My Least Favorite Word to Hear in Therapy ;-)

Words are powerful. Whether we are aware of it or not, the words we choose can actually shape your mood and even your behavior. For example, if you consistently use negative or catastrophic terms, pretty soon that colors your view of the world. If you say “I can’t take it” long enough, guess what – you will believe you can’t. It’s not always that simple, but becoming aware of the words you choose is a fairly reliable way to begin to strengthen your emotional state, your self esteem, and even disorders like depression and anxiety.

On my Facebook page, which I hope you are following and if not, here’s the link: http://facebook.com/sandiegotherapy , I asked people what word they thought I meant based on the title of this video. I got some great answers, and some really funny ones as well. I heard ones like “Doritos” and some that were pretty close, like always, can’t, and never. Those last three get my attention and will usually get me asking for more information.

 The one that I tend to notice a lot, though, is “should.” We all use it, maybe more than we realize. “I should earn more.” “I should not call him first.” “I should be happier.” On and on. When you really stop and hear it, this seemingly innocent word carries with it a degree of self judgment and maybe even shame. It’s like we are programmed to blame ourselves when things are not according to plan. We are all human beings with flaws and sometimes we make mistakes. “Should” is a flag we wave saying “Yeah, I’m not doing this well enough. I should do better.”

When I hear this word in session, especially if it comes along with depression, anxiety, and low self esteem, I ask about it. I want to know whose voice it is. “Who is telling you you should be thinner?” Often this gives the client a chance to stop and think. I have heard “Wow. I never thought of that. It sounds like my mom. She used to always tell me I should do better. It’s like I was never enough.”  So we notice that –that’s all. It’s a good start just to hear our own words. We increase awareness of language choices and how what we say affects our view of the world and ourselves in it. We don’t only apply “shoulds” to ourselves. It can be a way of indicating judgment of others, and is often met with resistance or defensiveness.

 By changing the “shoulds” and choosing more empowering language – like I will or I can, you may see some positive changes in your life and your outlook. It may help you to see where any negativity comes from. For what it’s worth, it will help you expand your vocabulary and say more precisely what you mean.

Communication, Family of Origin, Family Ties, Marriage Counseling, Mental Health, Parenting, Relationships, San Diego Counseling, San Diego Therapist, Saying Goodbye, Solutions, Therapy

Parental Alienation Syndrome


When a couple with children makes the decision to end their relationship, the effect on their children can be profound.  How the parents manage this major life change can determine the difference between a positive outcome for the children, or years of prolonged struggle.

Parental Alienation Syndrome refers to an active campaign to turn a child against the other parent. I have heard it termed brainwashing – it is damaging to everyone involved. In my work with families, I have rarely seen behavior this extreme. But I have seen families struggle with negative feelings between the parents spilling over onto the children – even without meaning to.

In cases of divorce or breakup, there can be animosity between the ex-partners. Even when they start out committed to remaining friends or ensuring that the children are untouched by the breakdown of their relationship, this is not always easy to accomplish. Ideally, when a relationship ends, the children’s interests are put first. When the parents move on, even remarry, it is possible for this new, expanded family system to be a thriving and healthy environment for the children. I have seen it in my practice in working with families.  It takes effort and commitment on everyone’s part, and sadly, it doesn’t always work out this way, especially in the first years following a breakup.

Issues like custody, visitation, and child support can become very heated. The ages and maturity of the kids plays an important part, as well as the type of home each parent can offer. By home, I don’t mean luxury or extravagance, I mean that the child knows that he or she has a welcome spot in each parent’s home, and in their life, and that they are cherished, understood, and cared for. They need to know they matter, and that they can trust their parent to still be a parent.

Children were probably witnesses to the breakdown of the parents’ relationship, and they may have developed a sense of who was at fault. As parents, it is not our role to trash talk the other parent, or attempt to turn the child against them. What we can do is try our best to separate marital issues from parenting. If a “good guy/bad guy” scenario exists for the child,  both parents have to first become aware of their behavior, their words, and even their body language. Notice if there are any ways they are contributing to parental alienation. Even if your partner was a lousy wife or husband, they may still be a great parent to the kids, and again, this is what matters most.

So, what if a parent is not such a great mom or dad to the kids? When is it parental alienation and when is the child’s reluctance to be with a parent justified? In his extensive work on Parental Alienation, Dr. Richard Gardner states that if “true parental abuse and / or neglect is present” and the child’s animosity is justified, Parental Alienation Syndrome would not be an appropriate explanation for the children’s feelings. In other words, if the child has feelings of animosity toward a parent who is abusive or neglectful, those feelings may be justified.  Even then there is hope for repairing the parent-child relationship, if the parent who lacks parenting skills or has emotional issues is committed to getting help. If not, again, the child’s welfare is what matters.

Divorced parents need to understand that loving both parents is important whenever possible, even if they have ceased to love their ex-spouse or ex-partner. When one parent repeatedly belittles the other parent, or consistently brings the child into discussions of their faults or the reasons for the relationship breakdown, this can be called Parental Alienation Syndrome. Even if the faults are true, this is not appropriate for our children. Any behavior which is intended to disrupt the relationship between child and parent may be considered alienation. As I mentioned earlier, if there is neglect or abuse, this is an entirely different issue – if the child is frightened, unsafe, ignored, or subjected to harmful behavior, then custody and visitation may need to be adjusted for the child’s well-being. Being a parent is a privilege, and we owe our children our very best parenting regardless of how we feel about our ex-partner.

I hope this very brief overview of Parental Alienation gives you an idea of what it is, and what it isn’t. If this is an issue in your life, I encourage you to explore parental alienation and reach out for support for yourself and your children, if needed.

Video on Parental Alienation Syndrome is here: http://youtu.be/aGkJ5l0Z82s

Medical Issues, Mental Health, Therapy, Toolkit

Sleep Deprivation

I was planning to make this video two weeks ago, but no joke, I was so tired that I took a weekend off to catch up. How’s that for ironic? The good news is I did catch up, and here I am to talk about this topic that affects nearly everyone from time to time – not getting enough sleep.

We have a new puppy in our house who is still in the crazy puppy stage, and our other dog had routine surgery. I think we had about 3 nights where neither of us got more than a couple hours sleep. I felt exhausted, sore, couldn’t think as clearly as usual, had no appetite, and finally caught a cold.  Maybe when I was 20 this would not have been much of a problem. Even at 30 when my daughter was born, sleepless nights were not a big deal. Nowadays, I need to catch it and get my sleep cycle back on track to function my best. I find that to be true for my therapy clients as well.

People who come to see me for counseling sometimes must think I am a broken record, but I do ask about sleep patterns during most sessions.  I want to know how they are sleeping, if they have trouble falling asleep, staying asleep, or they are sleeping too much – especially if they wake up unrefreshed. More often than not, there IS a sleep problem – most often not enough.

How much sleep is enough?

The standard answer to this is eight hours of sleep for adults. This can vary from person to person. What seems to be most important, according to the Centers for Disease Control, is Rapid Eye Movement, or REM, sleep. REM sleep starts about 90 minutes into a sleep cycle and generates the most active dream states. This period helps the brain sort through experiences of the day and neurologists have identified this stage as a period of reorganization of your brain cells.

One reason this matters to us is that being deprived of this necessary period of rest and repair can lead to psychological and physiological problems. A study conducted by the University of Berkeley showed that a severely sleep-deprived brain shows deficits in decision making, appropriate thought patterns, and can even result in psychosis. Not getting enough sleep has also been linked by the CDC to obesity and depression.

There are some mental health conditions that seem to always include disturbed sleep. I have rarely seen someone for Post Traumatic Stress Disorder, for example, who did not have problems sleeping. People experiencing anxiety also will usually report problems either falling or staying asleep. It’s surprising to me how many of us report regular bouts of insomnia, or feel they are always running on a sleep deficit.

Here are some common sense ideas for getting a good night’s sleep:

Substances like alcohol, caffeine, or sugar can make it much harder to sleep. If you can’t cut these out of your diet entirely, try not to ingest them after dinnertime. The half life of caffeine is seven and a half hours. That’s plenty of time to keep you awake long after you drink it.

Speaking of dinner, going to bed on a full stomach can interfere with sleep. The same is true for intense exercise. Allow your body to wind down as you approach bedtime, and see if this improves your sleep patterns.

Make your environment as conducive to sleep as possible. Keep your room cool, dark, and ventilated. If you find yourself tossing and turning, don’t lie in bed and fight it – get up and find a calming, quiet activity until you are ready to fall asleep.

If you are a female over the age of 35, symptoms of perimenopause can begin to interrupt your sleep. Both sexes can experience things like restless leg syndrome or sleep apnea, which can prevent the needed amount of REM sleep. For all of the above, I strongly recommend you see your health care practitioner to talk about your symptoms and see what might help. There are a number of non-prescription methods to improve sleep, so if you are worried you will just be given a bottle of sleeping pills, chances are your practitioner has a number of alternatives to try first.

Many people report difficulty sleeping. I hope these ideas were helpful in getting you closer to a good night’s sleep. I welcome your comments below on anything that has worked well for you. Thank you for reading!


Let’s Talk About Sex!

Of all the topics that are difficult to bring up, even in the therapy room, sex has to be near the top of the list. If sexuality is an important part of who we are and our relationships, but it’s uncomfortable to talk about, we’ve got a bit of a Catch-22.  I think we can find a middle ground, and this video will give you some ideas for addressing issues around sexuality in your relationships in a way that increases your comfort and increase your sense of freedom.

 First, when we are uncomfortable with being sexual with someone else, and the relationship is basically sound, sometimes what is underlying is a feeling of not feeling comfortable with yourself.  Worrying about things like your body or your performance get right in the way of your ability to relax and enjoy the connection of sex. So first and foremost, feeling good about yourself, the way you are, is the first step in healthy sexuality.

Second, your connection with your partner in non-sexual ways is extremely important. Things like holding hands, hugging, or other ways of showing physical connection create a couples connection even out of the bedroom. If the only time you are touching is as a prelude to sex, you are missing out on all the ways you can use touch to show that you care for your partner.

 Third, communication is key.  Yes, it can be difficult to talk about, but telling your partner how you feel and what you like are ways to strengthen your sexual bond. Worries can feel much lighter when shared, as well.

 Finally, those of you who do seek therapy to work through issues of sexuality may be in for a surprise at how helpful it can be.  We are not there to judge you, and chances are we have heard stories similar to yours before. We can work with you to help turn sexuality from a source of confusion or worry to a renewed connection with yourself and your loved one.

Thank you for reading! I welcome your comments below.