<![CDATA[My Site - Blog]]>Wed, 16 Aug 2017 20:46:55 -0700Weebly<![CDATA[How Do Religious Beliefs Affect Our Health and Well-Being]]>Fri, 28 Jul 2017 13:53:36 GMThttp://yourcouplestherapist.com/blog/how-do-religious-beliefs-affect-our-health-and-well-being
By Robin Smith
​Updated 10:16 PM ET, Mon July 31, 2017

The Connections Betweens Our Beliefs and Our Overall Health

In a nutshell, being religious is strongly associated with better overall mental health and well-being. The devoutly religious have fewer symptoms of anxiety and depression in addition to having a better ability to cope with stressors. A 2005 study on adults in their 60s and 70s in the U.S. found that religious beliefs buffered against depression associated with poor physical health. And for those of you thinking, “well sure, people who are religious tend to enjoy the benefits of social support by attending weekly services at various houses of worship,” the buffering effects of religion was present even after controlling for social support. In a 2013 study, researchers found that patients who were being treated for depression and self-harm responded better to treatment if they believed in God. Of course, these results do not show causality.

Dr. Harold G. Koenig, director of the Center for Spirituality, Theology and Health at Duke University Medical Center, found that more religious people had fewer depressive symptoms after conducting a meta-analysis of 93 studies between 1872 and 2010 on religion and health. According to Koenig, "People who are more involved in religious practices and who are more religiously committed seem to cope better with stress. One of the reasons is because [religion] gives people a sense of purpose and meaning in life, and that helps them to make sense of negative things that happen to them."

What's the Downside of Religious Beliefs on Health?

Negative religious beliefs are associated with harmful outcomes such as higher rates of depression and lower quality of life. To make sense of all of this, the American Psychological Association sat down with professor of psychology at Bowling Green State University and an expert on the psychology of religion and spirituality, Dr. Kenneth I. Pargament. According to Pargament, if people perceive God as have a loving, kind disposition, they seem to experience psychological benefits; However, we also know that the God of Abrahamic religions has a darker reputation. If a person tends to see God as punitive, threatening or unreliable, then that takes a negative toll on one’s health.

If one is willing to be open to the facts, one has to recognize that some beliefs do indeed threaten a person’s health. Let’s consider the idea that people are, right now, refusing medical treatment for themselves and for their children because of their deeply held religious beliefs. People will refuse to get 21st century medical treatment because it is either prohibited by their faith or because doing so would demonstrate a lack of faith in God, when instead, according to their faith, they should be relying on the Creator to answer their prayers. This idea opens up the whole libertarian can of worms of an individual's personal rights; but when minors, when children - who by the way, aren’t old enough to make informed decisions about many other choices in their lives - are needlessly suffering and dying because their care was left to the rational and ethical choices of their parents, this is an obvious threat to health and raises a far more interesting question.

The scope of this article attempted to explore how religious beliefs affect an individual’s health and well-being.How do religious beliefs affect human societies’ health and well-being? This sounds like a blog post idea for another day.
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[The Child Inside: How Your Childhood Affects Your Parenting]]>Fri, 30 Jun 2017 19:24:23 GMThttp://yourcouplestherapist.com/blog/the-child-inside-how-your-childhood-affects-your-parenting
By Robin Smith
​Updated 4:42 PM ET, Fri June 30, 2017

NEWS FLASH: Your Childhood Influences the Kind of Parent You Are

With the kids out of school, many families are going on vacations, sending their children to summer camp, and of course there are those families whose schedules don’t change a bit other than having to figure out alternative arrangements for childcare. For many parents, the summer months can actually bring on more stress around the house because of having to adjust to a different routine from the previous nine months. As a parent it’s important to recognize that’s it’s not just the adjustment itself that brings about a stressed out family, but indeed, how you as a parent respond to the stressors that are presented to you.
 
What could be triggering this response in you, you might wonder? Think back to your own childhood and how you felt around your parents when summer came along and you were rushing to the airport, or going off to camp, or sitting at home in a very unstructured environment. The experiences (good and bad) we had when we were children get brought forth and influence the way we parent. Often, when these experiences have not been fully processed they can lead to unresolved issues that influence how we respond to our own children’s behavior. And as parents, we are especially vulnerable during times of stress to act on the basis of our unresolved past issues.

Raising Healthy Children Begins With Self Care

Let’s look at the classic example of a mother who sneaks out of the room without saying goodbye because she didn’t want to hear her child cry at the separation. I hear about this happening all the time at pre-schools and daycares - and by the way, I will admit, I’ve rationalized doing this as well; I was wrong. The child’s sense of trust gets broken when they look around for their mother and they get upset at her absence. The child feels insecure, betrayed, and uncertain about when she will return. If it turns out that this resembles what you experienced as a child, separation experiences might be challenging for you in your role as a parent. Your own sense of abandonment might affect the decisions you make when leaving your own child.
 
When parents don’t take accountability for their own emotional baggage, they miss an incredibly important opportunity to further their own self-development and become better parents in the process. Our unresolved “stuff” gets in the way of responding to our kids in the ways they need us to. Instead we become stuck in our life story and the reactive responses from our past wins out. We seemingly forfeit our ability to choose how we respond to our children when our limbic system hijacks the higher order neocortical processing of the brain.

What You Can Do Right Now

Keep a log tracking your emotions – you can do this daily or weekly whatever works best for you. Whenever there is an event that rubs you raw, pay attention and notice where in your body you feel movement. Observe what thoughts begin to bubble up into consciousness. There is no need to change your response at first, just practice strengthening your awareness muscle. You may notice that there are certain behaviors that your child engages in that are more likely to trigger these emotional reactions. Take note of these patterns and write them in your log. Being mindful of your thoughts and feelings is a crucial first step towards growing with your child, and becoming the parent you want to be.
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[Is Our President Actually a Tyrant?]]>Wed, 31 May 2017 21:36:27 GMThttp://yourcouplestherapist.com/blog/is-our-president-actually-a-tyrant
By Robin Smith
​Updated 2:32 PM ET, Mon June 5, 2017

How Can Democracies Fail?

After listening to an episode of The Waking Up Podcast with Sam Harris, I felt compelled to share the important message that his guest Timothy Snyder was speaking on. Timothy Snyder is an American author, historian, and professor at Yale University whose latest book On Tyranny: Twenty Lessons from the Twentieth Century is becoming more and more relevant, especially if you’re an American. Snyder argues in his book, “We have to spread out our political imagination and have a broader sense of what’s possible. The danger is that we just go day by day and then every day seems normal, even if today is much worse than yesterday; We’re very good at getting used to today, and then tomorrow the same thing happens.” This article will give you a taste of what Snyder’s book is all about. Can our democracy’s constraints contain our President? And, what can we do to make sure those constraints *do* contain our President?
Americans today are no wiser than the Europeans who saw democracy yield to fascism, Nazism, or communism in the twentieth century. One advantage is that we might learn from their experience. Now is a good time to do so.

​One of Trump’s populist messages on the campaign trail was very effective in resonating with people who have been struggling to make ends meet or find employment. Trump convinced his voters that globalization was one of the most important problems of the 21st century that needed to be addressed. Many Americans felt themselves the victims of globalization. Politicians from the 20th century, especially in the fascism and national socialism movements willingly ignored the inherent complexity of globalization and instead would attempt to simplify the challenges by blaming a particular group for these problems. Trump is doing the same thing. We've seen a similar reaction to globalization. The problem as Trump sees it is that globalization has a face, a Chinese face, a Mexican face, a Muslim face. So rather than addressing the multifaceted challenges of globalization, Trump has us chasing after the supposed members of these groups. The Muslim ban gets us into the habit of seeing Muslims as a source of our problems. The VOICE program gets us into the habit of denouncing our neighbors. You know the George Santayana quote, “Those who cannot remember the past are condemned to repeat it.”

Do Not Obey in Advance

Most of the power of authoritarianism is freely given. In times like these, individuals think ahead about what a more repressive government will want, and then offer themselves without being asked. A citizen who adapts in this way is teaching power what it can do.

​Snyder says that this lesson is number one for a reason. At the very beginning, authoritarian leaders require consent. The people have the power to resist, at the beginning. If you blow lesson 1, then you can forget about the rest, because if you can’t do "Don’t obey in advance", then the rest will become impossible, because the rest will seem psychologically senseless to you. If you normalize and drift, things which would have seemed abnormal to an earlier version of you, will start to seem normal now, and the point to start doing anything will never seem to come. You’ll keep saying, “tomorrow, tomorrow, tomorrow,” and in fact, internally you’ll just be adjusting, adjusting, adjusting, and psychologically you become a different person. Synder says that, “In America, in Spring/Summer of 2017, if you’re doing nothing, you’re actually doing something. You’re helping regime change come about.”

Defend Institutions

Institutions do not protect themselves, they fall one after the other unless each is defended from the beginning.

​Snyder uses Nazi Germany as an example and points out an editorial from an Austrian newspaper in 1933. From the perspective of German Jews, “We do not subscribe to the view that Mr. Hitler and his friends, now finally in possession of the power that they have so longed desired, will implement the proposals circulating in Nazi newspapers. They will not suddenly deprive German Jews of their constitutional rights, nor enclose them in ghettos, nor subject them to the jealous and murderous impulses of the mob. They cannot do this, because a number of crucial factors hold powers in check, and they clearly do not want to go down that road. When one acts as a European power, the whole atmosphere tends towards ethical reflection upon one’s better self and away from revisiting one’s earlier oppositional posture.” Snyder comments on this piece of history, “Such was the view of many reasonable people in 1933, just as it is the view of many reasonable people now. The mistake is to assume that rulers who come to power through institutions cannot change or destroy those very institutions, even when that is exactly what they have announced they will do.”

Beware the One-party State

The parties that remade states and suppressed rivals were not omnipotent from the start. They exploited a historic moment to make political life impossible for their opponents.

​Snyder points out the story that Americans tell themselves that we’ve had democracy for 200 years, and we’ll just keep having democracy. Really democracy is as old as the Civil Rights Act, and we've been drifting away from democracy since then. Allowing unlimited money into politics, gerrymandering, and voter suppression laws have chipped away the visage of a true democracy in our country. 31 out of the 50 State Houses are Republican because gerrymandering has become so unsettlingly precise. Snyder argues in this lesson that when we slip into a one party system it’s not just unhealthy for democrats, but it’s unhealthy for Republicans, and above all, it’s very hard to get out from under that again.

There is so much more to expand on here. If you've enjoyed this article, I highly recommend you buy the book. It's more of a booklet; you could read it in an hour or so.
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[Reduce Stress in Your Life: It Just Takes a Little Practice]]>Sat, 29 Apr 2017 19:55:12 GMThttp://yourcouplestherapist.com/blog/reduce-stress-in-your-life-it-just-takes-a-little-practice
​By Robin Smith
​Updated 4:32 PM ET, Sat Apr 29, 2017

What Is Mindfulness Meditation?

As April comes to a close, we raised our collective awareness of Autism, Sexual Assault, and Child Abuse Prevention here in the United States. April is also Stress Awareness month, and it could certainly be said of all awareness months, that we shouldn’t limit our acknowledgment of these causes or issues to just one month. And of the many things in our lives that contribute to or compromise our well-being, stress is an incredibly pervasive and potent adversary. That is why I feel no hesitation or regret from piling on to the mountain of articles, blog posts, and books that make the case for mindfulness meditation as an effective tool to mitigate stress. If you have no idea what I’m talking about, don’t worry, because you are in good company. Here in the U.S. only about 6% of the population practices meditation according to the 2012 NHIS Survey. Mediation is on the rise, and for good reason. 
Couples who practice mindfulness have a higher ability to identify their emotions and communicate them to their partner in more functional ways that de-escalate conflict. These couples are simply less angry and less anxious.
Mindfulness practice is beneficial for both therapy clients and therapists. I actually didn’t begin to practice mindfulness until I began training as a psychotherapist. Research on mindfulness mediation has revealed its benefits:
  • Reduced rumination
  • Boosts to working memory
  • Improved focus
  • Less emotional reactivity
  • Increased cognitive flexibility
  • Enhanced self-insight, morality, intuition, and fear modulation
  • Reduced stress
  • Higher relationship satisfaction
Source: APA Journal Psychotherapy 2011, Vol. 48, No. 2, 198 –208
 
While there are many good reasons to get into the practice of mindfulness mediation, for the purposes of this article, we’ll focus on how it strengthens our ability to reduce stress.

How Does the Practice of Mindfulness Meditation Protect Us from Stress?

Mindfulness is the practice of self-observation. When glance at the phenomena of consciousness, the thoughts, sights, sounds, and other body sensations that are experienced within us, we are neurologically disengaging automatic pathways that would otherwise disrupt our present moment input. Have you ever been lost in thought? Yea, that’s the stuff I’m talking about here. When we are mindful, we are no longer lost in thought, but rather clearly aware of any present sensations that arise in consciousness. And this way of thinking helps us to be less emotionally reactive, and respond to negative situations with a faster recovery to our baseline calm state of being.

Regular mindfulness practice (*after just 8 weeks) can alter the ways in which emotions are processed in the brain. Many mindfulness practitioners have quite literally changed the neural architecture of their brains, and this allows them to cope with stress in more adaptive ways. As a marriage and family therapist, this is particularly evident to me with the couples I treat in therapy. Relationship stress is simply a subcategory of overall stress. Couples who practice mindfulness have a higher ability to identify their emotions and communicate them to their partner in more functional ways that de-escalate conflict. These couples are simply less angry and less anxious.
*Premed and med students reported less anxiety and depression symptoms after taking an 8-week mindfulness based stress reduction training compared to the control group.

Staying in the Present Moment

When we are focused on the present, we can’t also be focused on the past. Mindfulness works because it shuts down brain activity associated with rumination. It shuts off activity associated with thinking about possible realities that haven’t happened yet. Practicing mindfulness for just 10 minutes a day can have profound beneficial effects on your life. There are many guided mediations out there, videos on YouTube, and apps that you can download on your device that make it easy to practice mindfulness wherever you are. If you decide to begin, or start again with your mindfulness practice, I suggest you do it at the same time of day each day. And it’s even more likely to become a habit that sticks if you do it in the same place, at the same time, each day. One unforeseen benefit I have personally experienced, in addition to stress reduction, is that knowing how to be mindful affords me the ability to never feel boredom again. That alone is life changing.
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[Retraining Your Brain for Improved Sleep: Part 2 - Good Habits Consistently]]>Thu, 30 Mar 2017 17:09:51 GMThttp://yourcouplestherapist.com/blog/retraining-your-brain-for-improved-sleep-part-2-good-habits-consistently
Make Lifestyle Changes for Improved Sleep
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By Robin Smith
Updated 12:24 PM ET, Fri Mar 31, 2017

STOP: Read Part 1 First and Then Come Back to This Page

Now that you understand how the Wake-Sleep system functions and you've downloaded your Sleep Diary, it's time to learn about healthy sleep habits and what you can do right now to begin the process of retraining your brain for better sleep. Notice that the Sleep Diary is for 6 weeks. Retraining your brain for improved sleep will not happen overnight. You will need to commit to practicing these good habits throughout the next 6 weeks, and then you can personalize which habits you feel were helpful and worth keeping as life long habits.

The 20-20 Rule: 20 Minutes in Bed, 20 Minutes Away From Bed

This is one of the most important habits for retraining your brain and it addresses stimulus control. As mentioned in Part 1, people who get poor sleep have associated their bedroom and bed as a place where they can expect to struggle falling or staying asleep. The 20-20 rule is simple in theory, but an ordeal in practice, and it works! When you get in bed, it is fine to spend anywhere from 10-20 minutes engaging in a relaxing activity. After about 20 minutes you'll want to turn the lights out. Once lights are out, the 20-minute countdown has begun. You now have 20 minutes to fall asleep (remember, do not clock watch). If you have not fallen asleep within 20 minutes, it is now time to leave the bed, and leave the bedroom. Yes, you read that correctly.
Improve sleep by changing your habits
Staying in bed to toss and turn will only further associate the bed and bedroom as a place of stress. You must now spend 20 minutes away from the bedroom to engage in a relaxing activity in darkness or in low lighting, no blue light from screens! I prefer to listen to a guided meditation for 20 minutes, but find whatever is right for you. Even if you feel drowsy after the first 10 minutes outside of the bedroom, you are not to return until the full 20 minutes are over. This is when the clock restarts and you now have another 20 minutes to fall asleep. Repeat this step for as long as it takes until you are asleep. Yes, it is an ordeal, but it works. You will no doubt be tired the next morning, and just as any other poor night's sleep, it is important to make up for lost sleep by catching a nap anytime during your day so long as it is before 1pm, and so long as it is no longer than 30-minutes. Once you're over the 6 weeks of "retraining mode" it is fine to nap later than 1pm, in fact, the ideal time to nap is around 2pm-3pm after lunch. But while you are retraining your brain, do not nap after 1pm or else you are delaying the time that your Wake System will wind down, and therefore, delay when your Sleep System is gearing up.
Even if we get stressed out during our workday, the remaining cortisol levels in our bloodstream can affect our ability to relax at night time, which can be disruptive to our sleep.

Change Your Negative Thoughts About Sleep

For many people, one of the things that gets in the way of falling asleep is turning off the mind. Do your thoughts race when you turn out the lights? Do you think negative thoughts about not sleeping, or perhaps how you will feel or perform the next day because you aren't getting the recommended 8 hours? It will reassure you to know that this 8 hour rule is a myth! For a more in-depth understanding of this, read The myth of the eight-hour sleep. In fact, getting 6-7 hours of sleep each night, instead of the standard 8 hours may lead to a longer life. Many sleep experts agree than at minimum, getting 5 - 5.5 hours of sleep is "enough" to function the next day. Knowing this can help (if you'll pardon the pun) put to bed the concerns or negative thoughts that "I won't be able to function tomorrow at work." Letting go of the 8 hour sleep myth, and reassuring yourself that 5 hours will be "good enough" can be powerful cognitive tools to help you relax and catch Z's.

Improve Relaxation Skills for a Better Night's Sleep

It is helpful to practice relaxation skills throughout the day and night time. Here's why:
  • When we're stressed, the hormone cortisol enters the bloodstream and can stay in the bloodstream for many hours
  • This means that even if we get stressed out during our workday, the remaining cortisol levels in our bloodstream can affect our ability to relax at night time, which can be disruptive to our sleep
  • Practicing relaxation skills throughout the day will help to regulate cortisol levels in the body; Practicing relaxation skills at night will help the body and mind to fall asleep more easily
Progressive muscle relaxation exercises can do wonders to mitigate the impact of stress on the body. Tension-relaxation exercises leave the body feeling a wave of relaxation that can run from head to toe.

Make Lifestyle Changes For Improved Sleep

There are many different options to make adjustments to one's lifestyle to improve their quality of sleep. Often times when we are making changes, it can be helpful to start small and choose something that you feel you'll be more likely to follow through with. Choose any from the following list:
  • Set a regular sleep-wake schedule (even on weekends)
  • Avoid alcohol close to bedtime
  • Finish eating dinner 2-3 hours before bedtime (and restrict liquids close to bedtime)
  • Avoid caffeine at least 6-8 hours before bedtime
  • Avoid activities that will arouse you before bedtime (arguing, paying bills, etc.)
  • Avoid medicines that may disrupt sleep
  • Establish a regular routine of relaxation before bedtime
  • Avoid exposure to bright light before bed time (use blue light filters if you must use screens, and set the lighting to low)
  • Regular cardiovascular exercise will help you get a better night's sleep, so long as it is done at least 3 hours before bedtime
  • Make sure your bedroom is dark, cool, comfortable, and quiet (to the extent that you can control this)
It is strongly recommended that you consult your physician first to make sure you understand the cause of your sleep problem and treat it appropriately. The importance of sleep cannot be overstated. Sleep deprivation for just 6 weeks can lead an otherwise healthy person to develop clinically significant depressive symptoms. A good night's sleep is a vital part of a healthy lifestyle. It is my hope that you found some use in this article. Good luck catching those Z's!
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[Ask an MFT #1]]>Wed, 01 Mar 2017 02:47:23 GMThttp://yourcouplestherapist.com/blog/ask_an_mft_1
By Robin Smith
Updated 10:05 PM ET, Tue Feb 28, 2017

Ask an MFT #1

Ask an MFT is an opportunity to answer questions from my followers on social media who would like some insights into the world of marriage and family therapy on many different topics. As I begin this platform, I want to reassure my readers that their identities are protected. While I get many questions, not all of them are useful for the general public so I can only respond to a select few each time. Ok, let’s dive in!
 
Q: What do you recommend I do about my wife’s drinking problem?
 
Robin: There are many things to consider here, and of course, many unknowns. I should probably start by saying that there are specific licensed professionals who specialize in drug and alcohol counseling, and I am not one of those. Having said that, the first question I would have is, does your wife see her drinking as problematic?
If she’s not there yet, there are still things you can do to support her. You can stop buying alcohol. You can stop drinking alcohol (at the very least, stop drinking while you’re around her). You can attend support groups that are just for the family members of people who struggle with addiction.
 
If she does admit that she has a problem, it can be helpful to have her join a support group such as AA or call a drug and alcohol treatment center in your area. There are fabulous programs that are aimed at helping the individual learn how to manage their addiction and begin their journey of recovery.
 
Q: What is the secret to a long and lasting marriage?
 
Robin: I’m afraid there is not one secret. Sorry! There are however, key traits that couples who are in long lasting and satisfying marriages have in common. For instance, the couples who stay together and are truly satisfied in their relationship tend to:
-Have a strong friendship with one another in which they feel emotionally secure to share anything with one another.
-Depend on and rely on their partner, and know that even when things go wrong, they give their partner the benefit of the doubt.
-Identify when a disagreement is starting to become a fight in the very early stages and slow down their communication process to listen for understanding before interrupting with a solution or rebuttal
-Make daily efforts to connect and share appreciation for one another
-Have clearly defined roles in their household for who will do what
-Have a solid understanding of what their partner’s life goals and dreams are
-Have a way to deal with stressors outside of the relationship such that these stressors do not “split up the team mentality” of the couple
-Create and maintain rituals of connection for real intimacy, romance, passion, and of course, great sex
 
As this is the first official Ask an MFT post in what will undoubtedly be a long running series, I’m afraid these two were the only ones that qualified with regards to my criteria for responding. Keep your questions coming!
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[How To Listen During Conflict: Tips From a Couples Therapist]]>Wed, 01 Feb 2017 02:52:28 GMThttp://yourcouplestherapist.com/blog/how-to-listen-during-conflict-tips-from-a-couples-therapist
How To Listen During Conflict
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By Robin Smith
Updated 10:21 PM ET, Tue Jan 31, 2017

Listening, It’s Not as Easy as You Think

What do couples who come to therapy often fail to do in the beginning of their treatment? Most couples therapists will tell you that 95% of their cases involve couples who are looking to improve their communication. As a therapist, it is my job to see what it is that the couple cannot see, that they have a pattern of communicating that ends in hurt feelings, gridlock, and/or withdrawal. My job is to see this, and help the couple see it, and get them to see what it is that they are doing that contributes to this negative pattern, and then change it. Easier said than done right? That’s why they pay us the “big bucks.”

So what do couples who end up in therapy often fail to do? In my 5 years of experience, there are general trends that I’ve noticed, and most paths lead to a failure of expression of needs. We are taught how to ask for what we need (or not ask) in our family growing up. Many times a partner will criticize, or verbally attack their partner which leads to hurt feelings, defensiveness, counter attacks, or withdrawal. Underneath this exchange was an important need that wasn’t getting met. The key here is to recognize what it is that we are needing from our partner, and then express it in a clear and direct way using language that will not put our partner on the defensive.
Why Is It So Hard to Communicate?

Why Is It So Hard to Communicate?

One of the most nefarious culprits that sabotage important couple conversations is threat. This threat that we experience can occur when our partner says something that we interpret as cutting, or disparaging, or blaming, or distancing. When we feel threatened, our heart rate changes, our breathing changes, stress hormones begin pumping into our blood stream, and the beautiful human body system that evolution has given us takes its course. What do we need to know or do when this happens? There are cognitive and physiological answers to this question. For the scope of this article, I’m going to focus here on the physiological interventions one can use.

Belly Breathing, aka, Diaphragmatic Breathing, aka, Deep Breathing, is a technique that can prove effective at keeping ourselves in the conversation and able to have the conversation that needed to happen instead of the fight that buried it. When I ask my clients to use this technique, I remind them not force it, even though they are doing something new, and it will take some conscious control, it is still important to allow the breath to come naturally. When we can engage this technique, we can reverse the effects of stress on our body and on our thinking, and consequently on our role in the conversation.
I am so happy to see Sesame Street is teaching the next generation this important skill!

Notice, Breath, Express

We first must be aware that we are becoming dysregulated in our breathing. Sometimes it can be helpful to pay attention to the temperature of our cheeks and/or forehead, if calf-muscles or shoulders are tense, odds are we are in “threat mode”. Some people who would prefer to not go into their body this way can choose to pay attention to their thoughts. Perhaps they notice that their mind is racing, or looking for the partner’s opportunity to “pounce.” This can clue us into our selves being dysregulated.

Once we notice that we are tense, or beginning to feel emotionally threatened, we can then engage in this technique. Here’s a video of how it’s done:
After we’ve rediscovered the safety of feeling more grounded and centered in our thinking, and after we feel calm to participate in this conversation, now it’s time to express feelings and needs. One helpful tidbit, is that before we express our own feelings and needs, it can be helpful to FIRST reflect back what we see and hear our partner saying, and listen for the feelings and needs in what they are saying. This might sound something like this:

Susan: “All you want to do is spend time with your friends, it’s like you’ve forgotten that I’m even here.”

Oscar: “I can see that I’ve really upset you by making these plans. I think I’m hearing that you feel shut out, or maybe even ignored by me, that I’m making others a priority, or putting my friends first. I never meant to hurt you. I guess this conversation means we aren’t spending enough quality time together.

 
Oscar is validating Susan’s feelings, and listened for her unmet need – “I don’t get enough time with you.” Even if Oscar may have thoughts of getting defensive, or is tempted to fight back and talk about how unreasonable Susan is being, this way of listening and reflecting back what our partner is saying can do wonders to any relationship. Once Susan feels that Oscar fully understands where she is coming from, then she will likely be more receptive to Oscar when he expresses his feelings.
 
Of course this is merely a fictional example, and your relationship might benefit from speaking to a trained professional. For more information, I'd recommend beginning at our Frequently Asked Questions page.
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[Bringing Baby Home: What Pregnant and New Parents Must Know to Build a Healthy Family Together]]>Thu, 15 Dec 2016 15:41:06 GMThttp://yourcouplestherapist.com/blog/bringing-baby-home-what-pregnant-and-new-parents-must-know-to-build-a-healthy-family-together
By Robin Smith
Updated 7:36 PM ET, Thu Dec 15, 2016

You Never Knew You Could Be So Vulnerable

The adjustment that happens when couples transform into parents can be joyous, exciting, and stressful all at once. Neither parent has any clue as to how much work this is going to be no matter how much they try to prepare. Loving this newest little member of your family brings about many emotional and psychological changes. Life goals, values, and priorities shift for new parents. Couples have a new focus of what it means to be a team. And through all of the crazy making, it's important to remember that with this adjustment comes normal responses to stressors. Responses from each new parent such as:
  • Increased stress
  • Increased couple conflict
  • Feeling more irritable (more frequently)
  • More fighting, miscommunication, and hurt feelings
​This barrage of new emotional experiences, both positive and negative, can overwhelm any relationship and drive new parents apart from one another. Expectant and new parents learn so much in preparing for this time, and once they bring their baby home, they need to know what to expect. It's crucial for new parents to learn about what changes will take place, and how to best lay the foundation for a strong relationship which will grow a strong and healthy family for this little one, as well as any siblings that might come along.

John Gottman and his team of researchers have been studying more than 3000 couples since the 1970's, some of whom have been followed for 12 years or longer. The team was able to collect data on couples who were becoming parents, and if you're about to become a new parent, or have just recenty given birth, you are going to want to read on.

​What Does the Research Say About the Transition to Parenthood?

Over 4 million babies are born in the U.S. each year. While this is an exciting time, research shows that within three years after a couple brings baby home, approximately two-thirds of these new families will experience a significant drop in relationship quality and will have a dramatic increase in conflict and hostility. Many mothers experience baby blues and other postpartum mood disorders. This can lead to a severely compromised co-parenting team and a decreased quality in the couple’s relationship. 

Half of all relationships break up in the first seven years. Why? When Gottman and his team studied young couples from the newlywed period through the transition to parenthood they discovered that most of these breakups were because couples became parents. The Gottman group's research showed four common trends among couples when they become parents:
  1. There is a Profound Philosophical Shift - Identities change, roles may become more traditional, views on work, finances, and faith change.
  2. Relationships Change - Conflict increases in the first year after baby arrives, sex and intimacy decline dramatically, communication between partners decreases or becomes more stressful.
  3. Some Fathers Withdraw - This adjustment can lead to withdrawal from mom, from family responsibilities, and from baby; Some dads feel like they need to spend more time working, leading to feeling resentful and some moms to feel like they are parenting alone.
  4. There are Physical and Psychological Changes - Sleep deprivation and exhaustion can make both parents depressed; Parents report increase in stress; Sexual desire may decline dramatically and stay low throughout the first year; Changes in roles, values, and identity can cause a psychological adjustment which for some leads to emotional withdrawal – for others, an increased neediness.

The Greatest Gift You Can Give Your Baby Is a Strong Relationship Between You and Your Partner

Like most couples who are expecting a baby, you want to be good parents and provide the best for your children. However, when such a strong focus is placed on your baby, it can be easy to forget about the importance of the relationship between you and your partner. The Bringing Baby Home Workshops, were created by the Gottman Institute to help these very couples who are about to become, or who have just recently become new parents. These new parents who master the skills and apply the knowledge taught in these workshops are more likely to have a good, satisfying relationship that lasts, which is the foundation for their children's positive emotional and social development as they grow.

These workshops are offered throughout the U.S. and other countries as well. If you happen to live in the D.C. Metro Region, and are interested in upcoming workshops check out the D.C. Area workshop listings here. For a complete list of upcoming workshops throughout the U.S. and beyond, visit the workshop listings here.
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[A November to Remember]]>Wed, 30 Nov 2016 15:03:52 GMThttp://yourcouplestherapist.com/blog/a-november-to-remember
By Robin Smith
Updated 11:40 AM ET, Wed Nov 30, 2016
Disclaimer – Psychotherapists tend to strongly recommend against publishing an article of this nature, due to the fact that it could impact the therapeutic relationship with current clients. Having already disclosed publicly on my professional blog where I stand on certain social and political issues, if a client reads this article and wishes to bring it up in our work together, that would be more than welcomed. The views expressed here transcend professional codes of ethics, and tap into a deeper moral and humanistic code of principles. 

​Through the Looking Glass

After taking a month and a half off from blogging, as much as I wanted to do a piece on the Transition to Parenthood, or on my continuing series of Retraining Your Brain for Improved SleepI have to address the 6’ 3”, 236 lbs elephant in the room. On Nov. 8, 2016, the people of our country spoke and elected Donald Trump as the 45th president of the United States. Yes. That happened. It’s the end of November and I am still digesting this news. As a political junkie, I’ve downloaded, watched, and listened to countless programs and interviews from many of the major networks, podcasters, and other cultural commentators; And yet, I am still digesting this.

​On the eve of the election, I knew history would be made. Through all of the polls and talking heads, through all of the scandals and weekly WTF-moments, through behind-the-curtain conversations indicating that even Trump himself was not expecting to win, this election still had "un-bubbled" liberals earnestly being afraid that Trump 
would win. And they turned out to be right.

The Whole World Is Watching

The Donald had made no investments in a transition team – apparently he is superstitious and didn’t want to jinx things. The more likely reason, in my opinion, was that he wasn’t expecting to win, so why bother. Historically throughout the primaries and the general election season, the President-elect has behaved in ways that would indicate that he really did not want the job. Donald Trump’s M.O. is today, as plain as it ever was, “Say and do things that will enrich me and my family; Say and do things that will get people to pay attention to me.”
 
Well, you have the entire world’s attention Mr. Trump. And you are apparently not backing down from any ethical conflict of interest in your new role as President-elect given your international holdings and assets. You are poised to enrich yourself and your family, as a presidential win will, no doubt, increase the value of your brand abroad since your name is now synonymous with the greatest superpower in the eyes of the international community.

"And to all of the little girls who are watching this..."

On Wednesday morning when Hillary Clinton delivered her concession speech, my dumbfounded countenance was finally pierced by the sadness induced after hearing her say, “And to all of the little girls who are watching this, never doubt that you are valuable and powerful and deserving of every chance and opportunity in the world to pursue and achieve your own dreams.” I shed tears listening to this, holding my 1 year and 4 days old daughter, because this message had to be delivered in the wake of a campaign filled with misogyny among other forms of bigotry.
 
If I were a youth after this election outcome, I may very well have been caught up in the marches, and protests joining in the chorus, “Not my president”. But I am compelled to follow the examples of those who have tasted defeat after so many other elections. I am compelled to listen to the political elders and role models of our democracy. President-elect Trump deserves a chance to lead. And if I look in the mirror and call myself a true patriot, then I want Trump to succeed. I want him to be a good president. A great president. *The greatest president there ever was*. That doesn’t sound a little like a textbook grandiose narcissistic self-statement does it? And oh yea, the previous sentence was carefully worded, because while MFTs don’t have to follow the Goldwater Rule, we do still have Professional Opinions (7.8 in our Code of Ethics). But based on Trump’s judgment so far, in whom he has picked to fill cabinet positions, I am not holding my breath.
 
Donald J. Trump, a reality T.V. Star, a demagogue, a con-artist (the likes of which our country hasn’t seen since the days of Joseph Smith Jr.), an Internet troll, a misogynist, will be our president. The same country that elected the first African American president also elected the man who attempted to delegitimize Obama’s presidency through the “Birther Movement”. The man who has electrified white nationalists from sea to shining sea, who chose Steve Bannon as his chief White House strategist, will be the 45th President of the United States. This man will likely appoint several justices to the Supreme Court and could shift the bench for a generation. Vice President-elect Mike Pence, a heartbeat away from the 70-year old cyber bully, is a climate change denier, believes in gay-conversion therapy (much much more on this later), and is one of the most anti-abortion politicians to date.

The Times They Are a Changin'

It would seem, that as fast as this country has been shifting on social issues, it is shifting just as fast (perhaps faster) in the opposite direction. This election has awoken a sleeping giant. New political activists that were silent or passive on the sidelines are now being galvanized to protect the values and principles this country has evolved to embody – the Civil Rights movement happened. It cannot and will not un-happen. Donald Trump lost the popular vote by over two million votes. The majority of the country (who voted) was in support of what Hillary stood for (or against what Trump stood for).
 
Get active. Get involved with your local levels of government. Or, at the very least, donate to organizations that fight for the values that you want represented in your constitutionally limited representative democratic republic. Given what's being threatened by the incoming administration, here's a good starting point:
Center for Reproductive Rights
Mexican American Legal Defense and Educational Fund
NAACP Legal Defense Fund
Natural Resources Defense Council
Planned Parenthood
ProPublica.org
Sierra Club
Southern Poverty Law Center
The International Refugee Assistance Project
The Trevor Project
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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<![CDATA[What We Can Learn From World Mental Health Day 2016]]>Mon, 10 Oct 2016 07:00:00 GMThttp://yourcouplestherapist.com/blog/what-we-can-learn-from-world-mental-health-day-2016
By Robin Smith
Updated 12:07 AM ET, Mon Oct 10, 2016

World Mental Day - October 10th, 2016

Today is October 10th, which means we, the global community, are celebrating our 24th annual World Mental Health day. World Mental Health day was first put on by the World Federation for Mental Health (WFMH) in 1992. This is a day for mental health education, awareness, and advocacy for the entire international community of which we are all a part. Indeed it is also a day, as the World Health Organization says, "for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide."
 
I’d like to focus less on my work, and more on my general outlook and philosophy on mental health care in society. We’ve got some serious work to do. This year’s theme,  ‘Dignity in Mental Health (DIMH): Psychological & Mental Health First Aid for All’, a campaign to eradicate the stigma and taboo that has surrounded mental illness for hundreds of years. Sure, we’ve come a long way since the mentally ill were thought to have demons in their heads, where the ancient medical professionals of the time would perform trepanation interventions, drilling holes into the skulls so the spirits could leave the 'possessed'. Our understanding of mental illness has come far certainly; and we need to go further in education and creating awareness. We all have a role to play in removing the stigma of mental health, and it starts with normalizing it.

The Power of Permission Giving

Imagine for a moment, you’re at your annual physical, and upon completing the examination, the doctor says, "You’ve screened positive for illness x." You’re feeling alarmed at this news, but then the doctors says, “This is quite normal, about 40% of the general population develops illness x in their 30’s.” Chances are you’re likely to feel more optimistic and even open about talking to others about this illness. It's as if you've been given permission to be this way, for the time being. If, on the other hand the doctor had said, “I’m afraid only 1 in 10,000 Americans develops this form of illness x,” you’re bound to worry more, feel less optimistic about your outcomes, and likely not talk about it with anyone. Bottom line, we need to normalize how common mental health disorders are. The more we talk about them, the more social connection and social support those who struggle with mental disorders will have. Furthermore, stigma, discrimination and lack of awareness often prevent people from accessing the support they need.
 
Some stats: 
  • Every 40 seconds somebody somewhere in the world dies by suicide, and the young are disproportionately affected. 1
  • Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population. 5
  • At least one in four adults will experience mental health difficulties at some time and there is nobody who has not had direct contact with somebody experiencing psychological or mental health difficulties. 1
  • According to the World Health Organization, ‘if we don’t act urgently, by 2030 depression will be the leading illness globally.’ 2
  • The U.K., the E.U. and the U.S. report findings that between 15-30% of their working populations will battle some form of mental health problem. 3

Why Mental Health Literacy Matters

We as an international community will have a far greater reaching impact by engaging societies at all levels, including domains such as:
  • Health policy
  • Social policy
  • Taxation
  • Employment
  • Urban planning
  • Education*
As with many issues that I’m passionate about, I come at this from an *educational perspective – promoting mental health literacy within the family, as well as within child-care, pre-school and school settings. As a marriage and family therapist, perhaps I am biased in believing that change begins with the parents of the next generation. In fact, the beginnings of mental health are “born” during pregnancy and the first years of a child’s life. One of the core objectives of the WFMH is to promote mental health literacy, including "socio-emotional skills, coping skills and stress management skills."

Physical Education vs. Mental Health Education

Let’s take a moment to compare how our society treats physical education contrasted with mental health education. Think about P.E. in the public school curriculum. Around the mid 19th century Germany, Sweden, and England influences the development of P.E. in the U.S. In 1866, California becomes the first state to pass a law requiring twice per day exercise periods in public schools 4. In the early 20th century different camps debate over why P.E. is important, “[contributing] to the physical well-being of children, as well as to their social, emotional, and intellectual development” (Thomas Wood and Rosalind Cassidy), versus, “[emphasizing] the development of skills and the maintenance of the body, [being] the primary objective” (Charles McCloy) 4. More recently, C Edwin Bencraft (1999) offered the following benefits of P.E.:
  • "Challenging motor tasks before the age of ten can increase cognitive ability due to a heavier, more dendrite-rich brain."
  • "Aerobic exercise improves cognitive functioning by increasing the number of capillaries serving the brain through the delivery of more oxygen and glucose and removal of carbon dioxide."
  • "Cross-lateral movements increase the communication ability between the brain's hemispheres."
  • "Physical activity reduces the production of stress chemicals that inhibit cognitive processing."
It seems as though as a society, we value P.E. for its “cognitive health” benefits, but are still failing to recognize the benefits of having formalized mental health education - in addition to intra-familial mental health education. Now I realize that the educational curriculum is packed enough as it is. I’m not asking for M.H.E to be added to P.E., Music, and Art – though it would be nice (baby steps), but could we at least have periodic mental health education given to students at developmentally critical times? We talk to kids about sex in 5th grade, 8th grade, and 10th grade (or at least in my County/State we did). Why not talk to kids about mental health topics in public schools, in developmentally appropriate ways starting in Kindergarten through 3rd, 6th, 7th, 8th, and 9th grades. People who know a lot more than me can explore when and why certain ages would be optimal, but it has to start somewhere.

What We Can Learn From World Mental Health Day, and the Action Plan Moving Forward


Speaking of those who know best on this topic, the WFMH recommends we focus on doing the following:
  • We call on governments to make psychological and mental health first aid a priority to bring it in line with physical first aid
  • We all need to learn to provide basic psychological and mental health first aid so that we can provide support to distressed individuals in the same way we do in a physical health crisis
  • We should all address the stigma associated with mental ill-health so that dignity is promoted and respected and more people are empowered to take action to promote mental wellbeing
  • We should do our bit to spread understanding of the equal importance of mental and physical health and the need for their integration in care and treatment
  • The media should educate the general public on the need for psychological and mental health first aid and the importance of fighting mental health stigma and discrimination
  • We call on all employers to provide psychological and mental health first aid to their employees just as they do for physical first aid
  • We call on all schools and educational institutions to make psychological and mental health first aid available to their staff and students
Related Articles:
School Based Therapy
Every Bite You Take: Nutrition and Mental Health
Becoming a Father: "Babies Don't Come With Instruction Manuals" ... Or Do They?

References
1 World Federation for Mental Health. (2016). Dignity in mental health: Psychological & mental health first aid for all (Report No. 24). Occoquan, VA: World Federation for Mental Health.
http://wfmh.com/reports/2016-07%20WFMH%20DIGNITY%20IN%20MENTAL%20HEALTH.pdf
2 WHO Global Burden of Disease (2008): 2004 update. Geneva: World Health Organization. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf (accessed Oct. 9, 2016)
3 WHO Mental health and work: Impact, issues, and good practices (2000): 2002 update. Geneva: World Health Organization. 
http://www.who.int/mental_health/media/en/712.pdf (accessed Oct. 9, 2016)
http://toastpedanzy.weebly.com/pe-history.html
https://www.nimh.nih.gov/health/statistics/prevalence/any-anxiety-disorder-among-adults.shtml

Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to Your Couples Therapist Blog.
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