Relationship Counseling

When I talk of “relationship counseling”, I am thinking of counseling for problems a single person or dating couple is having, i.e., mate selection (who you choose to date), problems that arise while dating (problem resolution, communication, etc.), or post-divorce dating (living with loneness, deciding when to be sexual with someone you are dating, etc.)

This area of counseling, I believe, is growing.  People today are much more accepting of counseling as compared to 20-30 years ago and counseling is much more affordable and accessible.  Further, people are more aware when they don’t have all their answers and need outside assistance.

When we talk of mate selection, the first concept that comes to mind is past relationships and childhood family experiences and past sexual abuse.  Nothing has a bigger effect on who we select to date, I believe, than what we were exposed to previously, especially during childhood and adolescence.

After years of being a therapist, I believe people marry for familiarity as much as for love.  Using the analogy of dance, as children, we are taught a dance by our parents.  The dance is about how the world and relationships work.  We use that dance later in life when we get out in life and look for a partner.  Those that seem to know how to dance the way we do, we select.  This is all very unconscious.  Ever heard the saying that we tend to marry our mother or our father?  Same concept.

In therapy, I try to help the person or couples understand what dances they learned from their background and how they are playing it out in their relationship today.  Further, I explore how they would want to “dance” with their partner when it comes to decision making, being sexual, disagreeing, ore expressing feelings like anger or love.  It is an interesting phenomenon to see a person/couple act out one dance and yet verbalize another, healthier dance.  It’s critical for the person/couple to recognize these differences in dances and move toward the healthier dance.

Post-divorce dating is a particularly interesting area for me.  Never before in my life have I been able to see so clearly how powerful the emotions of loneliness, sexual desire, and fear are.  I deal with these emotions every day, not only as a therapist in my office but also as a divorced man, at home.  This, I believe, has given me keen insight about such that I then pass on those I work with.

For the Friends and Family of Someone in Therapy

It is so difficult to watch someone you love struggle, especially with a mental health problem…anxiety, depression, etc.

I’ll never forget a situation described to me by the husband of a woman struggling with depression.  He had awoken one night alone in bed.  He heard her crying in the bathroom and found she had locked the door.  He spent the rest of the night trying to talk her out of the bathroom. At one point, he told her that if she didn’t unlock the door, he didn’t know what he was going to do.  He was at a complete loss as to how to help her.

What to do.

Educate yourself about the occurrence of mental health problems in your family background.  Did anyone in your family struggle with mental health problems, siblings, parents, aunts/uncles, grandparents?  The more you know about your background, the more you may able to recognize patterns that are continuing in your family member.

Research the mental health concern on the internet. Depending on your search, the internet can be a wonderful source of information. Websites sponsored by the American Psychiatric Association or the American Medical Association are recommended.

Talk, with discretion, to others close to the family member you are worried about.  Perhaps, you are misreading things you have seen. Perhaps, they are also seeing the same things and worried just as you are.

Talk to the person who is struggling. Tell them what you are worried about and what you have seen in their behavior that suggests they may be struggling with a mental health issue. Listen to their response and how they see their behavior/mood. Share what you have learned about your family’s background, perhaps what others have shared with you and what you have learned about

Suggest reasonable steps for the person to take, based on their behavior. For example, if you find them in the midst of attempting suicide, a trip to the emergency room is in order.  If they have become weepy or irritable, unable to sleep and have recently lost interest in life, consulting with their doctor, mental health therapist or psychiatrist, would be appropriate.

Many communities, through church, social service or mental health organizations offer services to aid those struggling with mental health problems. A few phone calls could provide you with a number of options for your loved one. Offer to accompany them to such meetings, whether such are with a doctor or a local AA or AA-like meeting.

Above all, don’t abandon the person, even if they refuse to seek help. You may be the only one in their life that they have connection with.  You may need to set boundaries, if they refuse to get help but continue to reach out to you.

Finally, seek assistance yourself, especially if they refuse to seek help and/or worsen.

 

The Relationship between the Therapist and the Person Seeking Therapy

If you notice, I didn’t entitle this “The Client-Therapist Relationship”….because you are not a “client”, you are a person!

I haven’t forgotten that (despite my 30 plus years as a therapist) in part because I have been the “client” about 10 times in my life. So, I know what it is like to sit in one of my chairs or reach for that door handle as I enter the therapist’s office building…that momentary pause just before I open the door, thinking to myself, “Okay Ed, you’ve got to talk about it…and be honest about it, otherwise, you are wasting your time and money.”

The relationship between the therapist and the person is a tricky thing. I have to be supportive and yet confrontive; be your biggest cheerleader and critic and do it in such a way that you know I care about you.

Traditionally, I believe society has thought of therapists as only supportive; a professional hand-holder as the person suffers through their situation.

While I am empathetic, I am also confrontive. When I was in therapy, I always made the most progress when my therapist would tell me what he/she thought, REGARDLESS of what I thought of their opinion. It wasn’t always easy to hear their opinion, but after a while, I came to trust that they would be honest with me. That trust, along with their empathy, helped me to look at what they were saying to me, think about it and not take offense.  Further, because I felt they accepted me, I could then focus on me; ask myself tough questions about my life, the choices I had been making, etc.

Let’s make this more complicated.

People come into therapy at different levels of readiness to change. Some come in against their will (i.e., the sullen teen forced here by their probation officer, the spouse caught in an affair, etc.), some are just thinking about making a change; some want to make a change but are afraid; some are ready to change and want/need someone to accompany then through the process. Often, I find people come into therapy wanting to change AND not wanting to change…even when they say they are ready to change. Further yet…consider the fact that the process and results of change are often not what we thought or expected.

This is why I think A LOT about how I say things. After 14 years in private practice, that says I have learned how to support and yet confront in a caring way.

The Stigma of Therapy

“Only crazy people go to therapy.”

“I don’t want to go to HR and tell them I’m getting therapy.  It’ll be all over the plant.”

 “Why pay someone to tell me what to do when I could just ask one of my friends?”

 “What would my family or neighbors think?”

 “The therapist will think I am crazy.”

 “I don’t want to end up on someone’s couch, talking about my dreams!”

 “I’ll just end up discussing my childhood and blaming my parents.  No thank you!”

 These are comments I frequently hear about coming in for therapy.

In truth, there is much less stigma today about seeking therapy than there was when I was a child (45 years ago).  It is estimated that 20% of Americans have seen a therapist and another 20% are on medication for anxiety or depression.* By the way, I am in both groups; I am on Prozac (for the past 16 years) and I have been in therapy over 10 times in my life.

Most people in therapy are average people, addressing average problems.  The American Psychiatric Association suggests that the average person will meet the criteria for Major Depressive Disorder (depression) approximately 5 different times in their life.

People seek therapy today for obvious and understandable reasons: to learn better ways to cope with stress, to help change a specific behavior, to learn more about themselves or why they do something or gain insight into a pattern they have noticed in themselves.  Sometimes, people go to therapy simply to get an outside view of themselves or a problem in their life.

Therapists are required by law to keep what is told them confidential (The only exceptions to this rule of confidentiality are if a child/elder is being abused or if a person is suicidal or homicidal.

Most Human Resource (HR) personnel are also expected to keep confidential an employee’s use of EAP or health insurance information for therapy.).  Larger employers will provide benefits to their employees called “Employee Assistance Benefits” (EAP).  These benefits can include paying for the first 3, 5, or even 8 therapy sessions.  An employee can access such by either contacting the human resources personnel or calling a number directly, usually found in the employee’s handbook or through the company’s insurance carrier.

Therapists don’t tell you what to do. You decide what to do. Therapists give you an outside perspective of the situation. My experience is that most therapists have been in therapy. They know what it is like to sit in that chair. Therapists help you look at your options and what each may lead to, understand why you chose the option you chose, explore how well it worked for you, look for patterns in your choices, etc.  What therapist’s sell is their experience dealing with life problems; their own and others, not solutions to problems. This is something you don’t/can’t get from friends.

The use of couches in therapy is rare today.  There are still some therapists that have persons lie on a couch but these therapists tend to be specialist in “Psychoanalysis” and are typically found only in larger cities.  It is always ok to ask a therapist how he/she conducts a session before scheduling.

Most therapy today is “goal-oriented” or “solution-focused”; short-term in nature, 5-10 sessions.  While there is validity to the re-examination of one’s childhood and/or relationship with one’s parents when addressing particular situation, this is not required.  It is similar to talking with your doctor about your healthcare; just as you may question your doctor if a test is necessary, it is also appropriate for you to ask your therapist if discussing your childhood or relationship with your parents is necessary.  I frequently ask the people I work with, “Did we talk about the right things today?”  I also encourage them to tell me if they think we are not talking about the right things during a session.

It is so important to understand that it is ok to call and talk with a therapist about what to expect before scheduling.  A good therapist understands this concern and will accommodate these questions.

 

 

* West Virginia University, WELLWU website.

Am I Normal Series, part 1

I read Men’s Health Magazine and enjoy an occasional article, “Am I Normal”.  It’s a question/answer feature where men send in questions that often relate to some psychological aspect about life/human functioning/relationships, etc.  I post these articles in my waiting room, so I thought I’d share them with you…

 

Men’s Health, March 2015

I often wonder who will come to pay their respects at my funeral. Connor, Baton Rough, LA

Is it standing room only? Are people crying so much that they’re ruining your cadaver makeup? Seriously, some people may have an unhealthy focus on others’ future grief as a measure of their own present worth, says psychologist Jackson Rainer, Ph.D., the author of Life After Loss: Contemporary Grief Counseling and Therapy.  If the casket scene in your head bothers you, check in with a therapist to explore whether your self-esteem has just hit a short-term dip or you’re actually courting depression.  But the more likely explanation is that you’re simply engaging in innocuous imaginings.  “Folks are curious about their impact on others and how they’ll be remembered,” says Rainer.  In fact, thinking about your departure from the land of the living may help you make healthier lifestyle choices and strengthen your relationships today, say researchers at the University of Missouri.  “If you deny your death, then it’s much easier to deny your health, ” Rainer says.

Normal.

The relationship between Chinese handcuffs and psychotherapy.

What to expect if you bring your child in for counseling at Esselman Counseling Services

What to expect at an initial and subsequent counseling session at Esselman Counseling Services.

My Therapist Rides a Harley….

Yes, I do…ride a Harley. What does that mean? Therapists are not supposed to RIDE Harleys. They are supposed to WATCH the guy on the Harley drive by, comment on his obvious death-wish or his attempt to rebel against his/her upbringing by dressing like a biker or his stunted maturity level. That is what therapist’s are SUPPOSED to do when they see a Harley….NOT ride one!

Well….guess what? You are wrong. I am a therapist, a good therapist and I ride a Harley! Not only do I ride one, I LOVE riding one. I have a Harley Crossbones….orange and black. Rides smooth, comfortably on the highway. I plan to take it to Lacrosse later this summer (six hours north) and to Joplin (six hours south).

So, what is my point? Assumptions. Watch out for them. They can really, really mislead you.

I sit in my office day after day and help people discover/identify the different and often misleading assumptions they are/have been living. For example: “I can’t say that…what would they think of me!”, “What does he know, he is a kid.”, “He won’t change; men never change really.”, “They (women) just don’t get it!”, etc. The assumptions I often find that cause the most damage are the seemingly “small” ones, like the one’s above. They have their roots in childhood frequently. They are often so much a part of the person’s view of life that they are frequently overlooked; not noticed at all when the person looks at themselves.

I sat with a family recently and it was the 10 year old boy that observed accurately what was wrong in the family….not the mom or dad or even the older children. The parents didn’t even hear what he said until I brought their attention back to the comment. I met with a women, a few months back, who came in for some assistance after she ended her fourth dating relationship. After a long examination of the four relationships, I realized she was operating off the assumption that women don’t actually ask for what they want, don’t say what they think. She immediately rejected my observation….after all, she was an adult, had a good job, was responsible for a small staff at work, made a good living; she obviously could speak up. I pointed out that all her evidence was related to her career and not her personal relationships.

Assumptions play a role in life. I am not saying they are all bad. They provide a basis to build an understanding, an internal dialog of a type of logic in our thinking. Assumptions provide a basis for a perspective in life and we all need a perspective to view the world from. The problem is that we forget to go back and look at these original footings. So, they can’t be seen and then we are stuck/caught in our own trap.

And I am not suggesting this is an easy process or comfortable….once identified, living contrary to our assumptions. Here’s a great example…..having to ask my daughter for help with the computer, or letting my date pay. But….I look at it as a way to telling myself to wake up and notice what is really going on in life.

Think about this….

More later…

The Sadness of Therapy

I recently had a discussion .  The person was facing a deteriorating marriage and was contemplating what to do…stay in the marriage and try to initiate some badly needed changes, divorce, ignore the whole marriage and just continue living in it as it, etc.

At one point, he said, “I feel so bad that I have wasted so much time, wasted time by ignoring these problems, the marriage…”

Most people can relate to this.  I know I related to it.  And this is sad, very sad.  We only have a limited time on this earth and to realize we have wasted some, perhaps years of it arguing with or ignoring your partner is very sad.

I affirmed his options but suggested the sadness he was feeling could be a motivator for him to get active; active in either changing the marriage or leaving.  He can’t get the time lost back but this lost time can still serve a purpose…as a motivator and living through such an experience is where wisdom comes from.

The experience of looking back on our life and honestly evaluating it (and feeling the feelings we feel when we do this) and then deciding on a course of action and getting active…this is what helps us make better choices in the future.  Yes, we may/will feel sad at some of our choices but to try to ignore/avoid this sadness renders us paralized to growing as we age.  Our society suggests we can/ought to only be happy.  This is wrong.  We (all) make mistakes. Looking at them without crucifying ourselves can help us to change and grow.

 

More later…