Friday, December 29, 2017

2018

I've been asking a lot of clients and friends about their new year's resolutions. I'm not looking for the usual "I want to lose 20lbs" answers. I don't want typical. I want real and doable goals to accomplish.
Let's face it, 2017 was hard, harder than anyone expected after the Hell that was 2016. I know a lot of you are not expecting 2018 to be a banner year for a happy, stress free string of successes. Most of us are just hoping to still draw oxygen a year from now with a roof over our heads. I know, a bleak outlook, but I am realistic if anything.
There are a lot of realms in life that could use a little push. Including coming up with ideas for "resolutions". So I am going to offer a list of potential areas in your life and mine where some improvement could take place:

1. Financial
   a. Buy only necessary items. Food, shampoo, cat litter and the like. Use only the money you have in your account to reduce credit card spending. If you have significant debt, pay back as much as you can afford each month. Review any automatic charges - memberships you don't use, etc.
   b. If you must buy something that is usually more expensive, check your local neighborhood sale pages. Someone may be selling what you need. The money goes right into the pocket of someone who will put that money to better use.
   c. Keep a daily expense tracker - either on paper or in your phone/tablet. This will help you stick with your budget and know where your money is actually going. 

2. Social
   a. Meet at least one friend per month for coffee, lunch, jog, or just a walk at lunchtime. Connect in real time, face to face. No phones allowed.
   b. If you find that your social life is taking over every other responsibility, take one day each weekend to get all of your chores done. Laundry, cleaning, grocery shopping. Then you can go out and be the little butterfly you are stress free.

3. Health
   a. Exercise three times a week for at least 30 minutes. This really shouldn't be an optional item. It is one of the most important things you can do for your health, along with NOT SMOKING.
   b. Eat clean - no junk food, fast food, soda, sugary drinks. Eat more fruit, vegetables, lean proteins and fish, beans, whole grains. Drink a lot of water. You'll feel better almost instantly. Get support from friends and peers who are also trying to do this. Pack lunch to work each morning so you aren't tempted to go to The Golden Arches. This doesn't have to be about pounds lost, if you want to quantify improved health, get your blood work done now, and again in a year.
   c. Cut back on alcohol. If you think you need to do this, then you probably do. Alcohol might be tasty and fun but it goes straight to the gut with empty calories, and probably some other unhealthy choices along the way.

4. Professional
   a. Depending on your profession, you may have to do some learning to maintain your job, or certifications. Learning doesn't have to be a chore, if you have some flexibility, then find a class or training that makes you excited to go.
   b. Read a book, article, blog post, watch a video,  a month on the topic of your profession. Keep a list of what you have read and what you learned.
   c. If you have thought about a career change, now is a good time to look into your choices. What will it cost? Is it right for you? How long will it take to make the switch?

5. Mental Health
   a. I wouldn't be a good therapist if I didn't bring this up. Be honest with yourself. Has your anxiety, depression, drinking, anger, gotten in the way of enjoying the things you usually enjoy? Your relationships? Your environment? Your job? It's a good time to find a friendly neighborhood therapist and work through some of the barriers that are keeping you from living life to the fullest. You deserve to.
   b. Like many people this year, there was a lot of anger. Make a resolution to get politically involved, join a campaign for a candidate you support, write to your current elected officials. Run for office if you have what it takes. Confront the things that are making you angry but have open dialogues with people to find solutions.

6. Dreams... My favorite.
   a. Keep a list of things you have always wanted to do. Ride a motorcycle, skydive, scuba dive, travel to Japan, adopt a pet. What would it take for you to accomplish one of these this year? With money saved (above) could you afford one of these things? Could you start planning to do one or more of these things in the next 5 years? Just because it's a dream doesn't mean it can't be done ever. Just maybe not right this instant. That's what a goal is - something to reach for, over time, and many steps to take. Make a vision board to keep you focused on it - cut out magazine photos of Ireland and put $5 in a jar every pay day. You can get there.

Along with looking forward, take stock of what is behind you in the last 12 months. You probably accomplished more than you realize, even if your old list isn't all checked off. I personally had a few ideas fall flat, but there were other good surprises that made up for it. It's important not to overlook those, after all. What is the saying about the best laid plans are paved with good intentions? That's all you really need: the will to move ahead.

Tuesday, October 3, 2017

Communication 101

Jul 8, 2017

The theme lately with several of my clients seems to be communication. I find myself saying similar things over and over to many of them, including with my online clients. Naturally that means a blog post is warranted!
Communication is the ability to send and receive messages clearly. The message’s intent is known to both/all parties involved. Messages can be verbal, non-verbal/physical and/or written. We communicate with dots and dashes, sign language, hundreds of spoken and written languages, flags, smoke, electronic or in person. Somehow, we still misunderstand one another! How is that possible?
Example 1:
Wife: Do you think you could take out the trash for me?
Husband: Sure
Trash does not go out. Why?
  1. Wife asks if Husband CAN take out the trash. Yes, he can. Will he? When? It’s not clear.
Example 2:
Mother: (to loud child) the baby is sleeping.
Child continues to be loud.
Mother: What did I tell you? Sssh.
Child: You said, “the baby is sleeping.”
  1. Mother did not tell the child to be quiet, only that the baby was sleeping. Child did not receive the correct message.
These are very basic examples of how a communication can be misunderstood. What we need are better skills at getting our needs and wants recognized and met. When we are born, the only way to communicate is by crying and other cues. Parents must learn to read these cues to meet the baby’s needs. Adults who are in the child’s life are usually the ones who set the example of what communication looks like in a family, and that child will go out into the world using that style: good, bad or downright ugly.
LISTENING
This is the message receiver’s role. It’s the parent who figures out a certain cry means hunger in the infant. It’s the spouse who is hearing his/her partner tell them about their day. You don’t talk during this part, other than some “uh-huhs” and “oh yeah, then whats”. Your mind may be racing through what happened in your day, or thinking about what to cook for dinner. You’ll miss a lot if you do that. Stephen Covey said that we don’t “listen to understand, we listen to respond,” and that causes a lot of breakdowns. If someone comes to you and says they need to talk, you stop what you are doing, and you look at them and you wait. And you listen quietly.
If you don’t understand something, ask. “Hang on, didn’t you say…?” or “I’m not sure what you mean by…?” Let them clarify what they’re trying to tell you. Active listening is another skill that can sound goofy if not done sincerely. “Let me tell you what I heard, so I know I’m understanding this…” And you repeat back what they said. This gives the other person a chance to clear up any part of the message that is confusing or incorrect.
LISTENING TO TEENS and KIDS
This is a trickier thing to do. Your teen may need your help and the last thing you want to do is say you’ll listen and then interrupt or have a massive (angry, upset, sad, worried) response to what they told you. Use the skills above, if you can’t keep it together, take a break! Go to the bathroom, splash water on your face. How you react to them is going to make or break your relationship. They want their parents love, attention, acceptance more than anything in the world. I don’t care if you don’t believe me, they do.
SPEAKING
You have something heavy on your mind. You really want to talk to someone about it. Maybe you want advice but you also think you know how to work out the problem. You need someone to bounce it off of. So you ask your (insert your person here). First, ask, “Hey I was wondering if I could talk to you about something important. Is now a good time?” If it is not a good time, set a time or let them finish up a task they were working on. This is now the setting and you have the floor.
Now a good listener will help you clarify what you’re trying to say, but usually it’s helpful to begin with an “I message.” This puts the speaker in the forefront, especially if this is a confrontation. The structure is: I feel (EMOTION) when you (BEHAVIOR) because (RESULT). “Honey, I feel frustrated when you don’t take out the trash because we keep missing the trash pick up.” Chances are, the receiver of this message has noticed trash piling up and starting to smell bad. There is a consequence that has already happened and they know they have some responsibility in this. Then the speaker has an opportunity: “help me figure out a solution for this.” They’ve just invited the listener to engage in problem solving. There is no blame being placed on the listener, there is no disrespect or hurt feelings.
There are good texts out there with a lot more advice on how to have difficult conversations, like Crucial Conversations. They are geared toward kids, teens and adults of typical and specialized needs and cultures. I want to stress how important it is to work on being clear, calm and respectful when communicating with others. Imagine how much kinder a world we could be living in if everyone made the effort to listen better and speak with clarity and respect? Pass this along and maybe – just maybe – this could be the start of something beautiful.

PRIVILEGE

I’ve been avoiding writing recently, I admit, because when I sit down to write something about mental health (that will speak to my ideal client and bring them in for therapy), something happens in the world that rocks me. It angers me. Muslim bans, Neo-Nazi’s and “free speech,” kneeling as protest, useless and greedy government officials, election tampering, the growing disparity between the rich and the poor, the attempt at healthcare repeal every three months, hunger, disaster responding, violence, mass murder, assault weapons. I could go on and on, and that is just in the United States. These things are not subjects for typical mental health blogs. Writing on those topics, anxiety, depression, parenting, feels pretty superficial these days because the problems are so much bigger than the individual’s reaction to the above current events. How can I help someone be less anxious or depressed aka feel safe and happy in such a world?
So I am going to begin with what I hear a lot in sessions. I hear a lot of what we are calling Privilege.
Privilege   priv·i·lege [ˈpriv(ə)lij]
noun
a special right, advantage, or immunity granted or available only to a particular person or group of people: education is a right, not a privilege
synonyms: advantage, benefit, prerogative, entitlement, right, concession, freedom, liberty
verb
grant a privilege or privileges to: English inheritance law privileged the eldest son

I am speaking to the concept of having an advantage. Being white gives you an advantage, as does being a male. It does not mean you have grown up with money. Obviously there are fewer and fewer people in that category so let’s not try to argue that point right now. Money is of course a concrete privilege, it doesn’t make you happy but it can solve a lot of problems. When I was a girl at PS 75, I was in a mixed community of white, Hispanic, African American, Jewish people. I was not wealthy, so when one of my African American friends asked if my barrettes was “real” as in “real gold,” I was confused. Why would I have real gold barrettes when I basically wore the same two pairs of jeans every other day? When I think about that now, I realize that they saw me as having an advantage, as having access to something that they did not. Why? You guessed it, I am white. And yes, I am privileged. My parents have advanced degrees, we had complicated books on the shelves, art on the walls, I traveled to visit my grandparents over the summers. The list goes on.
Now it is clear that while men have been feeling quite attacked on this subject as so many don’t feel like they’ve been privileged at all. Many are poor, undereducated, unable to make ends meet to support their families. Where they don’t realize they have been privileged: They can go for a 6AM run without being stopped by police because they’re “acting suspicious.” They aren’t racially profiled when they go for a drive. They aren’t sexually assaulted and told they shouldn’t have been jogging – in shorts – at 6AM. This list also goes on.
Laws have not been enacted to keep white people out of home ownership, or moving into certain neighborhoods or joining private clubs. Or drinking from a public water fountain, or using a public bathroom. It is not so long ago that these things were a reality in this country. We know where some of the most outspoken civil rights leaders are today – if they are not already dead/murdered. But where are the people who so passionately protested integration? They didn’t just disappear into obscurity. They became police officers, lawyers, members of government, the Attorney General. They used their privilege to undermine every layer of society. Slavery has not ended, it only looks different now (an entirely different subject but Google Industrial Prison Complex if you want more information).
The concept of being “woke” is about being educated about how all of these factors have led to the current situation and working to stop it. Working toward a real model of equality. However, it is hard to be Woke when every part of this culture is trying to convince you that it’s all okay exactly the way it is. They want white people to say, “it’s all too much, I can’t anymore…” and it is your Privilege to say that, because for the most part, you can. You don’t have to worry about being shot by police for reaching for your license and registration. No one asks you where you are from or tells you to back to where you are from. You don’t have to worry about being the victim of a hate crime. You feel safe. Putting yourself on the line is scary and has absolutely had consequences for some, but you, white person, are what is going to make the difference in the long run.
As a therapist, I am going to challenge you on these issues. I will correct you when you repeat myths of how immigrants are coming to the US and signing up for welfare. Therapeutically, it’s not my place to do this, but I feel I have some obligation to challenge you. If you’re not ready for this challenge, we aren’t going to be a good match to work together. I’m okay with that.

www.aliceriley.net
ARileyLCSW@live.com



Saturday, July 1, 2017

Predators in Our Midst

I am occasionally sought out by friends, relatives and colleagues because of my experience in working with children in therapy, what normal development looks like vs a concern, child welfare issues, reporting child abuse. I am happy to help and enjoy following the stories that are brought to me to see how they resolved over time.
Someone I know well called to ask my opinion recently. She was concerned that her early teenaged son had been be-friended by an adult male. She knows this person but discovered that the two of them had been having an ongoing daily back and forth conversation via email. Only when the youth had been invited out to an event with him did he have to ask his mother for permission.
What she found out is that this person works at the youth's school, has held events for students outside of the school's purvue and had requested all of the student's personal email addresses. Her son also admitted to the daily messages and defended them, saying he was glad to have found a friend who is supportive and wanted to be trusted. My friend was surprised at this pushback but realized that the adult male was likely responsible. I gently said, "It sounds like he's being groomed," and I could hear the relief in her voice. No, you're not crazy.
When your child is being groomed, the parents are as well. The person wants to gain your trust, and often they are in a position of trust. When they begin to test that trust, you begin to question yourself - which explains the relief my friend felt. They will make you think you are crazy and a terrible person for ever thinking such things about them. In a nutshell there are stages of grooming, the following are the most agreed upon:
1. Targeting the victim. My friend's son was among many until it appeared he was responsive to the adult. He wants and enjoys attention and struggles with friendships.
2. Gaining the victim's trust. This adult most likely has written, you are growing up now, you can make decisions for yourself. You don't always have to ask or tell your parents everything.
3. Filling a need. I can take you places you can't go on your own, that your parents won't let you.
4. Isolating the victim. I'm your friend, they are not your friends. Only I can do xyz for you.
5. Sexualizing the relationship. It is not believed that this took place for my friend's son but that would be the next goal for the adult.
6. Maintaining control. Keeping the victim from disclosing, using threats and other coercion.

My friend was right to pay attention to her raised hackles. She is angry that a seed has been planted that had already worn away at her relationship with her son. She asked me for some "magic words" to say to her son since she was not feeling clear-headed enough to verbalize something to him that would be understood fully.  So here is what I sent:
I've been trying to find the right words to explain to you why I am so worried about you right now. It isn't anything that you've done but it may be because you believe that the adults in your life are safe. I want that to be true -but recently when it came to my attention that you had an ongoing relationship with an adult it raised a red flag for me. There are some adults who don't believe that they are crossing a boundary when they befriend someone much younger than themselves. This person is probably telling you that you were getting older now and that your mom and dad are probably over protective and they don't trust you yet; but you have good instincts and good StreetSmarts and you don't need to tell them everything. When someone tells you things like that there's a word for it- it's not the same as manipulation. When an adult is making an effort to prepare you for more to come in that relationship -it's called grooming. They put themselves in your life as a person who is the only one who understands you and at the same time they drive a wedge between you and the adults who really care for you and will protect you. That way they will be the only person you have to go to for help/ advice and that is when you will be most vulnerable. There are some adults who do not believe that a physical relationship with the child is wrong. I pray to God that nothing of that nature has happened at this point. But I am genuinely concerned that the objective of your friend is to do you harm. In saying that- I know you're upset. I know you feel that you can protect yourself. I'm here to tell you that you cannot possibly protect yourself. These adults are extremely skilled at what they do. You need a safe adult to help you. I am going to need every written communication that you have had with him and I need you to now block his email address so that he can no longer contact you. I need your word that you will not disobey me on this. It is for your safety and your protection and it is because I love you very much and I would do anything to keep you from harm. 

Most parents' first instinct is probably more raw - we want to lay down the law right off the bat. "You better not ever ever see that guy or write to that guy again," with a lot of cursing perhaps thrown in.
The thing is, it will harm the parental relationship. The teen will likely push back even harder. "He said you were going to do/say that!" and then you have more secrecy to be concerned about. It is best to approach it within the context of your close and loving relationship. Spend some time building on that with some quality time and attention. Follow up on the information, make a report to the police if there is more to the story, and then keep your eyes peeled and your ears to the ground.



Friday, June 16, 2017

Therapist Vacation

Therapist vacation


I came home from vacation late last night and got a message from a client today. She said, “everything goes wrong for me. Always, no matter what I do.” And unfortunately, a lot of lousy things have happened to her and It’s frustrating to see her continually experience set backs and disappointments.
On any other day, my response would have been different. But I just came home from quite possibly the worst vacation experience I have ever had.
Every couple of years, my two kids go to stay the summer with their grandparents who reside in St. Croix. I take them down, they stay, their dad goes and gets them (and visits his family). Travel there from Colorado is not direct and there are long layovers, usually in Miami, due to limited service to the island. This year, we went and I took my mom, and we planned a very relaxing, beach and sea focused trip with shopping, snorkeling, sunset watching and sight seeing.
To sum it up: 3 cancelled flights, one of which had been rebooked to St. Thomas, then cancelled. My over night hotel fee is in dispute right now since we could never have made it. No rebooking opportunities for 3 days. Stranded in Miami 2 nights, one night in Charlotte, NC. Miami was apparently in some kind of rainy season. Luggage was all sent ahead to St. Croix the next morning while we remained in Miami. An excursion I planned to take my mother to St. Thomas on the seaplane was accidentally mis-booked and we had to pay change fees to get on the sea plane. I really had my heart set on flying that way – The plane takes off and lands on water and it’s 20 minutes between islands. Four days in St. Croix and we had to go home, saying our tearful goodbyes to my kids. That is never pleasant but I was worried about their return travels already! Flight home was St Croix to Miami, Miami to Chicago, Chicago to Denver. Flight from Chicago to Denver was cancelled. No rebooking. No seats on any flights for 3 days. I booked two one way tickets on another airline. I was not going to stay 3 days. Another hotel, a full day waiting in Chicago, before getting home at 1:30AM.
With that many turn of events, it was very hard to keep my chin up and not feel the way my client expressed. I was furious at the airline for cancelling so many flights, for so many people and not adding any to accommodate them. How many travelers had to go home because the extra expense would be devastating? I had been to St Croix two other times and I had expectations and plans. I wanted to swim laps every morning on Rainbow Beach… and I never even got to dip my toes in the water. I went to the beach three times the whole trip. And only once on St. Croix.

Now, despite being very put out… I forced myself to make a list. Several good things resulted from these mis-adventures!
1.       I went to South Beach (Miami) for the first time, saw a cousin of my kids who works for a large Hotel company who got us the family rate. He lives on Miami beach and we went out to dinner on Ocean Ave and had a beach morning the next day. When it began raining, we walked over to his apartment.
2.       My best friend lives in Charlotte, NC and her fiancé gave us his very beautiful home for the night, then they brought us breakfast in the morning before we had to go.
3.       I rented a car in St Croix and having my own wheels there for the first time (vs being chauffeured around by in-laws) was liberating. Driving on the left isn’t that hard.
4.       I got to ride on the sea plane and went to St Thomas, running an errand I had planned at a local shop. Also got to lie under a mangrove tree on a nearby beach.
5.       I met my new niece and got to see/hug/kiss my nephew, who lives there
6.       My kids are getting to spend time with grandparents, uncle, aunt, cousins, learn to cook Dominican food and speak Spanish
7.       My brother lives outside of Chicago and came to the rescue. I got to see/hug/kiss him and his family.
8.       I got to see the Art Institute of Chicago.

It’s important to make these kinds of lists when it seems like everything, well, sucks. It’s what I ask my clients to do every day – re-frame the experience. Trying to find the silver linings. Doing this tells your brain that you will NOT allow it to go down the dark path. Every time we only see the negative, our brain becomes more and more accustomed to going there as the default. It doesn’t make the experience any better, but it is certainly helping me not hate life right now! Things don't just go badly for you, but the cruelty of depression will tell you that it is you and that everyone else is living a wonderful life. I still had a vacation, just not exactly the one I had planned.



Sunday, May 21, 2017

Jedi Mindfulness Trick

You hear the word all the time: Mindfulness. "Be mindful" to reduce stress, improve relationships, treat that Borderline Personality disorder, etc. What does it really mean?

mind·ful·nessˈmīn(d)f(ə)lnəs/ noun1.
the quality or state of being conscious or aware of something.
"their mindfulness of the wider cinematic tradition"
2.
a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.



Aahh, now you get it... blog entry done. No, not really.









Some of you may recognize the Star Wars reference in the title. If you will recall Yoda, (Empire Strikes Back) telling Luke, that he was impatient, that he never had his mind on the tasks at hand, instead his mind always wandered into his fantasy of becoming a pilot "like his father." Now, I have issues with the Jedi philosophy, because they teach that emotions are a hindrance and should be repressed. I think that if Anikin had been allowed to grieve the loss of his mother when he left her to train, he might have turned out better. But getting back to the point. When we meet Rae, whose parentage has yet to be revealed, she is a scavenger. She spends all of her days picking off parts of grounded Imperial Star Cruisers on her desert planet, washes them in, trades them for food. At night, she waits to be rescued. When her powers are awakened, it takes her very little time to connect to them, her mind is clear, she can focus, and she wins. 

She can do this through mindfulness. Yes she has a fantasy life, but it doesn't interfere in her daily life. She can put it all aside until the right time. 

I have been listening to meditation recordings on the Calm app. The voice of the guide is pleasant, which is important to me. The message is that constant thought about everything all the time is exhausting and can make us sick, physically or mentally. It helps you learn to clear your mind and not judge yourself when thoughts peek their heads into your brain. But to just go back to the clear, open blue sky. Thoughts are little, white, puffy clouds that float away. There are YouTube channels as well that offer guided meditation, body scans etc as well, just so I don't plug the one thing I like particularly. 

If you do this a little every day on a scheduled basis, you can do this during times of stress. You can do this during times you need to focus. You can be present in your life instead of being distracted by the noise either around you or in your head. You might even get some good sleep! 

What would it be like to have a conversation with someone you care about where you were completely attuned to them? Or you were sitting on the grass under the tree and felt the breeze, heard the leaves rustle, smelled the flowers on the air? Just present? Not thinking tomorrow is Monday and there are 100 things waiting for me to do... Thoughts and anxiety are ever present, but they don't have to control you. So even if you think what you are doing is mundane, being focused on that mundane thing can translate into other parts of your life when you just might need to save the world!

Friday, April 21, 2017

GOALS

One of the most common sources for anxiety in people who want to achieve anything is how to set a goal. We tend to see the final result and we have no idea how to get there. To get to the magic coast, we have to hike through the desert, climb the mountain, battle the troll under the bridge, avoid the enchanted forest... these are the steps involved. There are always more than we realize.

I often hear, "I want to start my own business," or "I want to move out into my own place and be independent," and are overwhelmed by the task. The reason is: it's just too big. So how does a goal oriented person begin? 

There are several options:

SMART goals. The accepted way to write a goal is the SMART format. And yes, if I am your therapist, I will have you write it down someplace. A journal, a white board, the bathroom mirror - if that is where you will see it. 
S: Specific. What are you trying to achieve. The result of your efforts. 
M: Measurable. How are you going to quantify your success and progress? In terms of money? Lowering or increasing scores on a test? 
A: Achievable. If your goal is to grow wings and fly away then you're just setting yourself up. 
R: Realistic. You aren't going to play professional basketball if you are only 5' tall. But you may have other options for your talents. 
T: Time limited. What time frame are we looking at? What date are you aiming for?

So here is an example based on the above breakdown: (GOAL) Start a business
 (Tasks/action steps)
Write a business plan and submit to a loan officer for a business loan. 
Criteria will include type of business, current earnings, market research, etc
Use skills obtained in business school and enlist experts on subjects of xyz to consult/be on board of directors, etc
Due date for plan: (set dates for 1st, 2nd and final draft) Submit to Bank: (set date). 
There are probably many other tasks in starting a business but the idea is that you break down your lofty hopes and dreams into workable parts. 

If you have many hopes and dreams, then listing those in a grid format can also help break them down and prioritize. What do you want to / or have to get done in the next 30 days? 6 months? 1 year and 3 years? You're making 4 boxes and sometimes the tasks and goals will be moved up or moved farther out depending on what is going on in your life. 

I have one client who is using an app called "Epic Win" to record goals. What makes this app different is that it is based on role playing games (RPG). You are a character, and the more you meet your goal deadlines the more your character gains points that are applied to looks, charisma, etc. For younger people who play RPGs regularly this can be especially appealing. The app isn't free but it's not expensive. It's certainly a creative way to achieve!

Another creative option is the vision board. There are many many tutorials online about these. If you are unclear of what direction you want to go it, doing one of these may assist you in determining a course of action. It's also a wonderful way to procrastinate!

Are you ready to get started? I am including a handout on SMART goals and a goal grid here
Set those goals and smash them!

Monday, February 13, 2017

Animals in Therapy

The vast majority of people love animals – a cat, a dog, bird, lizard, rabbit, horse or even a mouse. They show us love as much as we show them, and it’s completely unconditional. Almost any domesticated animal can be a comfort animal or have therapeutic benefits – there is no certification for this but it helps to have a therapist write an official letter indicated a child or adult needs their companion to address mental health symptoms. Often therapists are asked to do this so a family can move into a new apartment with strict rules about pets. There is an enormous amount of research already on the books about how animal contact can improve post surgery outcomes, improve social contact in older adults, increase walking times and distances for dog owners, experience a generally higher sense of well-being through their pets.
So why would someone need a therapy animal? All you have to do is adopt a pet and all your troubles are gone, right? I am writing this because I have an amazing dog, a 6 year old black Labrador retriever named Rocky. He’s calm, intuitive, quiet, completely harmless to kids and older adults. I do not have any certifications at this time in doing any “real” therapy work with him but often kids or adults ask me to bring him in. I let everyone know that while he’s healthy, has all his shots, but I am not covered to use him officially. They don’t care; and I am not worried that he’ll hurt anyone. I’ve seen toddlers manhandle him and all he does is lie down and get comfortable. When you stop patting him, he’ll nudge you or put his paw on your knee to remind you that he’s still there. I have a security system because frankly he would just lick a robber to death.
To use an animal for therapy, you need a therapist. The animal can’t go to school for that. The animal should pass a screening for the right behavioral attributes and have basic training for obedience. Many therapists have their own pets – horses at a ranch, dogs, cats, goats. People who are anxious benefit from talking while petting the soft fur – that tactile stimulation can help ground people in the present moment, and help them connect back to their body (see my NARM post) as so often people will disassociate when stressed. Children who have impulsive behaviors learn more empathy so see that their rough treatment might not be the right way to get the animal to “make friends” with them.
The animal therapy has specific goals for treatment. It is the primary intervention for the client. The other type is animal-assisted therapy (AAT) where the animal’s presence is secondary to the therapy going on. An animal can get a reticent child into the office, or motivate a teen to engage, or be a surrogate face to talk to when in distress.

My favorite example of Animal therapy is from the first book written by abduction survivor, Jaycee Dugard. She wrote that for her first session she was handed a saddle and assigned to saddle a horse (something she had never done before). Her two daughters did fine. She could not do it, after many failed attempts. Her therapist then asked her why she did not ask for help? This then spurred a discussion and realization that for years she could have asked for help while living with her captors. Everyone brings something different to therapy, and animals can offer something different and unique to each situation either as the therapy or as a jumping off point. 

Wednesday, February 1, 2017

FIX MY KID


I see a fair number of adolescents in my practice. I enjoy them a lot because when I was in High School I was in therapy and it damn near saved my life. Not because I was suicidal, but because I was able to process out all of the stupid, silly, stressful and annoying parts of being a teenager and decide what was right for myself. I mentioned before that the therapist wasn’t perfect but he did his best and sent me out into the world a little better than I was before.
I wanted to go to counseling – I asked to go. It meant my mom spending a little money on me every week but I babysat a lot and I often paid for my own luxuries that way so why not? I could walk to the office on my own, and I was a good client – only missing one or two appointments. Parents now ask for counseling for their kids – and they should. I always ask if the teenager wants to come, and usually they do. I explain that I am not the snitch for the parents – in front of them both. The kid needs to be able to tell me things without the parent hearing ALL. But the parents also need to be involved to a degree, so they know what progress is taking place and any changes that need to happen so they can support their budding adult.
I cannot “fix” anyone’s kid. There are times, when the teens behaviors are direct result/rebellion of their parents’ behavior. In those cases, I help that teen learn healthy ways to deal with their parents so they can move out someday and lead a healthy life. These are very difficult situations from my point of view. But when it works, the parent sees “improvement” because the teen stops butting heads with the parent as much. They see the end date ahead – college and independence. Often teens don’t realize until you point it out, that they WILL grow up and they CAN live somewhere else. The ability to imagine the future is located in the pre-frontal cortex of the brain, which is not yet fully developed until we become adults. But we can give them a little nudge.
In discussing this with some colleagues, after being “fired” from a teen I had a nice rapport with, because her symptoms weren’t gone after 2 months, we came up with a few ground rules:

1.       The above rule – I’m not your snitch

2.       I can’t fix your child. Therapy is a process and it takes time to dive deep under the surface. Some symptoms are serious and debilitating and your teen may need at least a year of work.

3.       Therapy isn’t forever – my goal is to get the parents to learn to be the supportive adult in the teen’s life. You should grow alongside your child. You are forever.

4.       If your child is being treated for trauma – their “bad” behaviors in school or at home are often a direct result of the trauma. Punishing them for their trauma responses is counter-productive. Setting limits is good. A good resource on this topic is Heather Talbot Forbes’ Beyond Consequences.

5.       Check in and participate once a month at a minimum. Ask questions about how you can help support your child grow into an adult.

Unfortunately, a little “getting over” on parents is part of growing up, and very common. Be patient with your teen. They’ll make mistakes and they’ll learn from them. It won’t usually ruin their whole lives. You can warn them but they’ll still insist on finding some things out the “hard way.” Listen to them, ask questions, repeat back what they say and ask if you are understanding them right. “What do you think about that,” and “Hum, interesting,” will go a long way. And I am here to help!

Monday, January 16, 2017

Finding a Good Therapist

After you have decided to find a therapist, and you meet them and you begin. How do you know you have a good therapist? How do you know that what you need from them is going to be met?

Therapists are human beings, and they make mistakes. They say something too deep too quickly, or make an assumption, or look a little glazed over for a moment… This can happen from time to time. But the experience of being in therapy is much bigger than these little moments between you.

Your therapist should be open to your questions about their practice. What is your therapist’s theoretical framework? What is your therapist’s approach to helping people with your particular concerns? Where did the therapist get their training? If you get a sense that the therapist doesn’t want to answer or is impatient with you, keep looking, especially if it bothers you.

Your therapist should have an idea how long treatment should take, ideally.

Your therapist should check in with you about how treatment is going, on a regular basis.

Your therapist should, at least on the surface, appear to be organized and grounded, as a person. As I said before, they are humans, they’ve had bad experiences, they have problems too, but their problems should not spill into your therapy.

Your therapist should seem like an individual person, rather than a textbook. You should be able to get a sense of their personality in sessions. They use themselves in sessions.

Your therapist is not dominating the conversation with anecdotes about their own lives. They should spend most of their time listening and encouraging you to speak, explore and process.

Your therapist should adhere to ethical rules and guidelines. They don’t invite you to parties, or accept your invitations to barbecues or make uncomfortable suggestions. In Colorado, it is illegal to have a dual relationship with your therapist, including dating and sexual relations. They are in a position of power in your life and it would be exploitative and abusive to engage you in non-therapeutic activities.

Your therapist should inform you prior to the start of treatment of the above, to make sure you are going to be a good fit to work together. Your therapist should be confident enough to say, “we might not be a good fit, I can help you find someone who is.”


If you think I am a good fit for you – give me a call and put me to the test! www.aliceriley.net