therapy – Inspiring Change LLC

UPDATE: COVID-19

Therapy is best done face to face as we communicate with one another with our bodies, emotions, faces as well our words and our silences. But in these unusual times of pandemic control, I will be adjusting my client contact according to CDC and State Health Department recommendations.

I am now offering telephone OR Telemedicine (HIPPA compliant video conferencing) to all new and current clients. Please call me directly at 612-735-2229 or email me at: lynne (at) inspiringchange (dot) us to get started.

In-office sessions have resumed. I ask that all in-office clients reschedule sessions to telephone or video conferencing if they have any active symptoms.

We continue to learn, experience and suffer together. May this worldwide experience bring hope in the midst of despair, and empathy over suspicion, healing in the face of disease, despair and death.

I’m Not That Kind of Christian

I’m frequently asked by prospective clients for my counseling practice if I am a Christian counselor. I’m sad to say that it’s not always easy to answer this simple question anymore. Not because my faith has changed, but because American culture has changed. Very often those who ask are looking for a very particular kind of Christian to be their therapist. And so, to answer their question, I often need to figure out just what kind of Christian therapy they think they want.

In the last generation or so, the conservative evangelical portion of the American Christianity has so frequently attached the term Christian to their political causes that for many outside the church, to be Christian is to be a conservative, rigid, regressive social thinker. I want nothing to do with any so-called Christian perspective that is anti-science, anti-woman, anti-education and anti-neighbor. I see nothing in that perspective that points me to Jesus.

When I read and think about Jesus, I see a young, brown-skinned Jewish rabbi who turned his world upside down. He didn’t seek the rich and powerful to be his disciples; he chose fishermen and tax collectors. He spent his time seeking the company of the least powerful in his culture: women, children, outsiders, the diseased and the poor. He preached a gospel of forgiveness, love and service. He healed the sick and raised the dead, pointing to a God already in the world in a new kind of kingdom. He knew his scriptures, he understood the power structures of Judaism, and pushing at those powers is what led to his crucifixion.

When I consider how Jesus has been chronically mis-characterized throughout the generations, I really shouldn’t be surprised that we still face this problem two centuries later. My own religious tradition is based on a struggle to reform Christianity. The German priest Martin Luther, whose name later became synonymous with the 16th century European Protestant Reformation, was a serious scholar of the Bible and critic of the church. His sermons, lectures and religious tracts helped to lift Christianity out of centuries of crushing political enmeshment in which kings and princes appointed the local bishops and priests, the people never heard the scriptures in their own language and were taught to obey every law of the church in order to please God. Luther’s movement broke that world into pieces.

With such a fragmented, decentralized and diverse Christian church around the world, it seems impossible to hope for a new wave of reformation to sweep across our continent. The rigid conservative edge of the Christian community has the ear and wallet of the current political establishment, more and more of our young people are rejecting institutional commitments like congregations and seeking spiritual support elsewhere. Churches are closing, seminaries downsizing and church publishing houses are collapsing.

And yet, those of us who remain, who joyfully call ourselves Jesus followers, are called to continue to be a light to the world. To know down in our bones the kind of gracious, liberating God we follow. When I despair that one person can’t be of much effect, I find great inspiration in the witness of Pope Francis, who walks the streets, visits the poor, speaks several languages, opens his treasury for audit, holds his priests accountable for crimes, believes science to be the way we can understand our world, and advocates for the distressed with every president, prime minister or dictator who would meet with him.

Perhaps we are just in the early stages of another reformation, when the old is collapsing and the new is coming. May we not lose heart, for the world still cries out for light and hope and peace. I am a Christian, but not like you may have come to expect reading the headlines from Washington D.C. I follow a Prince of Peace, a savior to the nations, a healer of the wounded, and one who welcomed the stranger. He calls us to bear witness to the light. His name is Jesus.

(Originally published Saturday, February 17, 2018, Savage Pacer )

What is Structural Family Therapy?

I’m grateful to Sal Minuchin for helping us as family therapists understand, conceptualize and maneuver within the dynamic structures of families: the way that the emotional and legal connections of parents to their children over generations create fluid as well as fixed patterns of hierarchies, loyalties, rules, subsystems, coalitions and boundaries. While we may know these experiences instinctively, his theory gives us a vocabulary, structure and system of talking and thinking about these automatic family features.

I’m particularly glad for the way his ideas give us a way to talk about family power. How are marriages formed? How do parents use their power over children? What does it mean to be a grandparent, a sibling, a twin, a youngest or oldest child? Who creates the family rules? Who breaks them? Of critical importance is the way that this theory helps me to conceptualize children’s emotional dysfunction. I don’t have to think simply in individualistic, intrapersonal terms. I’m free to think, speak and intervene with children’s pain interpersonally by helping their parents better manage their own functioning, power, and relational well-being.

Every time I draw a new genogram, and hear about a conflicted marriage, a stressed child, or cut-off grandparents, and think about rules, power and family structure, I draw upon the core ideas of Minuchin and generations of clinicians after him who have helped us all become students of family structure.

1/2021: Here’s a great detailed look at Structural Family Therapy from a new counseling resource, Choosing Therapy: https://www.choosingtherapy.com/structural-family-therapy/

Sometimes it IS About You

As a family therapist and systems thinker, I view the conflicts and discussions in my therapy office as shared events and problems. We are all connected; what I do effects my spouse, my children and other close relationships, just as what they do effects me.

But there are times when one person’s habits, behaviors, attitudes, or choices are the source of a system’s pain. A problem frequently has a source. And it just might be you.

One of the most pained expressions I hear after couples therapy is the complaint that “therapy is always about me” and never focused on their partner. I hear it most frequently from my male clients. This reflects, I believe, the fact that men don’t often start conflict conversations in their relationships, leaving their women partners to do all that heavy emotional lifting. If their troubled patterns have been going on long enough, and the woman, despite how often she requests help or change, is always doing the complaining, the man is inevitably backed into his corner. Of course he feels that therapy is always about him. Because he has to travel so many emotional miles to catch up to where his partner has been.

In other situations, it may be that addiction is stealing away all the relationship and family stability. Or infidelity and secrets have damaged the sense of safety and closeness. Or one partner’s failure to care for their health, or work life, or family of origin problems weighs the entire family down. While all of these issues have system impacts, it just might be true that therapy, at least as we begin to unwind the issues, may truly feel like it’s All About You.

Healing Traumatic Memory

If only life was one long, beautiful, inspirational journey. But it’s not. Some of us know that life can include experiences of such fear, helplessness and pain that we wonder how we survived. Over time, and with support, most of us get back to what we would call our normal. Yet others of us discover no matter what, we just can’t.

We call these experiences psychological trauma, the kind of experiences that steal our mental equilibrium. Many traumas have their origin in childhood; our bodies and minds are dependent, small, developing and vulnerable. The younger we are when they occur, the more impact they may have on the way we learn to relate, think, feel and trust the world around us.

Traumatic memories happen within the brain when we survive a life-threatening event and experience overwhelming shock, loss, fear, horror and helplessness. The words we have for what we experienced are just not enough to explain it to others. Motor vehicle accidents, physical, sexual and emotional abuse, parental neglect and addiction, domestic violence, plane crashes, witnessing homicide, military combat, escaping house fires: these are among the experiences that can overwhelm our emotions and capacity to bear what we have seen and known. The memory of the experience is stored in a kind of jumble in the brain, never blending into what we would call our normal sense of self, our everyday explicit memory.

Neurologists, psychologists and other researchers have made wonderful strides in the last 30 years in understanding how trauma effects the brain. And as the science of trauma becomes clearer, so has the clinical work of seeking effective treatments: treatments for the post-trauma effects that are expressed in our bodies in the form of chronic pain, sudden panic attacks, visual and auditory flashbacks, depression, anxiety, relationship and work problems, addictions and patterns of emotional dissociation.

First generation psychological care for traumatic memory was talk therapy; some relief was attained by patients helped to fully describe their experience in a private, compassionate therapeutic environment. Second generation care added strong prescription medications to calm the nervous system, limit emotional affectivity or target psychotic symptoms. What the most recent research has shown is that both methods are insufficient; talking uses the cognitive portions of the brain without adequately engaging the emotional and survival systems, systems that were in charge during a trauma, and dulling trauma memories or disengaging them temporarily with psychotropic drugs won’t heal the damaged and chronically misfiring memory patterns.

What does work is helping the sufferer to carefully, artfully, and in a controlled and focused way to re-experience the memories, feel the experience again in the body while expressing the energy, body movements, sounds, sights and postures that were suppressed at the moments of helplessness, dissociation and physical restriction. To think the thoughts that seem too terrible to think, and to help the mind link up the original memory to the fuller, day to day explicit or narrative memory that we live and work in every day.

This is what the work of Francine Shapiro’s EMDR (Eye Movement Desensitization and Reprocessing), Peter Levine’s Somatic Experiencing (SE), Albert Pesso’s Psychomotor Therapy and Pat Ogden’s Sensorimotor Approach all seek in their similar models: to have the sufferer become integrated with their physical bodies, those same bodies that have experienced the trauma, to feel, tolerate, express, observe and rewrite their story in the present sense of the self.

All this is to say: there has never been a time in human history where more can be done to help the trauma sufferer than now. If you are besieged by physical and mental echoes of a terrible event in your past, please seek out care from a psychotherapist trained in the newer trauma resolution techniques. Many of us have found peace where there was no peace, and wish the same health and healing for you.

Please Don’t Lie to Me

I know as a person and therapist that Truth with a capital T is often a very subjective target. Your truth about an experience doesn’t have to be anywhere near my version of the truth of that same thing. You may LOVE Taylor Swift as a musician, and me? Well, I’m more Bruce. We went to the same concert perhaps, but did we have the same experience? No.

But when it comes to arriving at some shared version of what is or has happened in your family or marriage, or where you went on a vacation, or what your child said to both of you when she arrived after curfew last weekend, we should be able to agree on a mutual version of facts. We won’t get the details quite straight, but we should be in the same county. Even the same neighborhood. When we can and do, we can begin to talk about what is painful, or good, or what is not working or what you may want to talk about changing.

What sets us all up for failure, however, is when one person in the conversation is lying. Omitting facts or key feelings, covering up important details, scamming the rest of us in the group. I have to tell you, I’m a pretty good judge of people, most of the time. But I get slammed rather regularly by clients who have been lying to their spouse or to their family and friends for so long they are great deceivers. We will go session after session, even month after month, and I will notice that we aren’t getting much traction for emotional or behavior change. I will hear reports from one side of funny feelings or vague worries they have, and I keep working to be optimistic and focused.

And then the phone call, or the teary confession. “I’ve been having an affair.” “I want out.” “I can’t do this anymore.” Hits me up the side of the head every time.

If you are going to spend the money and time and energy to do therapy, please know that I will begin by trusting you to tell me the truth. Maybe not the Whole Truth, and Nothing But, but some version of truth that helps me know what we are all talking about. If you want some help uncovering that secret in the rest of your life, you will need to start by trusting me to hear it. Please don’t lie to me. I can’t help you when you do.

Why I Told My Clients about My Surgery

Years ago, when I was 6 years old, my family was in a massive car accident. That event, which nearly killed my parents, is a nodal life event for me. It is the source of many years of mental suffering, as well as the focus of eventual healing and my interest in psychology.

I was seated behind my father, who was driving, when the drunk driver hit our station wagon head on. The driver’s seat slammed into my knee, and jammed my hip into its socket. For the last 20 years or so, I have gradually lost range of motion in that leg, and felt occasional pain that has kept me in PT steadily for the last 5 years.

I finally decided it was time to find out what was what with my leg. It turns out the joint is destroyed by arthritis, and that there remains nothing more to do for it but replace it. I am going in for surgery next week.

As I have had to plan for a gap in my practice for the 2 weeks my surgeon anticipates I will need to rest and rehab at home, I decided to tell my clients why. I know that most of them would have asked me directly anyway, since we regularly talk about vacations, or trainings, or family obligations that change my practice schedule.

But the primary reason I share my personal health decision with my clients is that appropriately sharing more of myself within our therapeutic relationship is central to the way I believe good therapy works. I bring the whole of myself to our conversations, and that includes general personal information that connects me as a human being to their own lives.

I don’t believe that my clients need to know everything about me. Far from it. After all, therapy is about Them, and the worlds and issues they wrestle with in my presence and with my help. But sharing basic social information, stuff that connects us at a human level, is healing because it builds our connection as well as our equality before one another. My clients know I’m married, something about my hobbies, that I have young adult children, that I worry about how they are doing in their lives, that I have family I visit on vacations. They know I was a parish pastor; some of them have asked me why I left. I have shared some of that deeply personal and difficult journey with them. And we continue to build our relationship, even as we focus on their lives.

I believe what the research describes: that with over 200 or so discrete psychological theories, techniques and perspectives on human change that currently exist, what lies at the center of all of their effectiveness is the relationship between the clinician and the patient. The trusted, caring space between us that I work to sustain.

That is why I have told my clients about my hip surgery. My leg issue is not secret; most of them have noticed my limp. Nearly all of them have wished me well. For me, the old model of a clinically distant, intensely private therapist is less than helpful. As I see it, without trusting me to be human and real, how can my clients be real and human with me?

What Every Wife Ought to Know about Marriage Conflict

If I had the opportunity to share one essential marital tool with every wife in America, I know exactly what I would say:

Learn to bring up difficult topics with your partner in a calm, quiet and focused voice.

Marital researcher Dr. John Gottman has studied tens of thousands of marital conversations over 30 + years. He has found that there are 4 distinct communication habits that are poison to happy relationships. He calls them the “Four Horsemen,” like the biblical horsemen that bring in the end of times in the book of Revelation.

He has learned that men have a faster body response of adrenaline (increased heart rate, blood flow to the extremities, tunnel focus of attention) than most women to partner conflict. That means that when many women are just getting into the meat of their problem, their partner has become ready to run, fight and defend. It makes it very hard for men to stay focused and listen calmly without enormous effort.

If every woman could develop the personal skill of bringing up difficult discussions with their partner in a calmer way, their male partner is less apt to “flood,” focus and defend. And the conversation is more likely to be productive and problem-solving.

It’s a skill we practice in therapy all the time. Are you able to bring difficult topics up to your partner in a calm, cooperative way? If not, you may want to start working on this skill.

What is it that I wish I could tell every husband in America? Well, that’s for next time.

On the brink of a PTSD breakthrough

Today I was talking with two different clients about the research done at the VA in Minneapolis in veterans experiencing PTSD – finding in brain scans that traumatic memory seems to “reside” in the right hemisphere of the brain, right above the ear. So happy to have located a story on this research, and want to pin it here 🙂 On the brink of a PTSD breakthrough
Thanks to Dr. Apostolos Georgopoulos for his continuing research!

In The Therapist’s Office (now)

Every so often patterns seem to emerge from the diverse clients I see. Here’s what I’m noticing now:

1. Couples in my area are coming to counseling at higher distress levels. In our initial conversations, they easily say their problems go back years, not months. This often translates into one or both of the couple completely emotionally “finished,” and only coming to counseling out of a sense of obligation or the expectation that the divorce process in their county will expect some kind of counseling to occur.

Very often, men in these marriages are slow to agree to get counseling help. They may view the marriage differently, or be reluctant to reach out for support. When the wife begins to seriously talk about separation, the husband wakes up and says he’s ready and will often make the initial phone calls to therapists.

2. Couples have less confidence in counseling. Perhaps it comes from more choices for treatment (online, email therapy, coaching, prescription drugs) or a growing reluctance on many people’s part to give permanent change the time and energy it requires. I wonder if more people are willing to try therapy but quit when it gets hard to schedule or invest in, or if more people are choosing therapists by price alone. Many people will start therapy with less experienced counselors, but stop attending when the process gets bogged down.

Each of these issues makes helping couples heal and grow a true challenge. Therapy works best when there is less damage to heal, and works best when everyone is ready to invest themselves. Sometimes these factors don’t happen between partners at the same time.