“You hate me”, my five-year-old says through angry tears. I’m caught off guard by his accusation. My heart knows it isn’t true; nothing matters more to me than he does. But a different message is written across my scowling face. I’m mad and any stranger in the world who walked up right now would see plainly that, in this moment, we are against each other. I’ve made an enemy of a five-year-old child.
This is not the parenthood that I wanted. I wanted to be a safe, calm, and secure father for my kids. On days like this one, however, that vision gets away from me. My son has misbehaved and all he needs is loving and confident correction. But often I’m surprised to find that, apart from actually having anything to do with my kids, there is something in their misbehavior which is deeply threatening to me.
More than just about anything else, parenting has a way of dragging your stuff to the surface. This is because to be a parent is to be out of control. When I’m alone, I can arrange my world in such a way that I don’t have to hear the hurtful messages that, for one reason or another, I’ve been running from (and carrying with me) my whole life. Those messages are different from person to person and depend on our stories, but for most of us they essentially boil down to “you don’t matter, don’t count, and don’t deserve to be loved.”
Parenting precludes the stagnating luxury of hiding from these messages. Some days more than others, something in my kids’ (or wife’s or friends’ or coworkers’) behaviors blasts those messages on the surround-sound system of my internal world and I see now that those are the days that I don’t really believe in love at all. They are the days that I see life and all of its endeavors as proving ground for my validity and worthiness. I get sucked into the struggle of trying to get it all just right so that I might finally live down the accusations against me and be worth something in my own eyes. On these days, even my own children are either for or against me, and my capacity to love a five-year-old depends on the extent to which he cooperates in this test I’ve devised for myself.
But even on the days I fall prey to this trap, I know in my gut that it’s wrong. I know that isn’t how love works. Even on those days I could answer without hesitation that my children are worthy of love just because they are. We have it on the authority of Christmas that to be a human is to be made for, and the object of, love. They can’t earn it and they can’t lose it. When I forget this it is my failure, not theirs.
It is here that I have to deal with a difficult but life-giving dilemma: I can’t defend the inherent worthiness of my children to be loved while simultaneously disqualifying myself. Truly loving my kids, or anyone else, necessitates and depends on my willingness to receive that love for myself. It is in the security and peace of this love that I have the capacity to be the father I want to be and that my children deserve. If, like me, you have dragons to slay to gain access to that love, I promise you it’s worth the fight.
I am blessed this week by Andrew Peterson who lives out this truth in a song he wrote for his children:
While the weather seems to be unsure about it lately, the holidays are indeed upon us. Unfortunately, along with all of the blessings and joy that can come with the holiday season, the season also, paradoxically, offers its own unique set of stressors. I often have people ask me if my counseling practice slows down during the holidays due to so many people traveling. When I tell them that often people are more likely to seek out therapy around the holidays, I generally get a quick nod of understanding.
One of these seasonal stressors, for many of us, can be centered around extra time with extended family. You don’t have to look far to find books on the self-help shelf dealing with the topic of families and conflict. And you don’t have to ask too many people about how to deal with family conflict before you get similarly conflicting advice, even from therapists. We’re certainly not going to cover the entire topic of conflict with family in one blog entry, however there are two basic guideposts that, I think, can help us mentally and emotionally prepare for smooth(er) family interactions over the holidays.
1. The holidays really aren’t the best time to bring up conflict. One of my favorite tag lines for dealing with conflict is “strike when the iron is cold.” Having all your family together for a special and inherently somewhat stressful event is not an emotionally cold-iron-type of situation. When the water is already hot, it doesn’t take much for it to start boiling. Don’t get me wrong, I’ll be the first to recommend that you deal with your conflict head on (generally in a one-on-one situation, by the way) but how about we pick Valentine’s or Columbus day if we’re really dying to deal with our family business on a holiday.
I’d recommend taking a moment to reflect on experiences of conflict that have gone reasonably well for you. Was it during an already heated or stressful moment- whether it be positive or negative stress? Was it in the presence of a lot of other people? Did the conflict occur in a setting or around a set of circumstances that rarely occur? I’m going to guess that the answer is no for at least one of those (and I didn’t even mention the eggnog). If we think about the specific factors involved in past successful conflict resolution, we might recognize that the harvest is rarely ripe for conflict at holiday gatherings.
2. One of my favorite metaphors to use in therapy centers around our expectations in relationship. It can be summed up in the statement “Don’t go to the hardware store looking for a loaf of bread.” Essentially, the wisdom in this saying is that we shouldn’t expect what someone can’t/won’t/hasn’t ever given us. It’s simply not realistic for us or fair to that person. If you walk into the hardware store and throw a fit about there not being bread on the shelves, you’ll get some deservedly weird looks and likely very little sympathy. Now this doesn’t mean we should boycott all hardware stores; they have their place and are really great when you need to build or fix something. We all need hardware store-type people in our lives. But when you’re hungry? Go somewhere else. Don’t bring up a political hot topic with your uncle who loves to say absurd, upsetting things; don’t try to get your empathy fix from the worst listener in the room. The reality is, when we do this, the unhealthy interaction which ensues is our responsibility more than theirs. After all, in that scenario, our faulty expectations and our desire to change people into someone they’re not is to blame.
Change is tough for all of us and we all know we’re not perfect and neither are any of our family members. We all know- at least intellectually- that we can’t change other people. However, it is still tempting to think that we are capable of bringing about change in other people through the sheer force of our expectations via our disapproval, disappointment, and sometimes emotional punishment when someone doesn’t live up to them. In that moment, I believe we need to take a long look in the mirror and deal with what lie we’re believing about our role in our relationship with that person. If my role is ever to change or fix someone, something has gone awry for us in that relationship. We’re always better off meeting people where they are, not where we want them to be. After all, that’s usually what we want from others too, right?
The beautiful thing about assuming this posture in our relationships is that these boundaries allow us the freedom to have true, deep, meaningful relationships with those around us. Having a relationship with someone who you feel over-responsible for is daunting and generally not sustainable for long-term relationship health. But when we assume a posture with those we love that says “You may not be a bakery so you may not be able to help me when I need a shoulder to cry on. But when my car breaks down, you are the first person I know I can call and I’m grateful for you for that,” we are giving that person the freedom, relationally, to be their authentic selves with us. Isn’t that what we all, sometimes desperately, desire to receive in our relationships?
When it comes to changing our interactions with our family, we are wise to remember, “When we are no longer able to change a situation- we are challenged to change ourselves” (Frankl, 1984). The amazing part about that is we often find that when we start by changing ourselves it can make all the difference.
Frankl, V. E. (1984). Man’s search for meaning: An introduction to logotherapy. New York: Simon & Schuster.
Every profession has its fair share of jargon. Something specific, though, to the mental health world is jargon in the form of provider titles and credentials. The goal of this blog post is to help clear that up a bit. Once you know the basics, they’re actually pretty easy to keep straight.
Let’s start with an overview of the biggest contributor to the need for different titles: education. All professional licenses in the mental health world require at least a Master’s degree. Within the profession, though, there are a plethora of options for specific mental health care related degrees. The most common of these Master’s degrees in Arkansas are:
- Master’s in Clinical Mental Health Counseling
- Master’s in Marriage and Family Therapy
- Master’s in Social Work
- Master’s in Psychology
Another factor is the level of education of the mental health provider. Since counselors are only required to have a Master’s degree, most do not pursue formal education any further. However, some who are interested in teaching, research, or leadership may pursue a PhD, EdD, PsyD in a mental health field (again, as seen above, there are many different options). Professionals with a doctorate-level degree in psychology and the corresponding license are referred to as Psychologists.
Here is where I find that most people get confused- when the term “doctor” gets thrown around in mental health. First, if your mental health provider has “Dr.” in front of their name, you can conclude that they have either a doctorate-level degree in some type of mental health field (including Psychology, Marriage and Family Therapy, Counselor Education, etc) or a medical degree (just like your PCP). Mental health providers with a medical degree are referred to as Psychiatrists. Psychiatrists are the only mental health specific providers who can prescribe medications. Your psychologist can’t and neither can your Master’s level provider. Only a medical doctor (or other medical provider who can also prescribe general medications) can prescribe medications like antidepressants or anti-anxiety drugs. The most common mistake I hear people make involving the different licenses and credentials is in thinking that their therapist or psychologist can provide them with scripts.
Now, back to the different Master’s level credentials alluded to earlier. Let’s start with the “official” licenses and then wrap up with the more colloquial terms for this level of mental health provider. In the state of Arkansas, there are five main Master’s-level licenses that provide the credentials necessary to provide outpatient counseling services. Since there are three that are most common, I’ll focus on those. The three main licenses are listed below along with their provisional counterparts:
- Licensed Professional Counselor (LPC)
- Licensed Associate Counselor (LAC)- indicates that the provider still requires face-to-face experience hours in order to then be deemed an LPC and then are no longer required to be under the oversight of a supervisor
- Licensed Marriage and Family Therapist (LMFT)
- Licensed Associate Marriage and Family Therapist (LAMFT)- indicates that the provider still requires face-to-face experience hours in order to be an LMFT and then are no longer required to be under the oversight of a supervisor
- Licensed Clinical Social Worker (LCSW)
It would take another blog post or two to provide all the specific differences between the training and specializations of these three main licenses so we’ll just stick with the basics. For the most part, a provider who holds one of these three licenses can do many of the same jobs. For example, in a private practice like Little Rock Counseling, any mental health provider with these credentials could see the same individuals for outpatient therapy. The main differences are in the style and focus of the Master’s-level coursework as well as the specific requirements for securing and retaining the license.
One last thing that tends to add to the confusion is the way mental health clinicians often use the terms “counseling,” “counselor,” “therapy,” and “therapist” somewhat interchangeably. If you ask a therapist why they use the term “therapist” more often than they do “counselor,” they likely have a well-thought-out reason; however, this is generally based more in their personal preference than some “official” rules regarding the terminology.
Hopefully that cleared things up a bit. But have no fear, anytime you get confused about the different mental health titles, know you’re not the only one by any stretch and we, as clinicians, are quite accustomed to clearing this up for people.
Overall, pain has developed a bad reputation. Even the word itself, for some of us, feels a bit sinister. In this blog, I hope to shift the perspective on this a bit and show that many people’s view on pain is missing the boat.
First, I want to clarify that I, in no way, wish to come across as calloused to pain and its effect. It is very real and it is formidable, whether more physical or emotional in nature. People in pain can feel driven to do things that normally they wouldn’t even consider just to escape it for even a moment. Gabor Maté in his book In the Realm of Hungry Ghosts points to pain as the source of all addictions. “Not why the addiction,” he says, “but why the pain.” (Maté, 2013) Throughout this excellent book on addiction, Maté illustrates how his years of work with addiction have helped him to see that, while addiction and destructive behaviors can present very differently, the deep root of it is always the same. Pain. As a therapist, I can attest to this as well. In my role as a counselor, I have developed the habit of immediately attempting to look past the behavior and look for, instead, the pain driving it.
It’s important to note here that we’re not talking strictly about emotional or physical pain. The reality is that attempting to create some significant distinction here is futile. After all, according to the human brain, there isn’t much of a difference. It’s been known for years that a brain scan will show the same activity when an individual is experiencing physical pain and emotional pain. While some of us struggle to admit just how devastating emotional pain is (a whole topic of its own), I believe most of us would probably choose physical pain if given the choice. Emotional pain hits us at a much deeper, more core level, and it’s a force to be reckoned with. It also generally includes other people, and our connection (or disconnection) to others carries serious power.
Not only are they experienced in similar ways neurologically, it can also be surprisingly difficult for us to tell the difference within our own individual experiences. Just ask someone who has ever experienced a panic attack, “Is it emotional or is it physical?” The answer is it’s both. In our culture, we tend to have this unfortunate habit of wanting to completely separate the mental/emotional and the physical. This is simply an uninformed, perhaps over “Westernized,” perspective. I understand it though. Things would be simpler, maybe even easier in some instances, if we could totally separate the psychological from the biological/physiological. We’re just not given that option. Even psychology 101 students are constantly reminded “Everything that is psychological is biological.” (Myers, 2015) The research in trauma therapy, among other branches in the field, is beginning to focus more and more on the vital connection between the mind and the body. Bring on the yoga!
So we’ve established that pain is real and it’s not all “in your head” or your body. Now I want to invite you to perhaps a newfound appreciation, even, for pain. When I introduce this topic to clients in the counseling office, I usually start with a metaphor. Let’s say we’re chatting in my kitchen and I accidentally lean against the stove and my hand lands on a hot burner. Luckily my slower rational brain goes offline and the automatic fight/flight part of my brain quickly sends a message to move my hand before I even have a chance to think about it consciously. In that moment, of course, I’m cursing the pain in my hand and would wish it away if I could. Let’s then imagine the same thing happens but this time I have some type of nerve disorder where I cannot feel pain. In this instance, it may take us a few seconds or a minute to notice that my hand is on the hot burner. By then my hand has likely been damaged beyond repair. In this moment, I’d most likely be upset for not feeling pain and would wish for it.
The moral of the story? Pain is good for us. Pain is always telling me something. Without it, I think I’d be in some serious trouble. For me personally, I have no idea what would or could stop me from taking on way too much or for trying to do it all alone if it weren’t for pain. Pain in the form of stress or sickness keeps us from trying to be a human doing instead of a human being. Pain in the form of loneliness keeps us from unhealthy isolation. Pain in the form of anxiety illuminates the fears we need to face or deal with. Pain in the form of trauma responses shows us we have memories or experiences we need to process, perhaps with a professional. Pain in our bodies works the same way. This list could go on and on but I hope you’re getting the picture.
As difficult as it may be to admit most days, pain is our friend. It’s consistent, it’s loyal, and it cannot be fooled by any level of mental gymnastics we use in an attempt to get around it. Pain also demands to be felt. Whether we’re dealing with pain by going to therapy or in other ways, we’re going to come out better on the other side of it. When we ignore it or pretend it’s not there, we’re always missing an opportunity for growth. From this perspective, I would confidently argue that pain is a blessing to be grateful for. As a therapist I get a front row seat to how pain can, and often does, serve as a catalyst. Often it is what brings people to seek professional help through therapy and, on a broader scale, how it is often the force driving us down the road toward healing.
We can ignore even pleasure. But pain insists upon being attended to. God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is his megaphone to rouse a deaf world.
― C.S. Lewis, The Problem of Pain
Lewis, C. S. (1940). The Problem of Pain. New York, NY: HarperCollins.
Maté, G. (2013). In the Realm of Hungry Ghosts: Close Encounters with Addiction. Mississauga, Ont.: Vintage Canada.
Myers, D. G., & DeWall, C. N. (2015). Psychology (11th ed.). New York: Worth.
First let’s talk about the elephant in the room for many. For some of you reading this, you may have felt uncomfortable even clicking on the link because it’s about the off-limits subject, in your mind, of mental health. It does seem that people fall somewhere on a continuum with two polarizing ends when it comes to the idea of therapy– those who are overall comfortable with the idea of going to therapy and those who are terrified of it (more on that later). I’ve seen many people in my years as a therapist who benefit greatly from therapy regardless of where they fall on this continuum.
To give the latter end of the spectrum some credit, mental health stigma has been around for a long time and has some deep cultural roots. This stigma is real and I, in no way, wish to shame people for their fear of reaching out for help and the inherent feelings of vulnerability the topic of mental health entails. Fears like this, based in cultural lies we’ve been told, are certainly tough to push through. For those who have made the brave step to call or schedule their first counseling appointment in spite of these fears often do so because the discomfort they’re experiencing outweighs the discomfort of facing these fears.
First, I want to make evident that the stigma that surrounds mental health is certainly on the decline thanks to many different factors including the outspokenness of celebrities like Kristen Bell (you can read her excellent article here) (Bell, 2016) and Bradley Cooper, as well as organizations like the Heads Together campaign, This Is My Brave Foundation, among many others making it their mission to help create a dialogue to counteract the lingering stigma in our cultures. Consider that even back over a decade ago surveys showed that “48 percent of those polled reported a visit to a mental health professional by someone in their household this year, and more than nine out of 10 -91 percent- said they would likely consult or recommend a mental health professional if they or a family member were experiencing a problem.” (Chamberlin, 2004). Since 2004 when this survey was conducted the prevalence of individuals, couples, and families seeking out mental health treatment, as most of us can attest to, has risen significantly.
This is reflected in the number of people who know someone personally who has sought out a counselor as well as the rise in themes in the entertainment industry centering around therapy and the commonality of emotional struggles. We’re in an age of transparency like we’ve never been before. It only takes a few minutes watching the news or scrolling your social media to see that in some ways this transparency can be to our detriment, but this cultural shift has also done amazing things to help normalize our need for outside help when we’re struggling. You don’t have to look far in the realm of movies and TV these days to find references to emotional and mental health struggles and the encouragement to seek help. As a therapist, I’m personally excited to see where the benefit of this cultural shift takes us in the future and what impact it will have on the misguided stigma surrounding seeking out professional help.
Now onto my second main point regarding people’s fear of counseling and reaching out: vulnerability. Vulnerability is defined as “capable of or susceptible to being wounded or hurt” (dictonary.com). From this perspective, it makes sense that vulnerability is a scary thing for people and thus, for some, something to be avoided. But there’s another side to the story. Regarding any aspect of shame and vulnerability, I recommend turning to the amazing work of Dr. Brene Brown. Dr. Brown has this to say about vulnerability:
You might want to read that one a few times. Better yet, go buy the whole book. Vulnerability is a double-edged sword in our minds. But generally I think it’s safe to say that often we’re blessed by our capacity to be vulnerable. This is true in our everyday lives and this is also true when it comes to the decision to seek out counseling. We can all easily bring up in our memory times where vulnerability has created wounds that we feel for a long time afterward. I’m also certain, though, that every one of us can bring up an ever-growing list of instances in which vulnerability has been a powerful and beautiful force to be reckoned with. Good relationships and good therapy share this quality.
For what it’s worth though, I am aware of my bias regarding therapy and vulnerability. If you ask me, well, therapy is wonderful. This has proven true for me as I’ve journeyed along the road of counseling with clients as their therapist and as I’ve experienced my own healing in therapy. People make comments to me all the time about how it is that I’m able to do the work that I do with people and the answer is that therapy isn’t just about the hurt, it’s about the healing. I get to watch people improve and heal and that’s simply a beautiful thing to witness and to be a part of. So perhaps consider that the stigma against therapy doesn’t have much of a leg to stand on after all and should finally be laid to rest.
Bell, Kristen (2016). Kristen Bell Shares Struggles With Depression and Anxiety – Motto. (2016, May 31). Retrieved April 11, 2017, from http://motto.time.com/4352130/kristen-bell-frozen-depression-anxiety