Boundaries

What are boundaries?  They are the limits of our personal space...the point where we tell others "Stop!  I don't want you to cross this line."  Think of this as being similar to real estate property boundaries...everybody knows were the property begins and ends so they don't violate that boundary, the majority of the time. 

Why are boundaries important?  Creating and maintaining boundaries gives the person who has them a sense of self-respect.  S/he does not feel walked on by others, but respected by family members, friends, and within the community.  The person knows what limits s/he has set for others and does not allow them to cross those boundaries. 

How are boundaries created?  This is based on the person.  S/he has to think about what limits  to set with others.  Things like how much personal space do I need around me before someone is sitting/standing too close? Or how much contact can I handle with people who make me uncomfortable?  These are just a few examples.  There are many more boundaries that need to be set and a lot of them are individual to the person setting the boundaries.

Who needs to set boundaries?  Everyone!  Including me.

What happens if someone tries to violate my boundaries?  When I have difficulty with someone trying this with me, I gently explain to them that they are crossing the line and I don't like where they are going.  At this point the person usually backs off and frequently apologizes.  Rarely does it create a bigger problem.  When a bigger problem does get created, I leave the situation.

Boundaries provide structure to relationships.  Without them, we would be stepping on each others toes with little disregard for the other person's feelings.   They are easy to create, but sometimes difficult to maintain because we sometimes fear hurting somebody else's feelings instead of protecting our own. Yet boundaries are important in maintaining our own self-respect.

Mindfulness

What is mindfulness?  It would appear that this would have a simple answer and to some extent it does.  Mindfulness is being aware of what you are doing in the moment.  Sounds easy, right? However, the act of being mindful encompasses much more than that.  Being mindful can be a difficult process to learn.  For example, say you are doing the dishes.  Paying attention to what is going on in the moment while you are doing the dishes, without your mind wandering, can be hard to do.  Focusing on the way the water feels on your hands, the movement of scrubbing the dishes instead of going on autopilot, because this is something that most of us do every day, is challenging. 

What are some ways to be more mindful in your daily activities?  One excellent example is through mindful eating.  This is about being fully present while eating, noticing all five senses during the experience.  It is also about being nonjudgmental about yourself before, during, and after eating.  Eat, don't do anything else.  Notice with food smells like.  Notice how the food looks.  Notice how it feels in your hand or with the utensil.  Notice salivation and taste.  Chew each bite at least 20 times.  Notice any feelings of food in your stomach.  Continue eating the rest of your food paying attention to all of these sensations.  Notice feeling satiated and full.  This can be practiced with something small that you typically eat in handfuls such as popcorn, nuts, chocolate, dried fruit, or chips.  You can practice one mindful meal a week for one month.  Then practice 3 mindful meals a week for another month.  Eventually, it will be useful to practice one mindful meal a day.  Some statements to answer as you're practicing mindful eating are as follows:  "Things I noticed when I was 'Mindfully Eating'; Things that I was surprised by or didn't expect an eating mindfully; 'Mindful Eating' will be useful to me by; Ways that I eat mindfully on a regular basis." (Moonshine, 2008).

In being mindful, it is important to do one thing at a time.  If you are driving, just drive.  If you are at work, focus on the tasks at hand.  If you are taking a break or practicing self-care dedicate yourself to that moment.  Being mindful is focusing on the here and now and being present in the moment.  It is a skill that takes practice, but is well worth the reward.

References

Moonshine, C. (2008).  Acquiring competency in achieving proficiency with dialectical behavior therapy: Volume II, the worksheets.  PESI: Eau Claire, Wisconsin.

Generalized Anxiety Disorder (GAD)

Imagine yourself sitting there feeling anxious without knowing the reason why.  You may feel nauseous, have difficulty concentrating, and feel restless.  There is muscle tension, you are easily fatigued, and you have difficulty sleeping or you have restless sleep.  You find it difficult to control the worry.  Now, imagine that going on for six months or more.  These are some of the prevailing symptoms of generalized anxiety disorder or GAD.

I have known people with GAD who told me that there were times when they have been so anxious before going places that they wanted to turn around and go back home because the anxiety they were feeling at the moment was so intense.  This speaks of the potential debilitating nature of GAD.  It affects all areas of the sufferer’s life.  I realize for those who've never had GAD it can be difficult to understand its effects because you may be thinking “we all get nervous or feel a little anxious sometimes,” right?  The difference with GAD is the intensity of the anxiety is greater and the length of time that it occurs is longer.  

Frequently, it is difficult for those without GAD to understand how the person with GAD feels.  This is unfortunate.  The well intentioned attitude portrayed by well-meaning friends and family of "there's nothing worth being that worried about" often makes the person feel worse because s/he may now believe s/he are disappointing family or friends. 

So what is the solution?  As the therapist, I would refer them to see a psychiatrist for medication evaluation.  I would teach them relaxation techniques to help relieve anxiety such as mindfulness, meditation, and deep, diaphragmatic breathing.  Also, since I'm a certified hypnotherapist, I could use hypnosis as a relaxation technique as well.  Discussing the issues of concern can also be helpful.  Of course, this is only some of the things I could do.

GAD can have a paralyzing effect on the individual.  It is important for the individual with GAD to have supportive friends and family and to seek counseling in order to find ways to gain control over their anxiety.  GAD does not have to rule their life.

My Favorite Psychological Theorist

I realize it might sound strange to some to be talking about my favorite psychological theorist but I think that the work of John Gottman is very interesting.  Over the last three decades John Gottman and  his wife Julie Swartz-Gottman have created, with the help of their “Love Lab” studies, an effective method of treating couples in distress.  This method is centered in the here and now, is emotion focused, and experiential in nature.  What follows is a brief description of the Gottman method of couple therapy.

First let me add some interesting facts… Gottman defines a well–functioning couple as those partners that remain relatively stable and happy over time.  The couple is able to maintain control during negative conflict, create shared meaning in the relationship, and increase positive influence.  They were able to have a 5:1 positive to negative interaction ratio, which Gottman found was important to maintaining an effective, stable relationship.  A dysfunctional couple is partners that either stayed in unhappy relationships together or broke up.  The couple is unable to maintain control during negative conflict, create shared meaning within the relationship, or to increase positive influence.  This type of couple had a lower positive to negative interaction ratio of .8:1 (Gottman, 1999, p. 35).

Gottman's work is based on the Sound Marital House Theory (Gottman, 1999, p. 105).  There are seven levels to this theory arranged in hierarchical order.  1.  Create love maps.  Love maps are a road map of one's partner's inner world.  These maps are built by asking the partner open ended questions.  2.  Make the admiration and fondness system by articulating respect and love in everyday small moments.  3.  Turn toward instead of against or away from their spouse’s requests for affective connection.  4.  Permit positive sentiment override, meaning not taking negative or neutral partner events personally.  5.  Take a multi–pronged approach toward managing disagreements by using a gentle method in stating complaints, receiving influence, compromise, physical soothing, and by creating communication with continuous problems that explores each individual’s life dreams within conflict.   6.  Honor each other's life dreams.  7.  Construct a shared meaning system by creating informal and formal rituals of connection, building shared values and goals, common views of symbols and supporting each other's life roles.  The Sound Marital House Theory provides an overall structure for Gottman's assessments, therapy, and key interventions and techniques.

There are five goals the Gottman method.  I will briefly go over the five goals however I will not discuss the different steps involved with each goal.  For further information, I would recommend reading the chapter on the Gottman method of couple therapy in S. Gurman's Clinical Handbook of Couple Therapy (4^th ed., 2008).  The first goal in the Gottman method is to down-regulate negative affect during conflict.  Although conflict is inevitable, it is important to be able to achieve repair after the fight which means being able to process the fight by talking about it without getting back into the fight.  This also means being able to reduce what Gottman calls the four horsemen of the apocalypse, his greatest predictors of divorce.  This involves increasing the partners’ knowledge of the occurrence of the horsemen and teaching them how to use the appropriate antidotes.  The four horsemen are as follows: criticism, defensiveness, contempt, and stonewalling.  The antidotes for these are: complaining, accepting responsibility for at least part of the problem, respect within the relationship, and self-soothing.

Goal two in the Gottman method is to up-regulate positive affect during conflict.  This occurs by having couples turn toward each other when bids for affection are made couples can also build friendship in their relationship by increasing the activation of the positive affect system in non-conflict periods.  This could potentially lead to an increase in positive affect during conflict.  Goal three of the Gottman method is to build positive affect during non-conflict.  This can be partially accomplished by teaching clients to savor positive affect.  Goal four of the Gottman method is to bridge meta-emotion mismatches.  Meta-emotion is the way people feel about having emotions.  There are two broad types.  Those people who are emotion dismissing have poorly developed dictionaries of different emotions and did not care or know what they were feeling not having needs as a strength.  Those people who are emotion coaching see emotions as a guide on how to proceed through life.  They validate others emotions.  A meta-emotion mismatch predicts the pattern of turning away from bids such as the "pursuer-distancer" pattern.  Goal five is to create and nurture a shared meaning system.  This is something that all couples unintentionally or intentionally build, so it is important for the counselor to assist them in creating a positive shared meaning system.

This provides a brief example of Gottman’s goals in therapy.  He has published numerous books filled with assessments, references to the many tools he uses in his therapy sessions, and he offers seminars on how to use his methods in therapy.  He continues to do research as well. 

References

Gottman, J. M. (1999). The marriage clinic: A scientifically based marital therapy. New York: W. W. Norton & Co.

Gottman, J. M., & Gottman, J. S. (2008). Gottman method couple therapy. In S. Gurman (Ed.).   Clinical handbook of couple therapy (4^th ed.). New York: Guilford Press.

Hypnosis-What is it?

Today's blog is about hypnosis.  There are a large number of misunderstandings about what hypnosis is...that it is some sort of mind control by the hypnotist or mind reading, for example. Or the act of hypnosis is somehow cavorting with evil.   Defining hypnosis is really very simple.   Shelley Stockwell-Nicholas, PhD in her book Hypnosis: Smile On Your Face, Money In Your Pocket  defines it as "a natural state of heightened awareness where you easily accept suggestions, listen to inner wisdom,  replace limiting imprints and (meet) with your higher self" (p. 19).  We all enter into various levels of hypnosis throughout the day, while we are watching TV, a  movie, or reading a book, while we are driving down the freeway passing the exit signs without noticing them, and even while you are sitting in a church listening to the pastor give the message you are in a state of hypnosis.  When you intentionally engage in practices like meditation or yoga that involve deep breathing and a sense of inner calm you are practicing self-hypnosis.

I've given examples how hypnotic states happen to each person during everyday events.   Now I will discuss what happens during intentionally induced self-hypnosis.  Here I will be talking about what I do when I go into hypnosis.  This is the same process that I teach others when I am guiding them through the process.  First, I make sure that I am well hydrated by drinking plenty of fluids and that I have gone to the bathroom before starting.  Also, I make sure that I have 15 to 20 minutes or more of free time to spend in a relaxed state and turn down (or off) any phones or other distracting noise.  Here I find that soft music or white noise playing in the background can be very soothing; however, music with words can be very distracting.  I find a place in the room to either sit or lie down that is comfortable.  Then I take a relaxing deep breath.  Hold for 5 seconds and let it out.  I take another deep breath and let it out.  I continue to deep breathe.  In my head, I'm telling myself with each breath, I'm going five times deeper into relaxation than I was before.  For me, personally, it takes 5 to 7 deep breaths before I am relaxed enough to move onto the next portion of the hypnosis.

At this point I would think about the pathway to my favorite place to make the journey in my mind.   When I was first learning hypnosis, it was soothing to me to have a longer trek because I was nervous and it helped me relax more.  Now that I've been doing hypnosis for a while, I found that my trip down the path does not need to be as long to have the same purpose.  But in the beginning, I would think about every detail of the path: the sites; the smells; what I felt on my skin; what I tasted; everything down to the last detail.  This makes for a vivid experience.  My favorite place happens to be a rock below a waterfall on the South Fork of the American River so my trail goes through the forest in the woods. 

Once I have arrived at my favorite place, I can sit on my “rock” and enjoy the view in my mind for a while, relaxing.  There is no tension in my muscles; my breathing is calm and even; to an outside observer I may appear to be asleep.  While I am meditating on the rock I can give myself positive affirmations and reverse negative statements. (Note: the subconscious doesn’t hear the negative in negative statements, so if you tell it not to do something…it hears just the opposite.) 

The main "business" that I do while I am in hypnosis, besides positive affirmations, is go to my "control room."  This is a location that I have created at my favorite place that has door on it with a lock and key that only I can open.  Inside this room is a control panel to all the parts of my body including my mind.  Everyone's control panel looks different, but in explaining it to clients I compare it to the knobs on radio.  The volume on the dial or lever can be turned up or down to increase or decrease the sensation being felt.  For example, if I'm feeling highly anxious, I can go into my control room, see what number my anxiety knob is set to and turn it down to a number that I'm much more comfortable with.  This can be done with any sensation being felt. Any issues of concern can be taken care of at the same visit, each with it's own control, dial, knob, or lever.  

To bring myself back to room awareness I count to five.  1, slowly, calmly, gently.  2, everything is relaxed.  3, I’m feeling great from head to toe.  4, it is like I have splashed my face with fresh spring water.  5, my eyes are open and everything is fine (Stockwell-Nicholas, 2009).   That is the basic extent of what happens with hypnosis.  There really is nothing mystical about it. 

It is my hope that this explanation has clarified for the readers what hypnosis is and isn't.  Of course, if anyone has any questions, please feel free to post them in the comments section and I will answer them either there or in future blogs.

References: Stockwell-Nicholas, S. (2009). Hypnosis: Smile On Your Face, Money In Your Pocket. Creativity Unlimited Press. Rancho Palos Verdes, CA.

New beginnings

I  have recently been able to get a new job as a registered Marriage and Family Therapist Intern at Life Practice Counseling Group.  This is a private practice facility with low rates in order to better meet the needs of the private pay community.  The counseling group works with MFT trainees and MFT interns as the primary counselors and does not accept insurance.  This is an important step for me because this is my first paying job since 2002.  Needless to say, I am very excited and happy about the prospects this job holds for me.  I am a little nervous about the private practice portion of the position because it means I will have to find my own clients (so if anyone reading this knows of anybody that needs counseling, my rates are $65 per session and I have two offices in Sacramento).  I can be reached via my cell phone at 916-949-6517.  My official start date is July 2.  Okay enough of the shameless advertising, on with the rest of my post.

So, I have entitled this post new beginnings as this is a new start for me, but also because I wanted to talk about how important new beginnings are in people's lives.  As I'm sure we have all observed in our day-to-day living, when we have something new come up in our lives it creates in us feelings of excitement, nervousness, maybe exhilaration, and upon completion helps us to feel good about ourselves.  Think, for example, about the first time you went to school.  You probably felt nervous, anxious about meeting new people, and excited about the prospects of what you're going to learn or what was going to happen.  Once that first day was over, the might have felt a mix of emotions such as happy with all the new friends you've found, sad that the first day is over, and a release of anxiety now that you knew what to expect from school. Of course this is just an example of what you might have felt.  There is a broad range of emotions possible. 

New beginnings give us a chance to start over.  For many of us this is an important step in our lives, the chance to begin again with a clean slate.  Sometimes this is all a person needs in order to get back on their feet after making a mistake.  Or maybe it is a chance to try something new after learning about it in a book.  The important thing is allowing ourselves to have new beginnings.

In the future, my blogs will be psychology/MFT related postings on various topics from emotions to theoretical orientations and multiple topics in between.  I look forward to the opportunity to share some of my information with you.