myHope Therapy Services, LLC

Bullying has been hitting headlines lately in strong force.  Newspapers have been littered with horror stories of bullying and states have attempted to address the issue through legislation.  Historically, the impact of bullying has been minimized by the general public due to a general perception that being the recipient of such behavior is a rite of passage and that “everyone goes through it”.  This may be factually correct but whether this rite of passage is something we want to maintain is being challenged, and rightfully so.

Many of the teens and adults I see hold on to the trauma they experience as a result of bullying and it can have a concrete impact on how they approach relationships, academic opportunities and the work place.  Bullying tends to have its greatest impact when it occurs during our formative years (early childhood through young adulthood) because it has the potential to shape our view of the world and the beliefs we have about ourselves.  If severe enough or if there are pre-existing issues (depression, anxiety, family issues) this mold has the potential to become permanent. Being bullied teaches us certain things about how we need to behave in order to survive. It can make us risk-averse when considering relationships because of what we’ve learned about the kind of damage people can inflict on us when we invest our trust in them. Being the bully or perpetrator can be the result of being bullied or learning that in order to survive one needs to be on the right side of the line.  As a result, we begin to learn that aggression and manipulation are effective means to achieving an end.  In either case, when extreme or perceived as extreme, bullying can have a crippling effect.

I tend to avoid the term “bullying” when a teen or adult comes to therapy for issues related to being harshly and consistently mistreated and call it what it is-trauma. Trauma is defined as: Emotional shock following a stressful event or a physical injury, which may be associated with physical shock and sometimes leads to long-term neurosis. (Dictionary.com)   By framing bullying within this context we set the stage for clients to view themselves as survivors rather than victims and bullies as perpetrators rather than deserving members of some unattainable echelon. In my opinion, this framework allows survivors to feel greater legitimacy in processing their thoughts, emotions and reactions to triggering events.  On the other hand, it socially stigmatizes bullying behavior and adds a greater incentive for the perpetrator to change their behaviors.  This perspective, I believe, also allows clinicians to tie appropriate interventions to the presenting problems.

I define bullying as a consistent pattern of the following behaviors (not all inclusive):

·   Social Exclusion

·   Slander (word of mouth, social media, etc)

·    Direct verbal abuse

·   Other forms of psychological “warfare” (watch Mean Girls to get an idea)

·   Unprovoked physical altercations- this includes consistent pushing, shoving. If the action is severe and/or cannot be reasonably considered unintentional, action should occur after the first instance.

·  Unprovoked sexual assault including inappropriate touching, fondling- immediate action should occur after the first instance or if such acts are used as threats.

Victims can be targets because of a unique quality or set of qualities that sets them apart from their peers.  Qualities or characteristics such as intelligence, attractiveness, a learning disability, depression can set one up as a victim.  This is not always the case, but in my experience it’s true more than not.  Bullies do not typically fit the stereotype of the maladjusted brute. Many times bullies are charismatic, demonstrate great empathy towards those in their “circle” and have other desirable qualities that make peers gravitate towards them.  These qualities, in turn, lend a form of acceptability to the behavior through either a fear that others have of not being accepted or of being targeted or because of the belief that a “good kid” wouldn’t act this way towards another if it weren’t deserved.

So what actions can be taken if your teen is the victim?

1. Speak to the parents of the perpetrator and perpetrator directly in a way that provides the best opportunity for empathy.  Inform the perpetrator of the impact that the behavior is having on your teen without labeling the teen or using language that puts him/her or the family on the defensive, better yet allow your teen to verbalize this.  In some cases, bullies don’t realize that their behaviors are problematic for victims or believe that how they are behaving is “all in good fun”.  Sometime just being aware of the impact the behavior has on another person may initiate change.

2.  If this does not change the behavior, makes it worse or if for some reason it is not practical to have a discussion with the family and perpetrator directly, a meeting with the school may be a good first step.  I always ask parents and teens to provide their concerns in writing to the school during a face to face meeting.  Describe the behaviors that are occurring, the impact they are having on your teen and the concrete changes you would like to see. Ask for the school’s plan of action in writing. If they are unwilling to provide this to you, document what was agreed upon and write a follow up letter summarizing your understanding of what the school agreed to do in response to the problem.  Request a follow up meeting after the initial face to face so that the expectation that things must improve is clear.

3. If the situation continues to worsen or if at any point physical, sexual or other abusive behaviors that meet the standard for anti-harassment laws occur, consider legal action.  While there are an array of immediate consequences for physical assault in our homes and workplace, physical assault in schools has historically been chalked up to normal teenage behavior.  Sometimes this is true; however there is a clear difference between a typical schoolyard fight and physically assaultive behaviors that occur consistently or within the context of other bullying behaviors.

4. Help and support the teen in becoming less of a target.  There are certain behaviors, attitudes and mannerisms that make a teen an “easy mark” for bullies.  Please be clear that I am in no way suggesting that victims of bullying are at fault, however it is important that we consider every factor in addressing the problem. 

5.  Change Schools-This is a last resort. If your family has the means, the behavior is severe and there is nothing that can be done to change the behavior it may be time to consider removing your teen from the environment.  We encourage folks to remove themselves from living environments and work environments that are abusive and have a severe impact on their wellbeing and are unwilling to change but are not technically breaking any laws. Teens should also have this option available to them if possible.

So what actions can be taken if your teen is the bully?

1.  The first step is to understand why your teen is behaving in this manner and the need he/she is trying to meet through the behavior.  Discuss other strategies that can be used to meet the need and offer empathy and support if it becomes clear that the behavior is stemming from a difficult set of circumstances (history of being bullied, depression, fear of being bullied, family issues etc.).  If outside help is needed to resolve the underlying issues offer support whether it be informal (family, friends, church) or formal (therapy, in school support).  Help them understand that the interventions are not punitive and are meant to relieve the distress that is causing the behavior.

2.  Be clear on what makes the behavior unacceptable, the potential and/or actual impact the behavior may have on other people and the social and legal consequences of the behavior.

3. Be clear on what changes you are expecting with regard to the behavior and work together to develop a plan that seeks to change the behavior.  Implement a mutually agreed upon set of consequences that will be immediate and substantial if the behavior(s) were to occur again.

4.  Work with the teen in taking ownership of past behavior by making amends with the victim(s).

5. Work with school personnel in monitoring the behavior and implementing consequences.

It goes without saying that every individual situation is different and what is being presented in this article may not make sense for your set of circumstances.  In any case, strong communication with your teen, advocating for him/her and keeping the school involved are critical steps to resolving the issue.

I am not formally trained in DBT. My knowledge of it coming from texts, watching trained practitioners do it and gradually incorporating it into my practice. I’m comfortable with its use due to my background and training in similar modalities and have found the skills to be valuable for those who have a difficult time with more traditional approaches.

One area where DBT has been most helpful to me is in couples and family work as a compliment to Imago and traditional Family and Couples therapy.

Imago’s dialogue draws from communication skills such as “I messages”, Mirroring, Validation and Empathy. Most family and couples therapy around communication, regardless of modality, has included this skill set for decades.  In fact, it’s rare to read a book or manual on family therapy without any of these skills coming up. Many times couples and families who come to therapy become dysregulated in their communication and do not have the discipline to put them into practice. The “dialogue” does a good job in helping folks get communication on an empathic level but, in my opinion, falls short of helping them understand how to modulate intensity and the practical dimension of effective interpersonal skills. Lastly, clients often state that the skills seem packaged for “vacuum interactions” and most triggers occur unexpectedly; that although great in theory they do not feel the dialogue is a realistic alternative to their normal way of communicating. This is half true, in my opinion. The skills are useful in that, they give clients the tools to communicate but they do not increase or improve real world capacity to regulate this communication.

The Interpersonal Effectiveness handouts in the Skills Training Manual for Treating Borderline Personality Disorder  by Marsha Linehan has been useful in helping couples and families in my practice achieve the following:

• Understand the building blocks of relationships and interpersonal skill development- Many times couples and families in therapy aren’t able to recognize the areas they need to be attentive to in order to improve their ability to effectively manage relationships.  Clients can have a hard time putting words to where the relationship is breaking down.  “The situation for interpersonal skills” handout allows couples and families to organize these components in a way that allows for a more straightforward self-assessment of their relationship.  This skill set provides a “what to look for” when it comes to interpersonal skills so that folks are able to at least get a baseline.
  
  
• Understanding the purpose of interpersonal skills- Many clients get stuck on meeting the concrete or representative/historical need at hand. The “Goals of Interpersonal Skills” handout allows couples and families to broaden their understanding to include relationship maintenance and self-respect as equal parts to the communication equation. This handout can allow folks to get away from just going after the widget and to consider other, equally important factors in delivering the message.
  
  
• Understanding Legitimate Rights and Factors reducing Interpersonal Effectiveness-This allows couples and family members to receive “permission” to communicate a need and works to eliminate the barriers to interpersonal effectiveness (also included as a worksheet in Linehan’s manual).
  
  
• Modulating Intensity-The “Options for Intensity of Asking or Saying No, and Factors to Consider Deciding” has been the most valuable tool in helping couples and families in my practice. It asks clients to consider the intensity they are applying to their communication around a need. It presents ten items they should account for in a very concrete, guided and understandable way. Many couples and families actually assign a number to each of the ten items to come up with a ball park average on how firm they are going to be in the face of a demand or in making one.
  
  
• “DEAR MAN, GIVE, FAST”-I use the Imago dialogue within this framework across all three of Linehan’s communication worksheets. This helps couples understand why the dialogue makes sense while providing them a way to apply theory to how they communicate in very concrete ways.

Of course, going through the skills involves more than just providing the hand outs. Much of the information presented may not make sense to your client. The therapist should really have a strong command of the material before using it and should prepare to spend a full session discussing each hand out.

Adding the DBT communication module as a compliment to couples or family work can help folks feel comfortable in asserting a need effectively. I have found that applying the module lessens the learning curve around communication significantly. This has allowed me to move on to other issues beneath the surface more quickly. This occurs because the module provides clients with a much greater capacity to tolerate or communicate charged material that may be at the core of what brought them into my office.

Most teens look forward to summer, school is out and the good life begins. Teens with depression, however, face a real challenge during this time of year. Assuming that your teen’s school environment is positive or neutral, summer presents some real pitfalls when it comes to depression:

Isolation- School provides teens with opportunities to remain connected with other people. Relationships allow folks to gain support, provide an object of attention outside oneself, provide opportunities to contribute to the well being of others, practice social skills and check one’s potentially negative view of self against a more realistic barometer. Many times teens with depression have a desire to isolate because it feels safer and easier. The problem with this approach is that it makes the situation worse- spending too much time alone may lead someone with depression to focus on their perceived defects without a reality check. Lastly, school also provides teens the ability to make healthy comparisons- the struggles others have reinforces the fact that we are not the only people with problems- in fact we may be better off than most.

Free Time- A key component to depression is a lack of motivation. External expectations can provide a teen struggling with depression the sort of motivation they may not be able to muster up on their own. Depression feeds off of free time; it reinforces the distorted belief that a teen has no purpose or value because their ability to self motivate and initiate activity is impaired. It also stirs up feelings of guilt, shame, frustration and anger about having accomplished nothing in a given day. School provides teens with a purpose, an agenda and the opportunity to look back on the day with a sense of accomplishment- concrete evidence that their time was used productively.

Lack of Stimulation-One key to keeping depression at bay is stimulation- attention and focus away from feelings and thoughts that reinforce a depressed mood. School provides teens with the ability to remain distracted on productive activities. It gives teens natural opportunities to push away negative thoughts and feelings because there is other work that requires their focus and attention. 

Considering all the secondary benefits that school can provide to a teen with depression during the year,  teens and parents should look to carefully plan the summer so that the rug isn’t literally pulled out from underneath. Some natural and inexpensive ways to replicate the benefits school provides a teen include:

Schedule- Create a daily to-do list, even if some of the tasks seem minor. A list can act as a reminder that the teen has a reason to get up and get out. It also provides an opportunity for a teen to look back on the day and feel some sense of accomplishment.

Daily Physical Activity- It fills time, improves mood and is another opportunity to accomplish something.  Joining a local gym is ideal as it also allows for social opportunities and relationships built around common interests.

Employment/Volunteer Work- One effective tool against depression is the act of being useful and helpful to others.  Employment or volunteer work can provide abundant opportunities in this area while providing structure, stimulation and social interactions.

Strengthen existing commitments- If your teen is part of a faith community, for example, they may want to consider increasing their involvement either through activity within the community, structured prayer and reflection or taking advantage of opportunities within the community to learn more about their faith. If time with extended family took a hit during the school year, plan large family events (either celebratory or task oriented) to solidify relationships.

Stay focused on academics- Teens with depression and anxiety can benefit from keeping one foot in their schoolwork. It can make the start of the school year less overwhelming while adding structure and purpose to a portion of the day or week. Consider the possibility of creating a summer study group through the summer to add a social component and incentive.

Leisure- It’s important that time be set aside to blow off steam and that there are concrete activities built into this time. Leisure should be given the same priority as the other items listed above and should be social in nature.

Down time is Important- There is such a thing as too much structure or activity – going to this extreme leads to avoidance and burn out. It’s important that teens have time to unwind and be by themselves as long as it’s one part of many.

A thoughtful well planned summer can assist teens with depression not only avoid the dip that a lack of structure may cause, but actually help them make gains in managing their illness.

I always thought the title of this sitcom was clever and I'm psyched that I can finally work it into something. With that out of the way, to the point.

One positive impact managed care companies have had on the field of therapy, particularly with teens is their push for family involvement. Despite this push and the enormous amount of literature and research supporting strong family involvement in adolescent work, I continue to come across therapists who view parents as an obstacle rather than a resource.

One factor driving this is the lack of training many folks charged with working with teens have in the area of family work. This lack of competence intimidates professionals to the point that parents may end up talking to the therapist, by themselves for a few minutes at the end of each session. These mini-sessions are seldom productive and give parents an illusion of involvement. It also keeps the therapist in his/her comfort zone while giving them a false sense of having equipped the family to make the changes necessary to help a youth towards positive change.

Another factor is the misguided belief that teens are capable of the kind of change that therapy incites in adults, and that parental involvement equates to a violation of therapeutic trust. This not only pathologizes the teen (usually unintentional), but ignores the reality that youth do not have the same mastery over their environment as adults do. They simply do not have the authority, financial resources or life experience to enact change in the same way. Many times therapists label teens as “unworkable” because little change occurs despite multiple interventions over an extended period of time. Yet they ignore the very system that, on one hand may trigger the teen and on the other may act as a catalyst for positive change if only that system were involved and informed.

Lastly, some therapists simply view themselves as expert of a teen's needs despite the fact that they only see them once a week for 45 minutes to an hour. Sometimes the assumption is made that if a teen needs therapy then the system charged with that teen's care must be faulty. This is either the result of poor logic, arrogance or both.

Adolescent work demands strong family involvement even if parenting skills are lacking or there is a history of abuse and neglect. There is no sense in creating a “safe therapeutic environment” for one hour a week if the remainder is spent in an environment that is not adjusting to the teen's needs or acting as an obstacle to progress.

Usually, this issue is not prevalent in established community based agencies, IOP programs, Partial Care Programs or state funded youth and family intervention programs. These entities are held accountable to external organizations who want results and are aware of the impact family involvement has in adolescent work. Also, many of these agencies adhere to best practice standards in order to remain compliant with accreditation bodies. Lastly, some of these agencies grew from a family systems framework and family involvement is part of their treatment DNA. Individual therapists or group practices are most likely to fall into the trap of minimizing family involvement.

When selecting a therapist for your teen, there are some things that may be important to be aware of and investigate.

Your teen isn't necessarily the problem- Adolescence can be a difficult time for your teen. Many times the inability of a family to accommodate changes needed for a teen to experience this phase productively or how the system around a teen reacts or responds may be counterproductive and contribute to undesirable behaviors, thoughts and feelings. Families of teens in therapy must be open to change and involved.

Your teen has the right to keep most information shared in therapy confidential-This doesn't absolve your therapist from encouraging your teen to share this information with you. One goal of therapy is to help teens and parents share symptoms, concerns and disagreements with each other in a way that is productive and safe. Therapists many times consider openness in therapy as a primary goal- this is a mistake. Obtaining a teen's trust is certainly key, but helping the family and teen get to a point where they can independently communicate to each other openly and safely is the desired end result.

A diagnosis doesn't make the family bad but it doesn't relieve the family of responsibility either- A teen diagnosed with depression, anxiety or some other disorder does not mean the family is dysfunctional. However, it does mean that the family may need to work differently and/or harder to look at how it operates so that the home provides an optimal environment for recovery. A diagnosis does not make the family or teen a failure.

A full session of family work should happen at least once a month-Of course there are a few exceptions that center around safety issues. Discussions with the family about the teen should include the teen. Meetings should not feel secretive and issues should be discussed openly and honestly. Your therapist should be confident and competent enough to facilitate these discussions. Parents encourage their teens into therapy because they feel as if their ability to handle issues are stretched- your therapist should help you gain mastery back.

Interview your therapist-Its worth the session fee. Ask about formal training in the area of adolescent and family work. Also inquire about your therapist's experience- a provider with experience in an outcome driven community based family therapy program usually means they've worked with some difficult situations and have received specialized training. A therapist should have no problem with a client asking for a resume.

The great majority of therapists who work with teens understand the importance of family involvement and are competent enough to provide effective treatment. The lack of formal family therapy training in some counseling disciplines and programs along with the lack of accountability many individual outpatient therapists and group practices have to external entities continues to be an issue however. When deciding on a therapist take the time to know their approach and be clear about your expectations around family involvement.

I facilitate a Family Issues and Loss group for adults. What I find interesting is how one topic almost always spills into the other. When a family loses a member they are not only faced with having to cope with the absence of that person, they must also struggle with fulfilling that person's role(s). Failure of family members to appropriately compensate for these roles and/or support each other may lead to detachment and isolation between individuals and families within the family. Achieving acceptance and integration of the loss experience takes time and individuals may work through the process in different ways and at a different pace. These differences are expected and there are steps families can take to help each member feel supported and connected.

Avoid the “get over it” attitude

It's not uncommon for folks to get stuck when dealing with a loss. It may be difficult to differentiate between someone being unable to work through their loss and a long but substantive grieving process. “Stuck” behaviors usually involve maladaptive coping skills such as self medication (alcohol, drugs, etc), isolation or a new/worsening pattern of emotional dysregulation (anger, depression, anxiety).

A family member who is not moving through the grieving process at the pace you or most members of your family are, may not necessarily be stuck. A family member who appears well adjusted and 'happy go lucky” soon after the loss may not have worked through it. It's important for families to acknowledge these differences and attempt to support members in their individual struggles with the loss. If a member is using destructive coping skills in dealing with the loss, other members can help by normalizing the pain associated with the loss while recommending professional help.

Acknowledge the roles and work to challenge or fill them

The family member who died may have been the glue that held many parts of the family together. Crises usually present as the most fertile soil for dramatic change, positive or negative. Family members who hold on to old communication patterns or past injuries run the risk of detachment and isolation. They also run the risk of placing an unwilling family member in the role of the deceased. Conversely, family members who use the loss to question and challenge long established roles, feuds or maladaptive communication may find the work of bringing the family closer together that much easier during this time.

Memorialize the loss

If your family are members of a religion, a church or synagogue provides natural opportunities in this area. Family traditions that serve this purpose can also be established. I remember one client sharing that her family began having large annual reunions after the loss of a matriarch. Family members would go to a religious service together then spend the rest of the day sharing memories through pictures, stories and videos. Ceremonies and other formal expressions of remembrance give family members permission to openly talk about the loss. Folks at different stages can participate in ways that are meaningful for them while contributing to the larger grieving process.

Don't allow stigma to get in the way

A death due to suicide or overdose adds a very heavy dimension to the grieving process. Many times this causes families to clamp down on communication surrounding the loss. This can be devastating as it is in these circumstances families need to process the loss most. Families can find creative ways to discuss and memorialize these types of losses in ways that accommodate all members. This is particularly true for children and teens of parents whose death carries stigma.

Familial reactions to loss is a complicated subject and there are countless ways families can help make the grieving process productive for individual members. These four areas are simply those I hear most about in my work with folks on this subject.   

The subject of consequences comes up frequently in my work with teens and families. The fact that many parents of teens struggle with this area should come as no surprise. Up until adolescence, consequences are pretty straightforward and effective – if your little one wants this you distract with that, if she throws a tantrum you give choices and/or use a quick time out. For good measure we’ll throw in a simple set of rewards and consequences for chores and behavior. Such is the journey that leaves one completely unprepared to parent adolescents.

What make adolescence so difficult? Without getting into the whole thing too much, it boils down to teens realizing that they have the ability to resist authority and the desire to take charge of their lives.  Oh….and they’re smarter now.

Adolescence requires that you throw your parenting style into reverse. Instead of taking control and protecting, a much more difficult skill set (letting go) is often times called for. Allowing a teen to experience failure and the full impact of their behavior can be a most effective way to teach a life lesson. It removes you from the power struggle and leaves the teen with little choice but to analyze the logic and behaviors that led to the outcome.

I’ve worked with teens who would effectively adapt to being stripped of every privilege and comfort without giving an inch while their parents ran in circles to make sure grades and all other areas of their teens life remained on track.

Some parents would clench their teeth just thinking about the disaster, anarchy, plagues etc that would ensue if they decided to hand the reins of their teens life over to …well…their teens. But this approach does not translate into “hands off” parenting by any means. In fact, your involvement will probably increase. Your role, however, becomes very different. Instead of director, you take on the duties of counselor, guide, adviser and sounding board. The key to each of these is your ability to hold off on lectures and instead listen, put yourself in your teen’s shoes and communicate back from that perspective. This doesn’t mean your agree with what they did or intend to do. It does mean integrating your teens ideas and wants into your responses and/or guidance so they at least feel heard and understood.

Many times, when serious issues are present parents are reluctant to allow natural consequences, fearing it will become a game of chicken. Often, the reason it gets to this point is that the teen truly does not believe the parent would just allow the natural consequence to take place. In my experience, there have been many situations in which parents protect their teens from the wrath of school or the legal system. They then replace the consequences that would have naturally followed (those that have the greatest potential of initiating change) with ineffective consequences the teen can either adapt to or figure a way to get around.

The problem with this approach is that it only puts the natural consequence off temporarily and the issue remains unresolved as does the conflict typically associated with it. When this happens, many times the behavior remains unchanged and the transition to young adulthood becomes a harsh wake up call. The adult legal system isn’t as warm and fuzzy as the Juvenile Justice System and the outside world isn’t as forgiving as mom or dad.

Of course most teens aren’t on a collision course with the worst case scenario but supporting and allowing your teen to take ownership of making decisions (along with the responsibilities this carries) can be an effective way of preparing them for adulthood while making your relationship with him closer.

Anxiety is probably the most common issue I work with in therapy. Anxiety can take many forms, particularly among teens and children who often times present with physical symptoms (chronic lyme disease, stomach issues, etc). Anxiety can establish roots at several points in our life. Traumatic events, being held to unrealistic expectations and being harshly criticized throughout ones lifetime present with very fertile soil for anxiety to take hold. Anxiety can lead to symptoms ranging from somewhat frequent, non-intensive worry to rigid routines and obsessions to flashbacks, panic attacks and avoidance. Anxiety can also result in other disorders like depression.

I typically think of anxiety as the result of perfectionism or a strong mistrust of “life” or the “universe” (for lack of better terms). I'd like to focus on the latter in this entry. Folks who have an anxiety response to a trauma, PTSD for example, don't view the universe in the same way as most other folks. The trauma (or multiple traumas) they've experienced diminishes the fundamental trust most of us need to have in the universe to get through the day. Most folks get that anything can happen to them- car accidents, pianos falling on the head etc- folks with a trauma induced anxiety disorder may not just experience this as an occasional thought. In many instances, their lives operate under the assumption that bad things are not just possible but likely- that their lives are not guided by a benign or even neutral force, but one that is out to get them.

There are different approaches to helping folks work through a traumatic experience. Some common methods involve desensitizing the person to stimuli that trigger an anxiety response, assisting the person in processing the trauma, behavioral exercises that help contain what may feel like overwhelming feelings and helping a person adjust their thinking so that it is more in line with the notion that although the worst does sometimes happen it is more the exception than the rule. Medications can also play a very critical role in helping manage symptoms of anxiety.

If anxiety is causing you to isolate, self medicate through the use of drugs or alcohol or is affecting important areas of your life (eating, sleeping, relationships) you may want to consider meeting with a therapist or qualified medical professional to discuss your options.  

I will be co-faciltating a 5 part series on parenting adolescents with Rosanne Tobey this coming March.

Session dates are as follows:

Session 1 – Understanding Adolescence (March 3)
Session 2 & 3 – Communicating with Your Teen and the role of discipline (March 10th & 17th)
Session 4 – Helping your Teen through the High School Battlefield: Bullying, Cliques, etc. (March 24th)
Session 5 – Signs your teen may be in trouble (March 31st)

The series will take place in the cafeteria of St. Bartholomew the Apostle Church at 7:30pm, 2032 Westfield Avenue, Scotch Plains NJ. Admission is free.

To register simply email your name and phone number to jm@johnmigueis.com

Angie LeVan is becoming one of my favorite reads. She wrote this gem on visualization in December and followed up with a great article on thriving this month.

Don't get me wrong I'm not one of those "positive thinking" people. That is to say, I don't think of positive thinking as it's interpreted by many of those who claim to be disciples of the silly “if you think it, it will happen” commune.

It has been my experience, however, that many people get held back by negative thinking not based in reality, they avoid good risks because of catastrophic thinking grounded in haywire logic. We've all been guilty of this, in fact it is the sort of thing phobias are made of.

One method of overcoming irrational thinking is to simply have a debate with it. State the fear, determine whether it is reality based and if it's not, challenge it. Allow the fear to counter with a “what if” or alternate scenario and respond again until you've uncovered every irrational thought driving the fear and defeated it in argument.  All of this should be in writing. Once you've accomplished this, practice the argument over and over again in your head until its' memorized.

Another approach is visualization, which involves actually developing a mental image of achieving your goal. A pretty simple, easy to use example from Angie's post:

It may seem corny but I found this to be highly effective particularly with folks who suffer from anxiety disorders or chronic pain.

I've been reading a great deal on Imago the past 6 months and I found it does a very good job of applying standard interventions in a way that enables couples to implement change quickly (under the right circumstances).

The nice thing about Imago is that even if it's not your primary model, everything it offers can complement your work. The most effective tool is the dialogue – at worst you can say it is a superficial exercise meant to teach empathic communication. Quite frankly, I think if most people got this part of Imago down they would be well on their way to getting their marriage back on track (assuming it was off track).

That being said, the theory behind it and some of the following can be a bit much. Also, its not for everyone- I would never consider this approach if domestic violence (as one example) were an issue. Lastly, the potential for the therapist to lose control of the session is a bit greater than with other approaches in my opinion.

Despite some of the drawbacks, I look forward to integrating a good deal of Imago in my work. I found Wade Luquet's book to be both very digestible and practical.