College: A Generation at Risk

A College diploma is a goal for millions of Americans, yet graduation rates have never been lower and those who do graduate take 6 years on average compared to the 4 years of previous generations.  Recent research has helped us understand that these dismal outcomes are not because students cannot handle the coursework, because the vast majority of students can grasp the academic content; rather mental health issues are now the prominent struggle in College.   

The statistics tell a rather grim story at first glance.  A study by the APA in 2017 found 

86% of students with psychological and learning challenges left school without a diploma. The CDC discovered that suicide is currently the 2nd leading cause of death among college students and this year, WHO found that 1 in 20 full-time college students have seriously considered suicide. 

There is one statistic, however, that gives hope to these startling facts.  94% of high school students with emotional and learning differences receive some form of assistance. In contrast, only 17% of college students with the same challenges do so.  The remaining 74% still need assistance in navigating the new world of College life, but faced with logistical and financial constraints, Colleges will have to adapt quickly when it comes to providing services for the mental health of its students.  Currently, there is a nation-wide average of 2,500 students for every one counselor and this clearly isn’t enough. 

The good news, if you or someone you know needs help while in school, there are a couple of private and non-profit companies filling the gap in the state of Utah so please reach out for hope, healing, and help. 

Originally published on http://utvalleywellness.com

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

 

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

 

Understanding Your Childs Anger and Depression

Children often show depression through anger or being upset. They don’t know how to be depressed and act out instead. Understanding this, as a parent, you can approach your child in the right way. You would approach a sad child different that you do an angry child. Children need validation for what they are going through. The difficulty is that they often don’t recognize what they are going through. If you do, or if you have at least an idea, you can model for them how to recognize it. For example, if you child is getting picked on at school and is having a hard time with it, you could say to them, “It looks like school is hard for you right now and that it’s making you sad”. This would be instead of saying, “Hey! Stop being mean to your brother and yelling. What is wrong with you!?” It helps when you approach your child and give them permission and space to feel sad. It’s easier to accept and work through with someone who gets it. It’s not as scary when someone is with you.

Counseling for children uses the same principles. Children often act out instead of expressing their emotions. In therapy, children are given something to do instead of just talking about what they are feeling. This is partly how they are able to express their sadness. It’s easier to do something hands on then to talk about their emotions through words.  A good play therapist will be able to help children express and experience their emotions through activities at first and then eventually through words.

Written by Dr. Triston Morgan, LMFT, therapist at Holladay Center for Couples and Families

“C”ommunicating with Our Teenagers

We cannot NOT communicate. – Ray Birdwhistell 

Everything we do communicates something. It has been estimated that between 67-94% of our communication is nonverbal. What is non-verbal communication, you ask? It is everything except the words. It could be a grunt, a smile, a sigh, our smell, our jewelry, our clothes, whistling, the way we comb our hair, tattoos, the way we cook our food, piercings or the lack thereof, our posture, the nuances and history of a relationship, a stare at our son, a gaze at a pretty girl, the way we walk, our mode of transportation, hand gestures, or making googly eyes and funny sounds at a baby. We may say something, but our true intentions frequently will leak through our nonverbal behavior.  

The tone, the attitude behind the words when you ask your son to do something, communicates a whole lot more than the words that you verbally say. It is the attitude that he will respond to, not merely the words. Everything communicates. That is why the “C” in the title of this article is so large. Everything communicates something. We cannot NOT communicate. 

Even a dead person communicates. They communicate deadness.  

It is what is not being said that we pay attention to; this is why sarcasm is so dangerous. With sarcasm, there is a contradiction between the verbal and the nonverbal. Sarcasm is typically cutting. In fact, the word means, “to tear flesh.” For children, sarcasm can be very confusing.  

If you were to attend a communication seminar on learning “Effective Communication Skills,” you might come away with skills such as: having good eye contact, sitting on the edge of your chair, nodding and other non-verbal behavior to indicate you are listening. You might also learn about the importance of reflective listening. All these skills are important, however, do you suppose it would be possible to perform all these behaviors and not really listen in a caring way? And, if a person didn’t really care, do you think other people will be able to tell?  

Of course they can. 

“There is something deeper than behavior that others can sense – something that, when wrong, undercuts the effectiveness of even the most outwardly ‘correct’ behavior.” i  This thing that is deeper than behavior is something philosophers have been talking about for centuries. Carl Rogers called it “Way of Being.”ii  

Martin Buber explains that there are two fundamental ways of being, two ways of seeing another person. The first way is as a ”Thou,” a person with hopes and dreams and struggles similar to your own.  The other way of seeing a person is as an “It.” This is where one objectifies a person. “If I see them at all, I see them as less than I am – less relevant, less important, and less real.”iii This is then also about you and your perspective. There is always a good chance that a person does not see things the way they really are; that person may be missing something. We must be willing to honestly look at ourselves and see what part of the problem is our own. “Might I be provoking the other person without even knowing it?” 

When we talk to our teenagers, we sometimes ask them questions.  We must understand that they do not merely answer our questions; they are answering a relationship. Our conversations don’t happen in a vacuum. They happen in the context of a historical relationship.  They are answering a person, and with that person, comes an accumulation and history of their interactions. They answer according to the quality of their recent and remote relationship. 

For example, you might ask your daughter, “Would you take the dog for a walk?” She could respond in a variety of ways. She could ignore you. She could say, “of course.” She could tell you to eat rocks, or yell out while leaving, “maybe later.” On the other hand, if your daughter’s best friend (having a different relationship) said, “Let’s take the dog for a walk?” Your daughter may happily agree to take the dog for a walk. The relationship determines the interaction. 

In his book ”7 Habits of Highly Effective People,”iv Stephen Covey speaks of an emotional bank account we each have with our children. We must have enough positive interactions, thus building the relationship in our “emotional bank account,” before we can safely make a withdrawal (correction/discipline) without damaging the relationship. After all, we do not want to bankrupt the relationship.  When the emotional bank account is healthy, your child can take correction, knowing that it is coming from a place of love. 

The quality of the relationship determines our ability to be effective parents  

and our teenager’s willingness to allow us to influence them. 

 The moment a parent has a nasty verbal exchange with their teenager is not the time to try to immediately solve the problem. There are too many hot emotions for anyone to think clearly. If the relationship is generally good, waiting for a few hours, or perhaps a day to address the problem is wise. Time allows the parents and teenager space to see the situation clearly without the corrupting influence of these distorted and self-justifying thoughts and emotions.  

If the relationship has been rocky, time is needed for the relationship to heal. Part of healing process is deliberately working on developing trust again; another topic for another day. 

Originally published on http://utvalleywellness.com/

 

 

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/

 

Cleaning Out Your Marriage Closet – Couples Counseling

People are often worried about drudging up the past with their loved ones. There is controversy as to what is healthy for the relationship. People certainly don’t like to bring up an old fight when everything is going well. The issue is that we all have a closet of sorts where we hide everything that “isn’t worth the fight.” At first this closet is empty and the intention of putting things in there is good, you intend to talk about it later, it’s just not the right time.

The problem is that you enjoy the times you’re not fighting, who wouldn’t! You soon forget about what you’re storing in the closet, and you continue to throw everything “not worth the fight” into the closet. Your closet becomes full, and when you try to fit one more thing in there everything topples over. This is the fight of all fights, this is when you seemingly “loose it” out of nowhere about nothing and everything. This fight happens at a time when something was already “not worth the fight” and you were trying to put it in the closet. Therefore, you are probably not up for resolving everything in that closet either. It’s like if your junk closet toppled over just as company is coming over, you’re going to scoop everything up and stuff it back into the closet because you don’t have time to sort through it. This fight leaves everyone upset and confused and often nothing is resolved in this fight.

So how does one clean out this closet? Well its much like spring cleaning, you are going to take everything out and you begin to sort everything into categories. You evaluate if it is something that only happened once and will never happen again, if this is the case it truly isn’t worth the fight and can be thrown out. If it is something that continues to happen you need to address it, you will be bringing up the past not as a weapon against the other person, but as a justification for bringing it up as an issue. It is absolutely necessary that cleaning this closet is done at a time when your calm and you remain calm to be able to assess what the core of the problem is, what does their behavior tell you about your relationship with them. For instance, If someone is always late, how does their behavior effect you, why does it feel disrespectful to you and how does it create distance in your relationship, what is the message you receive about their feelings toward you. As opposed to judging their behavior as something you wouldn’t do and lecturing them about how it affects them.

When you clean out the closet you are transferring responsibility to the people it will be useful with. You will find that the cleaner your closet becomes the more clarity you will have in your relationships. Your intent in cleaning out the closet is not to change other people’s behavior, it is meant to change your relationships. You will find that some people will choose to become more distant because they are unwilling to make changes, but the relationships that become closer and the internal peace will be worth the distance in others.

Written by Madison Price, MS, LAMFT – therapist at Holladay Center for Couples and 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

 

Why Couples Therapy Often Fails

Couples often start therapy years after they first need it. I work with couples who tell me about their struggles years before they end up in my office. Its sad to hear how they saw the need for help, but didn’t get it for one reason or another. I hear them talk about things they try, reading books, talking with church leaders, trying harder, date nights…to no avail. There is nothing wrong with these types of activities as they do help strengthen a marriage. The problem is that the couple needs more fundamental healing and work. They need a solid relationship foundation (i.e., secure attachment, emotional safety), not a superficial fix (i.e., date night).

Here is what I tell these couples – start focusing on yours and your spouses emotional needs and experiences. Most couples struggle to do this because it is scary and unfamiliar. Understanding what your emotional needs are helps you to know what to communicate with your spouse. The trick is, at that point, communicating those needs in an appropriate manner. Extending an Invitation rather than an Demand regarding these needs is important. Invite your spouse to understand your needs and collaborate with you how to get them met. The more you then do this for your spouse the better your relationship will be. Understanding their needs and trying to meet them will help them feel safe and secure in your relationship and give them the ability to do this for you. This can be a difficult experience for both of you. Its scary to be that vulnerable and exposed with your spouse. No one else can hurt you like they can in this world. Opening up in this manner requires that you trust them to take care of you and be soft and caring. Them opening up in this manner requires the same type of trust in you.

A couples counselor can help you learn to be that vulnerable with each other while maintaining emotional safety.

By Dr. Triston Morgan, LMFT

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