Dr. Elizabeth Beckmann has joined the team and we are thrilled! She brings a wealth of knowledge and experience with her. She has a track record of helping clients and we are sure she can help you too.
Winter brings depression for many here in Utah. For some it comes on because of the shorter, darker days. For others it comes because of a change in diet (i.e., eating too much and too unhealthy at holiday gatherings) and moving less (i.e., not exercising or moving around outside. And for others it comes because of loneliness and feeling the pain of relationships not going well or relationships lost. No matter why you are depressed the fact still remains – you are struggling and not doing well. Lets talk about what to do when you find yourself feeling down during the winter.
- Move more – getting outside, even if its cold, can help you feel better. Find something that you enjoy and do it. Exercising at a local gym or community recreation center can feel good.
- Eat healthy – we often emotionally eat, eat because we are bored or because its a holiday. All of these experiences can leave us feeling worse than we felt before. Keep eating healthy. Rather than just restricting what you eat, try replacing unhealthy food for healthy food you like.
- Talk to someone – isolation is often a big precursor and proponent of depression. Talk to someone you like and share with them what you are going through. They might not have the answers, but it could feel good to let someone care for you.
- See professional help – there can sometimes be a negative stigma associated with getting therapy. Get over it. 🙂 Therapy has been shown to help those who are depressed. It can make a difference for you and your loved ones. Most all of my clients report to me that they are glad they got the help when they were struggling.
We have all been dependent at some point in our lives, whether it be on other people, a tool, or medication. Dependency doesn’t begin with malicious intent, we depend with a need. I think of a scene from forest Gump when forest had braces on his legs, and he feared taking them off would make his condition worse. It is unknown when his dependency on these braces became unnecessary, but they did and it wasn’t until he met a crisis in which the braces had to fall off when he realized he had been dependent on his braces longer than what was necessary. In this moment, he found his potential.
He would not have become dependent on the braces if he didn’t need them at one point. We are all dependent when we are in need to be or made to believe we are in need of dependency. Without the braces, Forest would have never met his full potential, his legs needed the assistance to become functional. Therefore, we should not be afraid of dependency its self. We should be afraid of being convinced we are in need of more assistance than what is healthy. Fear is very convincing, we become afraid when we experience something to be afraid of or we are warned by others to be afraid.
When you’re in fear of crippling yourself it’s difficult to know when what you depend on is no longer needed and its holding you back. Like Forest many people find out they are stronger without their dependency in a moment of crisis when you have no option but to let go. Throughout life we grow and change in moments of crisis. We have an instinct to let go of everything that limits us from survival. To know what we truly depend on we have to create a crisis for ourselves, challenge ourselves to experience discomfort in our relationships.
In Forest’s case if he were going to a physical therapist he would be challenged physically in a controlled environment where the physical therapist would challenge him further than his fear would allow, but ensure that his muscles would be strengthen by the challenge, rather than being permanently damaged by too much strain. Therapy for those who are emotionally dependent is similar in that a therapist is there to gage how much more you can endure while at the same time increasing your resiliency.
Moving forward allowed forest the flexibility to move directions when he wasn’t going where he intended to go. If he remained in that spot, in those braces, if he didn’t like where he was, there was little movement he could make. Building his strength and losing the braces allows for choices to be made. It’s not always easy to let go when you believe that you have no choice. Having someone there, giving you choices, faith in yourself, and pushing you when your fear tells you that you can’t handle any more, and supporting you when you need rest means everything when you are taking the risk of vulnerability.
Written by Madison Price, MA, LAMFT – therapist at the Holladay Center for Couples and Families
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
All too often, family members, friends, fellow employees, and even therapists become reactive, judgmental, and walk on egg shells when they interact with someone who displays characteristics of borderline personality disorder. Let me start off by summarizing some of the core characteristics of the disorder, specifically focusing on those traits which play out in the interactions with others.
- Affective Instability – This is where those with BPD struggle to regulate their emotions in predictable ways. Often, their mood does not match with expected life or social situations, thus making it difficult for those around them to understand or relate to the distress they are experiencing.
- Fear of real or imagined abandonment – Those struggling with BPD are often afraid of being rejected, abandoned, or left alone emotionally. These feelings are triggered when the potential abandonment is indicated, as well as times where it isn’t.
- Identity disturbance – It can be difficult for those with BPD to maintain a consistent sense of self. There is typically a variance of self-doubt, instability in self-image, and self-acceptance.
- Impulsivity – Due to the emotional and personal instability, impulsivity is often a regular occurrence for those with BPD. While this may not feel disruptive for the individual, it can be highly disruptive for those around them.
- Paranoid ideation and dissociative symptoms – In certain situations, those with BPD may struggle with feeling paranoid, especially in relation to how they perceive other’s intentions or motives. Also, they may experience dissociative symptoms, which is a disconnect from themselves, their reality, or their sense of self.
What we need to understand about personality disorders is that they are just that, disorders which occur within the core personality of the individual. This is important to consider, because it is extremely threatening to the individual when a personality disorder is suggested, or when a diagnosis is made, especially since it is difficult to be “objective” about your own personality. Because of this, it can be very threatening for someone experiencing symptoms of BPD to identify and accept that the symptoms are present in their life.
It is my professional belief that the symptoms of BPD are treatable, and that through treatment, people can reduce the identified symptoms to the degree that they no longer qualify for the diagnosis. This perspective can bring hope to those struggling with BPD, as well as those who are involved in their life. However, the process of therapy can be challenging, and typically requires long term treatment.
Selecting a therapist who can treat BPD effectively is an important step in the process. The therapist must be able to accurately diagnose the disorder, as well as position themselves in the therapeutic relationship as to control for and manage the identified symptoms. A careful balance between soliciting BPD symptoms and maintaining safety and security within the therapeutic relationship is critical. Failure to challenge the BPD symptoms results in no change, while doing so without carefully creating a safe therapeutic relationship will typically result in early or even immediate rejection on the part of the client.
Once someone with BPD can effectively accept the diagnosis, identify how the symptoms play out in their life, and learn new ways of managing and responding to the symptoms, then they can focus on the primary relationships in their life, and work on how they relate to others in new ways.
Written by Dr. Tony Alonzo, DMFT, LMFT, CFLE therapist at the Holladay Center for Couples and Families
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
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/
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
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
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