It's the Little Things

"Never get tired of doing little things for your partner. Sometimes, those little things occupy the biggest part of their heart." - John Gottman

The small interactions in marriage, will add up to have a massive impact on the quality of that marriage.  Be intentional in making those interactions positive. 

For a more detailed information on this concept, please check out this article I wrote for my office website. http://christianfamilyinstitute.com/little-things-count/

 

Wedding Expenses and Marital Success

The somewhat simplified results of recent research, suggests, that expensive engagement rings and weddings, actually increases the likelihood of divorce.  The exact cause or correlation of this is not yet understood, we just know that these things seem to occur together. One of the hypothesized reasons is that for some of these couple, the cost of the ring/wedding, contributed to the financial distress the couple as to deal with as husband and wife.  While it is true that finances are at or near the top of the list for issues leading to divorce, it is also near the top of the list for issues with which stable marriages have to cope.

I have my own theories. I suspect that the show, gets in the way of the message.  Couples, get so incredibly focused on having the biggest ring,  the fanciest wedding and all the associated events.  Then, the actual wedding service, the significance of the vows they are taking, and the reality of the commitment they are entering, gets lost in the spectacle.

Getting married is a big deal.  It certainly deserves a big celebration.  Just don't let the celebration, cast a shadow on the marriage, that has been created.

 

For more information on this research, check out this article.

Predicting Successful Marital Therapy

Predicting the success of marital therapy, is not an easy thing to do.  In fact, I've had some cases, that I thought should be successful, that ended up imploding. Then I've seen cases that I honestly thought it would take a miracle, and sure enough, I got to see the miracle. With that in mind, I must say I have seen some characteristics, of couples that suggest a higher chance of success in therapy.

Let us start with a description of a more difficult case. A difficult case is one where the couple says, “We decided to stop by your office on the way to the lawyer.” I’ve not had that statement made literally, but the effective message was the same. By the way, a colleague has had clients say, “We have an appointment with the lawyer this afternoon.” The problem is when clients, whatever the issue, come in after the problem has really beat them down, they may feel too tired to do the work or are desperately looking for quick relief. While I am quite happy to take up the challenge, the process is seriously handicapped by the fatigue and desperation these clients feel.

The more successful clients, tend to have different timing and attitudes. First, they come in much earlier in the process. They have a problem, they’ve tried to solve it, and are finding the solutions to be more difficult to identify than they thought. The problem is significant, but it hasn’t overwhelmed them. Then they consider getting some professional help. They choose to seek help, before the problem has begun to poison their view of their partner.  These clients also comes in with a different attitude. They realize that there is some work to do. Change takes effort. It won’t always be pleasant, but usually the results are. They are willing to be honest with themselves and those around them. These are the clients who are most likely to get something out of therapy.

Even if a couple, currently fits more of the difficult pattern, I think they can choose an attitude, more akin to the more hopeful couple.  Coming into relationship counseling, with the goal of healing, a humble perspective and a hopeful view of the future, goes a long way towards success.  These are perspectives that can be rationally chosen, even if the current feelings don't match up.

Real Connection vs Pseudo Connection

I joined Facebook and Twitter several years ago, after purposely avoiding social networking for many years.  As a therapist who did a lot of work with couples, I had a skewed perspective of how social media effected relationships.  Too many affairs have been started on Facebook, chat rooms and even via interactive video games. Since I have participated in Facebook, I realize the benefits.  I joined as a way to connect with college friends I had not seen in years.  I then realized many other friends I could keep up with from other times in my life, and I found this to be quite enriching for my life. 

However, I have become aware of new problems associated with our tendency to use electronic means of communication and connection.  The issue is that, so often we get so into our electronics, that we forget to connect with the people right in front of us. I have seen too many situations, where individuals are in physical attendance with someone, but they are distracted by their device.  I've even seen this happen at my church. I know it happens in homes across the country. And yes, I have frequently been guilty of this myself.

So we really need to do something about this.  Here are my suggestion. 1) Make meal times no device times.  The phones, ipods, whatever, must be absent from the room.  2) Take mini vacations from the devices.  Turn them off for an hour, day or even a week if you can. 3) Make a point of spending quality time with your spouse and family members, every day.  Again, no devices. 

These are just a few ideas. There are many ways to go back to a time (not that long ago) when these distractions didn't exist, and connect with the important people of your life. The common element of these scenario's is the simple absence of the source of distraction.

Four Areas of Intervention- #4 Spiritual

Our spiritual life also has great impact on our mental health. Many Christians struggle with depression, anxiety, and many other mental health concerns. Then they feel guilty for being a Christian with these struggles, making them more distressed. Our relationship with God can have great impact, positive and negative, on our mood. A number of spiritual topics can impact mood. Some of them include, sin, poor theology, inappropriate guilt, spiritual abuse, lack of forgiveness and many more. Helping clients to sort these things out, and helping them understand the love and grace of God can be incredibly healing.

Also, our relationship with God has significant impact on the other three areas I've discussed. Scripture has much to say about taking care of ourselves physically, psychologically and relationally. We must let God's word guide us in these areas of our life as well.

 

Four Areas of Intervention- #3 Social

Our social lives, that is, our relationships, can have huge impact on our moods. For example, it is very rare that you see a bride and groom in the throws of depression. When our relationships are good, often our mood is good. When they are bad, our moods are bad. God created us for relationships. It is pretty obvious that we were created to be in relationship with one another. When God made Adam, He said pretty quickly in Genesis 2:18 The LORD God said, “It is not good for the man to be alone. I will make a helper suitable for him.”

In the diagnostic manual, used by the psychotherapy world, many categories have some type of relationship difficulty as criteria for diagnosis. In fact, for a few categories, persistent difficulty in relationships is the predominant criteria.

Some clients have relationship issues from the past that impact their mood now. They may need to do work to heal those relationships, or to overcome the impact of a dysfunctional relationship.

If our relationships are in a difficult place,  then it will effect our emotions. As such the effective treatment of depression will often involve marital or family therapy.

Through this work, we can help clients, and those close to them, to navigate the world of conflict, to celebrate their connection, help them set boundaries, learn how to communicate and solve problems, . We can also help them to learn from traumas of the past and choose not to let past social issues, infect their lives individually or relationally.

Four Areas of Intervention- #2 Psychological

While I realize that all of the elements, that will be addressed in this series, can be included under the broad umbrella of psychology, in this conversation I am specifically identifying thought patterns. If you do a series of interviews with depressed individuals, you will pretty quickly notice that they have great difficulty identifying with anything positive. When you try to get them to notice the positive, the response in frequently a "yes but". I tend to agree with the cognitive school of therapy that says that our emotions are a direct result of our thoughts. People who tend to see the good things in life, tend to be happy. Those who tend to see the difficult side of things, tend to be more sad, anxious, angry or distressed in general. Also, these negative thought patterns can begin to poison the way we think about those in our social network, influencing the interactions with those who are important in ones life. I have even seen situations where distressful thoughts have distorted a clients view of their relationship with God.

Biblically, we are encouraged to live hopeful, encouraging thought lives.

"Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable, if anything is excellent or praiseworthy, think about such things."
Philippians 4:7-9

In the treatment of emotional issue, we must address this pattern of negative thinking. Interventions in this area, tend to focus on examining specific thoughts and determining if they are helpful or not.  Other tools can include ways to redirect thoughts, choose different ways of thinking, and even help clients to interrupt episodes, in which thoughts become intrusive and seemingly overwhelming.

This is but an introduction to the many resources that have come out of the world of psychological interventions. These psychological interventions are often quite powerful and have very real capacity to bring about changes in our lives.

 

Four Areas of Intervention- #1 Biological

Depression is an issue that can be simple to identify, though not always. We've all experienced at least a taste of depression. Even biblically we see many individuas who likely struggled with depressive episodes. It would be hard to conceive that Job in the midst of all his struggles did not meet clinical criteria for depression. As you read some of the Psalms, it becomes pretty obvious that David had some very distraught moments in his life. Even Jesus experiences some element of depression in the garden before his crucifixion. I'm not saying that He met clinical criteria, but it is hard to believe that he didn't have moments of despair.

Yes depression can be simple to identify, but quite complicated in its causes. The complication comes from the variety of elements that influence its origin and continuation. I see depression as a Biopsychosocialspiritual problem. It has all those influences in its makeup.

My next few articles will deal with each of these four areas of treatement.

Biology
We know that there is a biology to depression. I could go into all of the neurological details, of course I'd need another three years in grad school to actually understand it fully. I do know that there has been direct correlation of serotonin levels and depression. Specifically, postmortem studies have noted a strong pattern of low serotonin levels in those who've committed suicide. I have dealt with enough clients who simply did not respond to talk therapy. Their chemistry was imbalanced enough that they needed medical intervention to get out of the pit of depression. The percentage of my clients in that situation is relatively low. More often than not my clients are dealing with a more moderate level of depression. With those clients, I discuss medication as an option, if they bring it up or if our treatment hasn't delivered the desired benefit.. If the client wants to go that direction, I'm willing to explore the possibility. If they would prefer try talk therapy alone for a while, I'm all for that as well. A lot of my clients don't even like the idea of medication. Somehow they feel inadequate or like a failure if they need psychotropic medications. Yet these same individuals may be on a variety of medications for high blood pressure, low thyroid, diabetes, and any other number of issues. So why is medication dealing with the brain such a sensitive area. Lets be honest, we think of our thought process as somehow different from other bodily functions. To a large extent I agree there is something different about how we think and feel. As a Christian I have to believe that we are more than a pattern of nerve interactions in our head. However, we cannot deny that part of healthy brain function is the appropriate balance and interactions of our brain chemistry. So just like some of us need medication to balance our insulin levels, others of us need medications, to balance our neurotransmitter levels.

While medication may be a useful tool in some situations, it is not the only biological treatment we use with clients.  Let's not forget that diet, activity, improved sleep and even appropriate exposure to sunlight, may be helpful to clients struggling with depression. These are interventions I encourage for ALL my clients. 

When Your Child is Anxious

When Your Child is Anxious

We all strive to provide a safe and satisfying life for our children. We want to protect them, as long as reasonably possible, from the worries of this life. However, some children (adults as well) just seemed prone to be more anxious than others. This can be very discouraging for parents. These children tend to find things to worry about. They often find things that seem outrageous for a child to be concerned with, yet they lose sleep and find these thoughts intrusive and overwhelming.

So what is a parent to do. Initially, avoid going into panic mode. Managing your own anxiety is an important part of helping our children manage theirs.  Also, episodes of anxiety, that go away as quickly as they begin, are not abnormal for many children. We all have struggled with these moments in our lives. However, if a child has developed a pattern of excessive worry and it is beginning to impact his or her ability to function, then intervention is indicated.

Initially, helping a child to think clearly, and providing appropriate reassurance, may be all the help that is needed. Also, aiding them to find healthy diversions, to short circuit troubling thoughts, can be very helpful. Even simple lifestyle habits like a healthy diet and exercise can be useful tools in overcoming anxiety.

If these things are not enough, then professional help may be necessary. Many parents will want to start with their pediatrician. It is useful to have the pediatrician involved early in the process so that possible medical concerns can be ruled out from the start. The pediatrician may suggest seeing a therapist. A therapist can help the family determine the sources of the anxiety problem and suggest appropriate treatments. Typically, treatment will involve a combination of individual and family therapies. Treatment will often focus on controlling troublesome thoughts and managing stresses in a child's life. If response to these interventions is not sufficient , there may be a need to include medical intervention. The pediatrician and/or a psychiatrist would need to be consulted on these occasions.

Throughout all these processes, it is important for parents to be patient, hopeful and encouraging. The ability to model hopefulness and realistic expectations will go a long way though all aspects of treatment.

My Introduction to Grace

Ephesians 2:1-10

As for you, you were dead in your transgressions and sins, in which you used to live when you followed the ways of this world and of the ruler of the kingdom of the air, the spirit who is now at work in those who are disobedient. All of us also lived among them at one time, gratifying the cravings of our sinful nature[a] and following its desires and thoughts. Like the rest, we were by nature objects of wrath. But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions—it is by grace you have been saved. And God raised us up with Christ and seated us with him in the heavenly realms in Christ Jesus, in order that in the coming ages he might show the incomparable riches of his grace, expressed in his kindness to us in Christ Jesus. For it is by grace you have been saved, through faith—and this not from yourselves, it is the gift of God— not by works, so that no one can boast. For we are God’s workmanship, created in Christ Jesus to do good works, which God prepared in advance for us to do.(NIV)

 

Sometime, in late 1996, I had just begun to work at a Christian counseling center in Lawton, Oklahoma. As I settled into my new career as a counselor, I began to feel some real challenges. One of the biggest came from my boss and supervisor, Glen Ryswyk. This was no minor challenge. He was challenging my theology. Not so much what I believed, but, how I applied that belief to my thoughts and actions. I believed that I was saved by grace, but, I didn’t really trust that grace. Therefore, I still had to make it through my own efforts.

The contradiction of this, belief without trust, hit me when I was praying. On this occasion I chose to pray by writing a letter to God. The very first line went something like this. “Dear God, Help me to EARN your GRACE.” No, I didn’t use all capitals as I wrote it, but when I read it, that’s what I saw. In black and white (actually yellow) sat what was possibly the granddaddy of all theological oxymoron’s. Earning Grace. The idea, that someone could be good enough to earn a free gift from God. Especially when you realize that the very reason you need that gift is because of you are not good enough.

That was the moment that the Holy Spirit both inspired me and slapped me upside the head. Inspired with awe of the amazing love of God. Slapped by the realization that I had trusted my own abilities more than God’s grace.

Since then, I’ve continued to realize how grace casts a new light on so many areas of life. I believe grace has much to say to my clients as they deal with the issues that brings them to me. I know its had a lot to say to me.

Connection Matters

I’ve been gleaning more information on marriage, and I have come to a new realization in the last several years.  Previously I believed that prevention, of harmful communication, was the holy grail of marital therapy.  Okay, that is a bit overstated.  However, I did tend to focus on communication, a bit excessively.  I still think that healthy ommunication and problem solving, is a vital focus for many of the couples I see.  However, I’ve been paying attention to some of the things that John Gottman Ph.D. has been saying.  He suggests It is vital in determining the receptiveness, of one partner, to efforts of the other, to stop and/or heal from episodes of caustic communication.  So now, while I will often begin with a focus on communication, I will usually also give some focus, on how to improve the friendship, playfulness and emotional connection.  I find this focus on connection very useful, because it actually creates a positive perspective that makes the use of communication skills, much easier.  I find clients who come to therapy, typically don’t come for communications skill, even if they come in with that as the stated goal.  Couples come in because they are at risk of losing something very important to them, the friendship with their spouse.

Pro Marriage

It is not uncommon to be asked, if I ever think that some marriages just aren’t worth saving.  The question comes in a variety of forms.  Maybe its the idea that, some people just aren’t the right match, or, wouldn’t the kids be better off if the parents divorced rather than continued with their pattern of conflict.  Some have suggested that we’re just not happy, and as such, we should go our separate ways.

The fact is, research on these ideas, suggests that saving marriages is generally best for all involved.  Couples who weather hard times and stay together, tend to be more satisfied five years later than those who divorce.  This is true for them as a couple and as individuals.  Kids tend to function better in intact families than divorced.  Part of the reason is that, often, divorced couples don’t tend to give up the patterns of conflict they had while together.  So now the kids have parents who continue their conflict, except, now they fight mostly about the kids and custody, and they use the kids to manipulate, coerce and punish their exe.  I would suggest that this is the worse of two evils.  Some of the best research on these things can be seen at sites like smartmarriages.com and the research and reference portion of prepinc.com

All the above ways of thinking, tends to be based on an assumption that there are two choices. Continue our current pattern or go our separate ways.  There is a third option, stay together and learn to deal with your problems in a better way.  It takes work, usually hard work, but the results are worth it.

Back to the original question.  As a general rule, I am pro marriage.  I specifically got into the marriage therapy business in order to help people save and thrive in their marriages.  I don’t think I’d be inclined to go to a therapist who has a truly neutral stance on the value of marriage. This isn’t to say that I make decisions for my clients.  It is their decision to make.  However, I am honest with them about my pro marriage stance.