’s are hurting our communities and the people within them.

The second half of the Summit talks about the addictive cycle and then the panelist’s field questions about this issue, care, counseling, and faith.

I hope you take some time to listen to the recordings of the Summit.  The information and wisdom shared will prove helpful to those in social work, counselors, parents, teachers, pastors, and other care providers.  Teens would also benefit from watching these videos with their parents and could lead to beneficial conversations to help your teen make good choices and bring understanding to them about the seriousness of the opioid problem.

To those with a loved one struggling, there is hope!  There are many services available to those who are struggling and for their loved ones.  These resources are highlighted in these videos.

There are more Summits coming up over the next few months.  Below is a list of Summit topics and dates.

-Saturday, May 12, 2018, The Church and Suicide (Body Shaming, Self-Image, Bullying, Depression)
-Saturday, June 2, 2018, The Church and Trauma: Mental/Behavioral Health and the Homeless Man
-Saturday, July TBD, 2018, The Church and Trauma: Domestic Violence

By: Lianne Johnson, LPC, CTP

New Year’s Resolutions

With the start of another new year, many of us find ourselves focusing on things we’d like to change in our lives – many of us call these changes New Year’s Resolutions.

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Popular points of focus include health and wellness, career goals, financial management, and planning for the future.  These are all very important things to evaluate regularly, and the beginning of a new year seems like a particularly appropriate time for evaluation and reflection.  However, we fail to actualize the vast majority of our resolutions, and this failure has a great, negative emotional impact.  This isn’t usually because of a lack of planning or resources to achieve our goals.  

Rather, it is because we lack awareness of the emotions driving us to make resolutions to change.

One of the clearest examples of this is with the proverbial commitment to eat better and lose weight.  Many of us overindulge, stress eat, or “reward ourselves” over the holiday season at the end of the year and then subsequently attempt to restrict our eating to healthier options or simply less volume overall in the new year.  We tell ourselves, “Well, I’ve had mine. Now it’s time to be good.”  We say we will “eat right” as if we were being bad or wrong previously and really knew it deep down the whole time.  This idea carries with it a subtle, or for some not so subtle, emotional sense of failure already. In addition, we may not acknowledge to ourselves the probability that we will eventually fail again, sooner or later.  Many of us reach this point and chuck in the towel.  The discomfort of making a change or the powerlessness we feel from our failures kills our energy and motivation to try again.  In the same way, our career has stalled for circumstances out of our control or our financial burdens may seem too great or confused even to attempt to overcome.  All or even one of these things can be enough to leave us feeling isolated and hopeless.

There is not a simple answer or solution to these problems, but a great place to start is by asking what emotion is motivating the resolution or desire to change.  It may be based on a negative view of self; for example, someone may feel that less valuable as a person because of dissatisfaction with his or her physical appearance.  A negative view of others may also motivate a resolution; for instance, it may stem from a desire to outperform a colleague.  Success at these kinds of resolutions will only reinforce the negative view of self or others.  It will validate the first negative, emotional experience as true. The person who had a negative view of self may feel more valuable after changing his or her appearance, but that only confirms the feeling that he or she lacked value before.  The person who wanted to outperform a colleague may feel even more contemptuous of the colleague after surpassing him or her.   On the other hand, failure often drives the negative emotional impact even deeper.  We can come away feeling even worse about ourselves or more embittered toward others than when we started.

This year, you might try making a few resolutions intentionally with positive emotional foundations, instead of recriminating ones.  The health and wellness resolution has always proven the most difficult for me to keep, but this year I am reframing my resolution.  I am going to give myself the opportunity to eat more healthy foods and exercise.  I know when I am doing so, I have more energy and feel more positive generally, but I am also giving it as a gift to my family.  Now more than ever I need to be present and active in their lives as my daughter begins to crawl and walk.  I want to give her as much of my energy as I can.  Try writing out your positive motivation on a flash card you post in your kitchen or bathroom.  Go back to it as often as you need to.  

And if you find yourself struggling to keep it, remind yourself that every new sunrise, and not just the new year, brings a fresh chance to recommit ourselves to living our lives in a way we choose, not only for ourselves but also for those we love.

By Sam Bearer, PLPC

Survival Tips for the Holidays

by Courtney Hollingsworth, LPC

Here are a few small tips for changing the ways you engage with your relatives around the holidays. It isn’t easy to change the ways we relate to people we’ve known most or all of our lives, but it is often worth the work. This list is by no means conclusive, but a good place to start.

Take people at their word.

Try to notice how often you are attempting to read between the lines of others’ words or times when you feel expected to know what someone else feels or wants without them actually saying anything. Reading between the lines or finding the hidden meeting is common in family systems that operate more passive aggressively. Taking people at their word forces others to speak up on their own behalf, say what they really mean, and address one another with respect.

Mean your words.

The reverse of taking people at their words is true as well. If you are frequently not saying what you truly mean, then feel upset when others are not doing as you want, odds are you were not meaning your words. Speak directly and kindly, and you can avoid many of the passive-aggressive communication games that conflict avoidant families tend to get bogged down in.

Check your expectations.

Holidays are filled with expectations and typically time with family is also, therefore holidays with family members can be a double whammy. It can become the perfect traffic jam of various expectations.

Know your limits.

Try to realistically assess your limits on various planes prior to making your holiday plans. Are there certain family members you have a lower tolerance for spending time around? Is your social/extroversion threshold depleted more quickly at family gatherings? Are there certain relatives’ houses where you become a worse version of yourself longer you stay? Does being around babies and toddlers bring out the worst in you? Is your alcohol tolerance lowered in family settings? Assessing your limits prior to making your plans can help you make a more informed choice, and perhaps plan action steps toward self-care when you can’t predict that your limits will be tested and or pushed.

Know your triggers.

This one is similar to knowing your limits, in that it can be helpful to do some self-assessment prior to walking into family dynamics that are laden with emotional landmines. Try to think about instances in the past when time spent with family has led to blow-ups, arguments, hurt feelings, or even the silent (or shouted) conclusion that you’ll never go back again. Try to see if there’s a pattern between these various situations. Do you tend to be triggered by your mom’s passive aggressive comments? Do you tend to be triggered by your brother’s constant bragging about his successful career? Do you tend to be triggered by your niece talking all of the toys leaving them for the other cousins? Whatever your triggers, knowing them in advance can help prevent them from being a surprise, or even activated at all.

Make a private game of unavoidable unpleasantries.

Now, this is a little bit nuanced because it needs to be done discreetly and with wisdom, but can be helpful in surviving unavoidable unpleasantries. However, if you and your spouse or sibling share a negative feeling towards a person or behavior, you can make a private game out of how often you have to witness or endure that behavior. For example: does your dad tend to condescendingly correct other peoples grammar? Making bets on how often that will happen during the time that you spend with him. Does your aunt make snide comments under her breath? Rather than fume as you, it can be a survival strategy to find a way to laugh about it. What makes this game nuanced is you certainly don’t want others to find out about it or extend it to the point of being disrespectful.

The Difference between Dangerous and Unsafe

by Jonathan Hart, LPC

Whether we are talking about job sites, relationships, or simply walking down the street, we routinely confront the question of safety.  The fact is that we live in a dangerous world, and safety is a real question for all of us.

I have recently struck upon a difference between dangerous and unsafe.  The world is a dangerous place, but it is not always unsafe.  In terms of relationships with other human beings, we are all dangerous to each other: we all have the potential to cause hurt, whether deliberately, by mistake, by ignorance, or by accident.  

What makes a person safe or unsafe is how they handle their dangerousness.  It’s what they do when they have caused hurt that makes the difference.

Driving a car is a dangerous thing in its very nature.  How I handle that responsibility is what makes the difference between being a safe driver and an unsafe (reckless) driver.   The reckless driver des not acknowledge the inherent dangerousness of driving a 2 ton vehicle at 40 miles an hour among dozens of other 2 ton vehicles.  A reckless driver does not consider what the other vehicles might be doing but demands his or her own way, and that everyone else must make way for their vehicle.  People who are reckless in relationship behave similarly, and they act in relationally unsafe ways.

I can get into a wreck whether I am a safe driver or not, but it is more likely and typically more severe when I am reckless.

Let’s talk about relationships.  My responsibility when I speak is ALWAYS to speak the truth and to be respectful. That responsibility never changes and is never removed.   If I speak to you harshly for any reason at all, I owe you an apology, period.  Having said this, I have to acknowledge that there are a lot of reasons I might speak to you harshly.  I might be having a bad day.  I might be in a hurry, or in pain.  You may have done something to offend me.  You might have made a mistake that affected me somehow.  You might have been a jerk toward me and I responded in kind.  In this, I am dangerous: I have a lot of potential to hurt you.  

What makes me safe or unsafe is how I handle that responsibility both before and after I cause hurt.  

I am a safe user of words when I consider the words and tones I am willing to use, when I resist the tendency to speak in anger or harshness.  I can still get into a “wreck” so to speak:  I am still capable of speaking in hurtful ways.  When I am safe, I will do so less often and with less intensity, and I will stop myself sooner.

When I do cross that line, what happens next is important.  If I blame you or say you deserved it, I am creating an unsafe environment.  If I refuse to acknowledge the hurt, I am creating unsafety.  If I tell you you’re too sensitive or that you’re making a big deal out of nothing, I am creating unsafety.   If I say “I’m sorry, but…” I’m actually saying, “This is why I ‘m not sorry,” and I am creating unsafety.

What makes me relationally safe is when I own my responsibility and the fact that I broke my responsibility, and I genuinely apologize for crossing a line.  When I am open and accepting of the fact that I am human and fallible, I am more willing to be called out on misbehavior and better able to resist the defensiveness that naturally arises.  If I can accept my own humanity, I am likely more able to accept your humanity and we can have a human conversation. 

We are always dangerous to each other, but it is never a foregone conclusion that because we are dangerous, we are unsafe.  As we pay attention to the dangerousness of living and interacting with other human beings, take up our responsibility for conducting ourselves appropriately, and own our mistakes and limitations, we engage in “safe driving”.  So… buckle up, it’s dangerous out there.

Change is Loss and Loss Requires Grief

by Melinda Seley, PLPC

Several months ago, I went on a very restricted diet in hopes of resolving some chronic health issues.  And quite frankly, even with the hope that this change could bring about something good, it was haaaard.  I felt totally overwhelmed by having to figure out a new way to eat, with new recipes and new ingredients, and finding the time and energy to do so.  I wanted to throw a 2-year old style tantrum – particularly by flailing on the floor – for not getting to just eat what I want to eat.  And throughout the process, I was reminded of two things: change is loss and loss requires grief.

Change is Loss

In their book, Leadership on the Line, Linsky and Heifetz note that “people don’t resist change…they resist loss”.  Have you thought about change as loss?  Even when change is due to the best of circumstances, it requires us to lose something – whether it be a routine, a relationship, familiarity, a place that holds memories, convenience, a reputation, a known experience.

Change means unknowns. Change means having to relearn something. Change requires you to face the reality that you’re not in control.  And change often makes us face things within ourselves that we could conveniently avoid when things were status quo.

How might naming the change you are facing as loss be helpful to you in navigating it well?

Loss Requires Grief

The English Oxford Dictionary defines grief as “intense sorrow, especially caused by someone’s death.”  Grief is most often and naturally associated with death – so much so that the Oxford Dictionary even defines grief with a reference to it.  However, any loss we experience – big or small – is a cause for grief.  Not just the death of someone.

I am often asked in the counseling room what it looks like to grieve.  And though it looks different for everyone, in every situation, I believe there are some core components to this process of grieving:

  1. Name what has been lost. This includes very specific details of what you lost – because every single detail matters in understanding how you have been impacted.
  2. Allow yourself to feel. Sadness can be uncomfortable. And deep sorrow can be scary. But healing cannot come until you face your pain.  
  3. Consider if there is something you need to do to honor your pain or what has been lost. Do you need to journal about what ____ meant to you?  Do you need to create a photo book? Do you need to tell someone something?  
  4. Recognize that grieving is not a linear or predictable process. Grief can often be surprising and strike us when we are most vulnerable. A smell, a taste, a word spoken can bring with it a flood of thoughts and emotions that require going back to step one above. That is okay. That is how grief works. It is an ongoing, unpredictable process.

If change is loss and loss requires grief…it logically follows that change requires grief.  Have you considered this in your life?  Even changes that are bringing about something good have some element of loss intertwined with them when we stop to fully consider it.  How might it be helpful for you to name change as loss and grieve that loss today?