Congratulations! You got engaged and have decided to spend the rest of your lives together. It is a wonderful, magical time in your relationship and planning that wedding will be one of the most joyous and possibly challenging waters you navigate in the next few months.
But what about the challenging times you both will traverse in your actual marriage? Have you, the lovely couple, thought about how your relationship will weather the bumps down the road? Couples getting married in Central Texas spend an average of $27,743 on their weddings and just looking at that amazing amount tells you that these couples are most definitely putting a lot of thought into the event. But how many couple’s put that amount of thought into their life-long relationship? This is precisely why pre-marital counseling is so vitally important to your future and ability to “go the distance” with your partner.
What to expect: When a couple comes in for pre-marital counseling, the vibe is usually a little giddy, a little nervous and very inquisitive. After all, you are basking in the glow of your engagement, you may not have encountered some of the issues you could potentially face in your marriage (or maybe you’ve seen some inkling of what those issues are poking out in your couplehood). A therapist’s role in these “preparation” sessions is to get you both, as a couple thinking about what these potential pitfalls may be.
Now, don’t get us wrong. We are not trying to bring you down or kill that effervescent “buzz” of love that is in the air. In fact, quite the opposite. We couple’s therapists take our jobs very seriously and our job is to help you, the happy couple, insulate your marriage from the things that can damage it so you stay happy. Therefore, we are going to bring up a plethora of topics that could be sources of conflict in the future and we’re gonna get ‘em out in the open, right here and now, so you are thinking about this stuff before you even knew it was a problem. In effect, we are helping you think about and solve the issue before it is even an issue! BOOM! After all, we are rooting you on, we want you to grow old and wrinkly together.
Some of the many topics that come up for couple’s entering pre-marital counseling may include: children, alcohol/drug use, finances, friends, hobbies, technology/internet use, in-laws, jealousy, sex and intimacy, religion, cultural differences, etc. As you can see, there is no shortage of subjects to review. Being able to do so in the room together with a caring therapist to guide you, you will know just where your partner stands on these really important issues. And trust me, you need to know!
So, when you are planning that big sparkly wedding, I caution you to not forget an integral part of planning your life together: your marriage. A few sessions of pre-marital counseling is a small price to pay up front that pays big dividends in your future.
Flourish is offering Premarital Retreats for couples getting ready for marriage! Join us on a fantastic weekend on beautiful Lake Travis with interactive activities and education on making your relationship work!
At Flourish, I practice equine (horse) assisted psychotherapy, which is work I really enjoy. I love working outside with clients, and giving our clients a more “hands-on” experience in their therapy. However, one comment that I have consistently heard during the first sessions from my clients who have never worked with horses before, is that “its [the horse] like a big dog.” This could not be further from the truth, I assure you.
It is in our nature as human beings to use what we know already and to apply it to what we don’t know that may look similar. Doing this is essential to understanding our world and for our safety. You may notice a young child who has already been taught what a cat is, and points at a dog for the first time and says “cat” because the child has never seen a dog before.
In this case, take it one step further with dogs and horses. Many adults have never had much, if any exposure to horses before in their lives. Many adults find horses scary and intimidating, largely due to their size. This is understandable, given a average quarter horse weights around one ton, and stands 5 to 6 feet tall. A part of equine assisted psychotherapy is building a trusting relationship with a horse, and learning how horses behave and communicate.
Lets look at some of the key differences between dogs and horses, in a therapeutic sense:
In equine assisted psychotherapy, its all about the relationship you are building with the horse. Its helpful since horses will tell you why a relationship isn’t working, without all the “noise” we would get from the complexities of human relationships. Wanna talk more about equine assisted psychotherapy? Email me at email@example.com
When I was a junior in high school, my older sister who was two years older than me left to go out of state for college. Even though we had fought like cats and dogs at times, I realized that I was left with a feeling of profound sadness when she was gone. It was a sadness that stayed with me for a very long time, a sadness that made me lose interest in some of the things that I once loved doing and no matter what I did, I couldn’t shake the feeling of loneliness. I also remember feeling like no one could really understand what I was going through and it seemed impossible to explain. Some days I would just feel empty and hopeless, and some nights I would cry not really comprehending this darkness that seemed to encapsulate me. After all, my parents were still around, I still had friends and it’s not like my sister wasn’t a phone call away. But I was sad all the same. It wasn’t until years later in my twenties when I was on a walk with my father, that he told me that he, too, had depression and that my grandfather had suffered from depression as well. And then it all made sense: just like others in my family, I was also prone to depression.
Depression is an illness that affects many of us regardless of our age, race, gender or socio-economic status. It comes in many forms ranging from situational, when an event or circumstance triggers a depressive episode, to a general sense of “the blues” when we know we just don’t feel right, to more major episodes that can literally last years. Many people describe depression as a sadness that they cannot shake, that debilitates them to the point of not wanting to get out of bed. Often people isolate themselves or lose interest in things that under normal circumstances would matter immensely to them like spending time with friends or family or enjoying hobbies. Depressed folks may have a decreased or increased appetite, sleep more than normal or be susceptible to insomnia.
Many folks who suffer with symptoms of depression describe the feeling as a darkness or cloud over them. Depression can wrap itself around you like a blanket. Not a comforting blanket, but a heavy one that you feel you cannot shed even if you wanted to.
What is truly remarkable is how prevalent depression can be and yet, we don’t realize the magnitude of it. According to The Anxiety and Depression Association of America, in 2014, around 15.7 million adults age 18 or older in the U.S. had experienced at least one major depressive episode in the last year, which represented 6.7 percent of all American adults. At any point in time, 3 to 5 percent of adults suffer from major depression; the lifetime risk is about 17 percent. As many as 2 out of 100 young children and 8 out of 100 teens may have serious depression (https://www.adaa.org/understanding-anxiety/depression). Research has linked depression to higher incidence of heart disease and strokes as well as many other health problems. It is quite astonishing that we as a society do not treat depression as a very real, debilitating condition that is just as important to attend to as any other serious health problem.
So what can you do if you notice symptoms of depression closing in? First of all, talk to someone. Don’t keep these feelings under wraps and further isolate yourself. Tell a family member, a trusted friend, your doctor or your therapist. Even if others haven’t gone through what you are experiencing, they can understand and be a voice of support when you need it the most. It also helps for others close to you to know that you may not feel like yourself right now and you may need them to be a little more patient until you feel better.
Another factor that people often don’t realize is the biological link to depression that can be passed down through families. I have had many clients who, through investigating past family history have discovered patterns within their families that definitely make them more likely to have an incidence of depression in their lifetime.
Remember, depression is unique to each individual and there is no “one size fits all” treatment. Although research shows the best outcomes to treat depression are a combination of medicine and therapy, each person needs to decide for themselves what they feel works best. Often well-meaning friends or family will say things like ”try this medicine or natural remedy, etc. – it worked for me!”, each person needs to have the autonomy to decide what feels right for them.
Also, and most importantly, realize you are not resolved to these feelings forever. There are ways to combat depression including medicine, speaking to a counselor, changing life patterns and becoming more aware of thoughts, particularly negative thoughts that may have become automatic to us. Just know, there is help out there.
For more information on depression and ways to combat symptoms go to these links:
Apologies: we love them and we hate them. They make us feel better…sometimes. Sometimes, they don’t but they make us feel like we can’t really be angry anymore or hurt because the person is sorry. Sometimes, they don’t feel genuine. Sometimes, they’re not. Sometimes we offer them when we don’t really mean it, right? Sometimes, an offense feels like no amount of sorrow could offer any reprieve. Sometimes, we don’t want to say we’re sorry out of fear of being misunderstood, overlooked, or enabling. Sometimes we don’t want to say it because we don’t think we are sorry…or because apologizing would mean admitting we did something wrong. Hell, sometimes we mean to cause harm. Did you ever sit back and really think about how complicated an apology can be?
An apology is complicated…for the one giving it and the one receiving it. When delivered effectively, it can mean the difference between the end of a relationship or a stronger one.
It’s our inclination to be defensive. Someone accuses us of hurting them and we get so hell bent on proving that it wasn’t our intention that we forget they’re hurting. We want to make the hurting stop so we try and change their minds about how they interpreted things. We want the shame of being wrong or rude or inconsiderate to go away and it can’t until they understand why we did it. They MUST understand where WE are coming from! The thing is, there’s nothing wrong with some clarification, especially when someone is completely off base about your intentions, but here are some tips to make your apology worthwhile and impressive.
Many people who come to a see me for the first time often also ask about medications for mood or sleep. They want to know things like:
Do medications work? Will I have to take them the rest of my life?
Generally, medications for mood, including the most common line of SSRI medication (Prozac, Zoloft, Wellbutrin) do tend to help individuals suffering with depression or anxiety. However, studies show that for up to 25% of the population, they are not effective or don't work. One of the major problems with figuring out if a medication works is that it takes about a month to reach full effectiveness and get into your system. By that time, many people already stop taking the medication because they have not felt instant relief and think the medication is not working.
It can also take a fair amount of trial and error with each potential medication regimen, which involves patience and being willing to try other medications without losing hope. Again, that can be very difficult when you are feeling depressed or anxious to keep trying, especially if your mind is telling you that you are a lost cause and will never feel better.
If you do find a medication that works, then no, you do not have to take it the rest of your life. Depression and anxiety tend to get worse when we are juggling a lot of different aspects of our lives that are particularly stressful. Medications can be used simply for those stressful episodes in your life that are difficult to manage on your own.
Do I need medications to get better?
Not necessarily. There are certain mental health conditions with more biological components (rather than something stressful in the environment), such as bipolar disorder and schizophrenia, that would require medication on a long term basis and will get little benefit from psychotherapy until their symptoms are under control with medications. That being said, I believe the majority of mental illnesses can get better without medications. Psychotherapy has been shown to be equally effective as medications in numerous studies.
Now being completely bias as a therapist, I would tell you that psychotherapy is also better for you in the long run because it teaches you coping skills and strategies to help you in the future as well, so that the same issue does not keep coming up every time stressful things happen and you need to take medication again. You get confident in your own ability to handle your issues instead of relying on medication. All in all, a combination of both medication and psychotherapy in the research shows the best outcomes for recovery.
Can you prescribe medications for me?
No. Psychologists and other types of therapists (LPC, LCSW, LMFT, etc.) are not medically trained and therefore cannot prescribe medication (In some states Psychologists can prescribe medication under the supervision of a physician, but not Texas). We are trained in psychological theory and how to apply it to human behavior to help with mental health concerns. Psychiatrists (usually MDs or DOs) are medically trained as physicians with specialty training in mental health, therefore can prescribe medication. Primary care physicians can also prescribe different kinds of medication for mental health concerns. We also can work with your physicians to let them know our clinical opinions of if medication is needed or would be helpful.
What if I don't want to take medications?
That's fine too! I can understand why a lot of people get concerned about taking medications for mood or for sleep, and have heard some horror stories from some people about side effects, in addition to the long list you hear from commercials on TV. Just be careful about generalizing one person's experience as you own, because medications affect people so differently.
In an ideal situation, I always like to have clients try a few weeks of psychotherapy with me first to see if they get any relief. If after a month or two things are still really bad, then maybe medication is something to consider to help as well. For example, if the client isn't getting enough sleep, therefore they can't concentrate, work, or function well in daily living, its hard to work on improving yourself in psychotherapy. This is where medication can help if there is a barrier in psychotherapy.
Many times, after medication can help get symptoms to a more manageable state, we can then work on getting you the skills you need in therapy so you won't need to take the medication for a long period of time.
At Flourish, we work with your primary care doctor or psychiatrist to help you make the best choice for you, with or without medication.
The coveted passenger seat of the car, claimed before siblings or the dog. What a win! The control of the radio, prime scenery viewing, and no shoving, pushing, or line-crossing to contend with. The triumph though, can be claimed by the driver as well: we’ve got a stake in the battle for the front seat.
For the length of the ride – and in Texas, it’s at least 20 minutes wherever you go – you have a captive audience. Wifi in many vehicles can be turned off, the radio might have only talk stations pre-programmed. Your kid is in earshot, and – Dr. Paul Ekman, father of human emotion research would say this is key – you aren’t looking directly at each other.
This is optimal connection opportunity: with very few distractions, you have the chance to hear about soccer practice, SAT’s, who is dating who… okay, okay, I’m not really selling this. It’s a way to check in and see how your progeny is feeling. Are they really okay after losing a beloved family pet? How is their best friend’s new relationship affecting their friendship? Are they struggling with identity, weight, popularity, academics? That front seat can be anything from a chance to share plans, to try out new ideas, to test a life theory or a boundary, or collaborate on an upcoming social event. Or sing Top 20 radio together.
The best conversations aren’t always serious and face to face: sometimes, they come with rush-hour traffic, spilled Starbucks and a sound track.
This is a continuing blog series on information about therapists, based on my experiences as a clinician, exposing what it is like to work as a psychologist, and possibly how this can be applied to your own life. Got a question you have always wanted to ask your therapist about themselves? Email firstname.lastname@example.org
I recently received the following question via email: What happens when a therapist falls in love with their client?
This is probably the biggest ethical question that comes up in our training as therapists, and what I remember as the one biggest take away from my ethics class in graduate school: DON'T SLEEP WITH YOUR CLIENTS.
It actually bothers me a lot when therapists are portrayed in movies and TV shows as an occupation that seems to always be sleeping with their clients. Not only does it project inaccuracies about the profession of therapists, but also that this is a normal occurrence. Does it happen? Yes. Does it happen often? No. Is it okay? No. Why?
The biggest reason this is a big no-no as a therapist is because we, whether we like it or not, are a type of authority figure to a client. We are in a position of influence, and we are incredibly skilled in the power of persuasion and social skills. We also know things about you that no one else may know, have a great connection with you personally, and we also understand your feelings and are often times your ally versus what the world may be throwing at you. The conditions can be optimal for love to happen.
I'm not going to lie, I have clients that I genuinely like more than others. The connection with them is stronger, they are more likable, and easy to work with. The reason I find that I have feelings of affection for my clients are they follow my instruction, reflect on their progress, are open with me about their concerns, and they come to their appointments. Basically, they respect me on a human and an expert level, which is really cool and empowering to a therapist when you are that respected. Imagine if everything you said another person thought was so brilliant and insightful! You'd have some feelings of affection for them too, and good feelings about yourself. I can also tell you that my friends and family do not listen to me like my clients do. I'm not in a position of authority with my friends and family. To them, I'm just Candice because that is the relationship I have with them.
As therapists, we can use our superpowers for good, or for bad. This is bad because breaking a professional boundary with a client when they are the most vulnerable, is taking advantage of them, whether you are actually in love with them or not. Other professions get in trouble as well for having intimate relationships with clients, students, or subordinates. Therapists are no different.
If a therapist and client decide they want to pursue any kind of romantic or sexual relationship, there is generally a waiting period suggested in our ethics codes before any relationship can happen, and neither side should have contact with one another. This is to ensure that both parties get some distance from the relationship, get some perspective, and determine whether or not this is different from the therapist-client relationship.
In the America, Psychologists are asked to refrain from resuming the relationship for 3 years. If this criteria is not met, a Psychologist could risk being professionally reprimanded by their professional associations and having their license revoked from the state where they practice. If you, as a therapist, cannot control your impulses enough, cannot ask colleagues for perspective on the situation to help you see the problem, or call your licensing board when you have questions about this area, then you are a risk to the public.
If you are a client of a therapist who has an inappropriate relationship with you, including romantic acts, sexual acts, or anything that you wouldn't normally do with a physician or other medical provider, please contact their state licensing board. It is NOT okay. While you feel this may be true love or genuine feelings, and possibly it is, there is still a shroud over your relationship that puts two unequal people in an incredibly intimate relationship, which could turn toxic and unhealthy very quickly.
Another thing to consider is that you may not be the client this has happened to. Licensing boards are there to protect the public from any therapist who uses their superpowers for bad reasons, and by reporting them you are potentially protecting others as well from psychological damage.
I’m so often hearing clients recite something along the lines of “I know I need to learn how to be alone.” It’s usually centered on a discussion about relationships. It’s the idea that somehow they need to get over the discomfort of not being in a relationship. Perhaps they’ve had a series of unhealthy ones or simply just lost one and feeling pressure to find another. There seems to be this widely held idea that the discomfort indicates a deficiency in independence.
“You need to spend some time alone…figure yourself out.” It’s a well-intended thought but, in my opinion, slightly misguided. There is a huge difference between being okay with being alone and being okay with being by yourself. Definitively, they are synonymous of course but let’s look at it perspectively.
Dependencies and co-dependencies are indicated when a person feels anxious, lost, or out of control without a partner guiding them or someone to take care of. These types of relationships can be very unhealthy. There likely are dynamics within a dependent/codependent relationship that view doing something independently as uncomfortable or threatening. This is very different from someone desiring companionship.
Humans are a lucky species equipped the skill of language. We are a social species. There are exceptions to the rule, but those exceptions don’t include introverts. Introverts still very much crave social interaction, but on a smaller, more intimate scale. At the heart of social interaction is companionship. An extrovert may be able to fulfill the needs for companionship through numerous friendships or less intimate connections, but aren’t usually opposed to the idea of deep companionship.
Companionship is a healthy connection between people that thrives on respect, admiration, and enjoyment of one another’s company and usually involves meaningful and trustworthy sharing. These relationships often make us feel more secure and we learn to depend and rely on them for those things. They aren’t necessarily limited to one person, but many people do choose to hold at least one person exclusive or prioritized to certain aspects of companionship. For someone to rely on this aspect of their life as necessary for optimal wellness is not an indicator of something wrong. To want to replace this when it’s lost is not concerning. The concern comes when the person compromises their self-worth or boundaries in order to accomplish companionship more rapidly or withstands mistreatment out of fear of not achieving companionship again.
So next time you hear or tell yourself “you need to be alone for a while before your start dating again,” just make sure you’re exploring the deeper meaning of that.
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