When To Get Marriage Therapy

Most couples come to therapy when they have completely run out of steam. While there is a great deal that MFTs can do to help, it’s not a time in the family when people feel resilient, optimistic or energized. In order to create permanent change, one needs a good deal of hope and energy. And so does one’s partner.

I’ve observed that for many couples (especially those who have had a less-than smooth relationship history, full of stops and re-starts, difficult emotional turmoil, previous long-term partners and/or huge life stress) there are much better times to come to couples therapy and have a much bigger chance for successful growth.

They are:

1. Before marriage. PLEASE consider pre-marital counseling, whoever you are. There are fabulous tools available to me as a therapist to assess your relationship as it is now, help you understand your unique partnership in basic system and personality terms, and help you enter the marriage more awake to your strengths and weaknesses.

2. After the FIRST really big, painful, emotionally threatening argument. Happier couples, those whose likes and dislikes, personality styles, family of origin patterns and conflict themes are more similar to each other may never even have one of these blow outs. Ever. That would be ideal. The moment a frightening, threatening, abusive fight happens, think: Help. We need help.

3. When one of you feels as if you are drifting away from your partner and couplehood in a big way : a job that takes you away from home for days or weeks at a time; when new parenthood strains the closeness; a crisis of faith or health or employment. Couple relationships are always managing their own sense of healthy emotional distance from one another. But the marriage should always feel quietly, confidently connected. If it doesn’t, don’t let it drift without comment and professional support.

These are the times I have noticed in marriages of change and opportunity, when both partners may be open to learning new things about each other and themselves, and still see the relationship as positive, life-affirming, permanent. These are the points at which relationships can be strengthened, renewed, matured. Don’t wait until you can’t stand it any more to reach out for counseling. Chances are, your chances of recovery get lower with every week you wait.

What I’ve Been Talking About This Week

I find it interesting to notice that sometimes my conversations in therapy, with vastly different people and circumstances, seem to circle around themes on occasion. This week, I’ve noticed two topics that I am repeatedly seeing in session:

1. Men who have become “awake” to their own conflicts, problem behaviors and thinking and have made radical steps to be fuller, more peaceful people. Some have partners that are whole enough people themselves who rejoice in the change, and despite years of distance, hurt and resentments, fight along with their men to restore and renew their partnership. Others have partners who are too fragile, conflicted or hurt that the reversal appears like an “act” and feel the need to flee. Whatever the result, their is great Joy in the awakening, and it’s a pleasure to keep giving these new men feedback on their personal discoveries.

2. Narcissistic Personality Disorder. If there is a personality style that kills a marriage slowly and with deep pain, this is it. Whether the partner is male or female, the chronic lack of empathy on the part of the partner leaves the hurt, bewildered and worn-out one talking to me about how empty they feel when their partner, despite all evidence to the contrary, blames the spouse for all the pain, ignores the needs of their children, and never seems to connect with them. Worse still is the adult child who begins to recognize what growing up with a narcissistic mother or father has done to their sense of self, their confidence in relationships, or their ability to trust the empathy and care of another.

(I’m looking forward to the publication of the newest edition of the DSM-V. In it is a new model of personality disorders that I think will be helpful to the therapist as they come into regular contact with these persistent personality types.)

It’s been a long winter here in MN and the snow won’t quit. Once again, we will probably go from winter to summer in 24 hours. Hope that, wherever you are, you get all 4 of the earth’s seasons.

Peace,
L

What’s So Bad About Excellence?

I had another conversation with my professional mentor last week, and she said something about me and my good friend, K, as we finished the conversation:

… “it’s because you (both) over-function.”

Now, if you have been part of my training in psychotherapy, you would know that over-functioning is not a great thing. It’s not even a good thing. It implies that I regularly do more in my relationships than is necessary or even helpful. I felt the power of her comment today in a session with a couple in which I was working hard, being helpful, resourceful, and empathetic all at once. I was working, but I was working very hard.

But here’s the rub: what’s the difference between doing more than necessary and striving for excellence? Because that’s what I see myself doing. Pursuing professional and personal excellence. My clients count on me to bring a centered self into their time with me, a professional who has done her homework, reflected on their lives with them in session and on my own time, and who is prepared for their questions.

If I don’t bring my best efforts to my sessions, isn’t that the same as me under-performing? In the context of the primary models of family therapy, doing too much in the room doesn’t allow the space or energy for the client to lead their own therapy.  I want my clients to lead their own work. I just find, however, that that is only possible when I model what that means in the context of self reflection and critical thinking.

I know one thing for sure: I don’t want to be an under-functioner just to show how flexible I can be. Like most things in the therapy room, I will be looking for the sweet spot of the middle way, doing my best and then, helping my clients succeed, to get out of their way and walk beside them. 

Empathy First

I recently had a conversation with a mentor, in which I was the subject. Sharing as I was, I was surprised to find myself feeling increasingly confused and annoyed. I kept talking, and continued to listen to the detailed feedback, but I felt increasingly alone, misunderstood and distressed. Why?

Because the first thing I needed, and expected, I think, was some empathy. It wasn’t therapy, but it was still very personal conversation. I expected more support and companionable sensitivity. Emotional affinity. That wasn’t what I experienced.

So I was reminded – in a very personal way – that the very first thing that I must bring to the therapy or supervision conversation, the first thing I offer to the one who sits, vulnerable, across from me in my office, is compassion. Understanding.

Empathy first. It’s the necessary start of healing.

TMI

One of my professional supervisors recently referred someone to my practice for couples counseling. A day or so later, my colleague got an angry call from this same person, wanting to know why he gave him my name. Did he actually know who I was?!

Of course, my colleague said. I gave you her name because she’s a very good therapist.

I looked her up online. Have you read that newspaper column about the Church? he countered.

Well, yes, and I don’t think there was anything in that column about the Church and child sex abuse that wasn’t true, my mentor said. After some other choice words, the caller asked for a different referral.

I think that’s what we call client “self selecting.”
 
One of the risks of writing or speaking in public is that people may actually listen to you. Since most if not all of what I write would be considered persuasive speech, what happens as a matter of course is that some people will agree with me, and some people won’t. And in that process, some form strong opinions of me as a therapist, or former pastor, or even as a human being.

And while occasionally it brings with it positive, affirming comments, it’s the angry, bitter, divisive opinions that most often get shared with me. Before the internet, my audience was my congregation and those who received the local paper. Now, my published words are stored, copied and accessible for anyone who wants to find them online.

Being someone who likes people, ideas and happy relationships, it’s a bit painful to hear that my name is being denigrated for an opinion that is factually true and holds church leaders accountable for their power over children. Am I willing to stand up for what is true, and advocate for change in the Church, for example, even if I get personally attacked? I am. But I will also have to grow a thicker skin, because some people who might have sought me out for therapy will turn elsewhere, convinced I can’t serve them because I don’t think just like them.

Too Much Information: does my writing give potential clients too much information before they contact me? Should a psychotherapist be perceived, as we once were, as aloof, private blank slates upon whom clients projected their lives for reflection and perspective? With all my words out there, that’s not possible for me. I believe that I have been given an important opportunity to write, think and reflect on life in newsprint and online, and I’m not going to waste it.

If people who might become my clients think it’s important to vet my ideas for their own version of truth and correctness, so be it. We probably wouldn’t be happy together as client and therapist, anyway. I seek the light of God in every person I serve. If a client can’t get their focus off of me and onto themselves, we won’t get anywhere.

Best they find themselves a therapist they THINK thinks just like them. I guess that’s what being online does for me: if someone believes their counselor needs to pass a political or religious litmus test to help them, they can test drive me without ever dialing the phone. And I’ll just keep working to help those whose hearts open to include the unique writer, person and therapist I am.

Summertime Unease

The summer is a difficult time to be a church-attending believer.

The pews empty, what with church education programs closed down for summer break, clergy finally taking some long-anticipated vacation time, choirs enjoying their evenings free of rehearsals and every other family traveling somewhere. Some congregations do better than others, having a longer visiting clergy list to draw from, or a deep bench of talented musicians to call on to carry the songs and liturgies along.  But the offering plates are dangerously lean, and the newsletter articles about the summer mission trips are anxious and urgent in their optimism. In those congregations where there is literally nothing between services, the hours pastors walk the halls of an empty building during a 3 service Sunday is deadening to their spirit, believe me. The church seems more dying than asleep.

The only up sides I enjoy in summer church are easier parking and longer Sundays at home. Not good indicators of a strong communal future.

I have never felt the demise of the traditional Protestant parish to be so urgent as I have in the last two years. I’m sure my late optimism was driven into me, having graduated from a traditional Midwest Lutheran seminary full of teachers and administrators educated and serving in the heyday of the institutional Church, the 1950s and ’60’s.  A changing American church? They didn’t see it coming. Or if they did, they looked the other way. Ordained in 1984, I remember all the years of denominational articles, letters, programs, trainings and trips to stimulate the parish life I inherited. I knew I was captain to a ship taking on water. Members expected strength, growth and spiritual pride in their church. I bailed faster, and felt the panic deep within me. Some of that panic propelled me out of parish ministry in 2004. In the six years since, I’ve been quite focused on my training and work of family therapy. But I haven’t left.

I struggle with this common distraction and panic. Everywhere I turn, the denomination I claim as my own seems lost in a scramble for relevance. Liturgy, once rich with words and movements and rhythm has been replaced by giant screens flashing PowerPoint versions of reworded creeds. I am numbed and bored, and I don’t seem to have a place any more. The denomination I claim to be my second church home keeps moving along with a common liturgical focus and broad social net, but seems nonplussed by its lack of growth and aging congregants.

There is a new time of the Church coming, but I can’t see around the corner just yet. I’ve been reading the New Testament book of The Acts of the Apostles in the one hand, and Phyllis Tickle’s 2008 The Great Emergence: How Christianity is Changing and Why in the other.  This summer, with empty pews and open parking lots, the questions seem particularly urgent. 

Helplessness = Trauma

I have been thinking about my, and our, experience of helplessness in the face of the Gulf oil disaster. About what it feels like in our bodies to be continuously exposed to experiences in the world that we can’t control but which have large, perhaps even life changing effects on our lives.

In the last 50 years or so, psychology as a science has become increasingly wise about experiences that wound the soul. The kind of happenings that lock up a part of our brains, quite literally, from easy connection to the rest of our inner experience and cause us to emotionally get stuck in the memory. We call these experiences traumas. Trauma with a capital T.

In the current mental health definition of post-traumatic stress syndrome, a person witnesses or experiences something life-threatening, shocking, and horrific, but with one key experiential ingredient : they feel powerless.

Powerlessness is what seems to turn a terrible experience into a Trauma; the inability to respond. Being able to do something in the midst of a rape, or fire, shooting or car accident seems to be the way that human beings help themselves mentally manage the horrors of life.

In all of human history, with the exception of the last decade, the way that human beings were exposed to the darkest part of life was that they lived it. Civil war, tornado, forest fire, genocide, death in childbirth were all experiences limited to the people who lived them in the Now. The average person may have heard about a battlefield massacre hundreds of miles off weeks after it was all done; the sinking of the Titanic days after the ship sat at the bottom of the ocean. The physical distance and the oral or written account were buffers from the sense of immediacy of pain. And while illness, death, disease, and war came very close to everyone, the human struggle had a local feel.

I am concerned for us in the age of constant media exposure. Not only do we hear about the devastation of Haiti or Guatemala after earthquake, we are taken there by professional as well as citizen video, blog, radio, television and internet streams. Rivers of emotional information, rushing at us day and night, eliciting in most of us sense of chronic helplessness. We are being exposed to suffering not in the scale of a single lifespan, but on a world-wide scale, a level most of us can’t possible sustain. And the only way that most of us have of being less helpless, of sending money, is a weak antidote to the larger emotional burden the river of news places on us.

When we watch the oil wash up on the unique marshlands at the mouth of the Mississippi, or see a dead dolphin or pelican laying on the beaches of northern Florida, we layer yet another experience of helplessness on our brains. Haiti, Afghanistan, Iraq. Over and over. It’s trauma, with a small t.

Will we all become a species so accustomed to the experience that we will adopt what is called a “learned helplessness,” where sooner or later nothing moves us any more, and we emotionally disconnect from the needs and suffering of others?

What do you do to limit the exposure you and your family have to trauma you can’t fix, suffering you can’t stop, horror you can’t control? How can you spare yourself and your children from emotional wounds of trauma caused by round-the-clock media?

Pastors are a Bridge

When I first began my private mental health practice, I knew one thing was certain: I needed to meet as many area clergy as I could. Today I had the pleasure of having coffee with an another local parish pastor. Thanks, C!

So many people still experience embarrassment, resistance and fear when it comes to seeking therapy for relationships, emotions, or behaviors, they stall when it comes to getting help. They may talk to their friend or family member. They may occasionally tell their physician about how they feel. But as they get ready to reach for help, they may also talk to their pastor.

Most pastors are great at emotional triage. Trained in basic listening skills, taught how to manage themselves in emergencies, experienced at handling emotions at funerals, parish clergy are the go-to folks in many people’s lives when it comes to figuring out what to do when the going gets rough. I am honored so many people trusted their lives to me over my years in the parish. I learned early on to have a small group of trusted counselors I knew and to whom I could refer my parishioners who needed more help than I could give. I tried to think of myself as a link between suffering and help, and I kept in touch with those counselors on a regular basis.

Now, I strive to be one of those counselors that the pastors, ministers and priests around me trust. Someone they have met, looked in the eye, and gathered a personal sense of me for themselves. As I reflect on clients who have recovered well, who make the most progress in their personal goals, the ones who feel that therapy was a success: most have come to therapy via their pastors.

Thank you, Pastor, for being on the front lines in people’s personal lives. You are under appreciated in our secular culture, and over-worked inside the special world of the congregation. You may not feel it often enough, but you are loved, respected and trusted by your members, and a lot of neighbors and strangers, too. Helping people navigate the details of mental health care is a compassionate gift you give. Thank you for trusting people you care to me, and to other therapists you know and trust.

Oh, and one more thing: you are often neglectful of your own mental health. Don’t forget to reach out for help yourself. Some of us know exactly what your life is like, and can be trusted as a confidential guide to increasing YOUR emotional health.  God’s grace surround you!