Relationship Land Mines – How to Handle Them

All people have topics or behavior that are emotional landmines. I think of watching M.A.S.H seeing a big sign saying, “DANGER-MINE FIELD.” I love to picture this sign in my relationships. If these emotional landmines are going to be there I think it is essential for survival to create a boundary around the mine fields. I have found it courteous to set boundaries around mine, so that people have more freedom within a relationship with me. If people don’t set boundaries around their own boundaries I have to create boundaries to keep myself safe from their emotional landmines, unfortunately I don’t know exactly where the landmines

are, so I have to create a boundary with large radius for extra safety. This is unfortunate because If boundaries are bigger than they need to be for the emotional safety this is limiting the potential for emotional intimacy in the relationship.

This is not only unfortunate for the person who “steps” on the emotional landmines, but also the person with the emotional landmines without appropriate boundaries. People thrive on relationships and connections. People who don’t create boundaries are absolutely terrified of being alone. Without knowing about emotional landmines, if you had the choice between land without blocked off areas and land that had nothing on it, the land without any blocked off areas seems more attractive, at least until you start walking over it! A person without boundaries want to attract people, and boundaries are not attractive. Their need for connection is not inherently bad, they are meeting this need in the only way they know how, because they haven’t experienced a long term intimate relationship as an example. Therefore, they have people around them who are avoiding a close relationship, or freeze to avoid any emotional landmines.

When you are in a relationship with someone who doesn’t create boundaries, you will often find yourself apologizing without knowing how you’re at fault. If apologizing becomes your default to suppress emotional explosions, you will attract people who have a need to blame.  People who blame are only considering their own needs, people who apologize as a default only consider the needs of others. A healthy relationship will balance your emotional needs with the needs of others with consideration of the context. If this isn’t happening your efforts to get closer to people will result in resentments. If you’re thinking “if they only knew what I was really thinking, they wouldn’t love me.” You will feel lonely in a room of people who love you.

When you share your truth, unfortunately you do risk losing people in your life.  However, knowing that even the one person who stays loves every part of you, and respects you enough to respect your boundaries will be worth anyone you lose. This is the most difficult part of setting boundaries, you have to reach a point where you can accept losing a relationship all together in order to do what it takes to be a healthier person. Accepting that you could lose a relationship means that if they are uncomfortable with boundaries they may cutoff communication with you. When you respect yourself and you respect other people enough to show them where your boundaries are to keep you and them emotionally safe, you will begin attracting healthier relationships.

Written by Madison Price, MS, LAMFT – Therapist at the Holladay Center for Couples and Families

 

The Impact of Borderline Personality Disorder on Relationships

All too often, family members, friends, fellow employees, and even therapists become reactive, judgmental, and walk on eggshells when they interact with someone who displays characteristics of borderline personality disorder.  Let me start off by summarizing some of the core characteristics of the disorder, specifically focusing on those traits which play out in the interactions with others.

  1. Affective Instability – This is where those with BPD struggle to regulate their emotions in predictable ways.  Often, their mood does not match with expected life or social situations, thus making it difficult for those around them to understand or relate to the distress they are experiencing.
  2. Fear of real or imagined abandonment – Those struggling with BPD are often afraid of being rejected, abandoned, or left alone emotionally. These feelings are triggered when the potential abandonment is indicated, as well as times where it isn’t.
  3. Identity disturbance – It can be difficult for those with BPD to maintain a consistent sense of self. There is typically a variance of self-doubt, instability in self-image, and self-acceptance.
  4. Impulsivity – Due to the emotional and personal instability, impulsivity is often a regular occurrence for those with BPD. While this may not feel disruptive for the individual, it can be highly disruptive for those around them.
  5. Paranoid ideation and dissociative symptoms – In certain situations, those with BPD may struggle with feeling paranoid, especially in relation to how they perceive other’s intentions or motives. Also, they may experience dissociative symptoms, which is a disconnect from themselves, their reality, or their sense of self.

What we need to understand about personality disorders is that they are just that, disorders which occur within the core personality of the individual.  This is important to consider, because it is extremely threatening to the individual when a personality disorder is suggested, or when a diagnosis is made, especially since it is difficult to be “objective” about your own personality.  Because of this, it can be very threatening for someone experiencing symptoms of BPD to identify and accept that the symptoms are present in their life.

It is my professional belief that the symptoms of BPD are treatable, and that through treatment, people can reduce the identified symptoms to the degree that they no longer qualify for the diagnosis.  This perspective can bring hope to those struggling with BPD, as well as those who are involved in their life.  However, the process of therapy can be challenging, and typically requires long-term treatment.

Selecting a therapist who can treat BPD effectively is an important step in the process.  The therapist must be able to accurately diagnose the disorder, as well as position themselves in the therapeutic relationship as to control for and manage the identified symptoms.  A careful balance between soliciting BPD symptoms and maintaining safety and security within the therapeutic relationship is critical.  Failure to challenge the BPD symptoms results in no change, while doing so without carefully creating a safe therapeutic relationship will typically result in early or even immediate rejection on the part of the client.

Once someone with BPD can effectively accept the diagnosis, identify how the symptoms play out in their life, and learn new ways of managing and responding to the symptoms, then they can focus on the primary relationships in their life, and work on how they relate to others in new ways.

Written by Dr. Tony Alonzo, DMFT, LMFT, CFLE therapist at the Holladay Center for Couples and Families

The Impact of Borderline Personality Disorder on Relationships

All too often, family members, friends, fellow employees, and even therapists become reactive, judgmental, and walk on eggshells when they interact with someone who displays characteristics of borderline personality disorder.  Let me start off by summarizing some of the core characteristics of the disorder, specifically focusing on those traits which play out in the interactions with others.

  1. Affective Instability – This is where those with BPD struggle to regulate their emotions in predictable ways.  Often, their mood does not match with expected life or social situations, thus making it difficult for those around them to understand or relate to the distress they are experiencing.
  2. Fear of real or imagined abandonment – Those struggling with BPD are often afraid of being rejected, abandoned, or left alone emotionally. These feelings are triggered when the potential abandonment is indicated, as well as times where it isn’t.
  3. Identity disturbance – It can be difficult for those with BPD to maintain a consistent sense of self. There is typically a variance of self-doubt, instability in self-image, and self-acceptance.
  4. Impulsivity – Due to the emotional and personal instability, impulsivity is often a regular occurrence for those with BPD. While this may not feel disruptive for the individual, it can be highly disruptive for those around them.
  5. Paranoid ideation and dissociative symptoms – In certain situations, those with BPD may struggle with feeling paranoid, especially in relation to how they perceive other’s intentions or motives. Also, they may experience dissociative symptoms, which is a disconnect from themselves, their reality, or their sense of self.

What we need to understand about personality disorders is that they are just that, disorders which occur within the core personality of the individual.  This is important to consider, because it is extremely threatening to the individual when a personality disorder is suggested, or when a diagnosis is made, especially since it is difficult to be “objective” about your own personality.  Because of this, it can be very threatening for someone experiencing symptoms of BPD to identify and accept that the symptoms are present in their life.

It is my professional belief that the symptoms of BPD are treatable, and that through treatment, people can reduce the identified symptoms to the degree that they no longer qualify for the diagnosis.  This perspective can bring hope to those struggling with BPD, as well as those who are involved in their life.  However, the process of therapy can be challenging, and typically requires long-term treatment.

Selecting a therapist who can treat BPD effectively is an important step in the process.  The therapist must be able to accurately diagnose the disorder, as well as position themselves in the therapeutic relationship as to control for and manage the identified symptoms.  A careful balance between soliciting BPD symptoms and maintaining safety and security within the therapeutic relationship is critical.  Failure to challenge the BPD symptoms results in no change, while doing so without carefully creating a safe therapeutic relationship will typically result in early or even immediate rejection on the part of the client.

Once someone with BPD can effectively accept the diagnosis, identify how the symptoms play out in their life, and learn new ways of managing and responding to the symptoms, then they can focus on the primary relationships in their life, and work on how they relate to others in new ways.

Written by Dr. Tony Alonzo, DMFT, LMFT, CFLE therapist at the Holladay Center for Couples and Families

Medication Management and Mental Health

In my career in healthcare, I have seen far too many patients who have been prescribed medication and continue to take that medication faithfully; Yet after a time, they are not really sure why they are taking that specific medication or if it is even helping with the diagnosed issue.  

 What is missing for these patients? Medication management 

Medication management is the process of following up with the healthcare provider on a regular basis to assess the effectiveness of the prescribed medication therapy, discuss any side effects that may go along with the medication, and make adjustments in order to achieve proper dosing. In some cases, the follow-up may be to change the prescribed medication therapy, if it is not providing the desired outcomes. Medication management should be an ongoing process. It should include open dialogue between the patient and provider about the effects of the medication combined with any other therapies or treatments that may be in place. This is to ensure useful data is being collected, so decisions can be made based on the whole picture; not just the medication piece. 

When it comes to psychiatric and mental health services, the importance of quality medication management cannot be overemphasized. Not all people who seek psychiatric help will require medication. In some cases, amino acid therapy may be appropriate or continued therapy and counseling with regular psychiatric follow-up is warranted. If medication is prescribed, the patient should plan to see the psychiatric provider within 2 weeks (in most cases) for the first medication management visit.  Continued follow-up visits should be scheduled monthly, or as needed depending on the individual case. 

During these visits, the patient should plan on communicating openly with the psychiatric provider about their use of the medication, any side effects that they may be noticing, and any changes they are feeling in relation to their mental health diagnosis. At times, genetic testing can be used to pinpoint what medications are more likely to work for each individual patient. This testing can be used not only for patients who are just beginning psychiatric treatment but also for patients who have been prescribed medication therapies that aren’t working. The patient should also plan to consult with the psychiatric provider before taking any other medications. They should inform the provider of other mental health therapies being used or medical complications that may arise during treatment. The patient should expect the provider to ask questions that will direct and lead the conversation, so time is well spent and modifications can be made with confidence. 

Ultimately, the key to effective psychiatric medication management is open and continual communication between the patient and provider. At the Center for Couples and Families, our psychiatric providers strive to provide thorough psychiatric assessment, follow-up, and medication management. 

Originally published on http://utvalleywellness.com/

 

 

Cleaning Out your Marriage Closet: Couples Counseling

People are often worried about drudging up the past with their loved ones. There is controversy as to what is healthy for the relationship. People certainly don’t like to bring up an old fight when everything is going well. The issue is that we all have a closet of sorts where we hide everything that “isn’t worth the fight.” At first this closet is empty and the intention of putting things in there is good, you intend to talk about it later, it’s just not the right time.

The problem is that you enjoy the times you’re not fighting, who wouldn’t! You soon forget about what you’re storing in the closet, and you continue to throw everything “not worth the fight” into the closet. Your closet becomes full, and when you try to fit one more thing in there everything topples over. This is the fight of all fights, this is when you seemingly “loose it” out of nowhere about nothing and everything. This fight happens at a time when something was already “not worth the fight” and you were trying to put it in the closet. Therefore, you are probably not up for resolving everything in that closet either. It’s like if your junk closet toppled over just as company is coming over, you’re going to scoop everything up and stuff it back into the closet because you don’t have time to sort through it. This fight leaves everyone upset and confused and often nothing is resolved in this fight.

So how does one clean out this closet? Well its much like spring cleaning, you are going to take everything out and you begin to sort everything into categories. You evaluate if it is something that only happened once and will never happen again, if this is the case it truly isn’t worth the fight and can be thrown out. If it is something that continues to happen you need to address it, you will be bringing up the past not as a weapon against the other person, but as a justification for bringing it up as an issue. It is absolutely necessary that cleaning this closet is done at a time when your calm and you remain calm to be able to assess what the core of the problem is, what does their behavior tell you about your relationship with them. For instance, If someone is always late, how does their behavior effect you, why does it feel disrespectful to you and how does it create distance in your relationship, what is the message you receive about their feelings toward you. As opposed to judging their behavior as something you wouldn’t do and lecturing them about how it affects them.

When you clean out the closet you are transferring responsibility to the people it will be useful with. You will find that the cleaner your closet becomes the more clarity you will have in your relationships. Your intent in cleaning out the closet is not to change other people’s behavior, it is meant to change your relationships. You will find that some people will choose to become more distant because they are unwilling to make changes, but the relationships that become closer and the internal peace will be worth the distance in others.

Written by Madison Price, MS, LAMFT – therapist at Holladay Center for Couples and Families

Shared originally by the Holladay Center for Couples and Families

Hidden Signs of Depression

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.  

Trouble Sleeping 

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.  

Losing Interest 
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.” 

Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed. 

Low Self-Esteem 

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.  

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Originally published on http://utvalleywellness.com/

 

Maintaining A Relationship That Is Juicy, Fun, Passionate and Loving by Dr. Matt Eschler, Ph.D

I am pretty certain that we all hope for a juicy, fun, passionate, loving relationship with our lovers! The relationships that maintains a spark over decades of being together are built carefully they most definitely are NOT accidents! You don’t connect with a “soul mate” and settle into mandatory bliss. If you are hoping, longing, reaching for a juicy fun passionate relationship then you will want to read the rest if this article!

Juicy fun passionate relationships are created. If you keep a few rules you can be certain your marriage is all you ever fantasized about! Keep these three incredibly simple rules of engagement and juicy, fun, passion will be yours!

Get to know each other every day.

By constantly developing connection and strengthening your relationship bond you breath new life into your marriage every chance you get. Sometimes you will be giving rescue breathes during crisis and struggle while other times you are giving extra oxygen creating a sense of peace and relaxation. Know your lovers top five or six needs to be happy. Many couples think they know each other and know what drives happiness only to find they have lost touch with change, growth, and each other. To keep on the razor edge front line of juicy passionate fun you have to meet together and talk. I suggest three meeting a week is the minimum. These three meetings each come with there distinct purpose. First have a date night. This is where couples flirt, tease, kiss, and talk about hopes and dreams with each other. Second meeting is couples council. In this meeting you discover the struggles you each face. You empathize with each other, grow through strife and strain while talking about hard topics trusting you will stand by each other for better or worse. Third meeting is family night. This is a time to organize your family share family activities, dreams, and structure the household as a unified front. All three of these meetings are really mandatory and refreshing if you engage weekly on purpose.

Transparency

Second of the three “must” for juicy fun passionate relationships is all about transparency. Share your whole self holding nothing back. If you only share what your lover approves of your holding them hostage. Allow your lover to see all of you and realize your love for each other grows with knowledge of what makes us tic. Sharing a deep sense of fondness and adorationfor each other! (Number one cause of divorce is contempt) is a major part of the intimacy you will Experience. Have you ever caught yourself thinking fond thoughts about your lover and not expressing these thoughts out loud because it feels way vulnerable? My challenge to you is be vulnerable every day! Dare to share all your fondness and admiration out loud and often! Pray with each other express gratitude to the God of your understanding for each other. Imagine the power you will have as Couple joining in prayer to begin each day unified! Celebrate victories, Support each other’s interests, and helping achieve each other’s dreams are all ways of generating juicy fun passionate marriages. I think you get the idea.

Positive Sentiment Override (Gottman Term)

Finally the third principle followed by juicy, passionate, fun couples is a constant positive sentiment override. You always have two choices in how you SEE your lover. You can think negative or you can see the good. You can interpret what is said through a filter of offense. Seeking to be offended will generally lead to you finding a way to actually be offended. The thousands of interactions will be filled with minor slights and errors that can be exploited and used to feel sad, hurt and bugged a each other. On the other hand you have every right to filter all those same interactions through a sieve that separates out all the warm juicy passionate sentiments and feel love and joy. It’s really fun p to you! No, your not burying your head in the sand your simply seeking the good gifts offered.

Think about all of this and have an incredible juicy fun valentines month in February.

About the Author:  Dr. Matt Eschler lives in St. George, Utah where he and his wife Chris are enjoying their life with each other. Since their kids have grown and moved out perusing their dreams Matt and Chris travel the world. They want to visit 200 countries before the are done. Matt and Chris are active in their community and enjoy working out, training for marathons, and spending time participating in numerous activities with their adult children.  Matt has received his PhD in Psychology. He is focused on the arena of resolving personal conflicts and improving interpersonal relationships. In addition to his Doctorate Degree Matt has earned a Masters in Marriage and Family Therapy, studied Criminal Justice and received a category I licensure with Peace Officer Standard of Training along with a degree in the Arts of Business Management. Matt is a professor at Dixie State University and hopes to be part of the positive growth of Southern Utah.

Hidden Signs of Depression by Alberto Souza, MSN, APRN, FNP-C

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.

 

Trouble Sleeping

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.


Losing Interest
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.”


Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed.


Low Self-Esteem

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.

 

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Sources

Healthtalk.org

helpguide.org

Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.

Couples Counseling with an expert

Couples counseling, if done right, isn’t a refereed fight in a therapist’s office. A trained therapist will help you to identify underlying, unmet emotional needs after helping you to deescalate from the tension and fighting you have been experiencing with your spouse. The problem is that most couples come into therapy years too late and it is difficult to change course – to learn a new way. It is possible, however! John Gottman, a world-renowned researcher on marital stability and satisfaction, has found that it is not the presence of argument that causes divorce, but rather it’s how a couple argues that causes divorce. Knowing this, couples don’t have to ignore what they are feeling, but rather they can communicate it differently and in a healthier manner.

Marriage and family therapists are trained to do this type of work. This is a specific degree and license type that focuses on relationships between people (husband and wife; father and son; mother and daughter, etc…) as the point of intervention rather than just focusing on fixing symptoms (depression; anxiety, etc…). Its important to alleviating depression and anxiety and its crucial to build relationships that help someone deal better with anxiety and depression in the first place.

Pornography Counseling

Pornography addiction is becoming more prevalent in our society. Organizations like Fight the New Drug do a great job of educating the public on the harmful effects of pornography. What do you do if you struggle and can’t seem to find a way out? For many, the way out seems elusive and unobtainable. It’s difficult to find how when you have tried so many things, only to have this problem keep coming back. Many that come into counseling have already been before and are discouraged that they just can’t ‘get over it’. Knowing how to use the power or education and relationships is part of the answer. A good therapist can help you access both in your efforts to let go of this addiction. At the Center for Couples and Families we specialize in relationship therapy in regard to pornography use. Knowing how to communicate with your loved ones about this difficulty is an important part of the process.