By: Karen Weier MA, LLPC, NCC

When we first meet someone, who we think will be our forever person, we are intentional on developing a friendship with them. We want to get to know everything about them. Why does this intentionality, this desire to be friends, seem to fade after marriage or a commitment is made? Many couples, who walk through my office door, have stopped strengthening their friendship. According to Dr. John Gottman (1999), in his study and observation of habits that make and/or break a marriage, he has found that at the heart of a happy marriage is a deep friendship. Bolstering the friendship is so critical, Gottman explains, because it fuels romance, passion, and intimacy. Gottman (1999), in his book the Seven Principles for Making Marriage Work, explains seven basic principles that can help guide couples on the path to a long lasting and harmonious relationship. The first three principles allow couples to rediscover the friendship that brought them together, in the first place.
The first step, in helping couples rebuild their friendship, is to help them learn how to build love maps (Gottman, 1999). Love maps are a road map of your partner’s internal psychological world. It’s asking open ended questions, remembering the answers, and really paying attention to the details of your partner’s world. It involves remembering the major events in each other’s history and constantly updating this information as the facts and feelings of your partner’s world changes. This is also the time to periodically take your partner’s emotional temperature, asking “how are you doing, baby?” and really wanting to know, how they are doing.
The second step, in helping couples rebuild their friendship, is to help them build fondness and admiration, two crucial elements in a rewarding and long-lasting romance. This involves focusing on the positive habit of mind by looking for what your partner is doing right. It’s a time to express fondness, affection, and admiration, verbally and physically, which is done in small amounts, but often. When couples are able to express fondness and admiration it builds a culture of appreciation, respect, fondness, and intimacy (Gottman, 1999).
The third step, in helping couples rebuild their friendship, is to help them learn how to turn toward bids for connection, which builds trust and romance. Romance is kept alive each time you let your partner know that they are valued during the grind of everyday life. Partner’s make bids for connection, for attention, interest, excitement, humor, conversation, affection, support, or playfulness. You can either turn towards or turn away from your partners bid. When you choose to turn towards your partners bid you are building trust and an emotional connection (Gottman, 1999).
A deep friendship is at the heart of a happy marriage/relationship. Happy couples have mutual respect, for each other, they enjoy each other’s company, they are well versed in the likes and dislikes of each other, they share in each other’s hopes and dreams, and they express fondness and admiration, for each other, in big ways but through small gestures, day in and day out. Do you need help rediscovering or reinvigorating friendship with your partner? Our qualified therapists, at All Things Possible Wellness Center, desire to help you and your partner rediscover and strengthen your friendship, as you continue to build your life together.

Gottman, J. M. & Silver, N. (1999), The seven principles for making marriage work, New York: Harmony Books.

By: Tonya Rice MA, LPC

One evening, I entered one of the local bookstores in my neighborhood.  When browsing the shelves, I reached for a book titled “Nowhere but Up”, a memoir written by Pattie Mallette.  I began to read the first couple of pages of her book and she described a dream that she had. She wrote,

“One night I had a dream in which my job was to clean out every room in a gigantic house, which was made up mostly of bedrooms.  The bedrooms belonged to girls of different ages, from babies to teenagers, and were stuffed with clothes, garbage, and toys piled almost a foot high.  I was so overwhelmed by the task.  In the first room, I couldn’t do much more than clear a bit of space around my feet by shoving some of the stuff to the side.  So, I decided to go to another room and to try again.  It was more of the same.  I repeated this process in room after room, with the same result- all I could manage to do was clear a small space around my feet.  I was frustrated.  I didn’t have a clue how to start cleaning up.

As I stood there, unable to move, I heard a voice.  Instinctively, I knew it belonged to God.  “Go to the beginning of the house,” He said.

My dream self knew what I had to do.  I went to the first room of the house, the living room, and started removing every single object from the room.  I dumped everything outside- couches, lamps, rugs, tables, pictures, books- until the room was empty.  Then I scrubbed the walls clean, repainted them, and brought back in only the items I wanted.  One room was clean.  Now I knew how to go back and clean the rest.

When I woke from the dream and meditated on it, I saw a correlation between the house in that dream and the events of my childhood.  The different rooms represented me at different ages and the areas of my life I was trying to clean up or heal as an adult.  The simple instruction from the dream struck me.  Go to the beginning.”

This dream explains the process of counseling in such a clear analogy.  We need to “go the beginning”.  Counseling is also a lot like gardening.  When you weed a garden, you first start with digging to the root of the weed to prevent it from growing back.  At the beginning of my counseling career, I found myself frustrated.  I spent time working with people addressing surface issues without seeing much change.   Or the issues seemed to be addressed, but would quickly return.  That was when I recognized that unless you get to the root of an issue, it will be as ineffective as cutting leaves from weeds or chopping the visible portion of the weed off, only for it to continue to grow and take over the garden.  Getting to the beginning or the root of an issue is key to the cure of it.  Once you get to the root, you can uproot the weed and move on to the next one.  Once your garden is free of weeds, you can focus on replanting beautiful plants and flowers in their place.

To begin we need to identify what weeds are in your life.  Simply put, weeds are the surface issues in your life that lead you to seeking help. It could be a failing relationship, a lingering sadness that will not go away, worry, stress, conflicts with friends, feeling alone, anger, unsatisfied in life, pressure to perform, addiction, affairs, lying, shame, guilt, trouble sleeping, irritable mood, disappointment, discouragement, hopelessness, worthlessness, difficulty concentrating, overwhelmed with life, desire to divorce, not wanting to live, etc.  These are the initial reasons that lead people to coming into my office for counseling.  Many aspects of counseling focus on providing you with coping skills, conflict resolution skills, and positive self-talk.  These skills are techniques are very important and are helpful, however, they do not eliminate the problem and do not deal with the root/core of an issue.

In order to fully understand and recognize how to truly root out negative problems in your life we first must understand our minds.  Our minds are the foundation of where the journey begins.  Through counseling at All Things Possible Wellness Center, we strive to help you get to the root of your issues and lead a life that is enjoyable, fulfilling and peaceful.  It is my hope that you would consider counseling as a method that can help you to process through deep rooted problems in a comfortable, non-judgmental and safe environment.

By: Linnea Sieh MA, LLPC

The recent popularity of the Netflix show “13 Reasons Why” has brought the topics of suicide, sexual assault, and bullying to the forefront of the public eye. To many professionals, this show is concerning, due to the high levels of trauma shown and the refusal to discuss any mental health symptoms or treatments that could have helped the main character. Because it was marketed primarily for teens, some teens are watching this show and feeling overwhelming emotions with no one to safely discuss them with.

Suicide, especially, is a topic that can be frightening or uncomfortable to talk about with your loved ones. One misconception around suicide is that by talking about it, you will put the idea of committing suicide into someone’s mind. This isn’t true, in fact if you are considering asking about it, the idea is oftentimes already in that person’s mind. As a professional counselor, my job involves frequently asking these hard questions to adults and teens. While it is never an easy task, it is important to be up front about suicide, sexual assault, and bullying. All of these topics can be triggers for people already struggling with their mental health symptoms. Knowing where to turn for resources, both local and national, is an important step in understanding how to help people who are experiencing these thoughts. The following is a list of 13 local and national resources and ideas for anyone who may need mental health help:

1.    Help get the person to see a mental health professional. All Things Possible Wellness Center is one of the best options for mental health treatment in Macomb County. We can be reached at 586-213-5505, or on the web at https://allthingspossiblewc.com/. We are located in Clinton Township and accept most private and also Medicaid HMO insurances.

2.    Macomb County Community Mental Health: This agency offers mental health care for those with state insurance and those who have a low income. Substance use services are also offered here. They have psychiatrists, case managers, and therapists on staff. They can be reached at 586-948-0222, or on the web at http://www.mccmh.net/.

3.    Urgent Behavioral Health Care Center accepts anyone as a walk-in for mental health emergencies. They are located at 43800 Garfield Rd in Clinton Township, MI, and provide services 365 days a year and are open 24/7. They can be reached by phone as well at 586-466-6222.

4.    Harbor Oaks Hospital is a psychiatric facility for inpatient, partial hospitalization, and intensive outpatient care that is available in emergencies as well. They provide services for mental health care and substance abuse. They are located at 35031 23 Mile Rd New Baltimore, MI 48047. They can be reached by phone at 855-738-8198.

5.    In Oakland County, MI, people can call Common Ground at 800-231-1127 for access to 24/7 crisis counseling and for an access screening to receive information regarding mental health providers.

6.    Mental Health First Aid training. Many of the core, or state funded, organizations offer some type of Mental Health First Aid training for non-professionals looking to understand more about how to help someone in a crisis setting. Training and Treatment Innovations, Inc, in Oxford and Troy is one of the agencies who has a grant to teach these skills. They can be reached at the Troy office at 248-524-8801 for more information on current and future trainings.

7.    National Suicide Prevention Lifeline: This crisis line can be reached online at https://suicidepreventionlifeline.org/. They can also be reached by phone at 1-800-273-8255. The Lifeline is a network of local crisis centers and resources that can be accessed 24/7. There is also a live chat option on the website. In addition to this lifeline someone in crisis can text 741741 24/7 for help as well. This text is not answered by the NSPF but has also been found useful.

8.    This article from Amy Morin, LCSW, details some reasons why the show could be triggering for people experiencing suicidal thoughts or other mental health concerns. https://www.inc.com/amy-morin/13-things-parents-should-know-about-13-reasons-why-according-to-a-psychotherapis.html?cid=search

9.    The American Foundation for Suicide Prevention is another organization that has multiple resources for those involved in any way with suicide. The website also includes resources for how to talk to someone about their mental health called “Look Both Ways.”  https://afsp.org/

10.  SAVE: Suicide Awareness Voices of Education has a set of tips and talking points for anyone watching “13 Reasons.” https://www.save.org/blog/tips-watching-new-netflix-series-13-reasons/

11.  Reporting On Suicide offers guidelines for those responsible for reporting or speaking about suicide. It includes recommendations for bloggers, journalists, and news media professionals. It also lists warning signs and what to do if you know someone exhibiting these signs. http://reportingonsuicide.org/recommendations/

12.  Another important piece of taking care of someone who is hurting is to first take care of yourself. Here is a list of self-care activities written by the Good Therapy staff members. It is a very thorough list. If you are having difficulties thinking of activities to do, lists like this can give you other options. http://www.goodtherapy.org/blog/134-activities-to-add-to-your-self-care-plan/

13.  Above all, know your limits and be prepared to keep your boundaries in place with regards to your own mental health. Have a list of safe people that you can talk to and get professional help if needed. Remember, even if it feels like it, you are not alone!

 

By:  Karen Weier, MA, LLPC, NCC

Most of us can probably agree that we have worried, about an actual or potential problem.   Our worries might be centered around our finances, health, relationships, finding the right partner, losing a job, parenting, peer pressure, driving, pet health, family problems, to name a few.  Sometimes we simply worry that we are worrying too much.  If you suffer from constant worry, you may already know that worry can create physical symptoms, cause relationships to suffer, one can become less productive, become irritable, argumentative, and lose interest in activities that were once enjoyable.

According to Kevin L. Gyoerkoe, PsyD and Pamela S. Wiegartz, PHD (2006) worry consists of three main parts:  future orientation, we worry about something that hasn’t happened yet; catastrophizing, we think about the future negatively, we focus on the worst possible outcome; and thirdly worry is language based thought versus image based.

Not all worry is bad.  Gyoerkoe and Wiegartz label worry as productive and unproductive.  Productive worry allows us to solve and react to realistic problems or situations in our lives. It pushes us to take immediate action to solve problems; taking care of an over-due bill or changing our eating habits in order to have optimal health.  Unproductive worry generates no clear course of action.  Instead of taking productive steps toward action these worries stop us in our tracks and creates more unproductive worry.  Unproductive worry also causes us to focus on an unlikely event; car crash, plane crash.  Unproductive worry stops us from living in the here and now, it causes us to miss out on opportunities, fun, advancements, adventure.

The next time you find yourself worrying ask yourself:

• Am I focusing on a realistic problem?
• Is the problem solvable?
• Is the worry motivating me to take action?
• Can I come up with potential solutions?
• Am I or can I act on these solutions?

If you answered no, to any of these questions, your worry is more than likely unproductive.

Gaining control of worry is not a simple task.  It takes hard work, motivation, but most importantly it takes commitment.  You need to commit to change and commit to sticking to the commitment.  Commitment is vital if you want to gain control and manage worry.  Once you have committed to change several other tools and techniques need to be learned and practiced.  These include; learning to relax, changing ones thinking, learning to react differently, learning to accept uncertainty, learning how to manage time, learning to communicate assertively, and learning to confront ones worries (Gyoerkoe & Wiegartz, 2006).

Worry affects how we think, behave, feel, and relate to others.  My hope for you is that by reading this you will be prompted to begin your journey towards managing unproductive worry.   If you would like to learn more about managing unproductive worry, our clinicians at All Things Possible Wellness Center would be honored to walk along side of you, and provide you with the tools and techniques you need to manage and take control of your worry.  Our desire is to help you have a life that is productive and filled with joy, happiness, and peace.

References

Gyoerkoe, K & Wiegartz, P. (2006) 10 simple solutions to worry.  Oakland, CA:  New Harbinger

Publications, Inc.

 

By: Tonya Rice, MA, LPC

Relationships are hard. Relationships with a people who are narcissistic/manipulative are even more difficult. How do you know if you are in a relationship with a person who is narcissistic or manipulative? Answer the below questions…

1) Do you feel angry/upset or confused after conversations with your partner?

2) Do you do whatever your partner wants you to do, even if you told them “No, I won’t do that.”?

3) Do you tolerate behaviors that your partner does that others would not?

4) Do you expect more out of yourself then your partner?

5) Do you feel that you must act like things are “ok” when they aren’t

6) Do you feel that your partner blames you for problems?

7) Do you feel that you need to do everything your partner wants in order to avoid conflict?

8) Does your partner overreact most of the time?

9) Do you feel you put more into the relationship than your partner does?

10) Do you feel anxious or nervous around your partner?

If you have answered “yes” to more than 5 of these questions, it is likely that you are in a relationship with a manipulative or narcissistic person. This may seem like bad news, or it may just be confirming what you already assumed about your partner. However, the question is, what do you do from here?

As you have probably figured out, you cannot change another person. It is impossible. The only person what we can control is ourselves. Here is the good news- you are part of the problem! Those who are manipulative and narcissistic are drawn to people who are over-responsible, overly caring, passive, and easily controlled through obligation, guilt and blame. People who are entitled always are attracted to those who are over-responsible and willing to accept responsibility for things they do not want to accept. Usually people who are over-responsible are this way because they are people pleasers who want to be accepted and approved of by others (especially people they are in relationships with). This desire for approval and acceptance leaves the person highly vulnerable to manipulation.

You can change the dynamics of your relationship by changing your actions and reactions to your partner, but first you need to identify when you are being caught in a manipulation trap. To avoid being caught in a trap, you need to know when you are being baited into one. Here are manipulation methods or “bait” that is used by master manipulators and narcissists.

1) Badgering- continually asking you for something again and again. The goal of this form of manipulation is to wear you down by repetition. You finally give in to make the badgering stop.

2) Martyrdom-Playing the victim role. They portray themselves as a victim to gain pity, sympathy and to get what they want from someone else. Caring people cannot stand to see anyone suffering and the manipulator often finds it easy to play on sympathy to get what they want. Also, the manipulator falsely accuses you of being wrong, negative or abusive when you stand up for yourself or set boundaries.

3) Butter Up-includes praise, charm, superficial sympathy, excessive apologizing, money, approval, gifts, attention, facial expressions such as a forced laugh or smile, and public recognition. This comes just prior to them asking you to do something you do not want to do or also comes before you are about to find out about something negative they have done. The purpose of the “butter-up” is to get you to feel good so that they can get what they want.

4) Lying- either direct lies or subtle lies (subtle lies are withholding a significant amount of the truth). Manipulators lie about their intension and lie about lying. Manipulators love to falsely accuse you as “deserving to be treated that way.” They often claim that you are crazy and/or abusive, especially when there is evidence against the manipulator.

5) Denial- refuses to admit that he or she has done something wrong

6) Minimizing/Rationalizing- excuses are made for their inappropriate behavior. They state that his or her behavior is not as harmful or irresponsible as someone else says, for example, saying, “I was just joking.”

7) Guilt/Blame/Shame- the manipulator will say things like- “you don’t care”, “you are selfish” or “you have it easier than me”. This usually results in you feeling bad, self-doubting, anxious and keeps you in a controlled position. The manipulator uses sarcasm and put-downs to increase fear and self-doubt in you as well. Shame can be used in the form of an angry look or glance, negative tone of voice, and sarcasm. Manipulators can make you feel ashamed for even challenging them. Blame, is done in order to make you feel guilty about making healthy choices, correct thinking and good behaviors. It is frequently used as a means of psychological and emotional manipulation and control.

8) Anger/Threats-Manipulator uses anger to shock you into being controlled. The manipulator is often not actually angry, he or she just puts on an act. He just wants what they want and gets “angry” when denied. Controlled anger is often used as a manipulation tactic to avoid confrontation, avoid telling the truth or to further hide intent. Anger is also used as a defense so the manipulator can avoid telling the truth. Anger is often used as a defense to ward off questioning or suspicion because you become more focused on the anger instead of the manipulation. Threats are used by the manipulator to scare or intimidate you into being controlled. Blackmail and other threats of exposure are other forms of manipulation.

Now that you understand the methods of manipulation that are used, here are ways that you can change yourself and your behaviors to stop the manipulation cycle.

1) Address your Approval Addiction. People-pleasing is an addiction. It will lead you to doing things you may not normally do in order to get the thrill of being accepted for a moment. The high from the “approval drug” wears off and you need to do something else to gain more approval. It is a BIG trap. You need to learn how to be okay with people not being happy with you or approving of you in order to be truly free of manipulation.

2) Create Boundaries. Boundaries are safe and reasonable guidelines, rules or limits that a person creates for other people understand how to behave around him or her and how they will respond when someone steps outside those limits. When boundaries are in place and a manipulator violates those boundaries then they chose to have their consequence by their behavior. The important thing to note about boundaries is that in order for them to work- you MUST follow through with enforcing whatever consequence you stated.

3) Increase Assertiveness-Being assertive means that you respectfully express yourself clearly and directly while standing up for your point of view. This is a skill that must be taught, practiced and built- especially if you have never considered yourself to be an assertive person. Counseling may be helpful in obtaining this skill.

4) Increase Self Esteem. When you know your self-worth, you will be less likely to be manipulated. Often parents understand this concept as they will not defend themselves, but if someone mistreats their child then they will stand up for them, because they know their child’s worth and value. When you know your own value- you will stand up for yourself.

5) Increase Your Support Network- manipulators often work to isolate you from others in your life and prey on your loneliness. Your fear of being alone will fuel their control and manipulation over you as they know you will do anything not to lose them. Also, it is often hard to recognize when you are “taking the bait” and falling into a manipulation trap. I highly recommend that you see a counselor regularly and have a good friend with healthy boundaries that you can trust to talk to about conflicts in the relationship. They can help you identify when you are being manipulated and keep you accountable to setting boundaries and increasing your assertiveness.

I hope this helps! If you have any questions or comments, please feel free to email me directly at atpwc.tonya@gmail.com. If you’d like to schedule a counseling appointment with me, you may call my office at (586) 804-5501. 

 

By: Ashley Kraut, MA, LLPC, NCC

My desire to help people through counseling has been motivated by my own personal life experiences and struggles, and I have found similar motivation in many of my professional colleagues. Each individual has his or her own experiences that have shaped the way he or she thinks, feels, and functions. Some life experiences are clearly beneficial and healthy, while other experiences may leave us searching for a change or for healing. My early experiences greatly influenced my emotional wellbeing and functioning, and by coming to realize how the experiences influenced me, I was able to take my first steps in the process of overcoming anxiety and its hold on my life. A diagnosis of Generalized Anxiety Disorder through the American Psychiatric Association (2013) calls for certain criteria and clinical significance. The DSM-5 states the person must be experiencing “excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance),” difficulty controlling the worry, and three or more physical symptoms such as fatigue, restlessness, sleep disturbance, difficulty concentrating, irritability, or muscle tension (American Psychiatric Association, 2013, p. 222). I began to explore my symptoms, how my anxiety developed, and why it continued to be present in my daily life. The many instances in which fear was an appropriate response in my life had begun to shape my reality; I began to believe there were threats, when logically there were none. Fortunately, our brains are flexible and habits can be changed. The ability for your brain to change is called neuroplasticity (Burdick, 2013). The dendrites in our brain can grow when new patterns of thought are repeated (Hebb, 2009 as cited in Burdick, 2013). We can form new paths in our brain to lead us to new paths in life. Once we are aware of what has triggered the patterns of thought that contribute to symptoms, we can take captive the thoughts, and change the thoughts. In Burn’s (2007) book, When Panic Attacks, Burns changes a quote of the philosopher Descartes from “I think therefore I am” to “I think therefore I fear,” to demonstrate the power of our thoughts over our feelings. Burns (2007) continues to describe cognitive behavioral approaches to alleviating the symptoms of depression and anxiety, and discusses the research supporting this method of treatment. Our thoughts greatly influence how we feel. If we are letting our thoughts take control without fighting the patterns that have developed, our symptoms may continue. When we make the choice to change our automatic responses and unhealthy beliefs by replacing them with healthy thoughts and beliefs, our symptoms can begin to subside. Interestingly, Anxiety can be invoked by the desire to control circumstances that one cannot control. We may not be able to control every aspect of the world around us, but we can control our thoughts and behaviors in response to the world.

Speaking from a Christian counseling perspective, such techniques can be applied along with one’s faith and ideas about truth and love. One can challenge anxious thought patterns by replacing them with verses such as “Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” (Joshua 1:9). God also calls us to the renewing of our minds (Romans 12:2). I encourage you to take captive any thoughts that may be contributing to mental health symptoms, and know that you are not alone. The clinicians at All Things Possible Wellness Center have not only experienced similar struggles to your own, but we are here to help you persevere, gain insight about your symptoms and experiences, and guide you through a healing process that fits your individual needs.

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Publishing.

Burdick, D. (2013). Mindfulness skills workbook for clinicians and clients. Eau Claire, WI: PESI Publishing and Media.

Burns, D. (2007). When panic attacks: The new drug free anxiety therapy that can change your life. New York, NY: Harmony Books.

Hebb, D. (2009). The organization of behavior. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

By: Veronica H Visger, MA, LLPC, NCC

A common error in judgment can be found within the helping professions.  It has been found that too often we forget about, or are lackadaisical about, self-care even though we ask our clients’ to entertain this same ideal. The American Counseling Association (ACA) challenges us ethically to do no harm, benefit others, and pursue excellence in the profession.  As helping professionals we then should embrace self-care behaviors for continued personal and professional development.

Freud stated (1905) that “No one who, like me, conjures up the most evil of those half-tamed demons that inhabit the human breast, and seeks to wrestle with them, can expect to come through the struggle unscathed” (p. 184).  Clearly, the need for self-care has been spoken about since the start of psychoanalysis.

As a counselor we face various challenges that include burnout, vicarious traumatization, compassion fatigue, and elevated risks of stress (Tan & Castillo, 2014). Professional burnout has been described as a state of psychological, spiritual, physical, and emotional exhaustion as result from chronic involvement or exposure in human service work (Newell & Nelson-Gardell, 2014).  Newell & Nelson-Gardell (2014) further describe burning out as a progressive state “conceptualized as a multi-dimensional construct with three distinct domains – emotional exhaustion, depersonalization, and reduced personal accomplishment”.  Secondary traumatic stress (STS), or vicarious traumatization, is the result of empathically engaging in relationships with clients suffering from traumatic experiences and bearing witness to their intense and horrific traumatic experiences.  Symptoms of STS, or vicarious traumatization can mirror those of post-traumatic stress disorder (PTSD) in the helping professional (Newell & Nelson-Gardell, 2014).  Compassion fatigue is the overall experience of both emotional and psychological fatigue that can be experienced by helping professionals due to the chronic use of empathy (Newell & Nelson-Gardell, 2014).  Lastly, common with other professions, an occupational hazard also experienced in the helping professions is elevated risks of stress.  As we are all aware, stress is deadly.  Research has shown that self-care and planning is paramount in helping to prevent these challenges from affecting our professional ability to help others clinically in a therapeutic relationship.  Burnout, STS, compassion fatigue, and stress are a reality if self-care isn’t a priority for those in the helping professions.

Goncher, Sherman, Barnett, & Haskins (2013) endorse both graduate psychology students and psychologists engaging in ongoing self-care as both a foundational professional competency and an ethically imperative practice.  Furthermore, Tan & Castillo (2014) found that self-care strategies for the professional self and personal self are rather intimately related.  Their research found that self-care should include ongoing self-awareness, using helpful self-care strategies, and active self-assessment.  Goncher, et al. (2013) endorse the ongoing use of 12 self-care strategies by psychology trainees and psychologists in order to manage inherent professional challenges and stressors, these include: “valuing the person of the psychotherapist, refocusing on the rewards of the practice of psychology, recognizing occupational hazards, minding the body, cultivating and nurturing supportive relationships, setting boundaries, cognitive restructuring, sustaining healthy escapes, creating a flourishing environment, personal psychotherapy, cultivating spirituality and mission, and fostering creativity and growth” (p. 57) (Tan & Castillo, 2014).  While Goncher, et al (2013) and many other researchers have given us lists of strategies to engage in self-care it is best to also operationally define the physical, psychological, spiritual, and support components of self-care.

The physical component of self-care entails the incorporation of physical activity into your daily activities.  This can be achieved through exercise, activities of daily living, or sports.  Recommendations are usually made to engage in physical activity, under the supervision of a physician, for at least 30 minutes a day.  While there are specific advantages of engaging in physical activity it has also been shown to benefit general wellness, decrease symptoms of anxiety and depression, increase the health component of quality of life, and also increase women’s satisfaction with body functions and ability to cope with daily stresses (Campenni, C.E, Muse-Burke, J.L., & Richard, K.C., 2010).

The psychological component of self-care entails seeking personal counseling to share in the same benefits of counseling that we offer our clients.  In the practice of implementing self-care strategies it is of importance to remember that we need not be so self-sufficient, prideful and independent to think that we can care for others and ourselves with our own strength alone.  We need others, both personally and professionally, so must remain mindful of the suggestion of personal psychotherapy (Goncher, et al, 2013; Tan & Castillo, 2014).  Mackey & Mackey (1994) found that personal counseling supports professional development for counselors as it allows for better understanding of self-care and development of an awareness of one’s limitations and boundaries. Research by Mahoney (1997) that included psychotherapy practitioners (N=155) found the most frequently reported personal problems clustered around emotional exhaustion and fatigue although they were concerns among less than half the sample.  On a positive note, Mahoney (1997) found that of the 155 practitioners in this study 90% of them were active in personal counseling with very positive ratings of their experience.   Counselors’ empathic skills and self-awareness are both enhanced in personal counseling and are significant advantages in professional development (Mackey & Mackey, 1994).  The study by Mahoney (1997) speaks volumes about the need for the helping profession to engage in self-care. If we were to generalize this sample of psychotherapists to the norm it appears as if most psychotherapists understand the importance of the component of self-care about personal counseling.  However, even with personal counseling half of the psychotherapists still self-reported experiencing emotional exhaustion and fatigue – symptoms of burnout.  Caring for ourselves personally and professionally thus isn’t an option it is a necessity.  Cleary, engaging in personal counseling as a self-care activity is very beneficial personally and professionally as Mackey & Mackey (1994) found.

The spiritual component of self-care is described as how a counselor connects and makes an understanding with both their sense of purpose and their meaning of life (Campenni, et al., 2010).  Spirituality has been found to not only promote quality of life but also a sense of self-awareness (Campenni, et al., 2010).  Spiritual/religious beliefs and quality of life are positively correlated.  Furthermore, Hamilton & Jackson (1998) suggest that spirituality is important for the continued progression and development of self-awareness.  Included in spirituality is the practice of meditation for counselors.  I have personally incorporated meditation time into my daily routine and have found this very beneficial to help to stay centered and more fully present with each client.

The support component of self-care includes interactions and relationships that are developed from both personal and professional support systems.  Professional support entails supervision and consultation from peers, supervisors and colleagues.  Professional support also is defined as continuation of professional education through personal research, seminars, and education. (Campenni, et al., 2010).   Personal support is defined as our relationships with a spouse, friends, companion, and other family members (Campenni, et al, 2010).  A suggestion that was made in my graduate education was to create support groups amongst ourselves that get together monthly for both professional and personal support and growth after graduation.  This suggestion rang true and aligns with the self-care principles found within the current research as described here within.  I enjoy the benefits of this and am grateful this suggestion was made. As we learn in the educational and clinical process both supervision and consultation help us to recognize and overcome ethical and clinical difficulties and can help us in our case conceptualization.  Per Campenni, et al. (2010) mental health professionals should routinely participate in professional communication with colleagues in order to prevent burnout as well as for the benefit of further professional development and thus greater continued self-awareness. As demonstrated here within thus far self-care influences our self-awareness (Hamilton & Jackson, 1998).

Research conducted by Campenni, et al. (2010) of N=148 mental health professionals holding a bachelors degree or higher and practicing as fully licensed or graduate students in the northeastern United States found some interesting correlations as described here within.   Utilizing the definitions of self-awareness as “knowledge of one’s thoughts, emotions and behaviors” and mindfulness as “maintaining awareness of and attention to oneself and one’s surroundings” results showed a significant positive correlation between the two.  Specifically, when self-awareness increases so does mindfulness, and vice versa (Campenni, et al., 2010).  Of note, this research found a significant positive correlation also between self-care frequency and well-being indicative of increased participation in self-care activities associated with an increased general well-being (Campenni, et al., 2010).  While mindfulness and self-awareness are positively correlated neither were found to be significant mediators in the relationship between self-care activities and well-being in the research.  Furthermore, “mindfulness was found to indirectly influence the relationship between self-care importance and well-being but not the relationship between self-care frequency and well-being” (Campenni, et al., 2010).  The research by Campenni, et al. (2010) did find a positive correlation between self-awareness and well-being independent of self-care suggesting that an increase in self-awareness increases well-being and vice versa.  Lastly, the research by Campenni, et al. (2010) also showed a significantly positive correlation between self-care frequency and self-care importance.  This correlation is also then indicative of frequency of participation in self-care activities bringing about a rise in perceived importance of them and vice versa (Campenni, et al., 2010).  To best summarize and understand the correlations in this research this researcher has noted the correlations as found below:

CAMPENNI, ET AL., (2010) CORRELATIONS

Increased Self-Awareness  = Increased Mindfulness

Increased Mindfulness = Increased Self-Awareness

Increased Self-Awareness = Increased General Well-Being.

Increased General Well-Being = Increased Self-Awareness.

Mindfulness is NOT a significant mediator in relationship between self-care frequency and well-being.  Mindfulness influences self-care importance and well-being indirectly.

Self-awareness is NOT a significant mediator in the relationship between self-care and well-being.  Self-awareness influences self-care importance and well-being.

Increased self-care frequency = Increased General Well-Being

Increased General Well-Being = Increased Self-Care Frequency

Increased frequency of participation in self-care activities = increased perceived importance in them.

Increased perceived importance in self-care activities = increased frequency of participation in them.

Practical Application

How can we practically implement the results of this research?  First we must be mindful that ultimately we are responsible for our own wellness and this includes both personal self-care and professional self-care.  To improve personal wellness and professional effectiveness mental health professionals should regularly adhere to practices that enhance their overall well-being. Research by Goncher, et al. (2013) found that disconnect in self-care use clearly highlights the importance of appropriate self-care strategies being taught to graduate students.  Furthermore, they found that the importance of stressing self-care strategies at the beginning of graduate training is paramount in helping professionals learn to utilize these strategies throughout their professional career (Goncher, et al., 2013).  The importance of participating in self-care activities regularly, seeking greater self-awareness and mindfulness, and striving to foster a sense of general well-being should be something that is spoken of in graduate programs and among licensed professionals frequently.  A starting point for self-care strategies for current graduate students and the seasoned helping professional are found below again for quick reference (Goncher, et al., 2013):

• Value the person of the psychotherapist
• Refocus on the rewards of the practice of psychology
• Recognize occupational hazards
• Mind the body
• Cultivate and nurture supportive relationships
• Set and maintain boundaries
• Utilize cognitive restructuring
• Sustain healthy escapes
• Create a flourishing environment
• Engage in personal psychotherapy
• Cultivate spirituality and mission
• Foster creativity and growth

 

References

Campenni, C. E., Muse-Burke, J. L., & Richards, K. C. (2010, July). Self-care and well-being in mental health professionals: the mediating effects of self-awareness and mindfulness. Journal of Mental Health Counseling, 32(3), 247+. Retrieved from click here for reference link

Freud, S. (1905) Fragment of an Analysis of a Case of Hysteria. S. E. 7. London: Hogarth Press

Goncher, I.D., Sherman, M.F., Barnett, J.E., & Haskins, D. (2013). Progammatic perceptions of self-care emphasis and quality of life among graduate trainees in clinical psychology: The meditational role of self-care utilization. Training and Education in Professional Psychology, 7, 53-60. doi:10.1037/a0031501

Hamilton, D.M., & Jackson, M.H. (1998). Spiritual development: Paths and processes. Journal of Instructional Psychology, 25, 262-270.

Mackey, R.A., & Mackey, E.F. (1994). Personal psychotherapy and the development of a professional self. Families in Society, 75, 490-498.

Mahoney, M. J. (1997). Psychotherapists’ personal problems and self-care patterns. Professional Psychology: Research and Practice, 28(1), 14-16. doi:http://dx.doi.org/10.1037/0735-7028.28.1.14

Newell, J.M., & Nelson-Gardell, D. (2014). A competency-based approach to teaching professional self-care: An ethical consideration for social work educators. Journal Of Social Work Education, 50(3), 427-439.

Newsome, S., Chambers-Christopher, J., Dahlen, P. & Christopher, S. (2006). Teaching counselors self-care through mindfulness practices. Teachers College Record (Columbia University), 108(9), 1881-1900

Tan, S.-Y., & Castillo, M. (2014). Self-care and beyond: a brief literature review from a Christian perspective. Journal of Psychology and Christianity, 33(1), 90+. Retrieved from click here for reference link

 

 

This company was formed one year ago today.  My heart is overwhelmed with joy while reflecting on how my life dream is a beautiful reality.  One year ago ATPWC was in an office the size of a walk-in closet that a loveseat barely fit in with a shared waiting room and restroom.  I would still be joyfully celebrating if that was where I was still at as it is such a joy to do this.  However, in less than a year since ATPWC opened to serve this community ATPWC is now in a beautiful 1,400 sq foot office and four other amazing clinicians have joined my team.  I couldn’t have done this on my own.  This was the collective power of Gods will alongside the love and support of amazing family and friends.  ATPWC is also where it is today because of our many clients.  We are so grateful for our clients that refer their loved ones to us as well.  A referral is the greatest compliment we get.  We thank you from the bottom of our hearts!!!

While seeking to discern God’s will for this business Jesus’ words found in Matthew 19:26 spoke to my heart.  Jesus said, “With man this is impossible, but with God all things are possible”.  I know this to be a truth in my personal, and professional, life.  In the last almost four decades of my life this has been a truth throughout since my first breath.  I beat all odds to enter this world.  In the past I have felt like giving up on life and struggled to find purpose or meaning.  At times on my life path I have felt alone.  I am a survivor of some very traumatic events.  I know, without a doubt, that all of that happened in my life for a reason.  I know that God never left my side and that He oftentimes carried me. I am grateful that 16+ years ago He led me to seek counseling and that is where I found healing and hope.  It was in my own counseling while also digging deeper into His word that I discerned this was how He wanted me to serve others. His plan for me was to understand the gift of counseling and then become one for others.  I seek His wise counsel and thank Him daily for His grace, His love, His wisdom, and His sacrifice for me.  I am who I am because of Him.

Left to our own thought processes and humanness we all fall short.  We always will. Sometimes the world tears at us and we allow the word, and works, of others to resonate within our soul rather than the word of God. Sometimes we allow negative messages and images to permeate our being and make all of our life decisions based on these ugly fallacies. Sometimes we allow others to abuse us – mind, body, and soul.  Sometimes we engage in harmful behaviors to punish ourselves or because we simply do not know what to do with our emotions. Sometimes we have unresolved pains and fears that we carry from one relationship to the next.  Sometimes we find ourselves repeating damaging behaviors or words we personally know the pain of yet we cannot stop.  Sometimes we crave instant gratification at a very high cost.  Sometimes we cannot look in the mirror at ourselves.  Do any of these things resonate with your being?  If so, please call the licensed clinicians at All Things Possible Wellness Center, PLLC at 586.213.5505 or email us at clinicians@allthingspossiblewc.com.  We would be honored, and humbled, to be able to help you to discern God’s will for you and your purpose.  ALL THINGS truly are POSSIBLE with God.  We hope to be able to help you to believe this for you as you start to experience hope and healing at ATPWC.

Please note that all of the licensed clinicians at ATPWC are Christian.  This business was founded on Christian principles. If you are a Christian and choose to have your beliefs implemented in your treatment please let us know. Please note that we do not discriminate against other spiritual or religious beliefs.  We will gladly implement your beliefs into your treatment as you wish as well. We believe that ALL are worthy of love, hope, and healing and we would be honored to help you.

Again, we THANK YOU!  We celebrate YOU!

Veronica H. Visger, MA, LLPC, NCC

Clinical Director