Counseling in St Augustine, FL
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The Stages of Change

5/22/2022

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There is a model of ​Stages of Change developed by Carlo DiClemente in the 1970’s.  The stages explain people’s readiness for change.  Sometimes, we may hope a loved one is ready for change when in reality, the loved one is still in denial there is a problem.  We see this a lot with substance abuse or in other problem areas.
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The stages include:

1. Pre-Contemplation - Denial:  "I don't have a problem."  Here the individual is unable to admit there is a problem and is not ready for change.


2.  Contemplation: “Yes, I may have a problem but I don’t want to do anything about it. “ 


3. Preparation: “Yes, I have a problem and I am ready to make some changes.”


4.    Action: Making changes - The individual works on change.


5.  Maintenance: Maintaining the changes.  This takes effort and attention so the individual will not relapse into the problem behavior.
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​I often use this model in therapy.  I explain the stages to the client or clients.  They are then able to identify which stage they are in.  If I am talking about making changes  and the individual is in the pre-contemplation stage we will completely miss each other, making it frustrating for both parties.   


If I am seeing an individual who has a partner or loved one who has a problem that is affecting the relationship, I teach the stages of change.  The individual is then able to understand why their loved one may be so reluctant to make changes.  


Yes, it is true, if we push someone to make changes and that individual is not ready to make changes all will be frustrated.  This is why we back away from loved ones who aren’t asking for our help.  We need to take care of ourselves, when our loved one is not ready to make the needed changes.  


John was consuming so much alcohol that he was irritable and unapproachable by 8:00pm overnight.  His children knew not to talk to him at night.  His wife had to wake him to go to bed after he passed out on the couch, nightly.  CeCe, hi wife, was pressuring John to quit drinking.  John was in the pre-contemplation stage, denial.  “I do not have a problem.  Stop nagging me!”  John would yell at his wife.


In therapy, CeCe told me about John’s drinking.  I explained the stages of change and she was able to see that John was not ready to make changes.  We talked about taking care of herself and not focusing on John.  She decided if he didn’t see his problem soon it would be a deal breaker for her.


When Vic came to my office he was struggling with a porn addiction.  He stated he was so tired of being a slave to his addiction that it was affecting his work, and his relationship with his wife.  He told me he was so ashamed of himself for not being able to kick the addiction.  I guessed Vic was in the Preparation stage and when I explained the stages to him he agreed.  He admitted he had a big problem and was ready to make changes.  Vic was able to work towards health at a good pace because he and I both agreed he was ready and worked on taking action, making the changes he needed to. Vic was able to get into recovery for his addiction and continued to meet with me while in the Maintenance stage, maintaining the changes.


Over the years I have been practicing I have found the Stages of Change helpful in my personal and professional life.   I am always hopeful that I'll be able to assist in people working through the stages and making positive changes!  If you'd like support to make the changes contact me.

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SOCIAL AWKWARDNESS IN A PANDEMIC

9/7/2020

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​I have been working right through the pandemic providing counseling for those who want/need it during these difficult times.  At first, I was working from home, with all the same issues all those working from home had, barking dogs, spouses, and computer glitches.  I have no children at home but loved seeing my clients virtually with their children, their pets, and inside their homes.  These are views therapists are never privy too!  Then, my partners and I decided it was time to go back to the office.  I offered in person, with mask, or virtual sessions.   Soon we measured and realized we were sitting at least six feet from our clients and began regular face to face sessions again or face to face with masks.!  One thing I learned during this pandemic is flexibility can be a thing in counseling!

After the quarantine/shelter in place period I noticed clients, family, and friends telling me they were so nervous to go back to doing things outside their homes.  Clients specifically booked sessions with me to talk about their anxiety regarding returning to life outside their homes.

A good friend in Alaska told me she was going to the local wine bar to meet friends. The first time out and about since the pandemic began.  Fat Stans had a reservation policy in place.  You could reserve a table for up to five people and stay only an hour.  My friend told me this with both excitement and trepidation in her voice. We were on a group text with some other friends and she texted how nervous she was to go because she had been at home, with only her family, for so long.  We all encouraged her to go and have fun.  She reported to us that she had dressed up, applied full make-up, and left the house feeling socially awkward and quite anxious.  A half hour later she texted the group she had gotten to Fat Stans but did not see the people she was meeting.  She contacted one and was told, “Loren, we are meeting tomorrow night!”  We all had a good laugh! She had been so nervous to leave her house and be social that she went on the wrong night.

Although Loren’s story is funny it rang true to me because I was hearing, in my office, people were also feeling socially awkward about going out.  I worked to help people through it and to adjust to the new phases of normal we were going through. Yesterday, I saw this opinion piece and had a chuckle.  Someone else had noticed, researched, and labeled what I am calling Social Awkwardness in the New Normal.  I think I will share it with Loren.

​www.nytimes.com/2020/09/01/sunday-review/coronavirus-socially-awkward.html
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Are You Worrying About What You Can't Control?

5/19/2020

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Worrying about or not being able to let go of the past may cause or contribute to depression.  Worrying about what is not in our control causes anxiety. Worrying about the future, in general, causes anxiety. Worrying to excess about what we cannot control, what may or may not happen in the future can be diagnosed as Generalized Anxiety Disorder.  The “what if, what if, what if” problem.

An example is Vicki.  Vicki worries about almost everything she hears.  She worries her daughter is doing too much, she worries her son isn’t satisfied in his marriage, she worries her grandchildren are falling behind in school, she worries that she will be late when she goes somewhere, she worries that something is wrong with her car, she worries that plans won’t work out, etc.  Basically, Vicki worries all day and all night.  In the Covid-19-time Vicki is worrying about her family’s health, she is worried about her daughter needing to go the Dr., she is worried someone she knows will become ill. If a family member does not call for a few days she worries something has happened to him or her. 

Vicki came to see me because she could not sleep due to worrying excessively.  She worried so much she had difficulty focusing on anything she needed to do. I diagnosed her with Generalized Anxiety Disorder. Worrying about, “what if, what if, what if” can be Generalized Anxiety Disorder.  I worked with Vicki to look at what she can control and what she cannot.  We worked on some Cognitive Behavioral techniques, such as how to change her thoughts, and some relaxation skills (breathing, meditation, butterfly hug). I taught her to think about the percentage of chance of what she was worrying about happening.  If it is a low probability, she is wasting her energy worrying about it.  We worked on letting go of what she was worried about that may never happen.  After a few sessions, Vicki reported great improvement and more positive energy freed up because of letting go of some of her worries. 
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This is a simple chart that helps us to understand what is in our control and what is not.  By understanding this we can take the first step to less worry and focus on what is in our control: Ourselves! 
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Have You Checked Your Mental Health Today?

5/11/2020

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If you are experiencing mental health issues you usually know.  However,  sometimes we may need to think about or assess why we aren't feeling well.  We may avoid doing this.  Here is an easy cheat sheet for thinking about what is occupying your mind.  As always.....reach out for help if you need it.
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Thinking/Journaling Prompts

5/2/2020

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By now one thing I know for sure is that we are all mentally fatigued from Covid 19.  As I write this different situations are happening in different states.  My son, in Seattle Washington, who survived the virus, has just received another month of shut in orders from the Governor.  My daughter, in LA, has been told to expect longer shut in orders.  My brother and family, in Chicago, also just received another month of shut in orders.  Meanwhile, I am in Florida and was able to enjoy a lovely beach walk this morning and will be opening my office next week. 

The fear of the unknown is still with us.  Will there be a new spike in illness and deaths?  Will reopening states be OK?  Is it safe for us to be out?  We all want the economy to reopen.  We are all mentally fatigued from this ongoing situation. 

I have a suggestion for thinking about different things than the virus all day long.  Here is a list of suggestions for different thinking or journaling topics.  Try to do one or several everyday.  The list is an idea of positive topics for your brain.  Let me know if the list is helpful to you.

The important thing to remember is to try to remain positive in this time of uncertainty.  Reach out to a mental health professional  if you need help.
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Keeping Sane in the Time Of  Covid 19

4/4/2020

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 By this time, I am certain you have all read something or a ton of stuff about dealing with the Coronavirus but I’m going to add one more blog for your reading enjoyment. 

During this time, I have noticed we have all gone through different stages of adjusting to the new, ever changing normal.  When the virus first became a reality, people accepted and dealt with it at different levels. Some people immediately became fearful and took the advice to self-quarantine.  In some states this was not a choice.  My son has been quarantined, in Seattle, since March 1st!  He is going stir crazy in a house with 4 roommates, not enough toilet paper, for a time not enough food, and none of them working.  All five of them have lost their jobs and tomorrow is April 1st, rent is due.   At this writing my son is sick with the virus. Positive vibes accepted for his healing.

My daughter is in Los Angles where they have been ordered to Stay in Place for several weeks now.  Initially, she was fearful and crying.  She called me and kept telling me she was scared.  What could I do from almost 3,000 miles away except listen and talk to her?  Not much.  It is a pretty scary feeling when you can’t get to or help your kid.
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One of my foster daughters is 19, with a three-month-old baby in Anchorage.  Two days ago, her boyfriend beat her up, was arrested, and she was taken to a women’s shelter.  The shelter has put her in a hotel for two weeks to be quarantined before she enters the shelter.  She has limited food and money (Thankfully there is PayPal).  She is crying to have me help get out of Alaska and to us.  Another situation where I can’t mother or help my adult child as needed. As tensions build and people are stuck in their homes, we have already seen an increase in domestic violence, and it has hit close to home for me.

Having my inner circle people also in South Carolina, Chicago, Santa Fe, Atlanta, and Alaska makes my tribe spread out over the country.  Looking at the map and hearing about their situations brings us close but can be stressful from so far away.
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As we have all progressed to living with a new normal, we have been dealing with it in or own ways.  In Florida, there were not a lot of initial guidelines from our leaders. The news was mixed with what we should do and how serious this was.  Some people self-quarantined while others refused to accept the virus as a real threat and flocked to the beaches.  This seemed to cause issues with business owners, employees, partners, neighbors etc.  Currently, people have become more accepting of the situation.

I noticed fears arising a couple weeks ago.  As people began to be shut-in, I saw people watching the news 24/7 and nothing else.  It was hard to adjust to this new world.  I admit my schedule went wacky.  Although I am working virtually, sessions were canceled due to loss of jobs, and at home I was watching too much news.  I noticed one day last week four people in my orbit asked me what day it was.  People were having difficulty focusing.  I am usually an avid reader but was unable to read any of the books or magazines I have on my coffee table and Ipad.  I was staying up later than usual and sleeping in later than usual.  My dogs seemed confused as to why I was home all day!  I’m still not sure if my retired husband likes me being home full time or if he misses his alone time. 

This week I think people are accepting and adjusting to this crisis although people are starting to know people who are sick with the virus.  People seem to know what day it is.  I am getting fewer stressed calls from my LA daughter.  She now calls to tell me which exercise class she took on YouTube or what she cooked that day.  My son has found a store that sells single rolls of toilet paper and seemed to have enough food when he fell ill.  My foster daughter is still in a hotel and not doing very well.  She must deal with the thought of being on her own with baby, isolated and struggling. When (and it will) the virus dies down I will look at being able to get her to Florida if she hasn’t reunited with her boyfriend. (Sadly, it takes an average of three times for a woman in a violent relationship to successfully leave.)
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As we all adjust, at different rates, to the new normal there are some things I want to suggest to help us get through this!
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Mental Health Issues

We all have heard or are experiencing the anxiety and uncertainty of these times.  Now that 87% of us in the country are under mandatory stay home orders, people are experiencing different emotions at different levels of severity. Many people live alone and are now completely alone.  My mother lives five minutes from me and I am trying to see her a few times a day including making dinner for her every night.  Over the weekend we took a long drive just to get out. 

This virus has caused a loss of control for all of us.  Not knowing what the future brings, who will get sick, how sick people will get, and the fear of death are challenging thoughts to deal with.  A loss of control over our individual and our family’s routines and health is scary!  This can lead to irritability, fear, uncertainty, anxiety, depression, and even suicidal thoughts.    So, what do you do when the world feels so out of control?
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The most important thing for us all to do during this time is to keep a schedule and structure.  A lot of us were wandering around in a daze during the beginning of this situation.  When we began to stay home it felt so odd.  Trying to get set up to work from home, losing our jobs, having family so far away and not knowing when we will ever get to see them again.  This is all out of our control.  I was one of these people.  Trying to find a meaningful approach to this crisis is not easy.

By this time, I hope people are beginning to adjust.  Having a structure and routine means trying to get to bed and wake up around the same time during the weekdays.  If you have kids developing and posting a schedule for the family is a good idea.  Be sure to include when to get up, chore time, exercise time, school time, family time, and bedtime. 


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During this time, we can expect depression, anxiety, and other mental health issues to be exacerbated.  Be sure to keep communication open with your loved ones and do your best to take care of yourself.  If you are really struggling to manage your mental health reach out to me or to another professional for help.

SNAPS

I saw an article on The Forks and Knives site that talked about SNAPS to remember what we need to do daily for our sanity and to take care of our mental health.

Sleep enough and not too much. Try to maintain a healthy sleep schedule.
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Be sure to eat for healthy Nutrition. Not only will this keep your immune system boosted it will help mitigate depression and anxiety.

Get moving, with physical Activity.  Exercise is so important during these times.  It boosts serotonin levels to ward off depression and anxiety.  It is so important to get out of your house daily.  The beaches here are now closed.  My happy place.  Now I walk, run, and bike around my neighborhood for what feels like hours a day with my Pitbull who needs a ton of exercise.  I am home, working virtually, and if he doesn’t have enough exercise he barks during my sessions!

It amazes me the amount of exercise classes you can find on YouTube.  There is no excuse for not exercising daily now. We have plenty of time. 

Play.  This is so important!  Be sure to play with family and friends even if it must be on Zoom.  I’ve had more than one dance party with my family on Zoom.  Don’t forget to take a virus break and find some joy and laughter.

Remember to nourish your  Soul.  Now is a great time to find the space and time to meditate or to take a yoga class on YouTube. 
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​By now almost all of us in the United States are sheltering in place. I am still working virtually and in person as needed.  I am also offering reduced fees during this crisis time.
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I am sure you have all read many articles suggesting things you can do with your now down time at home.  I may not be suggesting anything different but perhaps you will find a new idea, so I am going to tell you some ideas I have or ideas I have seen in my readings recently.
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Have you ever used an Adult Coloring Book?  This is a great activity to keep you grounded and mindful.  It is also a wonderful coping skill when you are experiencing anxiety.  There are some cool ones out there or just grab whatever you must draw and color with and doodle, draw, or color.

Now is a perfect time to start journaling.  This is the craziest time I have seen in my life.  What about you? Keeping a journal of how you are spending your days, how you are feeling, and having your kids do the same not only passes time but is a record of what went on during this time.  Journaling is also a healthy coping skill for mental health issues.
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We are all learning new ways of communicating with each other during this time.  Healthy communication is not only a valuable practice for adults but also for children who may be experiencing stress or confusion during this time.  Help your children express their emotions by talking to them, giving them an assignment to draw their emotions out helping them to journal if they are old enough.  I have a friend who is having her teens journal everyday during this crazy time.  Here is a link to their online Coronavirus Blog
https://thequaranteenys.com/
How are you communicating with friends and family?  The other night my family from all over the country got together and had a Zoom family get-together.  It was fun with a little bit of stress with the family dynamics as if we had gotten together in person.  I found that very interesting.  Families are families virtually or in person!  Have you tried the Zoom platform?  It is very cool!

​Zoom.us

​I am checking in with my inner circle people daily by text, phone, messaging, and face-time.  Don’t forget to frequently contact people who may be quarantined and alone.  My 75-year-old mother has been calling all the single people on lists from her church and her neighborhood to check in with them and just to say hello.  She tells me she has made some new friends by doing this.
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Although I do not usually promote video game playing, I have had several people who have told me about the new game Animal Crossing.  Apparently, it is about building community on an island. The characters are animals.  There is no violence.  One person told me the game is “wish fulfillment, relaxing and escapism”. 
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Try to teach yourself or learn a new skill through YouTube. Have you wanted to learn an instrument?  Because I am doing virtual sessions, I noticed a client’s Guitar in the background I asked if he played and he told me he had bought it 12 years ago in the hopes of teaching himself to play.  He told me he now has the time to learn he just must wipe the dust off the instrument! 

Can you imagine if this crisis had occurred before the Internet?  I don’t even want to imagine that!  I taught myself to French braid my hair.  Something I had never had the patience or ability to do.  Now with more time on my hands, and not rushing to get to the office I have had more time post shower and was able to make my first French braid! 

My husband and I have been having a fierce Backgammon tournament.  I can’t even remember the last time I played a game!  Board games are great family activities.  Amazon is still delivering, and games can be inexpensive.

Whatever you find to do to keep yourself sane during this locked in period remember to try to find some joy every day.  Be grateful for the small things.  Remember to tell those you love you love them every single day even ten times a day because these times are so unpredictable.

Take care of your mental health in whatever ways you can.  If you need help or some ideas, please reach out to me or any other mental health workers.  You are not alone!  We are all, globally, in this together!
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ARE YOU HAVING A BAD DAY?

3/2/2020

2 Comments

 
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Bad days happen to us all.  Yes, I have bad days too.  What do you do to help yourself when you have a bad day?  I try to do some self-care.  Perhaps a bath and going to bed early.  I like to find a good friend to process what has happened during the day.  Sometimes it can be a good girlfriend and sometimes my spouse. It helps if you can identify one trusted person to share your downs with and it is a good step for your mental health.  We are all human.  Relationships are reciprocal.  If you listen to a friend, perhaps they will listen to you when needed.  Some people don’t feel comfortable reaching out to anyone. They feel as though they will be a burden, or they are too down to bother anyone.  If you do not have anyone in your life who you feel can be a support for you perhaps seek out professional counseling to help with this.

Try to identify why you had a bad day.  What triggered it?  Did someone say something that upset you?  Was “everything” going wrong that morning?  I talk a lot about shifting to positive thinking. As helpful as this is, I do understand it is hard to do and takes time and practice.  If someone said something to upset you, think about what may be going on with that person.  Perhaps their issues caused them to say something hurtful to you.  If you think you may have misinterpreted what was said ask for clarification. Perhaps you took it the wrong way? We can not read minds or assume what someone meant to say that was said.  Check it out before you get upset. If it was a mean comment, tell yourself you won’t let it get to you.

If one bad thing happened in the morning it doesn’t mean the rest of the day will be bad. If you had a flat tire and were able to fix it, even though you ran late, it doesn’t have to ruin the rest of the day.   If you tell yourself, “what just happened ruined my day” then you will continue to have a bad day.  If you re-frame this and tell yourself, “well, that was bad but I am not going to let it ruin the rest of my day” it is a lot more probable your day will be more positive going forward. 

Sometimes we just can’t get out of the negativity or sadness that comes over us.  Remember, emotions come and go.  Do your best to take care of yourself and move into a better day.  If it is depression and it persists you may need to seek professional help to manage it.  If you are grieving or having another situation causing you negative emotions remember, it is a process to work through these emotions and situations.  Remember to be kind and caring to yourself.  If you know someone who is struggling, reach out to them as you would like to be reached out to. 

​However your day started today try to go forward with a smile and a kind word to yourself. Smiling actually boosts the neurotransmitters in our brains that help us feel better.

​Have a good day!
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HOW TO HAVE A POSITIVE WEEK

2/16/2020

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​I often make a social media post, on Mondays, in an attempt to start us off on a positive note for the week.  I do this because Mondays are the start of the work week and a lot of us begin our week on Monday.  I hope to encourage people to shift their thinking, from negative to positive, and set some positive intentions for a good week.  But what does all this mean, really?
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​The roots of my psychotherapy training and beliefs are in Cognitive Behavioral Therapy (CBT).  Simplified, this means our thoughts, feelings, and behaviors are all connected.  If we think something negatively, we will behave negatively, and we will experience negative emotions.  If I am thinking, “I can’t do anything right or this week is going to suck,” I am going to feel down, frustrated, and negative.  My behavior will reflect this.  I may withdraw be short with others or act irritably.
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​The CBT theory says if we change one of these things: thoughts, behavior, or feelings will follow.  If I work hard to tell myself, “I made a mistake this morning, but the rest of the day and week will be positive,” I will feel more positively, and my actions will be more positive with others and myself.  Or, if I go to the gym or go for a long walk outside (behavior) this has the high potential to improve my mood and turn my thoughts to the positive. 
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​There are even techniques to change your mood/feelings.  I will share one DBT skill called Half Smile.  The idea is to force a smile, even if it is just a half smile like the Mona Lisa.  Doing this activates the start of a positive feedback loop of happiness.  When we smile, we contract our smiling muscles, this causes a signal to fire back to the brain which stimulates our reward system and increases our level of endorphins (happy hormones).  In other words, when our brain feels happy, we smile; when we smile, our brain feels happier.   Using the Half Smile technique stimulates our happy hormones and will in turn lead to positive thoughts and a better mood.
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​When I talk about setting a positive intention for a good week, I am suggesting using positive affirmations, meditating on a positive week ahead, or simply telling yourself the week will be a good one.  By doing this we can adjust ourselves from a negative mind set to a positive one.
With today being a Monday, my hope is that we can all find a way to work on our thoughts, behavior, and feelings to make this a positive day and week!  Have a positive week! 
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CIRCLES OF TRUST

2/10/2020

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Who do you trust?  Who is closest to you?  Who do you keep at an arm’s length?  Do you have trust issues from being hurt in the past?  Do you trust too easily?

The Circles of Trust exercise is one of my favorites.  I like to look at this exercise for myself and I love to use it in my office with clients.  You can do it at home too!

The Circles of Trust have three circles, an inner, middle, and outer. If you draw them on paper you can do the exercise.  Here is what the circles will look like:
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Begin by filling in the inner circle. The most inner circle is for the people you are closest to; the ones you know will always be there for you and the ones you can trust fully.  Next, fill in your middle circle. This circle is for those you are close to but are a bit tentative about trusting fully. It would be normal to have a new friend, who you really like, in this circle.   These are your close people but not your inner tribe people.   
 
Next, fill in the outer circle with acquaintances.  People in your life you like but don’t know well enough to trust. Finally, beyond this circle are the people in your life who you absolutely don’t trust and perhaps, don’t like (we all have those people in our lives).


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Above is an example of a completed Circles of Trust exercise. This person has a healthy diagram.  She has a few people in the inner circle and is happy with that.  Other people may have more people in there.  If there are one or less the person may need another person int here in case something happens with that one person who is ultimately trusted.

I have done this exercise with people who have absolutely no one to put in their inner circle.  Usually these are individuals who have a childhood history of being hurt by those they were supposed to trust (parents, peers, etc.). These are the people who doubt others and have a hard time getting close and intimate with anyone because of their inability to trust others.  In therapy, with these individuals, we work on finding some support people to trust. Living without anyone in your inner circle is lonely and unhealthy.

Some people may trust far too easily.  These people may have difficulty with boundaries and let people into their inner circle too easily.  A person who trusts too easily will end up trusting the wrong people, revealing personal, intimate secrets to someone who shouldn’t have been in their inner circle.  When this happens trusting the wrong person may lead to betrayal later leaving the person questioning what happened and why they were feeling so hurt and betrayed.  With people who trust too easily we work on developing and keeping healthy boundaries with others and learning who fits into which circle.


By having clients complete this exercise we can then interpret the circles and look for trust issues to work on or can even explain some of the interpersonal difficulties the person may be experiencing.  Using exercises such as this one is informative and interesting.  Try completing the Circles for yourself and let me know what you think.

​Melissa Muller MA, LMHC

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Negative Core Beliefs.  Do you have them?

12/3/2019

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In your core do you believe you are worthless, can’t do anything right, or are unlovable?  Are you worried someone may find out these things are true about you?  Do you spend time finding ways to prove these beliefs are true?

We all have beliefs about ourselves that we developed in childhood.  Some may be positive, and some may be negative depending on events that took place during our formative years.  Negative core beliefs are negative thinking patterns that have roots in the past. A child who had a happy childhood, with few traumatic experiences, will see the themselves in a positive light.  This person may have positive self esteem and positive core beliefs such as; “I am lovable” “I can be successful”.  An individual who may have experienced verbal abuse or a lack of having needs met for one reason or another may have negative core beliefs such as;  “Because my mother said awful things to me they must be true” or  “There must be something wrong with me for my father to have treated me like that”, “ I never do anything right”.

When a child is young and not having his or her needs met or is being abused emotionally, physically, or sexually the child looks for reasons to explain this treatment. The child mind is not mature enough to understand the issue is with the adult.  This child instead assigns the blame to himself.  “I deserve to be treated this way because there is something wrong with me” or “I am unlovable and that is why Mommy treats me this way”.

If a child is bullied, abused, has learning disabilities, or experiences trauma the fault is usually attributed to himself.  This is where negative core beliefs are developed.   Carried into adulthood these self-beliefs remain buried deep and the individual looks for evidence to prove them true. 

Another relationship just ended for Melanie.  She can not seem to hold on to partners.  They always leave her. Melanie attributes this to her being unlovable and having something wrong with her.  “Things never work out for me,” she tells herself.  The feelings of hurt and shame are so strong because they go back to the way Melanie was treated as a child and the resulting beliefs, she formed about herself. She experienced the loss of a father and a stepfather as a child. 

Melanie goes through life believing she isn’t good enough and people will always leave her. This was the reason she came up with when she lost two Daddies.  No one told her the real reasons.  Due to these beliefs she acts as if these things are true perpetuating a self-fulfilling prophecy that people leave her and then they do.

Melanie does not consciously cause people to leave her.  Her behavior presents as if she believes she is less than, unlovable, and not good enough.  She tends to attract partners who are not healthy and end up treating her as if she is unlovable causing Melanie to have more evidence that her beliefs about herself are true.

Nick’s mother constantly told him he was doing everything wrong, that he was stupid, and he would never succeed.  This began in elementary school and continued through high school.  Nick is now married.  Every time his wife criticizes him, or he makes a minor mistake at work he beats himself up inside.  He tells himself, “You are stupid.  You can’t do anything right.”  Nick is constantly finding evidence that proves these beliefs about himself are true. 

Look at this list of negative core beliefs and identify the ones you believe to be true about yourself. 
  • There is something wrong with me
  • I am unlovable
  • I am worthless
  • If I love someone, they will leave me
  • The world is a dangerous place
  • I am not good enough
  • I am different
  • Everything is my fault
  • I am powerless
  • People will hurt me
  • I need to be perfect to be loved

How long have you had these beliefs?  When is the first time you remember thinking these things about yourself? Do you remember hearing these things from a parent, teacher, bully, or caretaker when you are young?  What would you tell a small child who believes these things about herself?  Would you tell her they are true, or would you tell her there is no way a child is stupid, worthless, unlovable or other? 

Maintaining these negative core beliefs contributes to many psychological issues including; emotional distress, low self-esteem, relationship problems, depression, and anxiety.
As an adult there are ways to correct your negative core beliefs. 

  • Work to gather evidence to refute these beliefs instead of looking for evidence to prove their truth. List the evidence and put the list somewhere you can see it daily.  Continue to add to it. 
  • Think of that small child who developed those beliefs.  Was it true for this child?  Most likely NO!
  • Listen to your running commentary of these negative beliefs in your head and talk to them as a friend would.

If you have difficulty changing these deeply entrenched, negative core beliefs on your own therapy can help.  Cognitive Behavioral Therapy, EMDR, Trauma Reprocessing, and other methods can help.  Changing these negative beliefs to positive ones can make a huge difference in your life and make you a healthier individual!
 
 
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Is Your Relationship Healthy?

10/10/2019

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Relationships are hard work!  I like to compare them to a garden with weeds.  If you don’t take the time to pull the weeds the garden becomes overgrown with them and you won’t have a beautiful garden.  Relationships are the same.  They need to be tended to on a regular basis.  If couples don’t take the time to care for the relationship it will not be a healthy one.  I’ve learned this lesson in my own marriage!

Teaching couple’s some basic skills, watching them learn and utilize them is rewarding. Couples can improve their relationships with some minor tweaks and some relationship care.  Gottman teaches a set of skills for improving our marriages and partnerships.  I teach these skills and talk a lot about Gottman’s techniques and theory on lasting relationships with couples in my office.    

​Here is a handout on some of Gottman's ideas:
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What areas do you and your partner need to work on?

Another concept Gottman talks about is the Four Horseman.  These are four negative and unhealthy ways couples may communicate with each other.  Gottman actually predicts if you use some of them the relationship won't last.  Do you use any of these unhealthy communication styles in your relationship?

​                                Gottman’s Four Horseman of the Apocalypse


  • CRITICISM:  Attacking your partner’s personality of character to make them wrong.
 
  • CONTEMPT:  Attacking your partner’s sense of self with the intention of insult or psychological harm (sarcasm, mockery, etc.).
 
  • DEFENSIVENESS:  Seeing yourself as the victim and responding as such.  (Excuses, cross-complaining, defending instead of listening).
 
  • STONEWALLING:  Withdrawing from the relationship to avoid conflict (silent treatment, monosyllabic responses).

​The first step to change is recognizing the problem.  Once you identify the dysfunctional patterns in your relationship you can work to change them and experience a more healthy and rewarding relationship!

If you want to read the book that explains these concepts more in-depth here it is!


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Do You Have Balance In Your LIfe?

10/4/2019

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It is difficult for all working mothers (and fathers) to find a balance between home and work.  This includes me.  While I was raising kids, I was first in school and then working full time. When I was in graduate school, I had young children.  I was at the library, at school, or at home.  The home balance was the minimal one.  My son was in Kindergarten.  One day he came home crying because I had forgotten it was Crazy Hat Day at school.  He had been the only one without a hat because I was so focused on school that I had completely forgotten to help him with a hat.  I was crushed.  How could I have let something so important to him slip?  I remember being in Supervision, at school, and telling my Supervisor this story while I cried.  I was looking for some empathy.  She looked at me and said, “I was always one of those people who was able to study, be on the phone, and breast feed at the same time”.  No sympathy or empathy there.  Was I the only one who struggled to find a balance as a woman and mother?

For years I worked seven days a week and was on call 2 hours a day.  During this time, I also had a house full of kids.  At the end of the day, after giving at work all day, I would come home and have noting left to give.  All at home wanted something from me.  My patience was thin, and I was always exhausted.  I tried to get up early and have time to myself.  I tried to exercise daily and to take care of myself.  There were times I would go for a drive after work to decompress and switch gears from the day before returning home hoping this would give me energy. None of this seemed to help.  I still arrived home and had no balance between home and work.  Home suffered. 

Now that I have an empty nest, I feel more balanced.  This is sad.  Did I need to have an empty nest to find the balance?  I asked my kids if they had sensed this when they were at home.  I was told I was a good Mom who worked a lot, but they understood and felt like it helped them to develop a healthy work ethic.  I sure hope this is true.
In the present I take time every morning to go for a walk or run, to go to an exercise class, to be sure I have plenty of time for self-care so I can give both at work and to all the people in my personal life. THe above photo is one I took at sunrise, this week, on my morning self-care walk. I do feel good! I do feel balanced!

In my office I tell women who feel unbalanced to be sure to take time for self-care no matter how they fit it in.  When they tell you on an airplane to put your oxygen mask on first and then assist your children what they mean is you can’t take care of others if you don’t take care of yourself first.  This is very true. You will burn out and run out of steam if you are constantly giving to others and not to yourself. 

​Now that I have finally found the right balance, I encourage others to do the same or to look at ways they can make the balance more even.  Positive vibes to you to be able to do so!  
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NAVIGATING THE WORLD OF TEENS AND TECH

8/2/2019

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We turned to a local expert for the inside track on kids and technology.

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Since 2000, Melissa Muller of Well Spring Counseling and Health has been working with children, adolescents, and families. So she’s been right in the middle of the ever-expanding world of technology and its new challenges. As our culture changes and technology becomes more and more a constant part of our lives, Melissa offered some advice in our August/September issue on fostering a healthy relationship between you, your kids, and their devices. Hoping to learn a little more? Here’s the rest of our interview.

St. Augustine Social: Do you have any age-related guidelines for when a child should have access to technology (whether that’s access to yours or buying them something of their own)?
Melissa Muller: There most definitely should be limits on children’s screen times. Technology has changed our world!  It is unavoidable today that our children will use technology, but they do need to have some guidance in the tech habits they will develop.  Kids need and expect structure and limits. This is an important area to be sure limits are set. There should be different limits for different ages. 
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Children birth to two years old do not need any technology.  Screens at this age should be limited to talking to family on FaceTime or video. Developmentally, children at this age are working on social development and healthy attachments. When children of this age are not connected to technology, they have more time to play, explore the world around them, and develop healthy attachments to others. Instead of screen time read to them, do projects, or explore using all their senses.  


Want to read the full Article?
​Click on the link below:
Full Article
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How Many "Rocks" Are In Your Basket?

7/15/2019

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I love this photo because it can represent all the resentments we carry as “rocks”.  How full is your basket of “rocks” or resentments?  If your basket is full and you are holding onto a lot of resentments it will affect your mood, relationships and mental health.  I suggest we work to let go of our resentments thus emptying our heavy loads and improving our lives.
 
I am often asked how to do this. These are some suggestions:


  • Write a letter to the person whom you are holding a resentment against, read it to a friend or therapist and then burn it or shred it. 
 
  • Talk to yourself positively about staying in the present and letting go of past hurts. 
 
  • Find a silver lining to the situation you are holding onto.  
 
  • List the positives you will feel by letting go of the negativity.
 
  •  Rewrite the story of what happened by the ending to a positive one. 
 
  • Have a ceremony with yourself or a loved one to signify letting go.

​By letting go of the “rocks” you are holding onto, your load will become lighter and more positive.  If you need help with this seek outside support in a friend or mental health therapist.
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When Infidelity Happens

5/6/2019

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​Have you experienced infidelity in your relationship?  You are not alone as infidelity is a common occurrence in relationships.  Statistics show that approximately a quarter of relationships experience infidelity.  It occurs in all types of relationships: heterosexual, same sex, young adults and older adults too.  In fact, a study by Wolfinger showed Americans age 55 and up are more likely to have extramarital affairs than adults younger than 55.

In a 2017 study published in the Archives of Sexual Behavior it was reported if an individual cheated in a prior relationship, he or she is three times more likely to cheat in a second relationship compared to people who report no infidelity.  Also, if an individual has been cheated on in a previous relationship it is two times more likely a second partner will cheat on that individual.

What are the reasons leading to infidelity?  There are a variety of reasons why people cheat. Some reasons:

Needs Not Being Met:
It is common in relationships for one reason or another for the partners to cease meeting the other’s needs.  Perhaps they get so busy with work, kids, school, or other situations that they fail to come together and connect as a couple.  They begin to grow apart and do not pay attention to their partner’s needs.  Perhaps they stop connecting and become lonely in the relationship. It then becomes easy to connect with someone outside the relationship.

Lack of Communication:
When couples cease communicating with each other or do not have healthy communication patterns deep thoughts and emotions are not effectively discussed with one another.  Lack of positive communication or positive reinforcement in a relationship makes it easy to hear the positives from someone else.  Lack of communication may also lead to not getting one’s needs met.

Grieving/Loss:
When there is a loss between a couple, a loss of a child, a loss of a family member, loss due to serious situations such as loss of financial means each partner may grieve or handle loss differently.  One may withdraw and become depressed while the other may seek support outside the relationship because the partner is unavailable.  Sometimes seeking support can lead to infidelity when the griever becomes too close to the support person. 

Revenge:
Sometimes a partner may seek intimacy outside of the relationship as a form of revenge for a partner’s infidelity or other form of betrayal. There are some individuals who will not feel OK in the relationship until the score is evened following infidelity.

Sexual Addiction or Love:
When an individual has a sexual or love addiction infidelity may be rampant.  Until the cycle of addiction is broken and managed the infidelities will continue. The issues run deeper than the partnership for the inflicted partner. This is rarely solved without outside intervention. In this case both members of the couple will need intensive counseling.

Alcohol or Drug Abuse:
Any form of substance use/abuse may lead to impulsive or poor decision making which can include sexual infidelity.
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There are several types of infidelities including Out the Door and physical or emotional.  Sometimes infidelities happen without the individual realizing her or she has crossed the line.

Out The Door:
Perhaps an individual has fallen out of love with a partner and doesn't know how to leave so is unfaithful with the idea he or she doesn't care if he/she is caught or is secretly hoping to be caught to have an excuse to leave the relationship.

Emotional:
Emotional affairs may start innocently.  Two people begin to text each other innocuously.  The texts grow more frequent and more intimate.  An individual may begin to feel good from the texts and believe unmet needs in the primary relationship are being met with this other person. People may believe because they are not having sex the relationship is friend to friend.  The line is crossed when intimate details are shared with someone other than the partner. This is infidelity, an affair.   People tend to think texting or other social media communication is not considered infidelity because there is no sex involved.  However, sometimes emotional affairs can be more damaging than sexual affairs because an emotional bond is developed. Sometimes these types of affairs will lead into a sexual affair.  45% of men and 35% of women admit to having had an emotional affair. 

Sexual:
Sexual infidelities may be the result of different causes.  As stated above, an emotional affair may eventually become sexual.  Some individuals may actively seek out sexual affairs through social media, ads, or on dating sites.  Some may start a sexual affair with someone at work or with someone from their circle of friends.

Can relationships survive infidelity?

The short answer is YES! If both partners are committed to rebuilding the relationship it can survive and even become stronger.  In my practice I follow these steps to help couples heal. If the cause of the infidelity is a sexual or love addiction, both partners will need individual counseling.  In this case the treatment looks very different.

1.  The affair must be terminated.  If it is allowed to continue while the couple attempts to repair their relationship it is guaranteed to be unsuccessful.  When an affair continues there are three people in the relationship and  unless it is a polyamorous relationship (more than two people in a relationship with all agreeing to the dynamic) this is a set up for failure.

2. Once the affair is ended the offending partner must take full responsibility for the infidelity.  If this is not happening, and the individual is blaming his or her partner this is considered Gaslighting.  Honesty and taking responsibility are key ingredients for the repair process, without this healing will be impossible.

3.  The hurting partner may want details of the infidelities.  Before these are disclosed, the hurting partner is encouraged to think about the information he or she wants to hear.  Once it is told it can never be unheard and may cause more problems for this individual. The hurting partner is encouraged to think about this before insisting on details.  

4.  Unless there is a sexual addiction there are most likely problems in the relationship that predate the infidelities.  These must be identified but without placing any blame on the hurting partner.  No matter how bad the relationship issues were it is the unfaithful partner who holds the responsibility for having made the choice to cheat.  

Once the issues in the relationship have been identified the repair and healing process can take place.  This is achieved through a variety of ways and individualized for each couple.  

Once these issues are repaired it will be important for the couple to maintain the changes and tend to their relationship to make it affair proof. Relationship care needs to be done daily.  Relationships are like gardens.  If not tended to they will become overgrown with weeds. 

It is always important to consider the issues with both partners as they will be jointly struggling from this experience. The unfaithful partner may have given up someone whom he or she has developed feelings for.  The hurting partner may show symptoms similar to someone who has experienced a trauma including; flashbacks, nightmares, hypervigilance towards the unfaithful partner, inability to sleep, anxiety, and trust issues.  All these issues will need to be addressed and mitigated.

Relationships can and do become stronger following infidelities but there is a lot of work that must go into the repair effort.  If the couple is willing to work hard the end result can be a much stronger bond.

A few good books to help you following infidelity are listed below.
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Melissa Muller MA, LMHC
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BELIEVE IN YOURSELF

4/28/2019

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This is something a client of mine wrote and sent to me following therapy.

​"Throughout the years I have learned the importance of trusting in yourself & your abilities. If you full heartedly believe that you are already living your dream the universe will believe it too. This is a concept I firmly believe in although It took me awhile to learn and understand it.
 
Growing up my dreams were bigger than the town I grew up in. In my heart I always knew I wanted to be successful.  Although I had an extremely supportive family, I can’t say the same for many of the peers who surrounded me. I was often teased, misunderstood, and doubted. I’d be lying if I told you that those people never affected me. They did, very much so. I went through times of pain, depression, and anxiety because of those people. But I truly believe those times were necessary, because without those hard times I wouldn’t be the strong woman I am today.
 
Whatever it is you are going after or going through you must understand that nothing is insurmountable. There will always be obstacles in life, there may even be times that you feel the lowest you have ever felt. NO matter what life throws at you you must look forward, continue working hard, and trust in yourself. 
People tend to give advice based on their own experiences, feelings, and fears. Take other’s advice with a grain of salt because at the end of the day, in your gut, you know what is best for you and it is Your Journey Not Theirs.
 
Some things that have helped me achieve my goals that I encourage everyone to do;
  • Practice visualization. If you can see it, you can achieve it. Practice speaking your goals into your reality. Your words are more powerful than you might realize.
  • Don’t compare yourself to others, we are all on separate paths.
  • Be easy on yourself, lift yourself up don’t tear yourself down.
  • Finally, remind yourself daily that you are capable of greatness and that nothing is insurmountable."
 

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Dialectical Behavior Therapy

2/20/2019

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​Have you heard of Dialectical Behavior Therapy (DBT)?  DBT is a type of therapy meant to help people with mood disorders, impulsive behavior, or negative patterns of behaviors such as self-harm or suicidal thoughts. Perhaps you have difficulty thinking and responding rationally and tend to respond overly emotionally? Maybe you don't think things through and respond with behavior you regret later? DBT is a skill-based model in which the DBT skills are taught and intended to be used to manage strong moods or negative behaviors.  Maybe you have difficulty responding to people rationally and tend to respond overly emotional or you tend to blow up at those you love too often.  Perhaps you struggle with self-harm or suicidal behavior.

DBT helps individuals learn to identify the triggers that are causing them difficulties and to use the skills to help you cope to avoid the past negative patterns. DBT helps with emotional regulation, distress tolerance, acceptance of situations, and mindfulness (being in the present moment without judgement).

A few of the skills are explained below.  For the purpose of this blog a few skills are all there is time for.  If you are interested in learning more of them reach out to me or to someone else who can teach them to you. 

Distract with ACCEPTS – This skill helps with Distress Tolerance. The purpose is to help to manage or distract from unpleasant emotions. The acronyms help to remember the skill.
  • Activities – Find positive activities to engage in.
  • Contribute – Find those in need and volunteer to help. This can be as minor as paying for a stranger’s coffee.
  • Comparisons – Think of people who are less fortunate than you are or think about a time when you were in a worse situation.
  • Emotions (other) – cause yourself to feel something different by watching a funny video, or something else to provoke humor or happiness.
  • Push away – Put your situation in the back of your mind. Think about something else more positive in the front of your mind.
  • Thoughts (other) – Force your mind to think about something else.
  • Sensations (other) –Find something to do that provokes an intense feeling like sucking on a sour candy, taking a cold shower, or holding your hands under cold water.

Ride the Wave –
This is another Distress Tolerance Skill to help manage strong emotions.  

Think about being in the ocean and having a big wave wash over you.  What happens next?  The wave washes over you and then dissipates.  It is the same thing with strong emotions.  Picture a strong emotion washing over you and eventually washing back out like the wave.  If we recognize that strong emotions will eventually dissipate, we can Ride the Wave of the emotion until it washes back out. Knowing the emotion won’t last forever helps with this skill.

Jeff had times where he felt so sad following his wife’s death that he wanted to check out of life.  By understanding the sadness comes and goes he learned to Ride the Wave when he felt overwhelmingly sad.  This helped him to be in the sadness and to know that it would be worse at times and better at other times. With this knowledge, he was able to avoid self-harm.

Radical Acceptance - Are you suffering because of situations you cannot change?  Do you have something from the past you are having difficulty letting go of?

​Radical means complete and total.  Acceptance is accepting life can be worth living even with pain.  If we do not acknowledge and deal with our pain it will turn into a life of suffering.  Pain + Non-acceptance equals suffering.  Here lies the key to this skill.  Saying yes to and accepting the reality of a situation, no matter how painful, is Radical Acceptance.

Lindsey’s husband left her for another woman five years ago.  When with friends she continues to talk about how angry she is, how much pain she is in, and what she wants to do to get back at her ex-husband and his new wife. She is angry daily.  The situation is horribly painful.    If Lindsey were to Radically Accept that her husband is gone and the situation happened, she would be able to let go and move forward.
 
Try these skills at home today!  They work.  If you are interested in learning more DBT skills reach out to me or to someone else who can teach them to you.  I currently run a DBT group for teens but also use DBT in individual therapy for adolescents and adults.
 

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UNHELPFUL THINKING PATTERNS

12/10/2018

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A lot of us use negative styles of thinking, or distorted thinking patterns. These distorted thinking patterns can be a major factor in both depression, anxiety and other mental health issues. Using negative thinking patterns certainly will cause you pain and problems in life. These thoughts are picked up early in life and become habits in our thinking. Negative thinking is connected to negative emotions and negative behavior. These patterns are destructive and insidious in your life. They are probably causing you emotional pain, problems with others and are making you feel terrible! Did you know that by correcting them you can feel better?   
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Look at this sheet and identify which ones you are using. If you discover that you are using a lot of them work to correct them.   Working to replace the negative patterns with positive ones will bring more positivity and happiness to your life! 
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How Can I Make A Difference?

10/29/2018

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Why is this world filled with so much hate?  Why do we wake up to continual, horrific news daily?  What can I do to make this world a better place?  These are questions I ask myself daily. My children ask me why the world is as it is. In my office I have clients coming in asking me the same questions and/or bringing in their pain and tragedies that are taking place in their lives.  I have friends grieving the losses of their children or partners.  What can I do to make the world a better place?  It is normal in this abnormal world to have feelings of powerlessness and fear.  By doing something we can. within our close world, we may be able to make a difference.

If we each ask ourselves, “What is something I can do today to make the world a brighter place?”  Then follow through and do it perhaps there can be a small difference?

For example:

·         Paying for the person’s drink in line behind you at the coffee shop

·         Asking an elderly or sick neighbor if they need anything at the store

·         Volunteering at the local homeless shelter

·         Or a local children’s home

·         Becoming a Big Sister or Brother through Big Brothers and Sisters (they always need Bigs)

·         Becoming a foster parent

 These are small things close to home that can make a difference in the world. 
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Did you know Mother’s Against Drunk Drivers was created by a mother grieving the loss of her child by a drunk driver?  Sometimes grief can be channeled into positivity and into helping others but only when the grieving process has reached the point of being able to be present to help others.
In my life I have been just as frustrated, saddened, and scared about the state of the world.  My husband and I do what we can for others in need such as having raised our children and foster children, continually offering help to our children’s friends, taking in sick or needy animals, asking neighbors in need what we can do for them or reaching out to hurting friends.  We have tried to create our home as loving, positive, and open for anyone in need and will always keep the door open to our friends, family, and neighbors in need.
I wish I had better answers.  I wish the world were a more positive and loving place.  I promise to do my part to continue to be kind and loving to all those in my path.  My hope is that each of us will also be able to do the same on a smaller, equal, or greater level.


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Positivity Boost

7/27/2018

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Do you have kids, adolescents, or others in your life who cold use a positivity boost or do you need one yourself?

When my kids and foster kids were in the house I would often sneak into their bathrooms and post positive post-it-note messages on their bathroom mirrors. This helped boost self-esteem, promoted positivity, and let them know they were loved.  I also give this for homework assignments to clients who may need a positivity boost or are working on feeling better about themselves. You can do the same thing! 

Either write notes to yourself or to those you love and leave them where they will be read several times a day.  The bathroom mirror is a great place because the notes are seen often.  I have individuals read the note and acknowledge it every time they are looking in the mirror.  Dry erase markers or lipstick also work well on bathroom mirrors.

Imagine my surprise when I walked into my bathroom one night and found many, many of these positive notes written by all my children while I was out!  It felt wonderful to know I was loved and to know that this positive note writing also taught my kids to reciprocate positivity and to show love to others!

I challenge you to do this positivity post-it-note messages for yourself or others today!
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