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?
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.
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:
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.
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 Sleep, I 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.
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.
Why Do People Get Poor Sleep?
Let me first say, I'm writing this article because I had insomnia. I no longer suffer from it. And I want to help others conquer their sleep problems, because let's face it, Not getting enough sleep makes our waking life much more miserable. So you aren’t sleeping well? Let’s talk about that. First off, you're not alone; Some stats:
So why do people get poor sleep?
If you’ve experienced any of these, chances are you’ve also worried about sleep loss, tried to “force sleep”, are stressed out, or have spent too much time in bed and therefore associated your bed with being awake and not being able to sleep. I'll talk more about stimulus control and how to succeed in making your bedroom a sanctuary for sleep later on.
Share This With the New (or Soon to Be) Dads in Your Life
Are you a new dad? Know a dad in your life, or perhaps someone who is about to become a dad? I know you've heard the expression before, "Kids don't come with instruction manuals." Everyone has advice to give about parenting. And you can certainly make yourself crazy trying to get as much of the most important and relevant information that will help you to be the best father you can be. Some of my favorite resources for new fathers (and mothers) will be included at the end of this article, but what I'm most eager to share with you has to do with raising emotionally healthy babies and children.
Full disclosure here, I have only been a father for about 10 months now, so I can only personally relate to the beginning of this journey. Last year before our daughter was born, I took the train up from Washington, D.C. to New York City for a training put on by The Gottman Institute called Bringing Baby Home. As a psychotherapist who is passionate about helping couples, families, and new parents making the transition to parenthood, this training was right up my ally. And with my first child on the way, this 2 day workshop couldn't have been offered at a more opportune time. I want to share with you what I learned, and how you (and your child) can benefit from the latest findings. As it turns out, there IS a manual! And one if it's most important teachings is that raising your child(ren) to become healthy, well adjusted people begins with your relationship with your partner.
What makes a person motivated to do something? This, it turns out, is a very complicated question to answer. I came across a somewhat thorough article in Psychology Today outlining the basic theories of motivation that I encourage all of my readers to skim through before continuing with this article. Come back to us after you've read Susan Krauss Whitbourne's article entitled Motivation: The Why's of Behavior - From instincts to self-actualization: What motivates us?
Ok, welcome back. Did you notice anything missing from that piece? How might we apply any one of those theories to the motives of a serial killer? A radical jihadist? Dr. Whitbourne comes close to mentioning a person's beliefs in her outline of Cognitive Theory where she talks about a person's expectations. But something missing in this equation is how a brain develops and what it is subjected to. How might a traumatic brain injury (TBI), or childhood abuse, or even adult onset mental illness influence what motivates us? I ask these questions because they directly relate to how a person thinks and what a person believes in the context of their behavior. A motive, by definition, is a hidden reason for doing something, and I would argue many times these reasons are hidden from ourselves; in other words, we are not conscious of why we are engaging in many of our behaviors. Now if this troubles you as much as it does me, then I invite you to read on.
Usually articles on habit formation appear around the New Year. I figured, why wait! After all, there's no rule that says you must stop or start a habit only after the new calendar year has begun. We all have old habits that we have tried to break, or new habits that we have tried to form, but they just didn't take. In this article, I will unpack the hidden forces behind what makes habit formation (or cessation) successful, and share some ways you can start to put all of this into practice starting today - or whenever you choose to begin. After all, it ultimately comes down to (the very real power of) choice. The good news is, it is never too late to form new habits!
How Habits Are Born
As with many things learned in therapy, one of the best ways to change something in your life is to first understand it's origin and it's purpose. A habit, by definition, is a behavior that occurs routinely, and more often than not, is occurring at the subconscious level. Habit formation begins with a triggering event that jumpstarts the brain into autopilot mode; For example, walking into the kitchen and before anything else is even consciously registering, the body gravitates towards the coffee pot. Next is the actual behavior, or the actual habit - the making of coffee. Finally, there is the reward that cements the formation of the habit - "Coffee gives me energy," let's say. Now remember, a "reward" is not necessarily good or bad. After all, we are "rewarded" by our bad habits too. That's why they have stuck around with us! In this context, we refer to the outcome as a reward because it increases the likelihood that we will repeat the behavior again.
After a week where many in the country are left shaking their heads, wondering why we can't seem to do a better job healing our country's long standing racial divide, the question lately being asked in this political season is, "Which presidential candidate will do a better job on this issue, Clinton or Trump?" Frankly, the question is aimed in the wrong direction. One president has not, and can not make the difference needed on this issue. Change must come from the greater society writ large, regardless of who we elect. Let's look to the very beginning of our country's founding to unpack this.
How Our White Forefathers Saw Blacks in a Burgeoning American Democracy
The original sins of inequality and discrimination were written into our country's very founding document, the Constitution, which sanctioned the enslavement of Africans through the three fifths clause and the fugitive slave clause. A little under a century later, the majority of our society (still predominantly white, thus enjoying the claim to the country's dominant culture) would still subscribe to the belief that whites were superior to blacks. Lincoln, who reinterpreted the document's phrase, "All men are created equal", who "emancipated" the slaves, still didn't think blacks and whites deserved the same social and political rights.
Robin S. Smith is a psychotherapist practicing in Bethesda, MD. Robin started Your Couples Therapist Blog to provide useful articles on issues related to mental health as well as articles on local, national, and international news stories. Learn more about Robin on the About Page.