Brenda was a beautiful woman with long black hair who came for therapy and recounted her story: “Two months ago I had a double mastectomy. At that time, my husband left me for another woman. My daughter, who saw me through all this, is leaving next month for school in California. Now I have no one. Both my parents died in a car crash when I was 12. I went to live with my grandmother who died when I was 17. That’s when I got married. And now I have no one.” She stared straight ahead, lost in reverie. The image of her parents’ violent death, her mastectomies, and all her other losses were overwhelming.

As a private clinician, and Manager of the Social Work Department at the Valley Hospital, collectively we view our purpose as making a difference, making connections, making meaning and making a life- all of which entails breaking barriers on a daily basis. As social Workers, we are trained to help people address personal and systemic barriers to optimal living.  Social workers are tasked uniquely to assist patients in the most difficult psycho-social circumstances and guide patients families and medical providers with navigating medical care coordination and social service challenges in the midst of an unprecedented pandemic.  We must adapt to change manage stress and innovate.  We are employed to effect positive change with individuals, families, groups and entire communities. Social workers use their collective skills to establish policies that give more people to access community services.

In the previous blog post, I addressed the importance of using the present-day conflicts that couples bring to therapy to access historical wounds, traumas and losses.  But often couples don’t want to talk about their pasts.  They have usually come to deal with current conflicts–not their family histories.

Intersectionality refers to the interconnectedness of social categories such as race, gender and socioeconomic status.  It can enhance understanding an individual and the interplay among their identities.  For example, a person may identify as non-binary and self-report in an ethnic minority category.  In addition to these primary identities, there could be less salient ones such as religious or spiritual preferences and generational group.  Intersectionality was first coined in 1989 by Kimberlé Crenshaw, Columbia University law professor, to describe factors contributing to the social being of African American women.  In particular, the intersection of their race and gender was purported as a significant factor.  Intersectionality became widely applied over the years and has relevance when understanding systems and structures that impact vulnerable populations such as children and persons who are wrongfully criminalized.  Consider a child who experienced adverse events such as family violence and is also subjected to impoverished conditions.  Knowing them from these circumstances will offer insights for clearer visibility.

Couples come to see us to help them resolve their conflicts — not to create growth.  But if we stop at attempting to help them resolve their present-day conflicts without moving on to creating growth, we have cheated our clients out of at least half of the potential of couple treatment.

Just like public speaking or any other skill, I am realizing that conflict resolution is a skill worth mastering. As an Army officer, you are expected to lead, but in order to lead, you have to know how to manage conflict to accomplish the mission. The “mission” does not always mean going into battle or winning a war. Depending on your specialty, your unit, or work environment, the mission may be proving good health care, gathering intelligence information, maintaining and supplying units, etc. Whatever the mission is, conflict in the workspace can feel like you are going into a battlefield. Your heart starts to race, your temperature may increase, you become nervous. It is a similar physiological reaction to when a soldier is facing a threat. The big difference is that work conflict, for the most part, does not present a danger to us. However, our physiological reaction makes us feel like we are, thereby guiding our thoughts and behaviors, potentially leading to increased conflict. This is why it is so important to consult, use humor, and not personalize the situation to be in the best possible stance to manage workspace conflict.

In 2009, the South Carolina governor reportedly “disappeared” for a few days.  It was later discovered that he had been with his mistress in Argentina.  In one of his former wife’s interviews on a news talk show, she described their therapy together after his return.  She said that she could recall the moment in their treatment when she knew their marriage was over, as she began to realize that he was not going to take any responsibility for his part of the problems in their marriage.

Positive Psychology is the study of conditions and processes that contribute to the optimal functioning of people, groups, and institutions (Gabe & Haidt, 2005). Therapy builds on the client's positive experiences to improve their well being and to ascertain the role of their positive experiences. Clients begin to recognize they have the solutions to their problems; each moment and each situation is a moment of growth and learning. Our clients need to have hope in their situation and in the challenges they face. 

New consensus study report from the National Academy of Science, Engineering, and Medicine is now available.  Read now to explore a #WholeHealth approach to improving the health and well-being of both veterans and the nation. The new report identifies five foundational elements of an effective Whole Health care system. It must be people-centered, comprehensive & holistic, upstream-focused, equitable and accountable, and grounded in team well-being. 

Early in the development of family therapy theory, authors used the term “identified patient” to describe the family member whose behavior brings a family into treatment.  This is usually one of the children, but not always.  It is the person who has acted out enough to cause the parents to seek help or to get the family referred for treatment.

Greetings to all from the American Board of Clinical Social Work (ABCSW) Certification and Membership Committee. I wanted to take a moment to introduce you to the committee. The ABCSW Certification and Membership Committee’s charge is to review certification criteria and processes, develop certification guidelines, assist ABCSW staff with decision making, develop membership benefits, to work with other committees in coordinating efforts to benefit certification and membership, to establish an open channel of communication with all stakeholders (a function of this blog post), and to be a reference point for ABCSW support staff with certification and membership issues. 

Read More Here

You … and some of your clients … have set goals for 2023 in the form of obligatory “New Year’s Resolutions” … many of which may be broken prior to January 30.  Have you considered setting up some mini-goals to assist in the process?  If resolutions are established annually, why not divide things up into more manageable monthly goals?

As students, those of us who were pursuing a career as psychodynamic psychotherapists learned about the repetition compulsion.  The Oxford Reference (www.oxfordreference.com) defines this phenomenon as “a tendency to place oneself in dangerous or distressing situations that repeat similar experiences from the past.” Webster’s Seventh New Collegiate Dictionary describes a compulsion as “an irresistible impulse to perform an irrational act.”

All psychotherapists know the importance of language.  We pay close attention to exactly what our clients say and how they say it.  In this post, I will share a case that illustrates how the perfect language of couples’ complaints provide the roadmap for their treatment.

“If you don’t know the language of gratitude, you’ll never be on speaking terms with happiness.” Chopra 

Best Practices in Mental Health is a premier, peer-reviewed journal that represents the highest quality scholarship in the field of mental health. With a comfortable format and a broad scope, BMPH is an excellent resource that provides an interdisciplinary and evidence-based focus for its audience of mental health educators and practitioners. Editor Daphne Cain is at the helm of curating new research from recognized experts on established best practices and from leaders in emerging best practices. The hand-picked editorial board ensures the journal keeps with National Institute of Mental Health's (NIMH) priority to promote the integration of technology, replicate and improve promising practices, and continue to provide diverse and enlightening perspectives that allow readers to remain engaged with the best research available in the mental health field. 

Call for Papers - Best Practices in Mental Health.pdf

Most forms of couples therapy are focused on resolving conflicts in the present-day lives of couples who seek treatment.  Some methods do delve into the historical antecedents of those conflicts, but their primary goal remains helping couples meet their current needs.

Most forms of psychotherapy require that the therapist perform a “delicate balancing act” between competing forces.  Some authors refer to this skill as dialectical thinking–the ability to mentally (and emotionally) hold seemingly opposite factors in dynamic tension in service of moving a system toward higher functioning.  In Neurodynamic Couples Therapy, there are primarily three areas in which the delicate balancing of the couples therapist is required for therapeutic success.

Read More

A frequent complaint that therapists hear from couples when they enter treatment is that they have felt hurt by each other.  They want to tell us all about the pain that their partner has inflicted on them, and they often seem to want the therapist to declare which one of them has been the “most” hurt.