Riner Counseling

Mary-Catherine McClain, PhD, Ed.S., M.S.

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Improving Relationships and Intimacy

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Improving Relationships with Vertical Questions

 

Fostering deeper relationships and achieving greater intimacy is important for our mental and emotional well-being. This can be a challenge as “small-talk” and focusing on logistics and surface level topics have become the norm. The glue, or what holds people together, is processing messy emotions, exploring difficult feelings, and working through conflict and disagreements. While small-talk questions are important for gathering information and will always have a purpose or role in daily conversations, they are not enough for maintaining depth in a relationship. In order to access emotions and raw feelings, vertical questions become essential; these questions focus on the inside rather than outside and also require time for reflection.

 

Examples of Vertical Questions:

  1. What is the perfect day for you?
  2. How do you feel about this decision/choice?
  3. I’m noticing your body language and facial expressions do not match your actual words. What is going on for you in this moment?
  4. I’m sensing ________ (e.g., sadness, angery, anxiety). What are you feeling?
  5. It seems like you keep coming home later and later. Is anything wrong or bothering you?
  6. What is your most treasured memory?
  7. Slow down. You are walking away as you tell me that everything is OK. Could there be something else going on that you want to talk about?
  8. What does friendship/partnership mean to you?
  9. How would you complete this sentence: “I wish I had someone with whom I could share…”
  10. When did you last cry by yourself? What were you upset about?

Achieving intimacy will require intention, strength, vulnerability, and self-disclosure. The questions

most difficult to ask are often ones that help individuals access true feelings, create opportunities for better understanding another person’s pain, and carve out a path for emotional connection between two minds.

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Eating Disorders and Misconceptions

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We live in a society that places significant focus on appearance, and a culture that is strongly obsessed with dieting and thinness. Media is filled with messages that portray an unrealistic thin ideal and imply that beauty is based on external sizes, shape, and weight rather than on internal traits, values, and abilities. Additionally, poor body image enhances vulnerability and often leads to the development of an eating disorder. In the first part of this series, myths and misconceptions around eating disorders will be addressed. Helpful and unhelpful comments will also be discussed.

CHALLENGING COMMON MYTHS

  1. People with a normal weight cannot have an eating disorder. The fact is that appearance alone doesn’t accurately identify or indicate who may be struggling with an eating disorder. Some illnesses are not externally visible to others. It is more about how thoughts regarding body image and weight impact a person’s self-worth and self-evaluation. Similarly, individuals in the “normal” weight range my have more difficulty recovering from an eating disorder because they don’t necessarily feel “sick enough,” or receive the attention and support from others during treatment. Behaviors change first, followed by irrational thinking patterns.
  1. It is only about the food. The fact is that eating disorders are complex, mental disorders and are NOT only about the food. While eating well-balanced meals and gaining weight may be part of treatment, it is not the only key component. It is not about willpower nor is it about trying harder to avoid binge eating. Issues regarding food relate to other unfulfilled emotional needs, such as lack of control, anger expression, and numbing out from difficult feelings and thoughts. Underlying issues relate to depression, self-esteem, anxiety, low assertiveness, stress, physical pain, poor body image, etc.
  1. Only young Caucasian girls are impacted by eating disorders. The fact is that both men and women are diagnosed with eating disorders every year. Likewise, individuals of all age brackets, SES classes, and ethnic backgrounds can struggle with symptoms related to body image and food concerns.
  1. People with eating disorders have the goal of hurting others. The fact is that individuals with eating disorders usually feel shame and guilt for their behaviors, and do not have the intention of acting out or lashing out in revenge. While it can be easy for families and loved ones to blame themselves, eating disorders run deeper than this and it is rare for these behaviors to be deliberately hurtful or spiteful. Eating disorders are also more about coping with stress, even if maladaptive, than a vanity issue.
  1. Normal blood work results indicate being healthy. The fact is that some doctors may not have the specialized training to be aware of key warning signs and traits, or have the knowledge on which tests to use. Similarly, the human body is resilient and adaptive. Therefore, blood tests can essentially be normal even during times of severe malnutrition. Blood tests may be misleading, but bone tests do not lie and do not minimize the potential devastating effects of an eating disorder.
  1. Eating Disorders are Hopeless. The fact is that 60-70% of individuals can make a full recovery if undergoing appropriate treatment. Recovery is a process and happens slowly, likely over several years, but a return to full health without distorted thinking patterns is possible. Do not give up on these individuals.

HELPFUL VS. UNHELPFUL

  • Be realistic regarding change, not expecting it to happen overnight. Be kind when having conversations, and do not get frustrated with lapses. Remain positive and don’t dwell on weight or appearance. Be gentle, resist falling into the guilty trap, and remember that recovery is not a choice you can make, but rather is the responsibility of the person who is struggling.
  • Do not threaten, bribe, or yell at someone who is struggling with an eating disorder, and avoid power struggles. It is important not to ignore the problem, while also not taking control of the situation. Eliminate shame talk and do not challenge someone who believes he/she “is fat.” This is not your role or job. Minimize conversations around weight gain and weight loss, as this could make someone believe a goal is being attained or make someone feel like a failure. Finally, don’t give advice unless it is specifically asked.

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Invisible Pain: Grieving and Finding Meaning After Loss

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One of the most difficult challenges in life is coping with the loss of a family member or friend. Whether the loss is expected or sudden, or caused by a sudden accident, natural disaster, mass shooting, or illness, grief creates overwhelming and complex feelings (e.g., sadness, anger, confusion, fear, peace) for the survivor.

 

While individuals may pass through five common stages of grief, specifically denial, anger, bargaining, depression, and acceptance, the journey will be unique for each person and the process will not follow a straight path. Some individuals may skip or bypass certain stages while others may leap around and come back to earlier stages of grief during their healing process. Although stages can help individuals to know what to expect and potentially assist in the preparation and healing process, it is important to remember that there is significant variability following a loss and that no two people will grieve the same way. The grief process can be made worse or made better by the types of responses and reactions from friends—regardless of whether the action was well intended.

 

Grief Etiquette Tips:

  • Listen well. Do not try to fix or solve the problem. Do not push a person to speak, but rather sit with them in silence and be present.
  • Think of your friend first. Do not force your method of grieving nor launch into your own grief story unless it truly is to benefit your friend.
  • Avoid minimizing the loss. Never tell the person to “get over it” or that it has “been too long” for her/him to still be grieving.
  • Demonstrate support and do not give up on your friend. Trust your gut and find a balance between respecting boundaries and not abandoning your friend during a time of need.
  • Send help. Solicit support from other community and religious groups that can bring food, run errands, pay bills, and write thank-you notes. Life may stop for the griever, but that does not mean that the world stops.

 

Don’t Say:

  1. He/she would want you to…..
  2. It’s time for you to move on
  3. At least you had the chance to say goodbye OR at least her/his death was painless
  4. He/she is in a better place
  5. I know someone who lost their husband/wife, and now they are happily remarried

Do Say:

  1. You are not alone in this journey
  2. We are here for you and will walk beside you
  3. We are heartbroken for you
  4. You will not always feel this way
  5. Nobody is judging you, and there is no time-limit for grieving a tragic loss

 

Finding Meaning

Grief and love are often intertwined. It is impossible to live life without the other, and when grief remains inside, the pain and hurt only deepen. It’s important to be upset and to cry, and by allowing those emotions, peace and meaning can be achieved. Consider the metaphor of building a sandcastle. Part of the excitement is that in the end, we give the sand back to the ocean as a gift. Use this process as a catalyst to re-evaluate priorities, values, and goals, and to establish a renewed vision, purpose, and sense of meaning. Consider talking about the death of your loved ones rather than denying or isolating from the event. Accept your feelings, whether they are frustration and anger or a sense of relief. Reach out to loved ones and take care of yourself by getting plenty of rest, exercising, and eating well. Share stories of your loved one and celebrate their lives by donating to a favorite charity or cause, building a garden in memory of the person you lost, creating a scrapbook, buying a pet and naming him/her after the deceased, or baking their favorite dishes around holidays and family events.

 

Seek Support from Professionals

Some individuals may experience complicated or complex grief, and feel unable to carry out daily activities. Hopelessness and despair may creep in. At this point, one may benefit from scheduling an appointment with a psychologist or another licensed mental health professional specializing in grief or trauma. These individuals are trained to help individuals process feelings of anxiety, guilt, fear, anger, and sadness. In this setting, you will learn healthy coping strategies, emotional regulation skills, and how to strengthen overall resiliency.

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Relapse Prevention

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Change is hard, and maintaining change can be even more difficult. The demands of life may at times outweigh the benefits of sustained change. Overwhelming feelings, such as disappointment, sadness, frustration, and/or anger may lead to the desire to numb or avoid feeling such pain. To make things more challenging, after a lapse or relapse, it is hard to terminate the harmful behavior(s) and re-gain control over maladaptive symptoms. As a result, reducing the chance for relapse is essential.

 

Red Flags and Early Relapse Signs: While these symptoms may differ from person to person, common flags are addressed below. Each sign or symptom can lead to a very slippery slope. It should also be noted that these red flags become more problematic when coping skills are limited, support systems are not used, and when self-care is neglected.

 

  • Isolating from loved ones
  • Loss of commitment to recovery programs
  • Not taking medication and doing what you need to do to stay abstinent (e.g., attending meetings)
  • Experiencing significant changes in mood
  • Increased romanticizing of days when using substances
  • Feeling agitated, frustrated, or tense
  • Having difficulty focusing, concentrating, and maintain motivation
  • Over or under-sleeping
  • Telling lies to loved ones
  • Consideration that one drink is OK or that one pill wouldn’t hurt
  • Increased defensiveness

 

Lapses (a one time return to addictive behavior) or relapses (return to addictive lifestyle) are often a normal part of the recovery process. One way to pick yourself up is to reduce feelings of guilt, shame, and embarrassment by talking to a supportive person. If layers of guilt, shame, and embarrassment are not resolved, the risk of relapse significantly increases. Finally, asking for help or additional support during such seasons represents strength, courage, and bravery.

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Making and Maintaining Friendships in Adulthood

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During childhood and adolescence, it can be much easier to develop friendships. Whether because parents have set up play dates, you are a member of a sports team, or because you are living on a hall with 50 other freshmen, you don’t have to exert as much effort or be as intentional in making friends. Similarly, most teens are at the same stage of life and share similar schedules. Fast forward to adulthood where the rush of work, life in general, and overall personal transitions (e.g., relocation, break-up, job change, becoming a parent) can place obstacles in connecting with others—almost like you are on an island isolated from peers. The problem is that meaningful relationships with others can decrease loneliness and anxiety, increase stability and happiness, and allow individuals to share their burdens or receive emotional support during difficult times. In order to swim off your current island, consider expanding your social network with the following strategies and tips:

 

  1. Show up: Woody Allen sums it up best, “80% of success is showing up.” When you are invited to a party or neighborhood events, when you walk by someone’s desk at work, when you are checking out at a grocery store, stop and make the effort to say hello. A perfect icebreaker may be, “How are you today.” Social media sites, such as Facebook and Google +, can help maintain relationships, but in-person contact is an important first step. Another way to consider it is by being the friend you want to have, as you will likely attract friends based on what you personally mirror to others.

 

  1. Consider your Interests and Passions: Use the gym, church, volunteer organizations, political group, and other settings that parallel common interests where you can connect with kindred spirits who share common values and pastimes. Eventually, you will likely run into the same people week after week, thus providing the opportunity for superficial friendships to turn into real friendships.

 

  1. Consider Social Media and Current Friend/Family Circles: Your family and friendship groups already represent a built-in buddy system. Consider networking through them or asking if you can interact with one another on a more regular and consistent basis. Alternatively, online communities (girlfriendcommunities.com) and groups (e.g., www.meetup.com) provide opportunities for not only connecting with others but also identifying activities and events in your community that cover a variety of interests (e.g., gardening and poetry to running clubs and speed dating opportunities). Consider getting a dog, which would allow you to pursue new interests while also connecting with human beings in dog parks.

 

  1. Challenge Negative Self-Talk: Fear of rejection is a real source of anxiety and worry for most individuals. It can be difficult to put yourself out there and take a risk to meet someone new. Using affirmations and positive self-talk, such as everyone desires and deserves meaningful relationships, most people do not like the beginning stages of forming connections and find it awkward, and every relationship has to start somewhere in order for it to become emotionally deep. Insecurities are normal, but remember you have the choice and power of quieting those unhelpful and generally untrue voices.

 

  1. Start Slow and Be Patient: Remember, the goal is quality over quantity, and that every attempt at forming a friendship or connection isn’t realistic. For example, you wouldn’t expect to marry the person you first dated (although it does happen) or expect to be hired with just one submitted application. So reduce some of the pressures when you are making friendships. It is also important to acknowledge that friendships will blossom over time as you become more vulnerable, open, honest, and intimate with each other. Consider the metaphor of a burning fire. In order for the fire to remain alive and strong, it takes energy, effort, and time. Some pieces of wood may make the fire burn more intensely, while other pieces may not be as powerful or helpful. Choose your wood wisely and don’t let your friendship fire extinguish due to neglect or becoming too busy.

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Self-Care Essentials: Take time for YOU and assess what’s on your plate

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Self-Care Essentials: Take time for YOU and assess what’s on your plate

            Coping in a “toxic” world and from other environmental pressures can be extremely challenging and difficult. For example, how often do you watch a story on the news that makes you cringe or experience fear and a heightened level of distress after listening to NPR? Ironically, when individuals are most stressed, self-care is typically the first priority neglected. Part of the trouble relates to understanding how one can demonstrate and practice self-care while a second difficulty is challenging the myth that self-care is selfish, self-indulgent, or self-pampering. Additionally, to stop the glorification of being busy—which is repeatedly reinforced by society.

 

Unfortunately, when human beings engage in poor self-care and make little time for themselves, emotions intensify and feelings of regret and guilt follow. The development of insomnia, addictions, self-harm behaviors, a hot temper, suicidality, and physical illnesses develop in response to minimal self-care, poor stress management, and over-commitment. While self-care is unique for everyone, there are several steps and strategies for enhancing self-care, and for achieving better life balance overall.

 

Self-Care and Physical Health: It isn’t always reasonable or realistic to assume that everyone can eat three square meals a day. However, it is essential that adequate nutrition is consumed daily (e.g., drink a boost). Sleeping 7-9 hours per night, exercising 5 times a week for at least thirty minutes, and scheduling regular health care visits are often overlooked. Preventive self-care is also important, such as getting massages, taking annual vacations, and engaging in pleasurable/sexual activities with your partner or yourself.

 

Self-Care and Emotional/Psychological Health: Equally important is nurturing yourself with supportive and caring people. Spend time with family and friends who make YOU feel good about yourself and who listen, while set limits and boundaries with people who drain or make you upset. Repeating positive self-affirmations, praising yourself, reading favorite books and movies, giving yourself permission to cry, drawing or writing in a journal, and playing with pets or your children are also emotionally healing. Don’t be ashamed to engage in counseling or therapy, make time for self-reflection, observe your inner experiences without judgments, say no to extra obligations, and practice receiving help from others.

 

Self-Care and Spiritual Health: If appropriate and based on your own beliefs and values, pray, meditate, attend church, and connect with a spiritual community, leader, or mentor. Consider volunteering, contributing to causes that you believe in, and try to be accepting of not knowing what the future holds. Likewise, become more comfortable with not being the expert or having to be in charge of everything in life. Stay curious and hopeful, and be open to new experiences.

 

Role of Sensory Stimulation: As you feel the stress and anxiety around you, focus on your five senses: touch, taste, sounds, sights, and smiles. This focus can re-direct your mind to the present rather than getting anxious about the future or sad about the past. Listening to running water, burning your favorite candle, getting cozy under a warm blanket, watching the sunset or sunrise, getting a massage, taking a bubble bath or hot shower, and listening to your favorite tunes are all ways for activating your senses and to self-soothe when life feels chaotic.

 

Next time you are debating between taking an extra thirty minutes for yourself, consider your answer to the following question: Would I rather get home stressed and with a short fuse or would I rather arrive 30 minutes later feeling grounded, centered, and relaxed? Reflect on potential long-term consequences. Remind yourself that self-care is making an intentional decision to self-soothe or energize you while selfishness is solely focusing on your needs without considering the needs of others—very different in nature. It is important to find a balance between pleasure (e.g., gardening) versus mastery activities (e.g., completing a crossword puzzle) as well as a balance between work, family, self, play, and other relationship activities. Remember, if your glass isn’t filled and your oxygen mask isn’t on, you aren’t going to be able to fill everyone else’s cup or help anyone else put on their own oxygen mask.

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Hello world!

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Welcome to my blog! I will be making posts about a variety of mental health topics and life concerns, and I hope you will find each entry meaningful and helpful! Please feel free to leave comments about potential topics or areas of interests for blog posts! Thanks for stopping by!

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