Why do clients come to therapy?

Written by Sharon Coulter, MA, PPS, MA LMFT on . Posted in Blog

A client asked me this past week why people come to me for therapy. It was a great question. In the culture I grew up in, you only went to a therapist if you were “crazy,” so of course hardly anyone sought out help unless they were experiencing a severe mental health crisis. You were also served platitudes, such as, “You need to suck it up,” or “Get it together.” Sound familiar?

What a price has been paid by so many people who have grappled alone with functioning in the world – because of their own misunderstood struggles, or the dysfunction of partners or family units.

Today, I’m happy we’ve come so far and therapy has become another important resource for people to draw from on this journey we call life. In my experience, here are my “Top Reasons for Therapy” and why I’m so honored to work with the courageous souls who seek me out.

  • To make a change
  • To address an emotional issue like anger, anxiety, sadness, depression, loneliness, shame
  • To address a physical issue that has emotional impact (what one doesn’t)
  • To resolve trauma (seemingly “small” – or “significant”; note, all trauma affects us)
  • To address an addiction or disorder that is getting in the way of relationships and life goals
  • To work though limiting beliefs and unhelpful ways of thinking
  • To learn to express emotions
  • To learn to communicate in ways that maintain connection with others, especially during conflict
  • To work through a mental block
  • To address phobias or release fear of something
  • Spiritual incongruence
  • Lack of meaning in life
  • Lack of a sense of belonging
  • Support for a quest of some kind that has been ignited
  • To understand a sense of incompleteness
  • To address a desire to live life more fully and understand what that means
  • To learn self acceptance
  • To learn self forgiveness
  • To identify co-dependent patterns and understand healthy boundaries
  • To process loss
  • Help with a life transition (geographic moves, careers, relationships, life stages)
  • Help to support the process of aging
  • A safe space to support the dying process (self and others)
  • A sense of being “lost”

Of course, many of the above issues are multi-dimensional and overlap. Perhaps some of them resonate for you. Whatever you’re struggling with or want to further develop within yourself, I hope you’ll consider finding a therapist who can support you to create the change you deserve.

Trauma – identifying and alleviating it with EMDR

Written by Sharon Coulter, MA, PPS, MA LMFT on . Posted in Blog

If you think trauma or an adverse event is interfering with your choices and what you want for your life, I’m glad you tuned in. Unfortunately, the concept of trauma is widely misunderstood in the general population. This is because most of us think of trauma as some catastrophic event, like falling off a cliff, being a victim of acute physical violence or witnessing a murder (secondary trauma). Yes, these are all events that could very well induce trauma for a participant; however, there is also what therapists often refer to as trauma with a small T. This can be related to adverse events that are often enduring — like a child’s experience of divorce in the family, school bullying, the emotional disconnect of a parent, growing up in an environment where there is constant fighting, criticism, addiction, illness, to name a few. Sadly, many people are oblivious of the long-term effects on adults of this second type of trauma, which can be critically debilitating and result in poor self esteem, lack of boundaries, fear of confrontation, addictive disorders, and much more. A third type of trauma is transgenerational trauma. This is trauma that is believed to have been transferred from the first generation of trauma survivors to the second and further generations through post-traumatic stress disorder mechanisms.

Research by leading experts in the field indicates that the treatment of trauma is more complex than previously thought. No longer are clinicians encouraged to have clients tell “the whole story” since it’s now believed that this may further re-traumatize the individual.

As a clinician who often works with clients suffering from both major and “small” trauma, I’m trained in EMDR—eye movement desensitization reprocessing—a leading recognized protocol to help heal trauma. According to the world health organization, EMDR is based on the idea that negative thoughts, feelings, and behaviors are the result of unprocessed memories. The treatment involves standardized procedures that include 1) focusing simultaneously on spontaneous associations of traumatic images, thoughts, emotions, and body sensations and 2) bilateral stimulation that is most commonly in the form of repeated eye movements. EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic or adverse event without going into detailed descriptions of the event.

In my own EMDR training and in my utilization of the protocol with clients, I’m impressed with the results, and I’m finding most individuals experience good outcomes. Of course, like any intervention, EMDR may be more effective for one person than another and it’s one of several potential approaches to help clients. It’s also imperative to ensure the client has strong skills/resources to stabilize themselves when addressing memories or events that induce a high degree of reactivity. As you might expect, EMDR is frequently used to reduce PTSD symptoms.

For more information: https://www.emdr.com/what-is-emdr/

Teenage Turbulence Survival Tips

Written by Sharon Coulter, MA, PPS, MA LMFT on . Posted in Blog

Is it hard to remember the happy times with your “good” kid amidst the increasing distancing, disdain, disrespect, or downright volatility of your teenager? Take heart if this is your current experience because you’re most definitely not alone. What’s most important is how you interpret these changes and the ways in which you respond to your teen. Much of this behavior is age appropriate. The most important thing you can do is remember this is a phase. Don’t take it personally but keep them accountable.

Let me repeat that: don’t take it personally but keep your teenager accountable for their behavior.

The truth of the matter is that your teen is experiencing a chaotic time and some will navigate these difficult waters better than others. Think back on your own adolescence: would you want to go back to that, again! Hormones are raging, friends are changing (daily), school is becoming more complex—academically and socially—and the innate desire and need to individuate (be one’s own person) may well be pushing your teen to break away from his/her safety net – the family. A death, divorce, marriage, geographic move are only a few examples that may add another layer of complexity to your teen’s life. How to balance respecting your teen’s burgeoning desire for greater privacy and individuality and establishing parameters that maintain his/her safety and a respectful and cooperative atmosphere in your home is tricky to say the least. Indeed, it is an ongoing process. Equally important is the need to be watchful for signs of “acting in” manifested as isolation, depression, and anxiety.

The following are some guidelines for dealing with everyday teen challenges:

Connect with Your Teen
Despite the struggles between you and your teen, your ability to maintain a loving connection is critical if you are to have any kind of influence over him or her. Develop a ritual of checking in with your teen at the end of every day—it could be over dinner, in their room, driving home, or during an activity your teen likes. Let them know it was a difficult and confusing period of your life. Avoid asking your teen questions that require one word answers. Ask them HOW their day went: what was fun about it and what was stressful. Briefly let them know what was difficult about your day. Address changes in mood and behavior in your teen by remarking on the fact that they don’t seem themselves and you’re concerned. Ask them if there’s anything they’d like to chat about that may be bothering them. If your offer to talk is rebuffed, don’t take it personally. Just let your teen know that if they want to talk at a later time, you’re available, and you love them. Yes, continue to tell your prickly teenager that you love them and affirm as many positive behaviors as possible (even the littlest things). This is vitally important as teenage-hood is typically a time when teens feel that all their parents do is pick on them.

Rude Behaviour – Formulate a Response Plan
Develop a spoken mantra such as, “We’re respectful to one another in our family” and model it as frequently as you are able. Should your teen act out or try to suck you into a power struggle, refuse to accept the invitation. Just because your teen wants to argue a point, doesn’t mean that you need to comply, and getting into a shouting match with a yelling teen is a losing battle as it only fuels the emotional fire and demonstrates your loss of control. There is nothing wrong with letting your teen know you are angry at their behavior and need time to cool off before you can speak with them about what has transpired and decide what consequences will follow. The key here is to address the behavior. Your teen’s anger or rudeness does not mean he/she is bad, lazy, etc., and labeling your teen in this way is damaging to their self esteem. It’s the behavior that is unacceptable.

Formulate a plan that has appropriate consequences and that match poor behavior or broken rules. Keep in mind that consequences are NOT meant to make your teen feel powerless. Rather they are to 1) set limits; 2) motivate your teen to do something different; and 3) help him/her not to repeat the behavior. For example, you tell your teen she isn’t going out with her friends until she’s straightened up her room. She verbally abuses you by calling you a derogatory name. Name calling is verbal abuse and should not be tolerated. A consequence could be that she’s grounded in her room until she writes you a letter of apology for cursing at you and tells you how she will deal with the situation differently if it occurs in the future.

When What You’re Doing Isn’t Working
If your teen appears distressed or anxious over a prolonged period of time or your strategies aren’t working, visit your pediatrician to have your teen medically assessed and meet with your teen’s school counselor to discuss any school issues they can shed light on. Poor behavior is almost always paired with poor grades. You may also want to consider joining a parent group and consulting with a psychotherapist for yourself and for your teen.