Category Archives: therapy

August 9, 2012 · 10:15 am

Holding On And Letting Go

I was preparing the house for visitors the other day, and had decided I needed to thin out the “stuff” around, on, and in my desk.  As I sorted into shred, recycle, file piles, I reflected on how much “stuff” I have, how much comes in each day, and how it seems to be harder to dispose of than to accumulate. These experiences aren’t just restricted to miscellaneous paperwork, or material items. They also occur emotionally. How much do I hold on to that is neither necessary nor helpful?

I grew up feeling like I needed to always be prepared to defend my feelings and behaviors.  I gathered evidence and stored in memory details of nearly everything, in case I needed to explain something later. Imagine an 8-year-old CSI agent.  It wasn’t ok to take a position without being able to explain why, so I learned to present my cases in a way any jury could understand.  Sometimes I overwhelmed others with my explanations of why I liked something. I remember as a new professional trying to identify accurately and completely why I didn’t like some wallpaper sample suggested by a designer for my new office.  Finally she said, “I don’t need to know why. I just need to know if you like it or not.  It helps me narrow down the selections to offer.”  What a concept!  My likes and dislikes provided information about me.  It wasn’t a contest or a test. There were no right or wrong answers.  I did not need to justify my preferences. They were … my preferences.  I began to let go of the explanations and the attempts to justify, and began to recognize and accept that I had preferences. It was ok to recognize and express them.  It was actually helpful to be aware of what I liked and didn’t like.  It saved time when sorting through options.

When it comes to stacks of emotional paperwork, I used to have a more difficult time sorting them than with actual paper.  It was difficult to let things go.  Painful, hurtful memories were as likely to be held on to as were the moments of joy, peace, and belonging.  A loved one of mine often kept her painful reminders readily available, literally as well as virtually.  At times of distress, she would say, “ Did I ever share that terrible hurtful letter my neighbor sent me long ago?”  She would remove it from an envelope in her desk and read the hurtful shaming remarks again – reopening her wounds.  Why would someone do that – relive the injury? Perhaps to feel the pain anew as punishment or as a reminder to not be “too happy,” or as a reminder she was alive, or as a way to feel something again- anything, even if only shame.  I don’t know her reasons. I’m pretty sure the process reinforced her critical view of herself. I know there must have been a better ways to emotionally care for herself.

Re-living slights, shame, or emotional pain does not necessarily help us grow or thrive. We have to learn to sort through and discard experiences that do not support our health and wellbeing. It is difficult to do without practice.   It’s like going through your sock drawer. Black socks might be good to have – but do you need 6 pair, the pair with the heel torn out, the pair that no longer fits, or the pair that hurts your feet whenever you wear them? You get the point. Keep what is useful, keep what you love, and keep what helps you become the person you strive to be. Recycle or discard the ones that no longer work for you.  Let go of them after they have served their purpose.

Holding on to your pain may be helpful for a while, but when it has outlived its usefulness, let it go.  Many processes have been developed for releasing negative energy from your life. They include things like burning the items and watching the concrete and material become air, burning paper with the items identified on it, Casting the virtual items into the sea or the wind, creating a vault where they pain can be locked inside and then buried, releasing balloons.  You probably have releasing visualizations/ rituals of your own.  The important action is to intentionally release the pain and its associated memories. Thinking negatively is a habit that requires an effort to change.

Hold on to your moments of peace, belonging, and recognizing all is right for the moment.   Keep them available to you to draw from when you are distressed.  Practice breathing, holding on and letting go of the breath.  It will make a difference.

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Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

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Filed under childhood trauma, counseling, emotional healing, healing, mental health, Penny Milczewski, psychotherapy, PTSD, therapy

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July 21, 2012 · 10:53 am

Creating and Nurturing Change

I just returned from a few days “off the grid” and have been amazed at the conflict between my desire to hold on to the feelings and mood of my respite and the pull to fall immediately into the habits and patterns I was so glad to leave behind.  I worked a little yesterday to put myself back into the tempo and peace of being back at the island park we visited. I imagined feeling the rocking of the boat, hearing the water lap the shore, the birds, the smelling the wind, the woods, and the beach. For a moment I was there, then my cell phone played its tune; I saw a virtual stack of email waiting to be sorted, read and answered; and I was reminded I need to call the appliance repairman because the refrigerator isn’t working right.  The serenity of the previous moment was gone.

Neuroscience has shown repeatedly that our imagined experiences are as “real” to our brain as our physical experiences.  We have the ability to use visualization to improve physical functioning. It takes focus and repetition, but even an athlete can improve performance by repeatedly imagining her successful moves.  This kind of practice can assist us emotionally as well as physically. Imagined experiences can also inhibit or otherwise impair our functioning.

One of the difficulties with anxiety and depression is that we create and repeat emotional scenarios that feed the fear and certainty of rejection and loss.  Our self-talk is increasingly pessimistic or critical. We lose sight of possibility, of alternative explanations, of changes toward the positive. Anxiety takes on a life of its own, so that our fear is about the feelings of anxiety, rather than the specific circumstances or triggers.  With depression, we lose memories of previous better times, and create a belief that things never were better and never will be.  But there can be change, and it can be change for the better.

I remember many years ago when visualizing and affirmations were being taught in management classes. I was a state social services administrator, and we were experiencing severe funding and staff cuts. Remaining staff members were becoming discouraged and burned-out. The agency provided a motivational speaker at a management conference, and he worked hard to pump us up.  After a morning of identifying example after example of the power of affirmations, visualizing success, and modeling success, we broke for lunch.  My director turned to me and said, “This is really good stuff. It’s just not for situations as bad as ours.”

Yes, it is. We might actually need it more than the people who use it to deal with inconvenience and discomfort. The thing is, it’s hard to do.  It’s hard to get started and it’s hard to keep practicing. It takes discipline. It takes action. It takes repetition.  It helps to have support, to share your goals, to help you see options.  But it is ok to start with just a little at a time.

Choose one thing to change: be specific, be focused.  Reward approximation when it occurs.  Approximation is the process of getting closer to what you want to have happen. Think of teaching a child to talk.  You don’t wait until they can say, “Could I have a drink of water, please?” to reward them.  WaWa or LaLa is close enough to start with. That’s approximation – you are rewarding movement toward the goal. Do the same for yourself.

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Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

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July 5, 2012 · 11:50 am

Reminders and Changes

Sunday was my mother’s birthday. At least it would have been, if she were still living.  She died in 2008 when she was 88 years old.  It is strange to be the oldest generation now in the family, something we babyboomers never really anticipated.  Maybe no generation expects to get to a time when they are the elders. Not many of us have parents, aunts, or uncles any more, even if we’re from families known for longevity.

When I think of my mother, I am reminded that many theories within the world of mental health look to mothers as the source of our health or illness. I remember my mother-in-law resisting the idea that my husband (her son) would benefit from seeing a therapist. “They all just blame the mother,” she said.  And I believe she worried that someone she never met would blame her for her son’s depression.  My mother, on the other hand, took that fear and wrapped it around her like a Kevlar jacket, preventing any inkling of contribution to anyone’s unhappiness from penetrating the shell. Once when I asked why she said such mean things about people (she had referred to a family member as a fat cow), she replied, “Because I can, and I like it.” She subscribed to the “every man for himself” theory of child rearing – even if that “man” were a toddler.   She was energetic, hard-working,  and very capable of being the center of attention.  There never was a power struggle she could walk away from. It wasn’t until I was much older and experienced  that I realized she was trying to as hard as she could to establish her place in this world.  She hated asking for help. In her experience, assistance always came with a package of shame, tied up in many strings. Asking for help meant she had failed. The person providing assistance would always know this, and could use it to maintain superiority over her.  Sometimes that person was my father: sometimes it was her father.

I believe it is true that much of our emotional development is influenced by the people who raise us, or abandon us. It is also influenced by our genetic composition, as continued DNA and gene studies show. The general circumstances of the times when we are children affect us, as witnessed by those of us raised by survivors of the Great Depression. Even the trauma of our parents or grandparents can influence the way we view the world and our place in it, as seen in families where there were survivors of the Holocaust, or colonization of the Native American, or veterans of combat.

Families and other communities create a culture that defines normalcy for its children.  Only as they explore other worlds, do developing minds and identities see alternatives.  The exposure doesn’t require travel. Those other worlds might be found at school, with friend’s families, at the elderly neighbor’s home, in books, movies, and other media.  I have always believed that my opportunity to spend extended time with my older cousin’s family allowed me to see a marriage relationship so different from my parents’, that I no longer saw theirs as the “normal,” and could have options in my relationship repertoire. I believe teachers have provided children exposure to adult-child relationships vastly different from parental ones.  I have been saddened by the increasing restrictions on teacher-child interactions resulting from reactions to isolated abuse, and to funding driven emphasis on the rote aspects of learning over the social development activities. Today’s children seem to have a group of trainers – school, soccer, piano, gymnastics. I wish there were more adult friends, teachers, and mentors.

I wanted to be a therapist so I could be a mentor, a guide, a helper to persons looking for alternatives to how they were living their emotional life.  Feeling better is much more than just changing the path you are on. It is really helpful to have an idea of where you want to go. In Alice in Wonderland, Alice asks the Cheshire Cat to help her find her way. The cat replies, “Well, that depends on where you want to get to.”  Alice responds,” Oh it really doesn’t matter, as long…(as it isn’t here).” The cat’s answer? ” Then it really doesn’t matter which way you go.”  Think about what you would like the new place to be. How would you feel?  What behaviors would be different?  How would your self-talk change?  How would your relationships  be different?  With a therapist you can head toward that new place with support and guidance.   Change happens.

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Filed under childhood trauma, counseling, emotional healing, healing, mental health, Penny Milczewski, relationship, therapist, therapy

June 26, 2012 · 3:07 pm

Redefining Normal

Thinking back on my experiences as a seeker of care and a provider, I remember two big misconceptions.  “Everyone experiences what I do,” and “No one understands what I’ve been through.”  While these statements may seem to appear opposites, they easily co-exist in the belief systems of people experiencing emotional distress.  Since I grew up in an alcoholic family, I have easily identified with the movement from the 70’s and 80’s focusing on Adult Children of Alcoholics: identifying the family system, the cognitive adaptations that help your world make sense, and the internal belief systems that rise from families where there is role confusion, denial,unpredictability, and secrecy.

When you do not talk about your inner life, you have few ways to compare it to others’. I remember in my 20’s having an eye exam that showed I was very far-sighted. The doctor asked me if I had experienced seeing double when trying to read. My response was, “Of course, I do. Whenever I get tired. Doesn’t everybody?” Or in my late 30’s when the dentist asked in a standard survey, “How frequently did I have headaches?” then responded with concern when I answered 5-7 days/week. “How had I gone so long without being concerned about it?”  I thought it was “normal.” Today I look back  with gratitude that someone asked a question in a way that I could respond, which resulted in recognizing that I could have a different experience than  I had.  It wasn’t normal, everyone did not experience it the way I did, and it wasn’t necessary that I struggle with it either.

The flip side (and yet companion) of defining your personal experience as normal, is seeing yourself as abnormal – the only person who feels this way or has had this experience. Part of the benefit of the Adult Children of Alcoholics (ACOA) movement, pioneered by people like John Bradshaw, Claudia Black, Jane Middleton-Moz, and Timmen Cermak,** was that it described a developmental process and set of beliefs that large groups of people had previously identified as individually unique to them. In the same way, group therapy is often the most helpful with persons having similar trauma experiences, because the individuals see that others have had very similar feelings,  emotional or physiological responses, and common self-talk,  generated from the common experience and not from a personal deficiency or inability to cope. This exposure  to others who share your difficulties “normalizes” the experience and the person’s response, and confronts the internal view that one is somehow “not doing it right.”

Now with all that said, don’t be too concerned about “Being Normal.”  A recent post by a friend said something like, “Normal is just a setting on your washing machine.”   And when you see a therapist or counselor, and they somehow start to describe fairly accurately how you might be feeling, or thinking, or experiencing something; don’t be alarmed.  They are not reading your mind. They are discussing common experiences of many persons in similar circumstances. Experiences you might learn from.Experiences that may be common, predictable, understandable, and human… that’s normal.

** These writers were important to me.  I have not tried to be inclusive here.There are many contributors to the ACOA knowledge base and treatment approaches.

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Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see your emotional expressions.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

Leave a comment

Filed under childhood trauma, emotional healing, healing, mental health, Penny Milczewski, psychotherapy, relationship, therapy, Uncategorized

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June 19, 2012 · 8:58 pm

Therapy: What it is and What it isn’t

Whether you call the process Therapy or Counseling, there are many misconceptions about it. I don’t pretend to know all the issues, but there are several I have run across – as a seeker and as a provider.

Your therapist cannot “fix” you. First, this assumes you need fixing, and secondly, it assumes the repair work is completed by someone else.  Healing from loss or trauma is a process that you take on.  Changing  behaviors that create barriers to your happiness takes a process of awareness and practice. In therapy, you choose a guide to assist you with the processes. Remember, the answers are within you and your therapist helps you find them – your solutions, not theirs. As you engage in a relationship with your provider, your patterns of interacting with others rise to the surface. So do the relationship behaviors of the provider (more about that in another post).

Your therapist is not your friend.  You are not paying for friendship. This seems to be an accusation that comes from others who for reasons of their own, need to discourage your healing experience. Your relationship with your provider has specific boundaries regarding when and where you meet, and has a specific purpose – to guide you in identifying and achieving your emotional  or relationship goals, or to relieve your symptoms of distress. Friendships are reciprocal in a way that counseling relationships are not.  Both parties have roles, but they are not the same as friends.  Don’t call your therapist for a ride after dropping your car off at the dealer’s, and don’t expect to be invited to their summer barbecue.

The actual rigidity of professional boundaries is affected by many things, including the size of community you live in. Living in Seattle, you might never even see your provider out of the office. If you do, they might not acknowledge you unless you have indicated a connection first.  In a much smaller community, you may interact frequently, sharing the kids’ soccer field, the grocery store, church, or even social groups. Not acknowledging you in public in this setting might be viewed as “snubbing.” How you prefer to deal with these situations will probably be a session discussion topic. Whether in a small or large community, you have the right to have your professional relationship kept confidential if that is what you prefer. No matter the setting, sexual relationships and providers using the therapy relationship for personal gain are never appropriate.

When I say that your counselor is not your friend, I don’t mean they do not care about you. It is a relationship and a collaboration. My experience is that providers share consumers’ successes and concerns.  Depending on treatment orientation, your therapist may have accepted the responsibility of modeling nurturing behaviors such as acceptance, encouragement, and responsiveness. They expect to care about you.

Paying for assistance does not reduce its value. You have chosen to engage in a relationship with a specific purpose. For the provider, this specific purpose is a professional service. You are paying for the education, training, and experience of your provider, as you would a doctor, mechanic, or plumber. Remember, in this process, you are the buyer and you have a right to choose the service you get. You are not obligated to “stick it out” if  you are unhappy with the provider or the process. Ask for what you need.  There is nothing wrong with looking for  a provider and a methodology that works for you, or with changing providers and methodologies after you have started.

The credentials of your provider do not indicate relative competency or quality of care. There are several paths into the profession of psychotherapy.  These include several master’s level degrees, nurse practitioners, PhD’s and MD’s. Other than the ability to prescribe medications, Psychiatrists (MD’s with specialized training) and Psychiatric Nurse Practitioners (Registered Nurses with specialized training and experience) do not necessarily have more counseling expertise. Many have less counseling /talk therapy training than the others.  Clinical psychologists in Washington State have to have academic doctoral degrees and pass a licensing exam. Some states allow folks with Master’s degrees to be licensed as psychologists, and some states permit psychologists limited prescribing authority.  Psychologists also do not necessarily have more counseling training or experience.  They are often valued for their testing and assessment credentials.  Master’s level degrees in social work, psychology, and counseling also offer entry into counseling.  If you are looking for a therapist, explore their training and experience in the areas of concern you have. Above all, ask yourself after an interaction, ” Is this someone I could work with?”

Sometimes, the most difficult aspect of participating in therapy is the reactions of the people closest to you: The mother who believes she will be blamed for all your sorrows; The friend who wants your time and attention; The spouse who is afraid your therapist will tell you to leave your marriage; or the person who thinks you should just “buck up.”

The goal of therapy is positive change. Change is difficult for most people  – even good change, so there may resistance on your part and from the people around you. Try to be accepting and patient with yourself and with them.

This is a journey of self discovery and healing.

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Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see your emotional expressions.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you here.  If you have questions or concerns, please leave a comment. I will attempt to address the content if I can.

Leave a comment

Filed under counseling, emotional healing, healing, mental health, Penny Milczewski, psychotherapy, relationship, therapist, therapy

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June 12, 2012 · 10:07 am

Toe in the Water

As a child living in the Pacific Northwest along the cold waters of Puget Sound, I learned to swim.  I had two primary sites for learning: Quartermaster Harbor on Vashon Island, and a big cement swimming pool filled with mountain spring well water at my Grandparents’ in Tacoma.  It wasn’t until I started teaching boating safety classes that I realized that nearly my entire childhood swimming experience was conducted in the early stages of hyperthermia – blue lips, chattering teeth, progressing to numbness in the feet and full body shivers. It was very difficult to ease into the water slowly.  Everyone seemed to endorse the plunge approach. Anyone testing the water with their toe or attempting to enter a pool using the ladder or steps was considered cowardly and unlikely to ever complete the task.

Some folks look at therapy or counseling in the same way (All or nothing), and that approach probably keeps many from ever being able to truly use the process in a way that helps them.  It is okay to stick your toe in, and decide whether to proceed a little more or withdraw. No one has to leap in or be in the deep end rather than the shallow.   The process of working on your own emotional wellness, of relieving your distress, needs to be at your pace, and in an emotional environment that is safe.  A therapist that takes on the role of the bully, and throws you in the deep-end to sink or swim is not honoring you.  You might survive, but you are unlikely to continue to use the techniques you employed, at least use them with pleasure and confidence.

Just as our emotional distress is highly unique and personal, so is our path to recovery. There is no single approach, technique, method, or set of exercises that is helpful to everyone. It is okay to try different therapies. There will be a therapist that can help, but it might not be the first one you meet. Try not to assess your potential for recovery based on a poor experience.

Today there are all kinds of ways to explore therapy approaches: audio books, videos, U-Tube, reading, attending public presentations, workshops, health fairs, and many more.  It is okay to shop. I believe (and there is research to support) that the key element in a successful counseling /therapy experience is the relationship between the therapist and the client. (Please substitute whatever word you feel comfortable with to describe the person seeking therapy – patient, client, consumer, seeker, student – the words used seem to vary based primarily on provider experience and training.) After years in social services, I referred to the people I worked with as clients, then after 10 years in a medical clinic, I found myself referring to them as patients. Mental Health Advocates seem to prefer consumer. I will probably shift among the various titles as I write.  The key point is that you – the seeker of service – are the one in control of the relationship, not the provider. You (or your insurance, employer, or taxes) are paying for a service. And within your provider’s boundaries, you are entitled to manage the level of intensity, the frequency, the content, and the direction of your care.

Identifying and challenging your fears, doubts, pain or sorrow is not easy. You won’t necessarily be comfortable all the time, but it is essential that you trust you will be safe, and that you can stop or slow down  when you feel overwhelmed.

There are also online options for testing the water.  Visit blogs or websites that have questions and answers with therapists.  This is not therapy, but you can get a feel for how different people approach identifying problems and solutions.  In some cases, there may even be an opportunity to transition into a therapy relationship with the person.  Remember, it is your treatment. You can approach it in the way that fits you. You will need to stretch your comfort zone at times for growth to occur, but you can also approach slowly and move in a little at a time.

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Remember, this forum is not intended to be therapy.  I have no way to view your body language, hear your tone of voice, or see if your words and your displayed emotions are matching.  These are essential to effective communication and great tools for the therapist (and for the consumer when reversed.) I will attempt to be as helpful as I can. I will refer you the best I can to needed services. Even though I will not be your therapist, I am a health care professional bound by law and ethics to act to protect persons from harm. I am required to report my concerns of  harm to self or others, and suspected abuse of children and vulnerable adults.  I am located and providing these services in Washington State.

Again, I am open to communicating directly with you through this forum.  If you have questions or concerns, please leave a comment. I will attempt to address them if I can.

2 Comments

Filed under counseling, emotional healing, healing, mental health, psychotherapy, therapy, Uncategorized

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