Your First Therapy Session

Many people are unfamiliar with therapy and want to know in advance what it's like. If you've ever seen therapy sessions on tv or in the movies, please be assured that it's probably not like that.

There will be some paperwork to fill out. Arrive ten minutes before your appointment time to fill out the paperwork. You were probably informed about financial arrangements when you made the appointment. Bring your insurance card, your pre-authorization number (if required by your insurance), and your co-pay.

The initial visit is a period for you and your therapist to get to know each other and get an idea where to proceed.  You will probably be asked what brings you to therapy. The therapist will be assessing your situation. You will be asked what you feel is wrong in your life, and any symptoms you are experiencing (such as insomnia, nervousness, weight loss, etc.) You may also be asked to tell a little bit about your history. Feel free to bring notes.

Telling your story

Some people think that they need to spend an hour or more explaining their background and history. Not so. Your history can come out gradually, particularly if you want brief, solution-focused therapy. It's often better for you if you limit the amount of time that you spend talking about your history to no more than 15 - 20 minutes. This way you can spend part of the hour getting feedback from your therapist and developing a plan. Some people only have a vague idea of what is bothering them. That's OK.  We'll help you to put words to what's bothering you. If you are in therapy because a spouse or parent thinks you ought to go, we'll want that person in the first session with you explaining the problem from their point of view. Sometimes parents come alone the first time to give a lot of important background history.

Summarize your history

You'll want to spend the majority of your session (which lasts anywhere from forty-five minutes to an hour, depending on the therapist) developing a plan. So, it's important to tell your story briefly. Here are some examples:

"I've been depressed for at least six months."

"I've always been anxious, but it's worse when I have to take a test at school."

"I've been pretty lonely since moving here a year ago."

"My boyfriend and I got along well for the first three years that we knew each other. Now it seems like we're fighting all the time."

"My wife says she's going to leave me if I don't stop drinking."

Your therapist will ask for clarification on some points and then ask you what you want.

Creating a treatment plan

In order to change your life so that you're happier, we'll help you with a treatment plan that identifies your strengths, your problems, and your goals. This treatment plan is a highly individualized path to wellness. It's an action plan that also describes which methods will be used to help you to reach your goals.

Thinking about strengths

I know, I know. You hate to talk about your strengths. But the reason we need to know your strengths is so that we can use them to maximize your success in therapy. Perhaps you could have a friend or family member help you with a list of strengths that you can bring to your session. Let your therapist know that you've done this.

Establishing goals

One of the most important parts of the session is to establish goals. Goals help both the therapist and the client to focus on what the client wants. You may already know what you don't want. So, establishing what you do want is generally not too difficult.

For example, you say that you've been sad and unmotivated. You lack energy and are prone to crying spells. If we think about the opposite of those signs and symptoms, your goals might be:

1. Increase happiness

2. Increase motivation

3. Increase energy

4. Decrease crying spells

How will you know?

You may be asked how you will know if you have reached your goal. We want to put this in concrete terms. For example, if you're depressed, you will know that you're not depressed because....

1. You'll have the motivation to follow through with projects and assignments in your world.

2. You'll be crying less.

3. You'll have more energy.

4. Others will tell you that you're smiling more.

How do you feel?

You will be evaluating how you feel about your connection with your therapist that first hour. Do you feel like your therapist cares about your situation, and is invested in helping you? Do you feel comfortable asking questions and sharing sensitive information? If the answer to any of these questions is "no," consider trying someone else. In fact, most therapists honestly don't mind referring a client to someone else if that connection just isn't there. We want what is best for you. Good luck!

10 Myths About Therapy

I used to dislike telling people what I did for a living because of the myths associated with therapy. Some of these myths are still out there, so I'm hoping to dispel them with this post.

1.    Therapy is for crazy people.

Therapy is for people who have enough self-awareness to realize they need a helping hand. Therapy helps you  learn tools and techniques to improve your quality of life and intimate relationships.

2.    The therapist will fix my problems.

The therapist focuses on strengths while helping you to identify unhealthy patterns and symptoms in your life that you need to change. The therapist is somewhat like a personal trainer in a gym – they can make suggestions and be a guide, but you still have to do the work.

3.    If I go to counseling, everyone will know.

Therapy is confidential. We can't tell your family members, employers, or friends what you've said without your written consent. The exceptions to this are if you threaten to harm yourself or someone else, we're required by law to tell appropriate authorities. We are also required by law to report child abuse if it has occurred within the past eight years. Some people ask about reportable abuse by saying something like, "Suppose I had a friend who....    Would you report that?"  We can talk about your "friend."

4.    The counselor will judge me and my life.

We are actually trained to be nonjudgmental. And we've heard it all. We're here to help you, not judge you. A friend recently said to me, "If you really knew me, you wouldn't like me." That's a fear that she shares with a lot of people. And it just says that you're judging yourself harshly. If you stop to think about it, don't you love your friends and loved ones even more when they open up to you?

5.    The counselor will tell me what to do.

I heard it again just the other day. "Are you going to tell us to get a divorce?" We can't do that. You are the one who must make your important life decisions. If you're severely depressed, we may highly recommend that you see your doctor for antidepressants. But we're not going to tell you what you have to do. It's still your life, your path. And you must make your own decisions.

6.    Therapy takes forever.

That used to be the case many years ago. It's no longer the case today. Most therapists are trained in brief, solution-focused therapy. The average person comes six times. Some people only need one or two visits. Once they have a few suggestions and resources, they can handle things on their own.

7.    Therapy is too expensive.

Although it can be expensive, it doesn't have to be.  I regularly see clients whose insurance pays everything except a $10 - $20 copay. There are community resources that can help you if you need free or low-cost therapy.

8.    Therapy doesn’t work.

There's a lot of research that says therapy is a highly effective tool to guide you toward the physical, emotional, and spiritual place you’re missing. It is important to understand what therapy can and cannot accomplish. It’s also important to recognize your goals for therapy.

9.    Therapy is about being analyzed.

Most of today’s therapy is about working toward goals, not being psychologically dissected. It's very here-and-now. And, no, I don't sit and analyze people when I'm at a dinner party. I enjoy their company. I have the privilege of helping people to focus on their strengths, identify their problem areas, and help them to find solutions to problems.

10.    Going to therapy means that I am not strong enough.

We all need help now and then. And none of us can see ourselves in the way that an outsider can see us. And the problem with just talking to a friend is that your friend may not have the skills, training, patience, or courage to tell you what you really need to hear. Sometimes an impartial third party can give you feedback that your closest friends wouldn't dare say.

Now that you know the common myths about therapy, won't you give it a try? Your life will improve in so many ways.

Calling Your Insurance Company

We bless them and we curse them. We try to understand their rules. We get caught in loopholes. Claims are delayed or disallowed for the most ridiculous reasons. We get just as frustrated as you do. At Resolutions we spend thousands of dollars every year so that we can bill them, comply with their rules, allow their audits, see their members, and provide you with the services that you want. Every month we bill dozens of insurance companies. Most are reputable and very helpful; some are not. Some plans are excellent; most are mediocre at best. Some are downright outrageous. I’m sorry if you’re in that group.

Being an educated consumer can save you lots of money!

Of course, you don't have to use your insurance. We're glad to accept credit or debit cards or cash for a discounted rate.  For those with a high deductible paying the cash discount could be a way to keep therapy affordable without the hassle. But, if you want to use your insurance, it pays to educate yourself. We bill dozens and dozens of different plans every year and are happy to do so as a courtesy to you. Please understand, however, that we offer no guarantee that your insurance company will pay. That is between you and your insurance company.

We are happy to bill for you.  We know a lot about insurance companies in general. We may not know about yours. There are just too many out there. In addition to that , plans change, rules change, and we're not informed of those changes--you are. We expect that you do your part by being an educated consumer, asking questions if you don’t understand, and communicating with your insurance company should a problem arise.  Many, many clients have saved themselves hundreds of dollars by understanding their insurance plans and taking the trouble to authorize their mental health visits ahead of time.

How to educate yourself

Navigating through the health insurance industry is a challenge. It is even more of a challenge if you do not understand the language that is used by those in the industry. So, to help you out, we are happy to tell you how to ask about your mental health benefits. We really do want you to be an educated consumer. Here’s what to do:

Look at your insurance card.

The “member ID” is on the front. Have the card in hand when you call your insurance company.

Turn your card over.

On the back you’ll see various numbers. Perhaps you’ll see an 800 number for customer service. More specifically, if your insurance company lists an 800 number for “behavioral health” or “outpatient mental health services,” that’s the number you’ll want to call.

When you call the number, you’ll reach a representative who will ask you what you want.

Ask ALL of these questions.

“I’m calling to determine eligibility and benefits for outpatient mental health therapy with Kathie Keeler, licensed clinical social worker.” They will ask you for your name, your member ID (or social security number), and date of birth. After they have determined that you are who you say you are, be sure to ask the following:

• Do I need a pre-authorization number prior to seeing someone?

• Do I need to keep track of the number of visits? (Usually you do.)

• Do I have a copay? How much is it?

• Do I have co-insurance? (This is a cost-sharing arrangement between you and your insurance company in which you pay a percentage of each visit.) What is the percentage? This is usually true for some Blue Cross/Blue Shield plans, which have both a copay and co-insurance. (It gets tricky because you have to pay both a percentage of each visit as well as a copay each time.)

• Do I have a mental health deductible? If so, has it been met this year? Some companies have a separate mental health deductible. So, even if you've met your medical deductible, it doesn't necessarily mean that you've met your mental health deductible. If it hasn’t been met, you’ll want to find out what you will need to pay at the time of the visit. You can do this by asking the following.

• What is the contracted reimbursement rate on my plan for an initial visit, billed under the CPT code 90801?

• What is the contracted reimbursement rate on my plan for subsequent visits, billed under the CPT code 90806?

More information you may need to know:

• If your insurance company only gives you five visits, you have the obligation to count your visits so that you don't go over your allotted amount. This is your job; not ours.

• Some companies will want to know the date and time of your visit prior to giving you a pre-authorization number. They ask this to determine whether or not the therapist has availability. Give them a date and time.

• Some insurance companies will want to know why you want to see a therapist. They ask this to determine whether or not the problem is “medically necessary." Most insurance companies will only cover medically necessary diagnoses, such as depression or anxiety. You have the right to privacy. You don’t need to tell your story to an insurance company representative, and probably shouldn’t.

• Be aware that insurance companies can only stay in business by making a profit. They do this by saving money. And this is where the horror stories begin. What you say can used against you.
  

  What NOT to say:

1. “I’m court-ordered to therapy."
2. “I want marriage counseling.”
3. “My child has AD/HD.”
4. “I’m just stressed and want to talk to someone.”
5. “I need some anger management classes.”

Although all of these things may be true and legitimate, your insurance company could use this information to disallow visits. Please talk to me first.

You will be given a diagnosis.

Please be aware that your insurance company cannot be billed without a legitimate "medically necessary" diagnosis. This diagnosis is part of your permanent record--not only with the insurance company, but also with the Medical Information Bureau (MIB) The MIB is a central database of medical information shared by insurance companies. About 600 insurance firms use the services of the MIB primarily to obtain information about life insurance and individual health insurance policy applicants. When you apply for life or health insurance, your insurance company may look for codes in the MIB that indicate you've had a problem in the past. The MIB is not subject to HIPAA. So, even though our records are confidential; your insurance company will likely forward the diagnostic codes to the MIB. Not only can insurance companies deny applicants based on prior treatment, certain government positions may require an explanation of why you were treated for a medically necessary diagnosis--even many years previously.

Preventing Relapse

Drug addiction is a complex but treatable brain disease. It is characterized by compulsive drug craving, seeking, and use that persists even in the face of severe adverse consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence. In fact, relapse to drug abuse occurs at rates similar to those for other well-characterized, chronic medical illnesses such as diabetes, hypertension, and asthma. As a chronic, recurring illness, addiction may require repeated treatments to increase the intervals between relapses and diminish their intensity, until abstinence is achieved. Through treatment tailored to individual needs, people with drug addiction can recover and lead productive lives.

The addict has a chronic, pervasive, progressive disease. In early recovery he/she CANNOT behave in the same way that other members of society do. In other words, the addict must identify and avoid those triggers that would lead to relapse. Although different people respond to different approaches, the research is clear on which approaches have the best success rates. The standard recommendations include:

1.    Recovery must be the number one priority in the recovering addict’s life.

2.    90 meetings in 90 days. The addict must substitute recovery for drug use and drug-seeking. Once addicted, the mere anticipation of getting high will trigger a marked dopamine response in the addict and/or alcoholic. Likewise early recovery from addictions is often hampered by the lack of dopamine d2 receptors that take many months to return to baseline functioning. The lack of sufficient d2 receptors is a primary reason that many drug addicts and alcoholics fail at abstinence during the first 90 days of their recovery.

Following the first three months of sobriety, the addict should attend no fewer than 3 meetings per week. After the first two years, the recovering addict can reduce this amount to one meeting per week if everything else is going well.

3.    Sponsorship. Daily calls and weekly meetings with a caring recovering addict are vital. Checking in with a caring person improves accountability.

4.    Step work. Homework assignments must be done and given to the sponsor on a weekly basis.

5.    Total and complete abstinence from ALL mind-altering drugs. This includes alcohol, even though it’s legal.

6.    A detailed and careful history to determine which triggers lead to relapse.

7.    Change of “playground, playmates and playthings.” The addict must avoid using friends, as well as places and activities that re-activate cravings.

8.    Abstinence from other addictions—cigarettes, pornography, etc.

9.    Relationships must be put on hold until the addict is on a firm footing with his or her sobriety. Although friendships are important, new relationships with the opposite sex should be avoided during the first two years of recovery.

10.    Study of inspirational literature. The people who have the greatest success rates are those who find a Higher Power and are able to “let go and let God.”

As I mentioned earlier, different people respond to different approaches. The above list has been standard for many years with minor variations for different people. With further research, even more variations are possible.  Those of us in the recovery field always hope for more research that can help the addict that still suffers.

Stress Relief

I was looking at my list of things to do yesterday wondering how I was going to get everything done. Sometimes I do more than what I can reasonably handle. And I know I'm not alone in feeling the stresses and pressures of daily life. Every day in counseling I see people who are stressed, anxious, nervous, pressured, and burned out. Life can certainly be stressful for all of us.

Slow down and relax for a moment.

We are all seeking solutions to problems in life.  But it's important to take the time to recognize stress and the body’s need to relax, even if the pace in your life is not slowing down. Guided meditations and breathing techniques can help give you simple ways to relax, even if for just a few quick minutes in the middle of a busy day.

Count your breaths.

The easiest way to start off when practicing guided relaxation is to count your breaths as you inhale and exhale. You don't need to do a lot. Start with five.  After all, our lives are busy.  Breathwork that involves inhaling through your nose as deeply as you can, will help your body start to relax. Hold this breath and then let it out slowly through your nose. Your heart rate will start to slow down and your muscles will start to relax. When learning relaxation meditation, remember to have a focus for the meditation, such as on your breathing.

Recognize and dismiss thoughts.

During relaxation meditation, all kinds of thoughts will come to mind. As you learn to recognize these thoughts and then dismiss them, your meditation will go deeper.  This is one of the main reasons why you will want to choose a quiet place for meditation where you will not be interrupted by the normal sounds of your life when you are teaching yourself how to to do this. Meditation for beginners can be frustrating when you can’t seem to get it right the first time. Just hang in there.

Stay focused on your breathing.

The key is to stay focused on meditating and to focus on your breathing techniques. The thoughts of frustration are ones that can take over and ruin relaxation methods for you. One great practice in meditation for beginners learning how to relax is to concentrate on the parts of the body. Start with your toes and focus on them as you feel them relax. Then move upward concentrating for a few minutes on each body part and how it relaxes. As you get to your head, your body will be completely relaxed. Ahhhhhh. It feels so good.

If meditation is not for you, don't worry.

The reason I like using The Wild Divine, a biofeedback tool designed to aid in the learning of relaxation and meditation, is because it's easy to sit at the computer and watch "a video game." (It's really not a video game, but it looks like one.) I find The Wild Divine works well with beginners, children, and people who suffer from anxiety. So, if the breathing and meditation techniques aren't helpful for you, use The Wild Divine instead. Biofeedback is a simple, but powerful tool that helps you to communicate with your body. You'll wear finger cuffs which measure your skin temperature and allows you to move through levels of the games. You can watch the demo below and see what I mean. Be well.

The High Costs of Drug Abuse

So often I've heard addicts say to me, "I'm only hurting myself."  They don't understand that drug addiction hurts everyone, not just the addict or the addict's family. Let's look at some of the financial costs of drug addiction.

There are many costs--health care costs, crime related costs, health administration costs, lack of productivity costs, welfare costs, and birth defect costs, to name a few.

Drug abuse and addiction are a major burden to society

Estimates of the total overall costs of substance abuse in the United States—including health- and crime-related costs as well as losses in productivity—exceed half a trillion dollars annually. This includes approximately $181 billion for illicit drugs, $168 billion for tobacco,  and $185 billion for alcohol. Staggering as these numbers are, however, they do not fully describe the breadth of deleterious public health—and safety—implications, which include family disintegration, loss of employment, failure in school, domestic violence, child abuse, and other crimes.

These figures are from NIDA (the National Institute on Drug Abuse).

The only thing that makes sense financially for the United States is prevention--beginning with the pregnant mother and for her child in preschool, elementary school and middle school. Every cost-benefit analysis of prevention vs. treatment points toward prevention.

What Causes Drug Addiction?

Most of this article is from NIDA  (the National Institute on Drug Abuse)

Many people do not understand why individuals become addicted to drugs or how drugs change the brain to foster compulsive drug abuse. They mistakenly view teenage drug abuse as a parenting problem and may characterize those who take drugs as morally weak. One very common belief is that drug abusers should be able to just stop taking drugs if they are only willing to change their behavior. What people often underestimate is the complexity of drug addiction—that it is a disease that impacts the brain and because of that, stopping drug abuse is not simply a matter of willpower.It's a brain disease.

Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume their productive lives.

What happens to your brain when you take drugs?

Drugs are chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs are able to do this: (1) by imitating the brain’s natural chemical messengers, and/or (2) by overstimulating the “reward circuit” of the brain.

Some drugs, such as marijuana and heroin, have a similar structure to chemical messengers, called neurotransmitters, which are naturally produced by the brain. Because of this similarity, these drugs are able to “fool” the brain’s receptors and activate nerve cells to send abnormal messages.

Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters, or prevent the normal recycling of these brain chemicals, which is needed to shut off the signal between neurons. This disruption produces a greatly amplified message that ultimately disrupts normal communication patterns.

Nearly all drugs, directly or indirectly, target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this system, which normally responds to natural behaviors that are linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to the drugs. This reaction sets in motion a pattern that “teaches” people to repeat the behavior of abusing drugs.

As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. As a result, dopamine’s impact on the reward circuit is lessened, reducing the abuser’s ability to enjoy the drugs and the things that previously brought pleasure. This decrease compels those addicted to drugs to keep abusing drugs in order to attempt to bring their dopamine function back to normal. And, they may now require larger amounts of the drug than they first did to achieve the dopamine high—an effect known as tolerance.

Long-term abuse causes changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function. Drugs of abuse facilitate nonconscious (conditioned) learning, which leads the user to experience uncontrollable cravings when they see a place or person they associate with the drug experience, even when the drug itself is not available. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decisionmaking, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively despite adverse consequences—in other words, to become addicted to drugs.

Why do some people become addicted, while others do not?

No single factor can predict whether or not a person will become addicted to drugs. Risk for addiction is influenced by a person’s biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:

·    Biology

The genes that people are born with––in combination with environmental influences––account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction.

·    Environment

A person’s environment includes many different influences––from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and parental involvement can greatly influence the course of drug abuse and addiction in a person’s life.

·    Development

Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability, and adolescents experience a double challenge. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it is to progress to more serious abuse. And because adolescents’ brains are still developing in the areas that govern decisionmaking, judgment, and self-control, they are especially prone to risk-taking behaviors, including trying drugs of abuse.

National Institute on Drug Abuse

10 Quick Anger Management Techniques

Need some help right now? Here are some proven techniques that can help.

1.    The 72-hour letter.

Write a letter that you do not send….at least not for three days. Get your feelings out. Vent. Fume. Explode. But only on paper. This is a great stress reliever that I love. If you absolutely must send the letter, have someone else  (like your therapist, counselor, pastor, or best friend) read it first. This is often a good first step.

2.    Give yourself a “timeout.”

Go do something else. Go somewhere else. Get your mind focused on something else. Play some music you love. Give it a rest. Get some space. Do not be in the physical presence of the person who is pushing your buttons. Get away from that person. Go outside or to the grocery store and push a cart around for an hour.

3.    Resist the temptation to get wasted, drunk, or loaded.

Self-destructive habits won't help you in the long run. In most cases, these habits will make things worse. We do stupid things when we're wasted.

4.    Get some exercise.

Hard physical exercise will help the adrenaline overload that frequently occurs when we’re angry. You’ve heard the urban legend about how a little grandma lifted a heavy car to save her trapped son who was underneath the car?  That’s the adrenaline fight-flight response. We need physical activity to burn off the extra energy. People tell me that some of their best workouts occurred when they were angry. They could run faster, climb higher, lift more weights, and feel more exhausted afterward. It's good and it helps a lot.

5. Brainstorm for solutions.

If the problem is still nagging at you and you feel like you just can't let it go, write down at least three possible solutions to the problem. Go over the solutions with a third party who wants what is best for you., such as your therapist or best friend.  Read about "your legitimate rights" and talk about them with another person.

6.    Use humor.

Watch a funny movie. Read jokes. Hang out with your funny friend who always cheers you up. Get some emotional distance from the situation by making a joke about it. This is how comedians get their best material....from painful situations that they could eventually joke about.

7.    Practice relaxation skills.

Do some breathwork. Listen to a hypnosis CD. What is relaxing for you? What puts you "in the zone?" Some people may want to watch a yoga DVD and practice the deep relaxation at the end. B-R-E-A-T-H-E.

8.     Let it go.

Let it go. Don't hold a grudge. Let it go. When your mind is tempted to ruminate over the same situation, say, “Stop!” Change the subject in your mind. Holding a grudge won't help you and it certainly doesn't hurt the other person.

9.    Use “I statements.”

When describing the problem, own your part. “I feel upset when you….” Own the fact that you are angering yourself. No one else can make you feel upset, hurt, little, or insignificant without your permission. Doing this will help you to claim your power over your feelings.

10.    Talk about it later.

Express your feelings when you’re no longer angry. “Yesterday I felt disappointed when…” In this way you’ll prevent yourself from exploding, yelling, blaming, criticizing, or doing something totally irrational. When we’re no longer angry, we don’t say things like, “I’m furious….” It’s more likely to be heard by the other person when you’re saying something less frightening. People don’t become quite as defensive when you say something less toxic. So, it’s OK to say that you were disappointed or hurt or irritated. But you may not get a sympathetic response either way. So, don’t expect it.

Some of these techniques will work better for you than others. Pick and choose. One time you may need one thing; another time another thing. Practice, practice, practice. Remember that your brain's chemistry is off when you're angry. And that's not fixed overnight. So, give it some time.

When Your Kid Breaks Your Heart

For the parents who mourn their children's choices, you will have to learn to re-direct your thoughts. Whether your kid is lost in addictions or has had  self-destructive habits, you need to learn to lift yourself out of depression and anxiety.

Do you remember dreaming about your kid—even before birth? Wondering what he or she would be like? You faithfully went through all the stages of growing up with your child, tolerating tantrums, dirty diapers, spider collections, and heartaches. You did everything possible to be a good parent, attending school plays, parent-teacher conferences, play dates, and soccer matches. You spent lots of money on hobbies, activities, violin or karate lessons, the latest clothes, everything. You fell in love with this remarkable little human, knowing full well that your job one day would be to help him or her to grow wings and fly away from you.

When your child became a teen, the thought of your child going away one day didn’t seem quite so terrible. Perhaps this stage helps us to let go as our darling becomes more and more willful. I know it helped me to let go. So, what do you do when your child breaks your heart?

1.    Don’t take it personally.

It’s not about you. Your child made choices, just as you did. Perhaps your child blames you, perhaps not. At any rate, you really need to remind yourself that your child made his or her own choices.

2.    Connect with your spirituality.

Do you have a belief in a bigger picture? Some people connect through their religious practices. Spirituality for other is volunteerism, connecting with nature, or helping humankind in any way that they can. You get to define it. Talk to spiritual leaders or spiritual practitioners that you respect.

3.    What you’re feeling is normal.

You’re grieving. People typically move through stages of grieving as they heal. So whatever emotions you’re feeling—anger, frustration, sadness, depression, guilt—it’s all normal and it’s all part of the process.

4.    Detach with love.

Detaching doesn’t mean that you stop caring about your child. It means that you focus more on moving on with your life. Letting go of hopes, dreams, and expectations is painful. Yet, it's very necessary....for all of us.

5.    Find peace and joy every day.

As you move on with your life, learn how to make yourself happy. Begin by appreciating the thing that bring you even a small degree of happiness each day. What made you happy in the past? Reconnect with those things.

6.    Look for the positives.

One famous therapy assignment is called, “The Five Best Things About….” So, clients learn to focus on the five best things about having cancer, the five best things about having a son who is a drug addict, the five best things about having a daughter who is a lesbian, etc. It sounds crazy, doesn’t it? People often give me an astonished look when I give them this writing assignment. Yet, it really does work. There are glimpses of sunshine in every storm. Learn to look for those glimpses.

Oh, and talk with a therapist if you get stuck. We're here to help, you know!

Three Things I Admire

My good friend and colleague, Carolyn, died today. I’ve thought about all the things that I’ve learned from her over the years. I’m so grateful for the things that she taught me. Here are my top three things that I admire about Carolyn:

1.    Our Wound is Our Gift.

Carolyn really understood that our "wound" is our gift. The greater our struggles and challenges, the more we have to give to others when we learn the lessons that those challenges provided. We become inspirations and models as well as teachers and guides. We are not here just for ourselves, but for something much greater.

She was an alcoholic who relapsed a number of times over a period of thirty years. She had a necklace made of dozens of 30-day chips from Alcoholics Anonymous. (Chips are the little circular pieces of plastic that you receive at an AA meeting when you’ve had thirty days of sobriety.) She became a drug and alcohol counselor because she REALLY understood addictions. And she helped thousands of alcoholics and addicts. She was loved by everyone. And she knew that she was no better than anyone else because of her wound.

2.    A Positive Attitude is a Choice.

I really admired Carolyn’s joie de vivre. Even as she was dying, she joked and laughed with us. She knew how to handle the stress. She wasn’t about to suddenly become depressed about dying. I can’t remember a time when Carolyn wasn’t excited about life. I believe she was able to be so happy because she worked on having a positive attitude and was fully present. She didn’t have a negative story running through her mind, like, “This is just awful.” She could always put a positive spin on any event that appeared to be negative.

3.    It's Not About the Money.

Even though Carolyn lived on social security, she was rich. She didn’t have money, but she was rich in friendships, rich in laughter, rich with stories, rich in experiences. She placed little value on money and lots of value on what really counts in life. We will miss her.

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