A Podcast Review: “Where Should We Begin?”

By Alisha Bennett, LMSW

A client of mine recently reminded me of the name Esther Perel — a name that I started hearing last year and continue to hear among friends of mine, client’s, and colleagues. If you are in a relationship, regardless of whether it is extremely healthy, or has it’s many challenges, I highly recommend her podcast, "Where Should We Begin?"

To give a brief summary, Esther Perel has been a couple’s therapist for over 30 years, and is also an author and now podcast extraordinaire living in New York City. Her podcast has now completed two seasons and she is currently working on her third. Esther’s podcast consists of approximately 40-45 minutes of her work with real client's that is part recording of sessions and part her providing explanations about the couple or reason for a treatment decision. 

Here are some insights from her podcast to consider if you are looking for some new perspective in your own relationship: 

  • No matter how different the couple on each episode is from you and your partner/significant other, you can always learn something about how to better your relationship. 
  • We often see perfect relationships portrayed in movies, on television, and on social media. Listening to this podcast shows you that all couples are flawed and have to work on bettering their relationships and bettering themselves. 
  • Initially, I thought that it would feel intrusive and odd to start to listen to real couples in their counseling sessions. I thought, "this is going to be so far from real-life, in the same way that the Real Housewives is." However, “Where Should We Begin?” is the exact opposite. Although many of the couples' issues were far from my real life, I could relate to every couple in some way. 
  • Even when the couple appears to be very dissimilar to you and your spouse, the principles and advice Esther gives may resonate with you and there are likely many parallels that can be drawn to your own relationship. 
  • This podcast reminds me that we all have backgrounds that have led us to where we are now and who we are in our current lives. Every relationship faces problems and conflicts and always will. To be in a relationship with no conflict or issues is not reality. “Where Should We Begin?” normalizes this and helps you to better understand ways to deal with these issues together as a couple. 

If podcasts are part of your commute or daily routine, or if you’ve been thinking about starting to integrate them into your life, Esther Perel’s is highly recommended by many (Particularly if you are in a relationship or are seeking to make improvements in future relationships). 

If you are interested in learning more about Esther Perel or her podcast, visit: https://www.estherperel.com/podcast

 

What Does Self-Care Look Like For You?

By Salina Grilli, LMSW

Self-care has taken off in the wellness community with articles, bloggers, and even influencers asserting the myriad of benefits that come from simply slowing down and taking time to connect with oneself. 

But what does self-care actually mean? When I talk about the importance of self-care with my clients, I often find it difficult to describe what exactly self-care means. Isn’t it self-explanatory? If you were to look at the definition of self-care, it essentially boils down to making a conscious effort to take care of your basic needs. 

What I have found, however, is that self-care means something different for every person. For example, think about a Mom with three young children. Self-care for her might simply mean taking a shower every night and fueling her body with nutritious foods that give her energy.  For a 20-something work-a-holic, self-care might mean taking a quick 10-minute break during the day to de-stress.

Point being, what your bestie swears cured her anxiety, might not be helpful for you. Establishing a self-care routine and finding what works for you will take time and practice. Here are some ideas to begin integrating self-care into your life:

  • Take a long, warm shower before bed.
    • If you are feeling adventurous, try incorporating essential oil or a scented body-wash into your routine.  Focus on finding a scent that you find soothing and relaxing. Lavender, rose, jasmine, and chamomile can be especially calming.   
  • Light a candle when you get home from work.
  • Mindfully take a few minutes to take some deep breaths (Check out our therapist Amy Brightman's blog post on how deep, calming breaths can be used to reduce stress and anxiety).
  • Sneak out on your lunch break and go for a short (or even long) walk. 
    • Maybe venture down a new block and see if you can notice something you’ve never seen. The city is full of wonderful surprises. 
  • Get a monthly (or even weekly) massage.
  • Keep a gratitude journal
    • Write down three things that you are grateful for every night before going to bed. This can range from your parents being in good health or being thankful for your favorite barista.
 (Photo taken from  Chelsea   Baker ) 

(Photo taken from Chelsea Baker

Salina Grilli is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Let’s Get Back to Basics with Sleep

By Shaudi Adel, LMSW

Over the past few weeks I've noticed that the topic of sleep has come up in sessions pretty frequently. Usually, it’s brought up in regards to sleep quantity and quality problems. This makes sense, given that we are in the long stretch of time between President’s Day and Memorial Day when work doesn’t throw us an observed holiday, and when midterms strike for students and all-nighters seem like the only viable option to stay afloat.

Repeated sleepless nights have an impact on emotions, negative thought patterns, impulsive behaviors, and physical health and well-being. Sometimes, I think we overlook the significance of adequate and restful sleep because of how simplistic it may seem – in fact, when I do a brief assessment on sleep, many people say that they’ve completely forgotten how sleep deprivation can affect them physically and mentally! Let’s get back to basics and answer some questions to determine if we can make some changes to move sleep up on our priority list:

  1. How many hours of sleep on average do I need to feel rested or wake up feeling energized? Over the past week, how many nights did I meet this target?
     
  2.  Am I getting to bed around the same time every night, including on weekends? If not, how can I make changes to get to bed at a relatively regular time? Similarly, am I getting out of bed around the same time every morning, including on weekends? If not, how can I make some changes to ensure I am staying as consistent as possible?
     
  3. What is my nightly routine in preparation for sleep? Can it be enhanced with anything, such as a guided meditation, to relax the mind and body before bedtime?
     
  4. What is my screen time on my phone, laptop, and/or TV like before bed? Am I ending my screen time at least 30 minutes before bed?
     
  5.  Am I drinking caffeinated beverages (coffee, black tea, soda) after 5pm?
     
  6.  When I can’t fall asleep, what do I do? What are my thoughts like? Can I get up and engage in an activity, like read a book or write my to-do list for tomorrow?

If sleep has been on the back burner, hopefully these questions can help guide you to make some improvements to your routine around sleep. As Marsha Linehan describes it, “when it comes to sleep, ritual is everything.”  Today, find a way to honor your mind and body and engage in some serious self-care with sleep.

Shaudi Adel is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

How to Relieve Event Planning Stress

By Erica Cramer, LMSW

Spring is a great time of year. As the weather gets warmer (let’s keep our fingers crossed) people become more motivated to be socially active and are inclined to plan fun gatherings. Whether it is an extravagant wedding or a small dinner party, planning an event can often be exciting and challenging. Although it is important to consider other people’s wants and needs, it is crucial maintain your sanity during the planning process and create a product that makes you proud. The following tips will help ensure that this is the case:

1. Stay focused.

When you start planning your event, create a concrete plan and stick to it. Set realistic expectations for the final outcome of the event and ensure that you have the resources and time necessary to properly execute it. When you see yourself losing focus or making unnecessary additions, refer to your initial plan to see how those additions align with it.

2. Create boundaries around planning and do not let the event consume your life.

With modern day technology, the planning process can be a 24/7 activity. It is important to devote a specific amount of time each day to planning and not let it be something that takes over your entire life. It is very easy for planning to transform from productive to obsessive. If you find yourself in bed every night browsing Pinterest or Instagram, it may be a good time to re-evaluate your boundaries and ensure that you make time to unplug from planning.

3. Ask for help when you need it.

There is nothing wrong with asking others for help (especially when it is something that they can do well, enjoy doing, or can do easily). This is a good way to take all of the stress off your plate and make planning a more fun and collaborative process. 

4. Remember why you decided to have the event in the first place.

When people become overwhelmed and stressed out they have the tendency to question why they decided to have the event in the first place. When you feel this way, take a deep breath and a step back. Write down all of the reasons you are having this event and what exactly you want to accomplish. Whenever you feel this way again, look at your list and it will be helpful in allowing you to regain focus.

5. Don't second guess yourself.

It is vital to have the confidence to execute your decisions and not question decisions that have already been made. You are the expert of yourself and the event you are planning, therefore you know best. Think of your decisions carefully before you make them and once they are made look forward not backwards.

Erica Cramer is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Finding the Right Fit

By Amy Brightman, LCSW

Beginning your search for a therapist can be daunting, especially if it’s your first time in therapy. You’ve gotten to the point of realizing it would be helpful to see someone, but the uncertainty of who to see and what the appointment will be like can add another layer of hesitation. Here are a few tips on searching for the right therapist for you:

If at first you don’t succeed, try, try again
Finding a therapist is like dating. You might meet the right therapist for you on the first try, but if not, don’t worry, you might have to “shop” around. Every therapist is not the same. There are different approaches, techniques, specialties, and even personalities that can impact your experience. The main priority is to find a therapist who can help you with the areas you'd like to address in therapy. Getting into the how and why is part of finding the right fit.

Share the sharing
Yes, during your first session you will do a lot of the talking so the therapist can begin to understand what brought you in, who you are, what your life has been like, and what you’re life is currently like. With this said, it’s important for you to know about your therapist as well. It’s totally fine to ask your therapist about their work and educational experiences, what their style is like, and how they approach therapy. Are they directive or passive in sessions? Do they work within a specific framework, such as cognitive behavioral therapy? Do they work with specific issues? If a therapist does not share this, feel free to ask. You both are equally trying to understand if this is a good match.

Assess Your Needs
Before your first session, you may be asked to fill out an intake form that will ask questions to get a better understanding of what brings you to therapy and what symptoms you experience. These forms can be particularly helpful for practices so they can match you with a therapist who specializes or is experienced with specific symptoms. If you are not asked to complete initial paperwork, consider these questions for yourself. What do you identify as your presenting problem? For example, if it is anxiety, what does your anxiety look like, feel like, and how does it impact your daily life? It can also be helpful to think about what you respond well to and what you are looking for. For instance, do you respond well to structure and goal setting or do you need more of a supportive, exploratory approach? This isn’t to say that a therapist has one or the other, but rather it’s to think about what you want and need from therapy so that when you find it, you’ll know it.

Make A Commitment
Therapy is a commitment, and if you are unable to make a commitment to your therapy, it will be difficult to see results and benefits. Typically, you can expect to see your therapist once a week. This will help you hold yourself accountable, use skills, and stay active with your goals. Therapy has become more and more accessible recently, particularly with the increase in telehealth platforms that allow therapists to hold sessions even when you’re traveling for work. Therapy is not only a commitment of time, but also of money. If you don’t have in-network benefits, work with your insurance company to find out what out-of-network benefits you have or if a sliding scale can be offered. Some therapists or practices will help you figure out your benefits. At Cobb Psychotherapy, we have experienced staff who will work with you and your insurance company to figure out your benefits.

Discuss Expectations
You will have expectations of your therapist and your therapist will have expectations of you. Discuss what these are so you both are on the same page. Expectations can range from: How do you get in contact with your therapist if you need to? Will there be homework? What are your goals for therapy? Knowing some of these answers will ensure that you and your therapist are working together and approaching therapy as a team effort.

Remember, when sharing your thoughts and feelings with a stranger, it’s completely understandable to feel strange and uncomfortable, but over time your nerves will decrease if you have found a good client-therapist match. Finding that balance of feeling supported and challenged can be a good indication of this. It's worth taking time to find your match so you can feel confident and hopeful about getting optimal results from therapy.

Amy Brightman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

3 Tips for Finding Lasting Love [Online]

By Allie Lewin, LMSW

The search for love can be exhausting. At times, finding a partner can even seem impossible, especially when the norm for meeting someone special these days involves swiping a screen populated by selfies. While some folks meet their significant others in college, through work, or through friends, many singles spend over an hour per day on dating sites or apps eager to find love. 

So how can we make this tiresome process more efficient and successful? How can we stop wasting our time on the person who will never turn into more than just a drunken hookup or a situation consumed by two months of back and forth texting followed by radio silence? Maybe the process of online dating can never be a quick means to finding love, but research on dating in the 21st century shows certain attitudes and behaviors can help people successfully find love online. Here are three tips to increase your chances of finding lasting love online.

1. Don’t Judge Pictures Too Much

It’s very easy to shutdown a perspective suitor based solely a picture. Physical chemistry is an important component of any romantic relationship, so it’s completely understandable that when faced with the decision to show interest in a perspective partner online we put a fair amount of emphasis on looks. However, studies show that in general people are more selective online than they would be if they met the person IRL (in real life). When comparing user activity data from OkCupid and a blind date app to investigate the extent pictures affect response rates, OkCupid creators found that on OkCupid, women who received higher ratings in attractiveness were less likely to respond to men with lower ratings; however, when the same couples were matched for a blind date through the second app, these women reported having a good time. Christian Rudder, a co-founder of OkCupid, explained “people appear to be heavily preselecting online for something that, once they sit down in person, doesn’t seem important to them.” 

This is all to say that in the pursuit of love, a few good or not so good pictures on a profile are even less meaningful than we believe. By swiping left or not responding to a message because the person “doesn’t look that cute” or “isn’t your type,” you are immediately eliminating a potential match you may have been stoked about had you met at a bar or at a coffee shop. Makes you think twice about your next swipe, right?   

2. Meet Up Soon After Matching

I’ve joked around with friends and clients about the importance of meeting up with a prospective partner soon after matching in efforts to keep the momentum going, but it turns out there is an actual “tipping point” in online dating when too much communication before meeting up affects the chances of the relationship working out. When there is too much communication prior to meeting face to face we tend to idealize the person and naturally feel let down when the person doesn’t meet our expectations. According to a 2014 study, the “tipping point” occurs after 17-23 days, so waiting any longer than that to actually meet becomes risky. In general, the more effort we spend getting to know someone before actually meeting them in person, the more disappointed we are likely to feel if the relationship doesn’t go anywhere (which makes the dating process even more exhausting!). If you’ve matched with someone and think there could be potential, I suggest trying to meet up within a week or two to give yourself the best chance of being pleasantly surprised by your potential mate and to decrease the likelihood of burn out. 

 3. If You Are Unsure, Go On At Least Three Dates  

In our attempts to find the perfect person in a sea of endless options, we all too often shut down potential partners before getting a chance to see who they really are. This haste often leads to missed opportunities for connection. The importance of continued interactions in dating is supported by what social psychologists call the “mere exposure effect”: repeated exposure to a stimulus tends to enhance one’s feelings toward it. In the context of dating, the mere exposure effect implies that the more we hang out with a potential partner, the more likely we are to develop strong feeling towards that person. Not only do you become more familiar with the person the more you see them, but you also start to get a picture of how that person relates to others and views the world, providing a better a sense of whether compatibility truly exists. So if you go on a first date and come away from it feeling unsure, don’t feel discouraged. Love at first sight may exist, but most love takes time. Give the person a chance, let the mere exposure effect kick in, and allow yourself the opportunity to sort out where your feelings really lie before saying yay or nay.

Not putting too much emphasis on pictures, meeting up soon after matching, and giving yourself adequate time to get to know someone in person can hopefully be helpful in making the online dating process a little less exhausting and more fruitful. That being said, I think it’s important to acknowledge part of what makes relationships special and ultimately work are the experiences we learn from along the way. So while the search for your partner may not be graceful or easy, as an individual you are ultimately benefitting from the opportunities dating provides for learning about yourself and what you are really looking for in a companion. 

References: 

  • Ansari, Aziz, and Eric Klinenberg. “How to Make Online Dating Work.” The New York Times, The New York Times, 13 June 2015, www.nytimes.com/2015/06/14/opinion/sunday/how-to-make-online-dating-work.html.
  • Fox, Margalit. “Robert Zajonc, Who Looked at Mind's Ties to Actions, Is Dead at 85.” The New York Times, The New York Times, 6 Dec. 2008, www.nytimes.com/2008/12/07/education/07zajonc.html.
  • Ramirez, Artemio, et al. “When Online Dating Partners Meet Offline: The Effect of Modality Switching on Relational Communication Between Online Daters.” Journal of Computer‐Mediated Communication, Wiley/Blackwell (10.1111), 17 Sept. 2014, onlinelibrary.wiley.com/doi/full/10.1111/jcc4.12101.

Allie Lewin is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

 

Recognizing Stress Awareness Month This April

By Vanessa Kensing, LMSW

Did you know that April is Stress Awareness Month? I recently discovered this when I was trying to decide what to blog about this month, and found that it really spoke to me.  Stress Awareness Month (emphasis is mine), is a month where we can dedicate ourselves to becoming more aware of stress. But what does that mean in practice?  The definition of awareness includes both knowledge and perception, and in the context of stress, are equally important! Therefore to build awareness around stress we first need to understand what stress is and how it manifests.

Stress is the response to a threat, either real or imagined. In small amounts it can be motivating and not cause harm, but in sustained and intense amounts it can impact one’s emotional, behavioral, interpersonal, and physical well being. Building awareness around how stress manifests for you can help in finding tools to effectively cope. Below are a list of ways that stress shows up in our life and what you can do to cope:

Being easily agitated, frustrated or moody

  • Monitor your thoughts to see where cognitive distortions may be impacting your emotion
  • Build self-soothing techniques to aid in emotional regulation

Feeling overwhelmed and out of control

  • Identify what you can control and make efforts to address more manageable tasks
  • Speaking with others to help gain perspective and get feedback

Having difficulty relaxing

  • Meditation, visualization
  • Breathing exercises

Aches and pains in muscles, clenched jaw

  • Yoga
  • Progressive relaxation exercise

Only seeing the negative

  • Utilize a thought defusion technique
  • Speak with others to help gain perspective

If you are anything like me,  you have allowed stress to be your constant companion without much thought. And in doing so, you haven’t left yourself much room to imagine a life where you are in control of your stress, instead of your stress controlling you. Therefore, when it comes to perception, how we perceive our stress can be integral in how we cope. Seeing it as something manageable, purposeful, and in our control can aid in utilizing necessary coping strategies mentioned above.   

Working with a therapist can help you learn, explore, and engage in techniques mentioned above to help manage stress. If you are interested in working with someone please reach out to Cobb Psychotherapy!


References: 

Vanessa Kensing is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

The Narcissist and Echo Dyad in Borderline and Narcissistic Personality Traits and Disorders

By Nadine Burgos, LMSW

The tales of Greek and Roman mythology that have been passed down throughout the centuries still serve as powerful lessons for us today. In Greek mythology, Echo, a forest nymph, falls in love with the egocentric youth Narcissus.  When he shows clear signs of rejecting her, she struggles through an attachment system which anxiously seeks him, despite his unrequited love. She engages in the masochistic task of echoing back to him all that he says. For her, echoing is painful and humiliating in this context since Narcissus sadistically exploits and rejects hers. All of Echo’s attempts to try to resolve her anxious attachment through an emotionally unavailable character are met with contempt.  The story of Narcissus is an allegorical representation and central feature of codependent behaviors in dysfunctional relationships.  A codependent giver or highly empathic person may mirror, echo, and compliment another at the expense of their own self-worth and dignity. In the case of egocentric Narcissus, falling in love with his own image was a punishment rendering him incapable of empathic love of another. 

Personality Disorders are a complex and controversial topic. It’s important to guard against loosely throwing out terms and labels without the understanding that personality is complex, fluid, and changes throughout developmental life stages. However, personality disorders are stable and debilitating and are often difficult to even identify. Writing about narcissism and borderline personality disorder is in an attempt to educate and encourage examination on the impact they weigh in on our lives.  It is not uncommon to come across an individual with a personality disorder as nearly one in ten individuals in the U.S. qualify for the diagnosis. This statistic is higher for those individuals on the sub-clinical trajectory.  

We all in some way or another have encountered individuals who have displayed narcissistic traits. Some have been introduced to us through literature, film, and the media. We are inundated by political smear campaigns, spewed by questionable leaders who shroud behind accusations of bullying, adultery, collusion, and treason. In 2017, the movement of #MeToo set the platform for publicly exposing the pervasiveness of sexual harassment and assault. Culturally, we question the fabric of a society that sacrifices our natural environment and resources in exchange for profit and power.

The book, The Culture of Narcissism: American Life in an Age of Diminishing Expectations, by historian Christopher Lasch, examines the roots and ramifications of the normalization of pathological narcissism in the 20th century. Lasch reasons that post-war America has produced a personality-type consistent with clinical definitions of "pathological narcissism.”  On a macro level, narcissism invades entire social macro-systems. As industries and corporations shirk social values and collectivism, the culture of narcissism continues to rise.                                                  

Narcissism falls on a continuum from healthy to pathological.  Narcissistic Personality Disorder (NPD) comes in many varieties with many variables and co-morbidities. Neurotypical individuals may exhibit narcissistic traits yet may not qualify for a clinical diagnosis under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A healthy sense of narcissism allows us to develop healthy self-love and confidence.  Healthy self-love allows for us to appreciate and respect that we have made real achievements in our lives.  We also develop the ability to overcome challenges and setbacks. We overcome these obstacles by engaging in mutually empathic relationships with other people.

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Narcissism become problematic when an individual’s narcissistic traits move across the continuum and beyond the social construct of what is considered socially, psychologically, and morally acceptable.  There are now many differing levels and categories of narcissism. At extreme levels and with further impairment, narcissism can result in a personality disorder (PD) diagnosis. On the narcissism spectrum, you will find sub-clinical narcissism teetering away from the center with a proclivity to lean towards the left or right.

The essential features of a personality disorder are impairments in personality, self and interpersonal functioning, and the presence of pathological personality traits. The Cluster B Personality Disorders (antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder) are marked by a codependent, neurotic need to feed off of the reactions of other people. Cluster B Personality Disorders are stable, maladaptive personality disturbances and can also be considered a cultural condition. Individuals with personality disorders can be described as being highly emotional, dramatic in nature, or erratic. Clinicians and mental health professionals use criteria from the DSM-5 to diagnose individuals.

So are personality disorders born or made?  There are two schools of thought about the origin of personality disorders.  Etiology is complex and remains unclear despite various theories that have been proposed. These include cultural, evolutionary, Gene X environment, and parenting and developmental models (Cambell and Miller, 2011).  Some suggest that there is an Amygdala dysfunction which directly affects emotional regulation and limbic resonance. Without this structural component of our brains, there is no capacity for empathy. Nurture argues that a traumatic childhood, neglect/abuse, or even overindulgent parenting can lead to one becoming narcissistic. 

The role of parenting styles in the development of young adult narcissism was investigated in a longitudinal study from Block and Block (1980). They examined  parenting and inherited genetic factors in subclinical grandiose narcism. The results showed that parenting styles had a direct effect on the development of healthy narcissism, but the effect on the development of maladaptive narcissism depended on the child’s initial proclivity towards narcissism. The study found overpraised children showed narcissistic traits six months to a year later.  BPD is approximately five times more common among people with close biological relatives with BPD.

 

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One of the distinguishing traits of Narcissism from other personality disorders/traits is the individual’s inability to truly feel and exchange feelings of empathy. Rather than having “feelings,” they merely register disconnected “intensities” which gives the impression of someone on the Narcissism spectrum as being emotionally stunted. Perhaps one of the most challenging aspects of narcissism is that individuals struggle to understand how their behavior impacts others. Unless they are mandated to attend treatment, most won’t be lined up to embark on a journey of introspection and self discovery with a therapist, especially if they don’t recognize that there is a problem within themselves.  Pat MacDonald, author of the paper "Narcissism in the Modern World," shares, “Traditionally, it is very difficult to reverse narcissistic personality disorder. It would take a long time and a lot of work.” Clearly, some may be in denial about their issues, and more still are fully aware of them and even embrace them. Narcissists are not always easily detected and often appear shy, coy, very polite, professional, and courteous. They gain the victims trust by mirroring and projecting the traits of those they wish to emulate.

The narcissist may bring traits of co-dependency into the relationship through demands, defenses, projections, and boundary infractions.  Individuals who are highly empathic and/or have borderline tendencies/traits are more likely to engage in relationships with individuals with narcissistic traits and/or NPD disorder. One of the distinguishing traits of Borderline Personality Disorder from other personality disorders/traits is the individual’s anxious/neurotic preoccupation with alleviating their anxious attachment style by seeking empathic emotional validation.  Individuals with BPD can feel empathy, however they may struggle with issues of co-dependency as a result of seeking to fill their emotional void through another person.

One symptom common to those with BPD is chronic feelings of emptiness. To counter these feelings, he or she may use sex as a means of trying to fill a vast void. These individuals may protect themselves from rejection/abandonment by acting so agreeable to others, via their mirroring capacity or through engaging in sex as a way to reinforce connectedness. For the narcissist, sexual partners may be characterized as trophies used to enhance his or her self-esteem and self-worth.  Rather than building an emotional  attachment before engaging in sex, they may simply be seeking pleasure rather than trying to bond and build a relationship. These transgressions set the stage for codependent behaviors and anxious attachment for the borderline personality type.

There is a symbiotic relationship between Narcissus and Echo, and because of it’s predatory relationship, it is one that cannot be sustained long term.  A relationship with individuals showing marked narcissistic traits will require others who will provide them with an ongoing narcissistic supply. Individuals with borderline traits/disorder may enter into relationships with a great variety of people, though at the core there is a tendency to choose situations in which unrequited love will be the outcome.  For those with NPD, a lack of emotional connectedness and closeness results in a lack of long-term relationships. Both individuals with traits of Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD) engage in maladaptive behaviors resulting in harmful relationship outcomes.

In the film Listen Up Phillip, a narcissistic writer, Philip, played by Jason Schwartzman is involved in a parasitic relationship with his girlfriend Ashley, played by Elizabeth Moss. The relationship seems unfathomable considering how little he actually cares for her, and yet still needs to harbor the illusion of being humanly connected.  Philip enters and exits Ashley’s life throughout the film. On one occasion he suddenly leaves her for several months to focus on writing in the country while casually saying,  “I hope this will be good for us, but especially me,” while waltzing out the door.  The film shows Ashley's emotional roller coaster in the wake of finally deciding to ban Philip from her life for good. At first averse to the notion of being actually alone, as opposed to figuratively alone, Ashley experiences depression and disinterest in her work. When she finally comes out on the other side of their break-up, which Philip deems merely a temporary separation while he accepts a teaching job at a college upstate, she is stronger than ever and finally able to cut ties with Philip. This may be the most redeeming aspect of the film - the fact that at least one person experiences a metamorphosis. 

Narcissistic Personality Disorder describes individuals who consciously feel superior to others (at least this is what they tell themselves). Individuals struggle with a strong discomfort with feeling vulnerable and a lack of empathic connection with others.  Narcissists choose their lovers based on whether the person enhances their self-esteem.  This ongoing need is referred to as a narcissistic supply.  As this need continues, there is little to no incentive to wait to get to know a person better.  The things that attract a Narcissist are not strong redeeming character traits or compatibility, but may focus on if a person has high status in their eyes. The experience of loving an individual with NPD can be emotionally traumatic and confusing. Since their real interest in relationships are shallow, they often leave relationships as suddenly as they began them.  

Borderline Personality Disorder is a complex disorder and involves many aspects of the human psyche. The poor relationship one has with themselves is mainly due to a combination of their upbringing and interactions with others at an incredibly early age and their genetics.  With borderline personality disorder, the individual fears abandonment in close relationships and cycles through an anxious attachment style and extreme emotions.  The emotional intensity surrounding this fear can lead to inadvertently enabling narcissistic behaviors in those for whom love, admiration, validation, attention, and empathy are sought.  The fear of abandonment is irrational for those with BPD but when they engage in relationships with individuals on the narcissism spectrum they may find these fears to be valid. This is especially so when they form quick strong attachments and resist any information that suggests that they should detach because someone may be an inappropriate mate. The idea of detaching brings up their underlying fears of abandonment, so they find reasons not to leave. Narcissistic and Borderline individuals want different things in relationships. Narcissists want continuous self-esteem enhancement and Borderlines want continuous unconditional love.  

If you are in a toxic and co-dependent relationship, and find that you are enabling narcissistic or borderline traits in another, it’s important to start protecting yourself:

  • Don’t be quick to be swept away by quick, intense romantic attachments without looking very closely at the other person’s real personality.  
  • It’s important to be honest with yourself and evaluate if this relationship is mutually empathic. Is there an equal emotional give and take? Does this person see you as their equal and not a source of narcissistic supply or an unhealthy codependency?
  • Know who you’re dealing with.  Some individuals with personality disorders may react with anger, resentment, or revenge when you confront them. Challenging their narcissistic supply or disagreeing with them may become a narcissistic injury, which may illicit a strong negative reaction.
  • It’s important to be confident, and to assertively set clear boundaries. 
  • Calmly and carefully explain to them how their behaviors and words affect other people.
  • Respectfully ask them to put themselves in the place of the other person.  
  • Help them to see behavioral expectations that should be obvious. 
  • They are capable of intellectually understanding their behavior outcomes, but this is very difficult for them. It is hard work and requires a firm and serious life commitment and the tenacity to openly discuss insecurities with a partner and therapist on an ongoing basis.

Listen to your intuition and refuse the temptation to overanalyze and diagnose. If you suspect someone is being abusive towards you and you are in a situation that is potentially dangerous, be proactive and take the steps to remove yourself from this relationship. Refer to a mental health provider and other qualified professionals to help you identify and work on changing your own self-defeating behavioral patterns.  And in the process of healing ask yourself,  what made you put up with the abuse in the first place?

References:

  • Alloway, T., Runac, R., Qureshi, M., Kemp, G. Is facebook linked to selfishness? Investigating the relationships among social media use, empathy, and narcissism. Soc. Netw. 2014;3:150–158.
  • Association between physiological oscillations in self-esteem, narcissism and internet addiction: A cross-sectional study  http://www.psy-journal.com/article/  S0165-1781(17)30425-0/references
  • Levine, Amir, and Rachel Heller. Attached: the New Science of Adult Attachment and How It Can Help You Find - and Keep - Love. Jeremy P. Tarcher/Penguin, 2011. 
  • Lewis, Thomas, et al. A General Theory of Love. Vintage Books, 2001. 
  • Bender, L. (Producer), &. Perry, Alex Ross. (12014). Listen Up Philip  [Faliro House Productions]. United States.

Nadine Burgos is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Self-Compassion: Recognizing Our Common Humanity

By Sarah Spitz, LMSW

Back around Valentine's Day last year I did a post on self-compassion as a reminder that we, as much as anyone else, are deserving of love and kindness. I referenced the research of Dr. Kristin Neff who has identified three elements of self-compassion.  My last post focused on the first element of self-compassion: "self-kindness vs. self-judgement." This means that we react to ourselves with kindness and understanding when we are confronted with personal failings. As Neff says, "self-compassionate people recognize that being imperfect, failing, and experiencing life difficulties is inevitable, so they tend to be gentle with themselves when confronted with painful experiences rather than getting angry when life falls short of set ideals."  

Today I wanted to highlight the second element of self-compassion: "common humanity vs. isolation."  Often when we feel that we have failed or made a mistake, we may feel very alone and as if we are the only person to have experienced this situation. I'm sure most of us have said some iteration of this phrase to ourselves: "I can't believe I made this mistake - I'm such a failure." We beat ourselves up and it can feel as though we are the only person flawed enough to have done what we did. How isolating does that feel?! 

A key part of self-compassion is recognizing that making mistakes is part of being human.  As Neff says, "suffering and personal inadequacy is part of the shared human experience – something that we all go through rather than being something that happens to “me” alone."  Below are two exercises to help cultivate this element of self-compassion:

Self-Compassion Journal
Neff offers journaling exercises for each of the elements of self-compassion, and for "common humanity vs. isolation" she suggests writing about how our personal experiences are connected to the larger human experience.  If you find yourself being self-critical about a mistake you made that day, take the opportunity to view it through a more universal lens.  Write about some of the factors outside of yourself that led to what happened, and also remind yourself that you are not alone in this feeling/situation. For example, write statements such as "other people have felt/feel this way" and "it's human to make mistakes."  

Loving Kindness Meditation
There are many versions of the loving kindness meditation out there, but one of the essential features is that it involves sending compassion to both ourselves and others. Inherent in that is the idea of common humanity—that we are not alone in the experience of suffering. You can either listen to a guided meditation or craft your own version that resonates with you. Below are some examples: 

 

Resources:

 

Sarah Spitz is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Hope Through Positivity (While We Wait for Science to Catch Up)

By Dan Perlman, LMSW

Clinical depression, or Major Depression, is characterized by “persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.”  Affecting nearly 3 million Americans each year, we’re only now beginning to understand the roles stress, trauma, genetics, and neurology play. From a scientific perspective, certain areas of the inner brain are believed to help regulate mood, although scientists' current understanding of the neurological underpinnings of mood is far from certain.  A study published in The Journal of Neuroscience in 2017 found that of 24 women who had a history of depression, the hippocampus "9% to 13% smaller in depressed women compared with those who were not depressed.” 

While no one size fits all, and many medications provide meaningful benefits, it seems apparent that talk therapy remains in the forefront of treatment.  The two most commonly used for depression are cognitive-behavioral therapy (CBT) and interpersonal therapy. Just talking and thinking seems to help relieve displaced anger that has been misdirected inward at oneself.

Many clients share a feeling of "emerging from a dark hole” after a positive talk. They say that life out here is “brighter and lighter," that a pressure has been taken off their heads, or that “the pushing down and weight on my shoulders has gone away.”  Often this occurs without medication, brain scans, or any sudden financial windfall to assign as catalyst. Sometimes they’ve just come in talk to someone and gone out feeling less alone. 

Clients' stunned reactions and almost confused sentiment at the lifting clouds is breathtaking.  In essence, they experience the lifting of depression, and I imagine their prefrontal cortex is springing back to life.  When they refer to the hole of depression having "moved over there” or for some, completely disappearing, it is powerful, moving, and almost spiritual to witness.  At this point in recovery I tend to believe something outside of our awareness is happening — call it love, spirits, or karma.   Sigmund Freud once wrote that psychoanalysis is “in essence a cure by love.” When done effectively,  psychoanalytic therapy shifts and eases the blocks that stop us from loving or being able to be loved. 

Being someone who believes in something more than we can see, I occasionally look toward those who can tie our craft to even broader ideas. This brings me to a sermon by Joel Osteen (He’s the pastor who fills the 15k seat Compaq center in Houston weekly and has millions of followers worldwide). Recently I read that he said, “Choosing to be positive and having a grateful attitude is going to determine how you’re going to live your life!”  I think he’s right, and that positivity is not only infectious for our clients, but it provides the love that Freud believed can become curative. 

References:

Dan Perlman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

What to do When You're Feeling Overwhelmed

By Bethany Nickerson, LMSW

Lately I have had several clients and many of my friends mention that they are feeling overwhelmed, and I can definitely relate. Between work, chores, family responsibilities, exercising, and trying to still have time for a social life, it's easy to feel like you're always a little behind. Here are a few things I have found that really help me when I feel myself getting anxious and caught up in racing thoughts about everything I need to do:

  1. Do some deep breathing. My favorite is alternate nostril breathing. It helps me to get out of my anxiety brain and back into my wise mind. You can find a great tutorial from The Art of Living.

  2. Move your body. Do some stretching or go for a nice long walk.

  3. Brain Dump. Take a few minutes and write down everything that is bouncing around in your brain. All of your worries, anxieties, and things that you want to get done. Then take a red pen and cross out anything that you have no control over. This will help you focus your time and energy.

  4. Prioritize tasks. Take the remaining things on your list and figure out which tasks are time sensitive. Number things starting with the most critical.

  5. Keep a gratitude journal. Every day write down 3-5 things that went well or things you are grateful for. When you are feeling down or overwhelmed look back in your journal. This is one of my favorite tools as it gives me perspective and helps me to focus on the positive and what I am doing right.

Bethany Nickerson is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Anxiety Reduction Exercises: Over Energy Correction and Butterfly Hug

By Kaylen Hagadorn, LCSW

Often, when we feel overwhelmed by anxiety, we are unable to focus or calm ourselves down in the moment. Two easy techniques that can be done quickly are "Over Energy Correction" and the "Butterfly Hug." See instructions below for both:

Over Energy Correction:

  1. Find a comfortable chair to sit in

  2. Cross your left ankle over your right ankle

  3. Extend your arms in front of your body, thumbs down, palms out

  4. Cross your right hand over your left hand and interlace your fingers

  5. Roll your hands up to your chest and tuck them under your chin

  6. Place your tongue against the roof of your mouth, just behind the center ridge

  7. Close your eyes and breathe deeply for two minutes

Follow this link for video instruction: https://www.youtube.com/watch?v=FOzjOOiTJ_Q

Butterfly Hug:

Cross your arms over your chest, so that the tip of the middle finger from each hand is placed below the clavicle or the collarbone, and the other fingers and hands cover the area that is located under the connection between the collarbone and the shoulder and the collarbone and sternum or breastbone. Hands and fingers must be as vertical as possible so that the fingers point toward the neck and not toward the arms.

Now interlock your thumbs to form the butterfly’s body and the extension of your other fingers outward will form the Butterfly’s wings.

Your eyes can be closed, or partially closed, looking toward the tip of your nose. Next, you alternate the movement of your hands, like the flapping wings of a butterfly. Let your hands move freely. You can breathe slowly and deeply (abdominal breathing), while you observe what is going through your mind and body such as thoughts, images, sounds, odors, feelings, and physical sensation without changing, pushing your thoughts away, or judging. You can pretend as though what you are observing are like clouds passing by

Follow this link for video instruction: https://www.youtube.com/watch?v=2FnWd9Pb7to

Kaylen Hagadorn is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Reducing Stress During Commute Issues

By Jessica Glynn, LMSW

There are many situations in our everyday lives that we have no control over. As New Yorkers, one of these frequently stressful matters can be our commutes to work. Whether its subway traffic, an MTA fail, or a train cancellation, we may become inpatient, frustrated, and on the verge of an anxiety attack. 

An anxious response to these situations are often speculation, and we find ourselves asking questions that can’t possibly be answered in that moment: Why is it taking so long? Why is that MTA employee not helping customers? Why is the subway line down? What if I am late to work? The list of questions can go on and on.  But, what if we instead surrendered to the fact that all of this is out of our control? And recognized that none of these questions could really be answered, and even if they could be, we likely wouldn't be satisfied. In taking this approach we may be able to gather some patience, take a deep breath, and relax.  Tell yourself this: I will deal with any of the logistics that follow as they become clearer and within my current state of control. 

Accepting these everyday struggles can help keep our stress levels down. If you get to your subway station and the line is down, there is nothing you can really do but find an alternative route. If the train stops for an extended period of time, there is nothing to be done except to wait until the problem is resolved. Trust me, it will be resolved at some point. Ask yourself, what purpose would it serve to get fired up over this? You might find that it doesn’t serve much of a purpose and only causes undue stress and anxiety for you. The MTA isn’t fueled by your stress, so it literally won’t help the situation. Remain calm and proceed to the alternate route. And if you are in turn late to work, train issues are probably one of your fail proof excuses. It will all work out in some way or another and hopefully you will be able to move on with your day as intended, remaining more balanced throughout the course of your day.

In addition to finding acceptance when we have to cope with issues during our commute, check out our other blog post on self-care strategies for the commuting New Yorker. 

Jessica Glynn is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Easily Irritable? Anxiety Might Be The Reason 

By Heather Matzkowitz, LMSW

We all become irritated from time to time — it’s part of being human!  However, the type of irritability I am talking about is ongoing and regularly occurring. So what's the cause?  While anxiety can manifest in different ways for different people, for many it may lead to irritability. Do you find yourself quick to react? Have you been noticing that smaller issues cause you to feel more annoyed? Do you abruptly snap at other people? Below are some things you can do to ease the irritability: 

Identify the Source
Often times we react so quickly that we do not take a step back to notice what is really going on and why we are feeling irritated. It’s important to ask yourself, ‘Why am I feeling irritated, and what can I do about it?’

Gain Perspective
Irritability usually occurs when we experience minute annoyances, such as someone cutting in front of us at the coffee shop. Try to take a moment to remind yourself of the things that are going well in your life, such as your good health or having a comfortable space to go home to. 

Sit in Solitude
Usually when we are feeling irritated it's because of an outside source. When we feel irritated it's important to carve out time for you to find a quiet place to reflect. Irritability can be your brain's way of telling you that you need some alone time. Meditation or some light stretching can be done during this time to help refocus and ease your mind.

Engage in Physical Activity
Exercise is wonderful for helping you to cope with negative emotions. Studies have shown that it can be beneficial to try and get at least 20 minutes of exercise each day to help reduce symptoms of anxiety. This includes walking or some restorative yoga stretches! 

It’s important to be kind to yourself when you're experiencing negative emotions. You’re allowed to feel annoyed sometimes, and when you're compassionate with yourself it can also help you feel more compassion for those around you.

Heather Matzkowitz is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Using Communication Skills to Strengthen Relationships

By Kristen Quinones, LMSW

Communication is our lifeline when it comes to connecting with others. There are ways to be more mindful of how we communicate and strategies we can better utilize to help strengthen our relationships with loved ones. Healthy engagement in communication means balancing listening, exploring, sharing, and mindfulness during interactions.

Listening
Good listening shows someone that it is safe to become emotionally vulnerable and share with you. Good listening means maintaining eye contact, paying attention, and making minimal interruptions. Eliminate distractions such as your cell phone and give your undivided attention.  It also shows you are listening when you acknowledge what the person is saying and ask follow-up questions.

Exploring
Asking follow-up questions is also part of exploring. When a friend asks how you are doing, be sure to check in with how they are doing in different areas of their life. Maybe even ask a question about something they have previously mentioned to you. This helps keep communication reciprocal. It shows you take an interest in their life and wellbeing, and that you care to remember things they have previously shared with you.

Sharing
Sharing your own feelings is also very important to deepening relationships. By making yourself vulnerable you allow for the development of emotional intimacy in the relationship. Another part of sharing is healthy confrontation. When we are honest about our own emotional needs in a relationship, or about a conflict in a relationship, we can deepen our connection with that person. By holding back on confronting conflict we may become passive aggressive, hold resentment, or feel our needs being unmet. It is healthy to confront difficult feelings and have challenging discussions. Ultimately this will lead to stronger and more satisfying relationships. 

Mindfulness
Before reacting to someone, be mindful of their intent and their own sensitivities before choosing how you would like to respond. It is also important to try to be mindful if you are picking up on the other person holding back some of their feelings. Try to assure them that this is a safe space for them to express how they are feeling even if the conversation may be difficult.

Ultimately it is very important to be mindful of your own communication skill set and practice healthy communication skills lifelong. Consider learning more about your own communication style in therapy.

Kristen Quinones is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Schema Therapy & Emotional Deprivation

By Rosie Barton, LMSW

I often work with men and women who describe a feeling of emptiness and persistent loneliness, but can’t seem to articulate why they feel this way. Often times, these clients lead lives that they feel “should” be fulfilling, though nonetheless they are plagued with this sense that something is missing. Although these clients may have successful careers, have friends they care about, social skills, and hobbies, they might feel as if they are going through life checking off boxes or a to do list, rather than truly being present or enjoying themselves.

Some of these clients benefit from integrating Schema Therapy into their treatment. A schema is a stable, enduring pattern which influences the way we view the world and ourselves. Schemas are often self-defeating, and they lead to maladaptive ways of coping with emotions and situations. An example of one such schema is called “emotional deprivation,” which is one of the most common, yet also one of the hardest to detect. Those with a schema of emotional deprivation might feel that they had a perfectly adequate childhood and that there’s no underlying reason for them to feel such a sense of disconnection. Some indicators that you might have this schema are: 

  • You feel disconnected, even from the people closest to you
  • You feel that no one is there to really listen and understand your true needs and feelings
  • You find it hard to let someone else protect or guide you, even if it’s what you really want inside 
  • You are lonely a lot of the time

If some of these resonated with you, know that you aren’t alone. More and more people are choosing to seek therapy to address these issues, rather than using self-defeating strategies to cope. These negative coping strategies are usually grouped into three categories: surrender, counterattack, and escape. 

Those who surrender to their emotional deprivation schema believe that they will never get the type of love that they crave, and thus might remain in relationships with cold and distant partners who can’t meet their needs. Those who counterattack might become demanding in their relationships, asking for more and more in an attempt to overcome the deprivation and emptiness that they feel in their core. A hard shell of anger might cover up the grief that is underneath. And finally, those who attempt to escape their schema might avoid intimate relationships altogether. By avoiding relationships, one doesn’t have to deal with the disappointment of feeling empty or dissatisfied yet again. 

There are many ways to cope with the emotional deprivation schema that keep you stuck in the same cycle of loneliness and disconnection. However, you aren’t doomed to feel this way forever. It takes a lot of practice and insight, but through therapy it is possible to have a different experience in your relationships. In my next blog, I will be writing about the three types of emotional deprivation and some of the exercises that can help you make sense of your schema and shift the power it has over you and your relationships.

Rosie Barton is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Need to Relax? Try Some of These Activities

By Cherise White, LMSW

Do you check your calendar and realize your time is booked? Maybe your calendar consists of work, family and community commitments, school, social events, or time with friends. However, how much of your time is booked for relaxation and self-rejuvenation? Here are some simple ways to relax:

  • Adult coloring
    Mentally soothe yourself by connecting with your inner child and pulling out the coloring pencils, crayons, or markers and get lost for a while coloring pages from an adult coloring book. Book stores, retail shops, and even some grocery stores sell adult coloring books. This is a great way to relax your mind and mindlessly do something productive. The elaborate colors and repetitive movements will help you reach a calm inner state and focus your attention on something outside your busy life demands. 
     
  • Finger labyrinth
    Try googling a finger labyrinth in your free time. There are different versions out there, so you can opt for a printable option or you can just pull it up and enlarge it on your computer. Trace it with your finger, the end of a pen, or even a colored marker. You can trace to the middle, to the exit, opposite side, or inward and then back outward. It’s such a great activity for feeling calm, and it only takes a few minutes. 
     
  • Aromatherapy/ Diffuser/Candles
    The power of smell is often overlooked. If you find different smells to be captivating, why no try out a new candle or getting a diffuser you can put essential oils in. You can even get creative and mix oils to make scents that intrigue you, or find oils already mixed that address different needs such as improved sleep, anxiety relief, or mood enhancer. Other ways to use smell as a relaxation tool include candle warmers, scented lotion, bath bombs, homemade/stovetop potpourri, or simply peeling an orange.
     
  • Guided visualization
    There are a number of apps that provide meditations and promote mindfulness, however, within mindfulness and meditations is a category called guided visualization. There are various ways to do guided visualizations. There are scripts so you could to do it with others, apps with pre-loaded databases containing guided visualizations like the app Insight Timer, or you could always find a guided meditation on youtube. 
     
  • Virtual Fireplace or Beach
    Slow down and put on a virtual fireplace or beach on your electronic screen. Step away from the emails, papers, social media, and just be present. Allow your mind to bask in the tranquility of the peacefulness of a virtual fireplace or beach setting and just take a moment to breathe and regroup.
     
  • Drink tea
    Become a tea drinker and engage your various senses. Close your eyes and focus on the smell of hot tea, feel the warmth flow through your body as you hold the mug in your hands, savor the taste. Diversify the teas you try, whether you prefer herbal, nutty, fruity, or medicinal types of tea, there is something for everyone. 
     
  • Stretch
    Take a deep breath and stretch each area of your body. Try to stretch areas you may not normally remember to stretch such as your feet. We can often hold tension in different areas of our body so it is helpful and beneficial to get a good body stretch in when you can.
     
  • Smile
    As awkward as this may sound, sit and smile. Meaning, sometimes you have to fake it till you make it. By smiling even with no reason, you send a message to your brain and before you know it you aren’t faking it anymore. Or you can take time to consciously draw on memories and things that bring you joy and naturally make you smile. Reflecting on good times can be very comforting and a great way to take a break from the fast-paced lives we tend to live. 

No matter what you choose you can’t go wrong when you take a moment to relax. You give so many things your time and energy, but who gives it back to you? Taking a moment for yourself is always a great way to promote good mental health. Take a chance and see if any on the list above work for you.

Cherise White is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Talking to Your Child About Sexual Assault

By Alisha Bennett, LMSW

Sexual Assault. Over the last several months we have heard these two words in the news more than we can count. We’ve heard countless stories of women who have spoken up and whose voices are finally being heard.  

Hearing questions like, “why now?” or “why didn’t these women speak up sooner?” made me rethink about how many of us were raised and socialized to normalize this behavior or hide it because we are ashamed. When did I really learn this lesson for myself? It wasn’t until an elective in junior year of college that I really recall having a real conversation about this topic. I was 20 years old, an age when 1 in 4 girls and 1 in 6 boys have already experienced sexual abuse, mostly by people that they know (https://www.nyfoundling.org/capp/). Additionally, from 2011-2015, the Associated Press found about 17,000 sexual assaults were committed by U.S. students (though the number is likely higher due to underreporting) and about 5% percent of the victims were five and six year olds (http://neatoday.org/2017/12/04/sexual-assault-in-schools/) So as an parent/guardian, when and how do you have this conversation with your children?

When: The right time to talk to your children is right now. If 5% of assaulted children are in kindergarten and 1st grade, it is not too soon to talk about this with your young children. The younger the victim, the greater the vulnerability that they will experience repeated assault throughout their life. 

How: Young children need lessons when they’re young about their bodies. About what is private for them, about what is wrong and never okay, about what to do if something is wrong, and how to speak up. They should know that they can always come to you or to another trusted adult. Help them to identify who other trusted adults are, including one in their school that they can go to. It is important for them to know that they can and should speak up even if they feel scared, frightened, or embarrassed. They need to know that any sexual abuse or assault experience is not and will never be their fault and that they can get help. Conversations like these can, and in my opinion should, be had in elementary school, even at the earliest ages so that they can know what is right and wrong in regards to their bodies. 

Below are some resources for talking to your children about sexual assault: 

Alisha Bennett is a therapist at Cobb Psychotherapy.  If you are looking for support in talking to your child about sexual assault visit cobbpsychotherapy.com to learn how therapy might be able to help. 

 

Exploring the Mind–Body Connection

By Vanessa Kensing, LMSW

For centuries humans have explored the connection between our mind and our body. Early philosophers hypothesized about the difference between mental and physical properties, and what effect one had on the other.  Later psychologists would examine what effect consciousness (or lack thereof) had on our mental properties/mind, and what this meant for its relationship with the body. While the modern Western medical model conceptualizes the mind and body as connected, it also supports treating them separately.

Seeing this unnecessary divide, and how it has impacted myself and many of my clients, I was inspired to explore the mind-body connection in psychotherapy. Somatic psychotherapy is defined as a “holistic approach, incorporating a person’s mind, body, spirit, and emotions in the healing process” (goodtherapy.org). From this approach a therapist may provide education, understanding, processing, and healing using the mind-body connection. This connection can be viewed from both the perspective of the present and the past.

Mind-Body Connection in Present Time
Our body sends us physical symptoms and/or signals in present time. For example, when we encounter a real or imagined threat our mind and body can go into “fight, flight, or freeze.” Some of the bodily experiences may include: dry mouth, tight chest, increased heart rate, shallow breathing, sweating palms, pit in stomach, etc. Learning one’s physical symptoms allow an individual to understand how to self-sooth (instead of suppressing, repressing, unhealthily distracting, or numbing these feelings), and begin to examine the root of the issue(s) that cause this response. Similarly, our thoughts not only impact our bodily expression and experiences, but also how our DNA is expressed (Lipton).    

Mind-Body Connection from the Past
Somatic therapy posits that trauma can also be “stored” in the body and thus is in need of release. In these instances therapists work with the client to begin to connect to their bodily experiences that they may be dissociated from, or aid the client in working with bodily experiences that "contradict the helplessness, rage, or collapse that results from trauma" (Van Der Kolk,). This allows clients to begin to explore how posture, breathing, visualization, grounding, and bodily movement can begin to slowly release the trauma and fully embody healing.

Because this is a very cursory exploration of the topic, the following books are valuable in exploring the mind-body connection in further detail. 

  • The Divided Mind, John E. Sarno, M. D.
  • The Body Keeps the Score: Bessel Van Derk Kolk, M.D.
  • The Biology of Belief: Bruce H. Lipton, M.D.
  • A Symphony in the Brain: Jim Robbins

Other References:

Vanessa Kensing is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Understanding Emotionally Focused Therapy

By Dorette Green, LMSW

In honor of Valentine’s Day day tomorrow I decided to focus this particular post on relationships. As a therapist who not only works with individuals but also with couples, I find relationships fascinating! Relationships are imperative because engaging interpersonally is one of the most important parts of human development and the human experience.  Romantic love relationships are an important aspect of human advancement and growth from both a social aspect, as well as an evolutionary perspective. This has much to do with individual attachment styles and whether those attachments are secure or insecure (but I will save that discussion for a future post).

For this post I want to provide some information about one of my favorite modalities for working with couples. For some couples, relational issues can become so overwhelming that they make the relationship difficult to navigate. Couples in relational distress can at times repair their relationships, or begin the process of amicably ending their relationship through the assistance of couple’s therapy. While there are several different approaches to therapeutic work with couples, one of the most well studied, empirically validated, and by far my favorite approach is Emotionally Focused Therapy or EFT.

Emotionally Focused Therapy or EFT is a therapeutic modality developed by Susan M. Johnson and Les Greenburg in the 1980’s. EFT as a therapeutic intervention focuses on couples’ abilities to “deal with their emotions and, how they send emotional signals to their spouse, and how this emotion becomes the music of their interactional dance” (Johnson Interview, 2011). EFT can be utilized with individuals, couples, and families in relational distress. This distress usually has some relationship to attachment, as EFT is firmly rooted in attachment theory. As an attachment approach, EFT works on the assumption that individuals have a great need and desire “for safe connection and emotional contact,” the lack of which results in people becoming “stuck in very negative interactional patterns” (Johnson Interview, 2011). As such, EFT examines the adaptive and maladaptive emotional responses and patterns that are usually underpinned by basic attachment issues that keep individuals, couples, and families trapped in these negative patterns of interaction.

EFT has been described as “an intervention explicitly designed to improve a couple’s relationship satisfaction by making their attachment to one another more secure” (Benson, 2013). The ability to identify attachment style as well as a couple’s interactional patterns or “dance” is integral to the effective use of EFT. Couples often cannot recognize their own attachment issues, such as attachment “injuries” for instance. Attachment injuries are incidents related to attachment in which one partner did not provide support to, or betrayed the other partner during a time of need (Halchuk, Makinen, and Johnson, 2010). Attachment injuries can precipitate the negative cycles of interaction which inhibits the couple from beginning the process of repair in their relationship.

Repairing relational issues is an amazing benefit of engaging in EFT, but it is far from the goal. The goal of EFT is not necessarily working through relational problems with a focus on salvaging the relationship, but rather, as a way to work through relational issues based on poor and insecure attachment styles. First we work to understand these attachment styles and how they are represented in our interactions with our partner, and next we work to be able to articulate these patterns, the underlying feelings behind them, and how these feelings perpetuate a cycle of negative interaction. Often it’s these destructive and negative interactional patterns that are an indication that individuals are seeking to feel both safe and fulfilled in their relationships. What EFT does is “teach people communication skills so that they can problem solve and bargain better.” Given this understanding, what people ultimately learn is how to communicate their emotions and needs for safe connection (Johnson Interview, 2011). The ability to engage in relationships where communication becomes a tool utilized for better interaction, as opposed to one of the primary issues within the relationship, allows the couple to improve their attachment and overall relational satisfaction.

While it is clear that EFT works, it is also important to understand why and how it works. In part, EFT works because it is sustainable. Once couples are able to resolve their attachment issues, they are more cognizant of when they have reversions back those negative patterns and are better able to work through those issues. Couples learn to communicate more effectively and are better able to not only trust but forgive each other when there are negative interactions.

Ultimately, relationships can be difficult to navigate, but they are not impossible. It is important to understand that the people we engage in relationships with are bringing unique experiences, perspectives and beliefs into the dynamic.  Understanding those things, but also effectively communicating our own as well, is integral to the quality of the relationships in which we engage. In the end, we find that everyone is trying to meet the same basic needs for love, connection, safety, and understanding.

References / Sources:

  • Benson, L.A., Sevier, M., Christiensen, A. (2013).  The Impact of Behavioral Couple Therapy on Attachment in Distressed Couples. Journal of Marital and Family Therapy, 39(4), 407 420=
  • Halchuk, R., Makinen, J.A., Johnson, S.M. (2010). Resolving Attachment Injuries in Couples Using Emotionally Focused Therapy: A Three Year Follow-Up. Journal of Couples and Relationship Therapy, Vol. 9, 31-47
  • Yalom, V. (Interviewer) & Johnson, S. (Interviewee).  (2011). Sue Johnson on Emotionally Focused Therapy [Interview Transcript] Retrieved from Psychotherapy.net: http://www.psychotherapy.net/interview/sue-johnson-interview

Dorette Greene is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.