Boundaries With Others – How To Set Them

When you’re trying to create boundaries with people they will be tested. It’s like when cows enter a new pasture, they will knock their shoulder against the perimeter a few times to check out where their boundaries are and how strong they are. Cows are strong enough to take down barbed wire if they really wanted to, but they aren’t really testing if they can get out, they are testing if they are safe from the external world. Once they know that the boundaries are consistent and stable they feel safe and they graze in the middle. If the cows don’t have that consistent boundary they will rely on the cowboy to tell them when they have gone too far. The cowboy however doesn’t have consistent boundaries, they will only correct the cow when they notice the cow has gone too far, which doesn’t create a feeling of safety. People are the same when they have never experienced consistent boundaries, or they are experiencing new boundaries. People will test boundaries, not enough to break them but enough to trust that they are there to stay and to trust that they are there to keep them safe.

A lot of young adults who never experienced boundaries, because their parents wanted to be their friend. They have a great relationship with their parents, but they will tell me that they feel like they grew up as an orphan because they don’t have a secure home base. but they will tell me that they are afraid to explore and take risks as an adult because they can’t trust that they have parents who are watching out for them, to make sure they don’t make a mistake big enough to ruin their entire life.

It’s important that people are given the space to grow and find their own solutions within appropriate limits. When your setting limits the goal is not to get a specific outcome, rather the goal is to prevent a specific outcome. It is quite spectacular what people can come up with when their possibilities aren’t limited, but just the same we don’t want anyone hurting themselves or others in the process. Limits are set to prevent irreversible and/or irreplaceable damage, while still allowing people to learn how to cope with and improve from mistakes.

When cattle are being herded they have the instinct to turn around when they feel blocked, which can be disruptive to the flow and requires more work to redirect them back into the flow. To redirect a cow, you want them to feel pressure on their shoulder. If you are in front of them when you apply this pressure they feel blocked, if you are beside them when you apply this pressure they will simply turn a bit from where they shouldn’t be. People are the same, when they are told to stop doing what they are doing (and they don’t continue trampling over you) they will do a complete turnaround, even if this wasn’t your intention. If you’re only wanting a slight redirection from a no go zone you want to adjust your approach to let them know that you understand that they want to move forward, and you want that too, but you want them going forward in a slightly different direction.

Written by Madison Price, MA, LAMFT – therapist at the Holladay Center for Couples and Families

 

Medication Management and Mental Health

In my career in healthcare, I have seen far too many patients who have been prescribed medication and continue to take that medication faithfully; Yet after a time, they are not really sure why they are taking that specific medication or if it is even helping with the diagnosed issue.  

 What is missing for these patients? Medication management 

Medication management is the process of following up with the healthcare provider on a regular basis to assess the effectiveness of the prescribed medication therapy, discuss any side effects that may go along with the medication, and make adjustments in order to achieve proper dosing. In some cases, the follow-up may be to change the prescribed medication therapy, if it is not providing the desired outcomes. Medication management should be an ongoing process. It should include open dialogue between the patient and provider about the effects of the medication combined with any other therapies or treatments that may be in place. This is to ensure useful data is being collected, so decisions can be made based on the whole picture; not just the medication piece. 

When it comes to psychiatric and mental health services, the importance of quality medication management cannot be overemphasized. Not all people who seek psychiatric help will require medication. In some cases, amino acid therapy may be appropriate or continued therapy and counseling with regular psychiatric follow-up is warranted. If medication is prescribed, the patient should plan to see the psychiatric provider within 2 weeks (in most cases) for the first medication management visit.  Continued follow-up visits should be scheduled monthly, or as needed depending on the individual case. 

During these visits, the patient should plan on communicating openly with the psychiatric provider about their use of the medication, any side effects that they may be noticing, and any changes they are feeling in relation to their mental health diagnosis. At times, genetic testing can be used to pinpoint what medications are more likely to work for each individual patient. This testing can be used not only for patients who are just beginning psychiatric treatment but also for patients who have been prescribed medication therapies that aren’t working. The patient should also plan to consult with the psychiatric provider before taking any other medications. They should inform the provider of other mental health therapies being used or medical complications that may arise during treatment. The patient should expect the provider to ask questions that will direct and lead the conversation, so time is well spent and modifications can be made with confidence. 

Ultimately, the key to effective psychiatric medication management is open and continual communication between the patient and provider. At the Center for Couples and Families, our psychiatric providers strive to provide thorough psychiatric assessment, follow-up, and medication management. 

Originally published on http://utvalleywellness.com/

 

Divorce – Counseling

Once the decision to divorce becomes imminent, components of the family system must prepare for change.  As a marriage and family therapist, its always my initial response to determine if the marriage can be repaired.  However, when people choose to end the relationship, the best course of action is to remain engaged in a therapeutic process throughout the transition.

The couple will need to work with one another to at least determine how to make decisions required for the legal aspects of dissolving the relationship.  If a couple can manage this on their own, and collaboratively and respectfully complete and submit the required documentation directly to the appropriate State department, and implement resulting legal stipulations, then this is typically the least intrusive and cost-effective method for divorce.  However, most couples have a level of financial, family, possession, and interactional patterns and history to require a divorce mediator to become involved. Typically, within a few sessions, the mediator can direct a process which results in immediate and long-term legal conditions to best assist the couple in divorce.  

All too often, individuals facing divorce immediately discontinue therapy because the marriage is over.  This can be biggest mistake they make in the process, especially considering how many different aspects of their life will require adjustment and change.  While I do not request that the couple meet together in session once they decide to divore, I strongly encourage them to remain engaged in individual therapy, and if children are involved, to make arrangements for each parent to attend therapy with their child(ren) in order to work through the questions, fears, concerns, and aspects of change they will all face, and most importantly, how to establish a new relationship with each parent individually.

Finally, without each partner exploring how they contributed to the dissolution of their marriage, they will most likely repeat harmful interactional and communicative patterns in future relationships.  Even if individuals post-divorce do not have the current intention of entering into another relationship, they should engage in the work which would otherwise place them in a position where they can, in the most healthy way, be available to engage in a future relationship.

Written by Anthony T. Alonzo, DMFT, LMFT, CFLE, Director at the Holladay Center for Couples & Families

Relationship Land Mines – How to Handle Them

All people have topics or behavior that are emotional landmines. I think of watching M.A.S.H seeing a big sign saying, “DANGER-MINE FIELD.” I love to picture this sign in my relationships. If these emotional landmines are going to be there I think it is essential for survival to create a boundary around the mine fields. I have found it courteous to set boundaries around mine, so that people have more freedom within a relationship with me. If people don’t set boundaries around their own boundaries I have to create boundaries to keep myself safe from their emotional landmines, unfortunately I don’t know exactly where the landmines are, so I have to create a boundary with large radius for extra safety. This is unfortunate because If boundaries are bigger than they need to be for the emotional safety this is limiting the potential for emotional intimacy in the relationship.

This is not only unfortunate for the person who “steps” on the emotional landmines, but also the person with the emotional landmines without appropriate boundaries. People thrive on relationships and connections. People who don’t create boundaries are absolutely terrified of being alone. Without knowing about emotional landmines, if you had the choice between land without blocked off areas and land that had nothing on it, the land without any blocked off areas seems more attractive, at least until you start walking over it! A person without boundaries want to attract people, and boundaries are not attractive. Their need for connection is not inherently bad, they are meeting this need in the only way they know how, because they haven’t experienced a long term intimate relationship as an example. Therefore, they have people around them who are avoiding a close relationship, or freeze to avoid any emotional landmines.

When you are in a relationship with someone who doesn’t create boundaries, you will often find yourself apologizing without knowing how you’re at fault. If apologizing becomes your default to suppress emotional explosions, you will attract people who have a need to blame.  People who blame are only considering their own needs, people who apologize as a default only consider the needs of others. A healthy relationship will balance your emotional needs with the needs of others with consideration of the context. If this isn’t happening your efforts to get closer to people will result in resentments. If you’re thinking “if they only knew what I was really thinking, they wouldn’t love me.” You will feel lonely in a room of people who love you.

When you share your truth, unfortunately you do risk losing people in your life.  However, knowing that even the one person who stays loves every part of you, and respects you enough to respect your boundaries will be worth anyone you lose. This is the most difficult part of setting boundaries, you have to reach a point where you can accept losing a relationship all together in order to do what it takes to be a healthier person. Accepting that you could lose a relationship means that if they are uncomfortable with boundaries they may cutoff communication with you. When you respect yourself and you respect other people enough to show them where your boundaries are to keep you and them emotionally safe, you will begin attracting healthier relationships.

Written by Madison Price, MS, LAMFT – Therapist at the Holladay Center for Couples and Families

 

When Teenagers Refuse to Accept Parental Influence

You have been there, most of us for the 2nd time around.  A parent offers a lifetime of experience, knowledge, and observance of others, and their teenage child refuses the knowledge, insight, suggestion, direction, or invitation.  Let’s explore how this plays out in families, and how we can approach these situations differently.

I know for myself, I was that teenager.  At the time, I felt like I needed to figure it all out on my own. My parents didn’t know my life, my situation, my perspective.  How could they get what I was going through, let alone provide accurate or helpful support?

I now find myself as the parent of three teenagers, and feel as though I see them clearly, and have excellent advice, support, and direction for each of them.  Of course I would, I am a therapist, however, my children refuse my support and suggestions on a frequent basis.

What’s really happening here, and what can we do about it as parents?  Although I cannot provide suggestions for every situation, I will propose an invitation to consider these dynamics from a different perspective.

First of all, we need to consider what relational process encourages the stance of resistance.  As parents, we want to feel valued in our role. We want to improve the next generation, and most likely, prevent our children from some of the difficult, painful, and regretful experience we have had in our life.  However, we typically deliver them in a manner which only reveals the constraints of though, belief, and action, rather than exposing the confusion, pain, and suffering caused by our previous and current actions in life.  

How would your teenager respond to you differently if they were afforded the opportunity to hear what those experiences were truly like for you.  Most teenagers will find it difficult not to get sucked into listening to those kinds of disclosures from their parents. Imbedded in these life accounts are lessons which they can then choose to interpret and implement in their life as they see fit.

Once we get around our teenager’s resistance, we then gain access to mentor, teach, and influence.  Do not take this as control over their decisions, as you are extremely limited in your ability to control your children’s thoughts, believes, and actions.  However, when your teenagers have no reason to resist, what are they left with? Its like engaging in a tug of war, and one side lets go of the rope. If there is no resistance, the attempt to pull on the rope becomes obsolete, and a new perspective of interacting becomes necessary.

I challenge you to attempt to do this in your own way with your teenager. The sooner you attempt to approach them differently, the more likely you will be successful in shifting your teenager’s resistance to your influence and create opportunities of connection which will influence them for the rest of their lives.

by Anthony T. Alonzo, DMFT, LMFT, CFLE

Hidden Signs of Depression

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.  

Trouble Sleeping 

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.  

Losing Interest 
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.” 

Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed. 

Low Self-Esteem 

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.  

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Originally published on http://utvalleywellness.com/

 

How Do I Help My Depressed Teenager?

Teens with depression can be successfully treated if they seek the right help. Teen depression doesn’t have to mean a lifetime of struggle, and it certainly doesn’t have to end in suicide. Wake up parents, be aware, notice the red flags and then seek to find the professional help that your teen needs and deserves. In addition to seeking professional assistance, below are a few key suggestions on how to help your depressed teenager.

Acknowledge their feelings: Acknowledging the pain and sadness they are experiencing can go a long way in making them feel heard, understood and supported. Often times adults try to talk their teens out of depression, by rationalizing or trying to convince them that their problems are really not that bad. Well-meaning attempts to explain why “things aren’t that bad” come across as if you don’t take their emotions seriously.

Focus on listening: Listen to your child without offering advice or lecturing. Once your teen begins to talk resist the urge to pass any judgement or get upset. You’ll do the most good by simply letting your teen know that you’re there for them, listening fully and unconditionally.

Encourage social connection: Depressed teens tend to withdraw from their friends and the activities they used to enjoy. Isolation makes depression worse, do what you can to help your teen reconnect with their peers and loved ones. Suggest activities such as sports, after-school clubs, or an art, dance, or music class suggest things that interest your child or that he or she has a special interest in.

Make Time: Set aside time each day to talk one on one with your teenager. Put your phone and work away and focus completely on your teen without trying to multitask.

Physical Health: Depression is associated with inactivity, inadequate sleep, and poor nutrition. Teens are known for staying up late, eating junk food, and spending hours on their phones and devices. Encourage your teenager to create healthy habits in their lives by exercising daily, getting enough sleep, and eating nutritious foods.

Set limits: Cell phones have become a way for teenagers to escape real life and ignore their problems. As the number of hours, a teen spends on their phone increases the number of hours that that teen spends being physically active or socially connected with their peers decreases. Which in turn, increases depression.

Be understanding.: Living with a depressed teenager can be exhausting.  At times, you may experience unnecessary guilt, rejection, despair, anger, and many other negative emotions. It is easy to blame yourself and to start doubting your own parenting skills. Remember that your child is not being difficult on purpose. Your teen is suffering, so do your best to be patient and understanding.

When Do I Seek Professional Help?

Listen to your gut. You know your child, you know what is and isn’t normal for their personality. As you are actively engaged in their lives you will know if something is up. Have the courage and the strength to seek the professional help that is necessary to help your teen learn how to manage and understand depression in order to live a happy, balanced, and fulfilled life.

 

Written by Brandi Hess, LAMFT

 

Telling Your Kids About Divorce

Making the decision to divorce is hard enough when thinking about only the spouses involved, add kids to the mix and things get ten times more difficult. If you are going through a divorce, most likely you are concerned about how your decision to separate will affect your children, and how are you going to tell them? As parents we are constantly trying to protect our children from any pain and suffering, the reality is that the news of your parents’ divorcing, no matter how carefully delivered, is going to cause some kind of pain, hurt, or confusion in the eyes of your child.  Although you can’t control how you or your child will feel during this stressful time in your lives, you can make the choice to commit to seeking out effective ways to handle and offer a positive healthy source of support for your children. Committing to this will allow them to adjust to the divorce in a positive way, and in their own way as you lovingly guide them through the process.

TIPS 

  • If possible the news of the divorce should come from both Mom and Dad together as a family.  During this conversation stress the fact that even though family life is going to look very different, you will both continue to love them.
  • Tell the children that the divorce has nothing to do with anything that any of the children may have done or not done. Reassure them that they are not the cause of the divorce.
  • Children thrive on structure, especially during transition periods. Keep a daily routine with school, activities, and their regular everyday life. Keeping as much consistency as possible helps the children to feel more secure.
  • Having some kind of a plan of what life might now look like for them can be very beneficial. It is comforting for them to know where they will be going to school, where they will be sleeping, and how often they will see mom or dad. Nothing is permanent in this arrangement but offering them some sort of idea of how their lives will and won’t change will again help them to feel secure. 
  • Address your children’s concerns. Encourage them to talk, scream, cry or celebrate. Help them to feel safe in expressing their feelings.
  • Lastly, make sure that they are told how much you both love them and how that will never change.

Studies show that children do best and have fewer long-term emotional, social or academic problems when parents can establish a healthy, respectful, co-parenting relationship. Transitioning into a new type of relationship and putting aside the hurt and anger that are associated with the broken marriage can be extremely difficult for many parents to accomplish. But through patience with each other and hard work, it can be done. Divorce changes families but it does not end your commitment to your children. Make sure you take the time to find the solutions that work best for your family to ensure a positive outcome for you and your children.

**If you or your children are struggling to deal with the life transitions involved with divorce, seek out professional assistance for individual or family therapy. The therapist can assist in encouraging better communication, and be helping all families members to properly heal and process the trauma of divorce.

 

Brandi Hess, MA, LAMFT

Brandi Hess has a passion for helping people to work through life’s difficulties, assisting them in finding joy, and the strength to reach their full potential. Brandi strives to ensure that she understands each of her clients’ unique needs. She provides therapy and counseling sessions tailored specifically to obtain her clients’ goals, in an individual or family setting. She offers a kind, honest, and straight-forward approach in therapy, allowing for trusting relationships to be built. She specializes in couples and family distress, pre/post-divorce, and adolescent treatment. One of Brandi’s many strengths is being able to connect with adolescents by creating a therapeutic environment where the adolescent feels safe and willing to start the process of change. Brandi works with a variety of concerns such as depression/anxiety, women’s issues, and trauma. Brandi received her Bachelors of Science in Human Development and Family Studies at the University of Utah, and her Master’s degree in Marriage & Family Therapy from Argosy University.

Family Therapy

Even the happiest families hit speed bumps along the way. Whether your family is experiencing major changes, experiencing a crisis, or things just feel off, you can find yourself wondering what has happened to our family? As your family grows and enters new stages of life, new expectations, and new life experiences in general, it can often be hard for family members to adjust and adapt. As these changes occur it is important for the family system to strengthen their communication skills and work together in the family unit. Change is part of life and is often something that adults and children are not comfortable with. Whether your family is overcoming a new transition or trying to adjust to the changing dynamics of your family system, seeking help from a therapist can help to create new ways of relating to each family member, strengthen communication skills, and learn better ways to work together so that your family can get back on track of enjoying each other through this thing called life!

 

Stayed tuned for some quick tips on things that you can do to help  strengthen your family!

5 Simple Tips for The Mother of a Teenage Daughter – Part III

This Is Me

During this adolescent stage, your daughter will be at war with herself trying to discover who she is. She is starting to build her own identity and differentiate herself from those around her. Sometimes teenage girls think that in order to become their own person they must either completely cut off from their mothers, or the relationship is so enmeshed that the daughter is frozen in fear when thinking about making any type of decision without her mother’s input. Both ways are detrimental. During this time help your daughter to find her voice and gain the confidence that she needs to speak her truth. When you and your daughter disagree on something, rather than becoming angry and defensive, apply active listening and show her that her thoughts and opinions as an individual matter. The bottom line is that you and your daughter can still have a close relationship without having to be the exact same type of person with the exact same type of thoughts, interests, and opinions.

Self-Reflect

Take the time to step back and evaluate the way that you are handling and contributing to the relationship with your daughter. This allows for you to be honest with yourself and to evaluate what is and is not working. Once you have identified some areas that you can improve on, be brave enough to be vulnerable with your daughter and discuss your weaknesses or the reasons why you may have been so triggered in a certain argument with her. Then ACT! Start putting in the effort to make the changes the relationship needs. Just as you would want your daughter to reflect on her actions and the way that she is treating you, humble yourself to do the same.

You can begin to implement these five simple ideas today! As you do so you will begin to see changes in your relationship with your daughter and you will be on a path towards a stronger connection and bond with her. If at any point you find that you and your daughter are stuck with issues from the past or can’t seem to change poor communication habits, you may need some extra help in breaking and understanding these patterns. If this is the case, seek out the help of a therapist and let them assist you on your journey of creating the relationship that you both desire and deserve.

Written by Brandi Hess, LAMFT – Therapist at Holladay Center for Couples and Families