How I Integrate Gottman Method Couples Therapy and Emotionally Focused Therapy

Integrating the Gottman Method Couples Therapy and Emotionally Focused Therapy allows for a flexible approach that can shift between relationship-building and attachment-oriented therapy based on the client's needs. In the late 1970s and early 1980s, Dr. John Gottman and Dr. Susan Johnson conducted pioneering research on creating happy and lasting relationships. Initially known primarily in academic circles, their work provided an empirical foundation to the often chaotic and unpredictable field of couples therapy.

Both Gottman and Johnson developed unique models of successful adult relationships, based on different perspectives and data sets. Gottman's research focused on longitudinal and observational studies of couples, examining both distressed relationships and satisfying ones. Johnson, on the other hand, drew from the theoretical framework of John Bowlby and her extensive experience in decoding and tracking couples therapy sessions, resulting in an empirical model of couples therapy.

The Gottmans emphasized relationship skill-building and an existential lens, while Johnson's approach was firmly grounded in Attachment Theory. There were also differences in their views on couples therapy and the role of the therapist. The Gottmans cautioned against therapists becoming indispensable to the couple and encouraged coaching couples to manage their own conflicts and intimacy. Johnson, however, saw the therapist as a "secure base" and aimed to create a secure container where anxiously or avoidantly attached partners could express vulnerable feelings and needs.

Despite their differences, the exciting development lies in the convergence of their approaches and the ability to seamlessly integrate both in couples therapy. This integration allows therapists to adapt their approach based on the couple's emotional system.

When working with couples, I begin with the Gottman Method, using the Sound Relationship House model. It provides a practical and understandable framework that couples can readily adopt. The structured assessment process of the Gottman Method is reassuring and transparent, allowing couples to share their story, be heard individually and together, and identify their relationship strengths and areas for growth. The process instills hope as strengths are highlighted, growth areas are connected with specific skills to be learned, and couples leave with a roadmap for their therapeutic journey.

However, the real work starts when addressing the emotional focus and the influence of attachment histories, styles, and internal working models in intimate relationships, as recognized by both Gottman and Johnson. While helping couples replace destructive patterns with healthier alternatives, I am attuned to their negative emotional cycles and unresolved hurts. With Gottman's language and relationship science in one hand and Johnson's emotion-focused and interpersonal tools in the other, I weave both approaches into the therapeutic process.

For example, when addressing criticism and contempt, I provide practical information to one spouse while simultaneously validating and exploring the attachment needs and emotions of the other partner. I employ Gottman's structured exercises, such as the Aftermath of a Regrettable Incident form, to help couples process arguments and improve their dialogue. Simultaneously, I examine the underlying dynamics of the conflict, considering attachment histories and their impact on individuals' ability to let go of anger or offer tenderness.

The integration of Gottman and Johnson becomes evident in working with bids, turning towards, and processing failed bids. I understand that not all hurts are equal and that certain emotional injuries can be traumatic, triggering deeply held beliefs about oneself, the partner, and relationships. Gottman's Sound Relationship House theory helps couples understand the connection between emotional bank accounts and the overall health of the relationship. Johnson's tools, on the other hand, aid in repairing depleted emotional accounts, acknowledging and healing attachment injuries, and restoring the bond between partners.

While I confess my initial affinity for the Gottman Method, finding comfort in its alignment with my therapeutic style, Johnson's approach challenges me to navigate the depths of primary emotions.

References:

Gottman, J.M. (2007). Marital Therapy: A research-based approach. Training manual for the Level I professional workshop for clinicians. Seattle, WA: The Gottman Institute.

Johnson, S. (2008). Hold Me Tight: Seven conversations for a lifetime of love. New York: Little Brown and Company.

Meunier, V. and Baker, W. (2012). Positive Couple Relationships: The evidence for long lasting relationship satisfaction and happiness. In Roffey, S. (Ed.) Positive Relationships: Evidence-based practice across the world. Sydney, Australia: Springer Publications.

Young, M.A. (2005). Creating a Confluence: An Interview With Susan Johnson and John Gottman. The Family Journal, 13(2), 219-225.

Elizabeth Mahaney, LMHC, MFT, Ph.D

Book an appointment with Dr. Liz: https://SouthTampaTherapyBOOKAPPT.as.me/initialintake

Preparing for the Climb: what to expect in your first therapy session

Congratulations on scheduling your first counseling appointment! If this is your first time in therapy, you may be wondering what it’s going to be like that first appointment. Even if it’s not your first venture into counseling, it’s helpful to know what to expect with your new counselor (me). 

I like to think of undertaking therapy as similar to climbing a mountain. Just like the steps one takes to prepare for an intense climb, the therapy process starts with gathering information, taking stock of your equipment/tools, and making a plan. Using this metaphor, let’s talk about the first step in therapy: the intake appointment. 

Step 1: Meet your climbing partner 

Climbing a mountain is hard work. It helps to take a climbing partner with you – ideally someone who has climbed before and is dedicated to walking with you through the most challenging parts. The same is true with counseling. During your first session, I will introduce myself to you and go over a few important details about the counseling process. 

A little bit about your climbing partner/therapist: Right now I am a Supervised Therapist at South Tampa Therapy, which means I am counseling under the supervision and licensure of Dr. Elizabeth Mahaney while I finish up my final 18 weeks of my Masters in Counseling program Northwestern University. (Previously, I spent 12 years working in corporate America.) My current education has qualified and prepared me to counsel individuals, couples, and families experiencing a variety of life challenges, and over the past year I have accumulated 1,000 hours of experience in clinical mental health settings. I take a collaborative, integrative, and holistic approach, which means I look at the whole person and pull in evidence-based tools from various counseling theories based on what we both believe will be most helpful for you. (Approaches I often use for individuals include Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT) including Exposure with Response Prevention (ERP), Narrative, Internal Family Systems, and Psychodynamic; for couples, I also use Gottman and Emotion-Focused Therapy.) 

Step 2: Learn about the climb

A climber needs to be informed about the mountain they are climbing, including any risks, benefits, requirements, and special considerations. You should know the same at the outset of your counseling journey. During the first session, I will tell you what counseling is, what you can generally hope to accomplish, any risks, and what the process will entail. Counseling is a collaborative process aimed at helping clients achieve mental health and wellness. It takes work on the part of the therapist and the client. Together, we will identify goals, gain insight, work through challenges, and practice new skills. If you are here for couples counseling, we will develop insight into what is underlying any relationship problems and then work to heal wounds, resolve conflict, and improve communication. 

Now, about the risks. While counseling is successful for many people, like any endeavor, there is not 100% certainty. It might not be the right time to climb the mountain, or I might not be the best climbing partner for you – and that’s ok if we find that out! I want the best for you. Also, talking about hard things can bring up difficult emotions – similar to training your muscles for a long climb, you may experience some emotional “soreness” along the way. That is why your counselor is here to train alongside you – so you’re not facing the journey alone!

Another important aspect of the therapy process is confidentiality and its limits. Confidentiality is of utmost importance to me, and I am also bound by law and my professional ethics to uphold it. Everything we talk about in session will stay in session. I may seek supervision from my supervisor (who is also bound by confidentiality) on aspects of your case to ensure I am providing the best possible care. There are only a few instances where I would be required by law to break confidentiality: if I believe you are going to harm yourself or another person, if there is suspected abuse of a child or vulnerable adult, or if my court records were to be subpoenaed (which is highly unlikely). 

Beyond confidentiality, we will cover policies and communication expectations – things like what to do if we run into each other out of the therapy room, how to get in touch between sessions, and cancellation/rescheduling expectations. I highly encourage questions about anything – I want you to feel confident and comfortable as we begin the journey. 

Step 3: Check equipment and readiness level

Embarking on a mountain climb without checking one’s equipment (what you bring with you) and readiness levels would not likely result in a successful outcome. My goal for counseling is to help you achieve your goals. And in order to do that, I need to get to know what you’re bringing with you in your emotional backpack! That’s why this first session will be more question-heavy than other sessions we will have together (where you will be doing most of the talking). I will ask you about your health, family history, and what symptoms you’re currently experiencing. Since we’re shaped by both nature (our genetic makeup) and nurture (family, community, experiences, and global events and messages), gathering information about these topics helps us get a sense of how these factors may be impacting you. Most importantly, I’ll ask what brings you to counseling now and what you’re hoping to get out of it. I may also administer one or more assessments that we can come back to over the course of treatment to check on progress. 

Step 4: Map out the journey 

During our first session, we’ll start to hone in on goals for our time together – you might think about it like determining which mountain (or mountains) we want to climb, how frequently it makes sense to train, and a goal for how quickly we can reach the top. Each person has unique goals. For instance, a goal may be to reduce the frequency, intensity, and duration of anxious  thoughts and feelings. Perhaps it could be to find clarity on a difficult, stressful decision. Or maybe it could be to improve communication in a relationship, process through a trauma, grieve a loss, or increase self-esteem. It’s possible that the goals will start out more general and become more specific as we gain more clarity on symptomatology. As we dive deeper, they may also shift. We might even add additional goals along the way! 

Goals are important because they provide direction for our work together. They also let us know if we’re on the right track or if we need to switch approaches. Finally, if we are successful during our time together, our goals will help inform when it’s time to begin winding down our sessions. 

With our goals set, we will discuss how frequently we want to meet (I usually recommend weekly to start with) and set our next appointment time. I may also ask you if you are ok with taking part in “practice” (which I find is a more palatable word than “homework”) between the intake and the next session. This could be, for example, reading a brief article, tracking your thoughts and feelings, journaling, or trying out a new coping tool. We can both expect to leave the intake with an idea of where we’ll be headed in therapy as well as what we’ll focus on in the next session. 

What to keep in mind when beginning counseling

Embarking on the counseling journey is a big decision – akin to standing in front of a tall mountain and making the decision to climb it. And the intake session is sort of like meeting your climbing partner for the first time, taking stock of your equipment, and mapping your route before the journey. It’s ok to feel a little nervous at this stage. It makes sense – talking about hard things and putting in the work is difficult! But know that as a counselor I am there with you, creating a nonjudgmental space to feel, process, and work through the most difficult parts of your experience. It’s so much easier to climb when you know you’re not doing it alone. And the view at the top? Well, it’s pretty spectacular.

Book with author of this blog post, Kaitlin Lowey, here: https://SouthTampaTherapyBOOKAPPT.as.me/KaitlinLowey

Why the transition from college athlete to the real world is so hard

The experiences of athletes like Simone Biles and Michael Phelps have shed light on the mental health struggles many athletes face. A topic that has received less attention – but deserves equal standing – is the mental wellbeing of athletes who are transitioning from intense competition into the next phase of their life. 

This period of time can be a difficult one for many reasons. Most athletes end their athletic career in college, which coincides with numerous changes that all college graduates face, including leaving the familiarity of school, entering the workforce, and a general sense of uncertainty that comes with starting a new phase. But for athletes, this period can be even more difficult because it can feel like a large portion of their identity has been lost.

Whereas most college students have the opportunity to test out new identities and “find themselves” in high school and college, athletes’ immense time and energy investment in their sports prevents them from doing the same. Their athletic participation, which usually begins early in life, provides them with athletic purpose, athletic identity, structure, adoration from others, camaraderie with teammates, competition highs, and social status. But this comes at a cost. They miss out on opportunities to explore life outside of athletics, experiment with various roles, and face conflicts that refine one’s sense of self. Ultimately, this can result in what is known as identity foreclosure, which essentially means not having had the opportunity to explore oneself before settling on an identity. In other words, athletes don’t have the opportunity to find out who they are apart from their sport. On top of this, retiring athletes face the loss of being highly skilled at something, the loss of a built-in support network, and the loss of public admiration. If all of this sounds like a lot, that’s because it is!

It’s no wonder that retiring student-athletes often struggle with adjustment difficulties, uncertainty, career problems, financial issues, social problems, and issues with self-esteem, self-concept, well-being, and life direction as they transition from their exclusive athletic identity to an uncertain one. The shift away from athletics has been associated with mental health symptoms including feelings of grief, anxiety, and depression, as well as decreased social support, isolation, declined sense of self-worth, loss of interest in activities, and lack of motivation. Furthermore, athletes who have not developed coping strategies may turn to substance use or unhealthy eating habits, which are common coping mechanisms among student-athletes encountering negative events. 

If you’re an athlete or recently retired athlete, you might be feeling anxious about the transition into the “real world,” or you might be nodding along in recognition of your experience. Thankfully, whether you are planning ahead for the next phase or seeking support during a recent retirement, there are many things you can do to ease the transition. The first is to develop interests and skills outside of your sport. Ideally, you would engage in pre-retirement planning a year or more in advance. However, if you haven’t done that, there are still many ways you can move forward with intention. The key is to consider your values and interests apart from your sport, begin to develop new skills that align with those values and interests, and set goals. These steps can help you develop a sense of identity outside of athletics that you can build on. Ask yourself what lights you up and gets you excited, and go from there. Ultimately, you will be able to take the motivation and hard work you applied to your sport and channel it into finding success in a new pursuit. It may take time, and the beginning may feel overwhelming, but think of it like building a muscle. It might hurt, and it might be slow going, but eventually you will see the results!

Another important step is to process your feelings about stopping your sport. You can explore what being an athlete has contributed to your life, what it is/will be like to no longer identify as an athlete or be part of a team, and what emotions that brings up for you. In addition, you should process through any fears, hopes, and beliefs you have about entering this next life phase. If you have already stopped playing your sport and are going through the grieving process, know that this is normal. It’s okay – actually, necessary – to allow yourself to grieve, and you don’t have to go through it alone. You can do this work with teammates and mentors, in therapy, or as part of a support group. 

Another important factor to consider is continuation of belonging and social support – two major benefits athletes receive from being a part of a team. Again, you don’t have to go through this transition alone! Be intentional about checking in with your team members who are going through the same situation, and make a plan for how to support one another through this time. You should also seek out groups of individuals with similar interests outside of your sports team. For example, you might sign up for intramural sports, take an art or photography class, or get involved in a company with lots of other motivated young people. It’s important to remember that building social relationships outside of sports can take work and take time, and they may look and feel slightly different than the ones you had in college.

The transition from athlete to the “real world” can be a tricky one, so if you are going through it, be gentle with yourself. It’s okay to mourn the loss of your athlete identity. And it’s okay to feel scared or anxious about what lies ahead. At the same time, it’s okay to look forward to how you will learn, grow, and find success – whatever that looks like for you – over the next several decades! There is so much more to you than the title of athlete. And your friends, teammates, and mentors are there to help you along your journey. We are all rooting for you! 

Book with author of this blog post, Kaitlin Lowey, here: https://SouthTampaTherapyBOOKAPPT.as.me/KaitlinLowey

Why your therapist won’t tell you what to do

One question us therapists often hear from our clients is, “What should I do?”

It makes sense that a client would want our advice. After all, we are often the only people in our clients’ lives who know all of the intricate matters of their hearts. We sit with the ambivalent feelings, desires, and conundrums our clients find themselves encountering. And, because we aren’t interwoven in our clients lives in the way that a friend or family member is, we aren’t directly impacted by the decisions our clients make. In short, we get the full picture without being in the picture. So, why shouldn’t we give them advice? 

Let me answer this question by painting a picture of a hypothetical client scenario. In this situation, a client has been dissatisfied with her relationship for quite some time. She feels that her partner cannot connect with her on an emotional level, and their sex life has been lackluster for the past year. She explains the full details of her situation to her therapist and asks, “What should I do?” Her therapist says, “Well, it sounds like this may not be the best relationship for you. I think you should leave.” 

What are the possibilities coming out of this? Let’s consider a few. 1. The client leaves her partner but later feels she has made a mistake. 2. The client leaves her partner and is thrilled about making the decision, but she is robbed of her confidence in her ability to make her own decisions and relies on her therapist for all future major decisions. 3. The client stays in the relationship and no longer trusts the therapist's opinion. 4. The client finds that she actually resents being told what to do and ghosts her therapist, losing faith in therapy and never getting the therapeutic help that would have helped her confront her deeper underlying reasons for seeking help in the first place.

As you can see, there is no winning when we provide advice to our clients.

In fact, this can do more harm than good. When providing an opinion, we may also fall into the unethical trap of imposing our own beliefs and values onto our clients – a direct violation of our ethical code. We also strip our clients of the very empowerment they come to therapy to build. While providing an answer to our clients’ problems may temporarily provide relief from uncertainty, it also reinforces reliance on the therapist to provide a sense of certainty. We want our clients to stand in their own power and trust in themselves – and to believe that no matter what the outcome of their dilemma, they will be able to handle it. 

So, what do we do when our clients ask us, “What should I do?”

We have several approaches we can take. We can help our clients to think through the pros and cons of each choice. Through this process, we may collectively uncover possibilities our clients had not thought of before. We might even go deeper than the surface level questions, challenging catastrophizing, black-and-white thinking, and other cognitive distortions. Perhaps we’ll find that the situation is not as bleak as it seems. If a client seems to be intellectualizing a choice, we might focus on expressing feelings and underlying needs. Contrary to popular belief, feelings and needs play an important role in decision-making and should not be ignored. Finally, we might explore how similar situations in the past are connected to the client’s emotions and beliefs about the current situation – or even confront the concepts of uncertainty and control more abstractly. 

We therapists are certainly flattered that our clients think our opinions are worth seeking on-high stakes decisions. But we also care about our clients enough to not tell them what to do. What we can do – and what is ultimately far more helpful – is  help them gain more insight into themselves. And this in itself is so powerful. Because when our clients know themselves better, they can make better-informed decisions that are aligned with their own goals, values, and beliefs.  

Book with Author Kaitlin Lowey: https://SouthTampaTherapyBOOKAPPT.as.me/KaitlinLowey

7 Daily Habits for Bettering Your Mental Health

Taking care of our mental health is crucial for overall well-being and happiness. Just as we engage in daily activities to maintain physical health, it's essential to develop habits that promote good mental health. In this blog post, we'll explore seven simple but effective tips for improving your mental well-being on a daily basis. By incorporating these habits into your routine, you can cultivate a positive mindset and lead a more fulfilling life.

1. Practice Mindfulness:

Start your day with mindfulness practices such as meditation, deep breathing exercises, or simply taking a few moments to focus on the present moment. Mindfulness helps calm the mind, reduces stress, and enhances self-awareness. It allows you to let go of negative thoughts and cultivate a positive mindset.

2. Establish Healthy Boundaries:

Setting boundaries is crucial for maintaining good mental health. Learn to say "no" when necessary, and don't overcommit yourself. Recognize your limits and communicate them effectively. By establishing healthy boundaries, you can reduce stress, prevent burnout, and prioritize self-care.

3. Engage in Physical Exercise:

Regular physical exercise not only benefits your physical health but also has a profound impact on your mental well-being. Engaging in activities like walking, jogging, yoga, or dancing releases endorphins, which are natural mood boosters. Aim for at least 30 minutes of exercise daily to reduce stress, improve sleep quality, and boost your overall mood.

4. Connect with Others:

Human connection is vital for our mental health. Nurture your relationships by spending quality time with loved ones, friends, or participating in group activities. Engage in meaningful conversations, express your emotions, and seek support when needed. Building a strong support system can provide comfort, reduce feelings of isolation, and foster a sense of belonging.

5. Practice Self-Care:

Self-care is essential for maintaining a healthy mind. Dedicate time each day to engage in activities that bring you joy and relaxation. Whether it's reading a book, taking a bath, practicing a hobby, or listening to music, make self-care a priority. Taking care of yourself enables you to recharge, reduce stress, and improve your overall mental well-being.

6. Prioritize Sleep:

A good night's sleep is crucial for mental health. Aim for 7-9 hours of quality sleep each night. Establish a regular sleep schedule, create a soothing bedtime routine, and ensure your sleep environment is comfortable and conducive to rest. Sufficient sleep improves cognitive function, regulates mood, and enhances emotional resilience.

7. Practice Gratitude:

Cultivating an attitude of gratitude has a profound impact on mental health. Each day, take a few moments to reflect on the things you're grateful for. This practice helps shift your focus to the positive aspects of life, promotes optimism, and reduces stress. Consider keeping a gratitude journal or sharing your gratitude with others to enhance its effects.

Improving your mental health doesn't require drastic changes; it starts with small, daily habits that positively impact your overall well-being. By practicing mindfulness, setting boundaries, engaging in regular exercise, nurturing relationships, prioritizing self-care, getting sufficient sleep, and cultivating gratitude, you can transform your mental landscape and lead a more fulfilling life. Remember, taking care of your mental health is a continuous journey, and each small step counts towards a healthier, happier you.

Author: Crystin Nichols
Book Appointment: https://southtampacounselor.com/bookappointment

Are You Arguing with Your Spouse?

Many couples believe that arguing with their spouse is a sign of a troubled relationship. However, the truth is that disagreements are a natural part of any healthy relationship. In fact, it's normal and even healthy for couples to have arguments from time to time. Here are some reasons why it's okay to argue with your spouse.

1. It allows for honest communication: Arguing with your spouse can provide an opportunity for honest communication. When couples argue, they are expressing their true feelings, thoughts, and concerns. This kind of communication is essential to building a strong and healthy relationship.

2. It helps to resolve conflicts: Disagreements can provide an opportunity to resolve conflicts. When couples argue, they are addressing issues that need to be resolved. By working through these conflicts together, couples can strengthen their relationship and create a deeper understanding of each other.

3. It shows that you care: Arguing with your spouse can also be a sign that you care about each other. When couples argue, they are expressing their passion, which is a sign of emotional investment in the relationship. It shows that you are willing to stand up for your beliefs and values, which can create a more meaningful relationship.

4. It leads to growth and learning: Arguing with your spouse can also lead to personal growth and learning. When couples argue, they are challenging each other's perspectives, which can lead to new insights and understanding. By working through conflicts and disagreements, couples can learn from each other and grow together.

5. It can bring you closer together: Finally, arguing with your spouse can actually bring you closer together. When couples argue, they are working through difficult issues together, which can create a stronger bond. By being willing to engage in difficult conversations, couples can create a deeper connection and a more intimate relationship.

Arguing with your spouse is a natural and healthy part of any relationship. It allows for honest communication, helps to resolve conflicts, shows that you care, leads to growth and learning, and can bring you closer together. The key is to approach arguments with respect, empathy, and a willingness to listen to each other's perspectives. By doing so, you can turn disagreements into opportunities for growth and strengthen your relationship in the process.

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Author: Crystin Nichols
Book Appointment: https://SouthTampaTherapyBOOKAPPT.as.me/CrystinNicholsMFTI

What is the difference between LMHC and MFT?

When it comes to seeking therapy, there are a variety of mental health professionals to choose from. Two common options are Licensed Mental Health Counselors (LMHCs) and Marriage and Family Therapists (MFTs). While both professions offer valuable support to individuals and families, there are some important differences to consider. In this blog post, we'll explore the difference between licensed mental health counselors and marriage and family therapists.

Elizabeth Mahaney, MA, LMHC, MFT, LPC, LCPC, CCTP, NCC, DCC, Ph.D has a MA in both mental health counseling and marriage and family therapy with specialized training in communication, trauma and many certifications. Here is why this is important:

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Licensed Mental Health Counselors (LMHCs)

LMHCs are mental health professionals who provide counseling services to individuals, couples, and families. They are trained to diagnose and treat a variety of mental health issues, including depression, anxiety, and trauma. LMHCs use evidence-based therapies such as cognitive-behavioral therapy (CBT) and psychodynamic therapy to help clients work through their challenges.

LMHCs typically hold a Master's degree in counseling or a related field and are licensed by their state's licensing board. In order to become licensed, LMHCs must complete a certain number of supervised clinical hours and pass a licensing exam.

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Marriage and Family Therapists (MFTs)

MFTs are mental health professionals who specialize in working with couples and families. They are trained to address the unique challenges that arise in family systems, such as communication breakdowns and relationship conflicts. MFTs use a variety of therapeutic approaches, such as Emotionally Focused Therapy (EFT), Gottman Approach, and Internal Family Systems, to help families and couples improve their relationships.

MFTs typically hold a Master's degree in Marriage and Family Therapy and are licensed by their state's licensing board. In order to become licensed, MFTs must complete a certain number of supervised clinical hours and pass a licensing exam.

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Differences between LMHCs and MFTs

While both LMHCs and MFTs provide counseling services, there are some key differences between the two professions. The main difference lies in their areas of specialization. LMHCs are trained to address a wide range of mental health issues, while MFTs focus specifically on relationship and family dynamics.

Another difference is the types of clients they see. While LMHCs work with individuals, couples, and families, MFTs primarily work with couples and families. MFTs use a systemic approach, meaning they view individuals within the context of their family and larger social systems.

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Which one is right for you?

The decision between seeing an LMHC or an MFT ultimately depends on your individual needs. If you are struggling with a specific mental health issue, an LMHC may be a better fit. If you are experiencing challenges within your relationships or family system, an MFT may be a better choice.

It's important to do your research and choose a therapist who is licensed and trained in the areas that are most relevant to your needs. Additionally, it's always a good idea to schedule an initial consultation with a therapist to get a sense of their approach and determine if they are a good fit for you.

Author: Crystin Nichols
Book Appointment: https://SouthTampaTherapyBOOKAPPT.as.me/CrystinNicholsMFTI

Book with Dr. Liz: https://southtampacounselor.com/bookappointment

Attunement Helps Love and Intimacy Last

A Key Ingredient to Lasting Love and Intimacy

When two people come together in a romantic relationship, there are countless factors that contribute to their success or failure. However, one of the most important elements of a healthy, happy partnership is attunement. Attunement is the ability to be fully present with your partner, to understand and respond to their emotional needs, and to create a deep sense of intimacy and connection.

In this blog post, we'll explore what attunement means, why it's so critical to a couple's relationship, and how you can cultivate it in your own partnership.

What is Attunement?

At its core, attunement is the ability to tune in to your partner's emotions and needs, and respond in a way that demonstrates understanding, empathy, and support. It involves being fully present in the moment, listening actively, and paying close attention to nonverbal cues like body language and tone of voice.

Attunement requires a high degree of emotional intelligence and self-awareness, as well as a willingness to prioritize your partner's needs and feelings over your own. When two partners are attuned to each other, they are able to create a deep sense of connection and intimacy that can weather the challenges of life and strengthen their bond over time.

Why is Attunement Important in a Couple's Relationship?

Attunement is critical to a couple's relationship for a number of reasons. First and foremost, it allows partners to feel seen, heard, and understood by each other. This is essential for building trust, emotional safety, and a sense of security in the relationship.
When partners are attuned to each other, they are better able to navigate the inevitable conflicts and challenges that arise in any long-term partnership. They are able to communicate effectively, manage their emotions in a healthy way, and work together as a team to overcome obstacles.

Attunement also plays a key role in creating a satisfying and fulfilling sexual connection. When partners are attuned to each other's needs and desires, they are better able to communicate about sex and explore each other's bodies in a way that feels safe, respectful, and pleasurable.

How Can You Cultivate Attunement in Your Relationship?

While attunement is a natural and intuitive part of some relationships, it can also be cultivated and strengthened over time. Here are some tips for building attunement in your own partnership:

1. Practice active listening. When your partner is speaking, give them your full attention. Put down your phone, make eye contact, and ask questions to show that you're engaged and interested.

2. Pay attention to nonverbal cues. Sometimes, what your partner isn't saying is just as important as what they are saying. Pay attention to body language, tone of voice, and other nonverbal cues to get a better sense of how they're feeling.

3. Practice empathy. Try to put yourself in your partner's shoes and imagine how they might be feeling. Validate their emotions and offer words of support and encouragement.

4. Make time for quality time. Attunement requires presence and connection, so make sure to set aside dedicated time to spend with your partner without distractions or interruptions.

5. Practice self-awareness. In order to attune to your partner, you need to be aware of your own emotions and needs. Take time to check in with yourself and understand how you're feeling before trying to connect with your partner.

Attunement is a key ingredient in any successful and fulfilling relationship. By prioritizing your partner's emotions and needs, practicing active listening, and cultivating empathy and self-awareness, you can build a deep sense of intimacy and connection that will sustain your partnership for years to come.

Author: Crystin Nichols
Book Appointment: https://SouthTampaTherapyBOOKAPPT.as.me/CrystinNicholsMFTI

Empowering Couples to Communicate Compassionately~ Using Non-Violent Communication (NVC)

The process of non-violent communication (NVC) was developed by Marshall B. Rosenberg and encourages us to connect with others in a more heartfelt and empathetic manner. NVC emphasizes the significance of language in our day-to-day encounters, calling for conscious responses, instead of reactions, based on perceptions, feelings, needs, and visions for what we DO want to see happen.

The Four Components of NVC

There are four basic components to NVC that include observations, feelings, needs, and requests. What actions are we seeing around us that have an impact on our well-being? How do we feel based on what we've seen or heard? What need, desire, or value sparked those feelings? All negative feelings are unmet needs. Finally, how may we make positive requests of others that will improve our lives? These elements all work together to create NVC's foundation.

Our Language Shapes Our Thinking

Sometimes our thoughts sabotage our needs. It is helpful to gather more data and not just react from our triggers or automatic thoughts. Our thoughts produce the way we feel. Negative thoughts point to an unmet need. If I don't know what I need and react from the story that I tell myself, a lot of bad habits can form from this bad habit. Instead, I can gather more data, not just from thoughts but I want to drop down and gather more data from my feelings, where my feelings live somatically in my body, and what needs I have. When I discover my needs, I am in a powerful position to get my needs met. If I do not know what I need in real time, I may react and sabotage my needs which disconnects us from ourselves and other people in our lives.

All attacks are unskilled ways of trying to get a need met. Attacks create disconnect and defensiveness. Using NVC helps us accept influence and stay connected even through some of the most difficult conversations.

NVC not only challenges us to change the way we talk to one another, it also challenges us to change the way we think and perceive the world around us. In other words, NVC is not just a process of communication where words are simply exchanged. We must reframe our thinking so that we are able to genuinely express ourselves and be empathetic to what others are observing, feeling, needing, and requesting. NVC is truly an amazing process that empowers us to connect with one another in a compassionate way.

How to Calm The Jackal and Put on Your Giraffe Ears

Marshall Rosenberg conceptualized our tendency toward aggression and dominance as a jackal, while our more compassionate side he imagined as a giraffe (since giraffes have the largest hearts of all land mammals). When we listen with Jackal ears, we hear complaints as criticisms and requests as demands. When faced with a demand, collaboration isn’t possible. You either submit or you rebel which disconnects us and neither feels good, nor works well in a long-term relationship.

Conversely, when we put on our Giraffe ears, we listen with more empathy and compassion. We are more likely to hear the feelings and the needs behind what someone is saying. We’re more likely to see those needs as being understandable and reasonable, and not in competition with our own needs. When we understand and empathize, compromise and collaboration become feasible.

Nonviolent Communication in Couples Therapy

With couples, NVC bridges the gap in understanding between each partner and helps counter the judgmental negative stories that may build up about the other person:

“They’re lazy.”

“They’re not putting in as much work as I am.”

“They don’t love and care about my feelings.”

These interpretations or evaluations discourage us from being vulnerable and trusting the other person, and they prevent us from making needed changes. When we choose to replace those judgmental stories with greater understanding, more connection is possible.

NVC may challenge our preconceived notions about others and the world, which can help us to appreciate one another and live more freely. When the guy who is cutting me off in traffic stops being a jerk and becomes a person going through something terrible in their own life, I am able to let go of my anger. When I recognize that my difficulties in keeping my home clean aren't "laziness" but rather a battle for motivation or a desire for "rest and recuperation," the self-compassion I gain not only lessens my suffering, but it also increases the likelihood that I will be able to satisfy that need AND keep my house clean.

Whether you’re looking for Couples Therapy or Individual Counseling, Nonviolent Communication (NVC) can help you create the life you want to live together as a team.

The Starved Brain: Why does your loved one with Anorexia think, feel, and act the way they do?

The Starved Brain: Why does your loved one with Anorexia think, feel, and act the way they do? 

If you have a loved one with Anorexia, you know more than anyone that eating disorders impact the entire family. It can feel like everything you know and have come to expect from your loved one changes overnight. I have had family members report to me: 

“It’s like he is a whole different person”

“Is my precious happy girl still inside that body?”

“My wife has always been the life of the party. That’s one of the reasons I married her, now I can’t get her to leave the house”

 It can be tremendously confusing and sometimes feelings of hopelessness emerge. That is very normal. It is scary. To understand these jarring changes, it is helpful to remember that Anorexia is a physical illness. It manifests, if not treated early, in significant weight loss and calorie restriction.  Your loved one is acting, thinking, and feeling the way they are because of what research tells us about The Psychology of Hunger. 

The Psychology of Hunger: The Starved Brain 

The most notable study conducted the starved brain was undertaken in 1948 by Ancel Keys, called “The Biology of Human Starvation or popularly known as “The Minnesota Starvation Experiment.” The purpose of the experiment was to demonstrate how the body and mind are affected by not eating, or by restricting food. In this study, healthy young men were observed under normal conditions then exposed to caloric restriction (1570 calories a day for 6 months). After the semi-starvation period, they were rehabilitated with the purpose of determining the most successful form of nutritional rehabilitation. Such a study would never be conducted in modern research, but the results were foundational in shifting perceptions and guiding modern treatment interventions for Anorexia. 

The Results

Below are the symptoms that were found at just 1570 calories a day for 6 months. *It is noteworthy that most sufferers of Anorexia eat far less than 1570 calories a day* 

• Physical: Less energy, reduced heart muscle mass, lower heart rate and blood pressure, headaches, decreased hormone levels, sensitivity to noise and light, a feeling of being cold all the time, loss of strength and greater fatigue and hair loss and dry skin.

• Emotional and Cognitive changes: Depression, anxiety, irritability, increased mood fluctuations, intense and negative emotional reactions, decreased enthusiasm, reduced motivation, impaired concentration, problem solving and comprehension, increased rigidity, obsessional thinking, and reduced alertness.

• Attitudes and behaviors related to food: Thinking about food all the time, eating very slow or very fast, increased hunger, unusual food routines and rituals, binge eating, increased use of condiments for flavor.

• Social changes: Feeling more critical of others, withdrawn and isolated, loss of sense of humor, feelings of social inadequacy, neglect of personal hygiene and strained relationships.

These men had no previous mental health diagnosis, significant childhood trauma, or any health conditions that would skew the results in any meaningful way. 

Implications

When working with sufferers and their family members I always share this study and pay special attention to highlight the results in the emotional/cognitive changes and social changes sections. I have seen the implications of this study reduce shame and destigmatize the individual suffering. I try to communicate that your loved one is still the same person you know; they are just experiencing the brains response to starvation. With appropriate nutritional rehabilitation and patience there is no reason to believe that most, if not all, of these symptoms will go away completely. The first step to treating Anorexia is weight restoration. Getting stuck in the “Why” vortex is tempting because the sufferer and family want to believe that if they knew why their loved one developed Anorexia it would give them the solution. Sometimes family members blame themselves: endlessly analyzing and hypothesizing about some unknown error they made. It is important to make sense of or peace with your loved one’s diagnosis but if there is anything you can do to support your loved one, it is to encourage them to seek nutritional rehabilitation first and foremost. I ask family members to avoid pathologizing their loved one. Going to therapy once a week while severely malnourished can be unfruitful  because of the starved brain. A therapist role is to encourage motivation for recovery, educate and normalize Anorexia, and celebrate the little wins. Once your loved one is weight restored, the deeper work can be done from a healthy nourished brain. Should you be a family member of a sufferer in early stages of recovery, the primary take-away is to remind yourself and your loved that their brain is starving and the way they feel, think, and behave are survival responses. Remind them that it is not their fault, and it will not feel like this forever. Your loved one is not ‘CRAZY’ nor has their character or personality fundamentally changed they are just starving.  

By Shaundra McGuire, MHCI

Book an appointment with Shaundra Mcguire:

https://SouthTampaTherapyBOOKAPPT.as.me/ShaundraMcguireMFTI

Additional resources for you and your loved one:  

https://www.nationaleatingdisorders.org/

https://www.gaudianiclinic.com/videos-press

References: 

https://www.eatingdisorderhope.com/information/anorexia/how-malnourishment-affects-the-brain-research-on-anorexia-and-neurobiology

https://eatingdisorders.dukehealth.org/education/resources/starvation-experiment

https://nedc.com.au/eating-disorder-resources/find-resources/show/issue-59-i-the-starved-brain-can-what-we-eat-determine-how-we-think

https://www.apa.org/monitor/2013/10/hunger

Why I Only Accept 50% of Insurance Clientele & 50% Self-Pay In My Private Practice (50/50/❤️ MODEL)

WHY I ONLY ACCEPT A FEW NEW INITIAL INTAKE INSURANCE APPOINTMENTS

USING MY MORAL COMPASS AND COMPASSION FOR HUMANITY, I’M CHOOSING TO CREATE A 50/50/❤️ MODEL:

50/50/ ❤️= 50% SELF PAY 50% INSURANCE ❤️SLIDING SCALE FEE

Sliding Scale Fees help advocate for affordable mental health care and create an opportunity for highly qualified INTERNS to counsel clients in need. I interview interns extensively, decide selectively, and supervise very closely and yet very trustingly. I will be an active participant in each session.

I initially started accepting insurance 15 years ago when I felt a strong need to support my community, who needed financial support, to get consistent help. Despite hearing horror stories from colleagues about insurance paperwork and clawbacks, I joined a few insurance panels. I loved every minute of being a therapist! I hated everything about the administrative process when it came to dealing with insurance companies. Don’t get me wrong, I love my insurance peeps! We have connected over the years and I will continue to support my clients who choose to use insurance as they should!

I too, have health insurance. I get it, we have health insurance for a reason, pay high monthly premiums, and should be able to use insurance when we need it!

Regardless, I will show-up powerfully for ALL of my clients.

I feel good about my choice to create a 50/50/ ❤️BALANCE in my Private Practice!

As a healthcare member and a private practice provider, I’ve had the unique experience of seeing both perspectives of the healthcare system in the US.

As my specialty has continuously evolved, I have realized that mainly accepting insurance no longer make sense for the advanced work that I do. Ultimately, my decision came down to acting with integrity and practicing what I preach to my clients.

Here are some key points to help you understand my decision to create this model for my Practice:

LACK OF PRIVACY & CONFIDENTIALITY

When insurance companies pay for your treatment, it also means that their employees (clinicians or not) will audit my treatment plans and read what we talked about in my session notes. These employees are paid to save the insurance company money by searching for fraud and determining whether you're overusing your insurance coverage. In turn, the insurance company may decline authorization of additional sessions because you're not progressing fast enough; our work in psychotherapy does not qualify as "a medical necessity": or because my treatment approach isn't recognized by the insurance company as an "evidence-based treatment" (that's code for short-term, as in 6-8 sessions).

Hell, some insurance providers don't reimburse for 60-minute sessions anymore!

This doesn’t seem right.

I recently got audited by an insurance company. This audit took me countless hours, staying up late at night, time away from my family, unnecessary stress and scrutiny to provide tedious paperwork and specific details to prove that my clients needed the services provided. This is just not okay in my book. I totally understand documentation for integrity but demanding extra proof during a pandemic when I am already submitting the necessary information and feel overwhelmed and overworked helped me create the awareness and opportunity for me to reflect on MY CHOICE to accept insurance.

At first, I reactively felt angry resulting in thoughts and hopes that the insurance company would fire me! However, when I pause and feel to respond intentionally, I honestly and truly feel honored to hold space and care for ALL of my clients and I would feel disappointed if I were unable to offer insurance as an option.

In conclusion, I believe that everyone has a right to confidentiality of your medical records. You also have the liberty to progress through treatment at a pace that's best for YOU - one that allows you sufficient time to process everything that you're experiencing. Things unfold differently for each person, especially when our world seems chaotic (Global Pandemic)! If the insurance company fires me, they rip the therapeutic relationship apart that my clients and I have securely built over the years. Emotional injuries and attachment issues can be easily re-traumatized within seconds.

DIAGNOSIS OF ILLNESS

Insurance companies operate on a medical model, which means they require a diagnosis to establish that you have "a medical necessity" to seek services in order to pay providers. To justify that you have a "medical necessity" I have to assign you a diagnosis to be reimbursed for our work together when there may not be one that really fits what you're going through. The vast majority of insurance companies don't consider relationship issues like couples or family therapy, developmental/attachment trauma, existential issues, life-transitions, personal development, or self-improvement as "medical necessities" because there are no diagnoses for these in the DSM-V.

And even if there are appropriate diagnoses, there are some diagnoses that insurance companies don't consider debilitating enough to pay for. So, if I know what diagnoses are and are not paid for, l'd have to label you with a more severe diagnosis they will pay for, but one that may not really reflect your situation. I am not ok with this either!

You're probably wondering, "What's the harm in that? A little truth-bending never hurt anyone." Well, that's just it - it can. It can come back to bite my clients in the ass... your medical record. While that might not be such a big deal right now, it may become one later on if you want to: get life insurance, work in the financial sector managing other's assets, regularly handle firearms, or seek employment in any sector in which your decision-making might be called into question due to your emotional state. Call me crazy, but I feel that people should get the help they need without fear, stigma, or reprisal for making their mental health and personal growth a priority.

FRAUD

If I engaged in the aforementioned truth- bending, I'd essentially be committing insurance fraud. There are providers out there that are willing to walk this fine line and take this risk. In my opinion, the penalties and professional consequences of insurance fraud are huge, and frankly, not worth it. I have a strong need for peace of mind that comes with integrity.

LOW RATES

In order to be "in- network" with an insurance company, I have to agree to accept a lower fee in exchange for the insurance company listing my practice in their directory of providers and sending me referrals. In the spirit of transparency, most of my clients find me through friends, family and through searching online. And each year, insurance companies continue to cut the rates they pay therapists for their work.

Here's an example with real numbers and real circumstances of how this happens: My fee is $170 per session. But I joined XYZ Insurance Co.'s network because I had a client in need of services. I chose to help and chose to agree to the insurance reimbursement rate of $60 per session. My client would also be responsible for a co-pay of $0-$40 per session depending on his plan, bringing the total to $60-$100 per session. That means I'm waiving at LEAST $70-$110 for each session. As a healthcare professional, I want to help! I have made these types of choices for the 20 years that I have been in private practice. I will keep choosing to advocate for my clients who have insurance because I also have insurance for myself and my family.

Would you be willing to forgo ~65% of your salary?:-/

I will also continue to set boundaries with ALL of my clients and companies that I choose to work with. If you no-show as a self pay or insurance client, I will treat you the same and ban you from being able to book an appointment until we have a meeting. I get it. I want to understand one another and use empathy. Life happens. I want to turn toward these curveballs

Additionally, insurance companies have been increasing their members' premiums, deductibles, and co-pays in the last few years claiming rising costs of care. You'd think that that would translate to higher reimbursement rates to care providers, but it doesn't...at least not in the mental health fields. In fact, insurance reimbursement rates have actually decreased over the same period of time. You're probably wondering, "How do the therapists and psychologists that take insurance afford to?

For such insurance-based practices, taking on more clients than is clinically prudent is the only way to make up the difference and keep their doors open. This then leads to another problem...

BURNOUT & EXHAUSTION

Here's the reality, many providers that accept insurance overbook their schedules in order to turn a modest profit after rent, utilities, malpractice, and other expenses.

Additionally, these providers often only offer a 30-50-minute session to maximize the number of clients in a day (10 vs 8) and the chances of insurance reimbursement (remember, most insurance companies don't pay for 60-minute sessions anymore). Also, if you use the 60 min codes, you are flagged for audits which take hours and hours to complete.

DELAYED (OR NON) PAYMENTS

Despite the insurance companies agreeing to a set reimbursement rate, these companies require therapists to jump through a bunch of hoops to get paid. It is common practice for most insurance companies to reject submitted paperwork to delay payments. When they're not seeing clients, these therapists are drowning in insurance paperwork and resubmitting billing claims in order to get paid, or spending hours on the phone contesting unpaid claims.

On average, it takes an additional 1.5 hours of UNPAID work outside of the session to get paid for sessions. And remember, the therapist is already making less by agreeing to take insurance. (In my previous example, it would cost $255 of my time ($170x1.5) to get paid my $60 reimbursement rate from XYZ Insurance Co.)

The alternative is to pay a medical billing company 8-10% of the claims' costs to do the aforementioned, but that increases expenses and cuts into that modest profit I mentioned before. But let's say that I or my medical billing admin ARE able to see the claim through the labyrinthine insurance payment process, the payment will finally arrive in my bank account anywhere between 3-6 months after the session took place IF everything goes smoothly.

RETROACTIVE CLAIM DENIALS (AKA CLAW BACKS)

Now imagine that, after all that trouble, that insurance company asked you to give the money back, even years later. Yep, this really happens and, unfortunately, it's a common practice among insurance companies. They'll audit your claims and paperwork for several years back. If they find any mistakes or inconsistencies in the therapist's paperwork they missed when they originally approved the therapist's claim, the insurance company will request that the therapist return the fees she was paid.

Pretend that your employer sent you a bill requesting that you repay the income you'd earned 3 years ago. Would that seem fair to you? I didn't think so. Claw backs can amount to thousands of dollars that can bankrupt a small business like a private practice. Many insurance- based clinicians live in fear of such retroactive audits.

Before reflecting and reassessing the insurance-based private practice I founded, I recently heard from a friend and colleague that a major insurance company requested thousands of dollars be returned by the end of the month. Talk about stressful!

All together that's a recipe for a tired, overworked, and stressed out therapist.

This may have been the problem if you've ever been to therapy that you felt didn't "work" with a provider from your insurance company. I should know. I started to experience the symptoms of burnout after two years of insurance-based practice. And that's when I realized, "Crap! I'm doing the things I tell my clients not to do!" Talk about incongruence!

So I changed my business model for the sake of the well-being of myself and my team to preserve the quality of care we want to provide every client. It breaks my heart to REDUCE ACCESS to care for people in need, but I realized early on that we can't help anyone if we're stressed/burned out or have to close our doors. I am choosing the 50/50/❤️ MODEL to advocate for mental health and well-being for all!

This makes sense to me!

WHAT ARE THE BENEFITS OF PRIVATE SELF-PAY AND/OR A 50/50/❤️MODEL FOR MENTAL HEALTH CARE?

No Labeling - You don't have to carry an unnecessary diagnosis on your medical record. Although, if you’d like to create awareness and assess for diagnostic criteria, I would invite this curiosity and self exploration.

Confidentiality & Privacy - You and your psychotherapist are the only people that will know you're in therapy. You get to choose who you disclose this information to. Session notes are private records so there won't be intimate details to “prove medical necessity/ diagnosis info”.

I am highly confidential and keep minimal notes. I naturally remember our sessions together because I truly care and our therapeutic relationship is genuinely important to me.

Self-Determination - You get to work with a psychotherapist that is free to use the best therapeutic approach to help YOU meet YOUR goals. You and your psychotherapist are the only people involved in the decision about the length of your care. You won't have to seek additional authorization to continue your work or return to psychotherapy, if you have new goals you'd like to explore.

Quality Care & Attention - You'll get a psychotherapist that's alert and engaged during your session, remembering the details of previous conversations. You'll have the help of a professional that's invested in your process of growth because they've taken the time to do the same for themselves. She will be able to use the healing methods that are most appropriate for you.

You might be thinking that this is just one therapist's rant against insurance companies. Don't take my word for it. Feel free to do your own research!

If you tried psychotherapy and were disappointed with the results or the treatment didn't seem to "fit" after working with a provider from your insurance company, I hope you have a better understanding of what might have been happening behind the scenes. We urge you to reconsider getting some support now that you do. There are great providers in the healing professions on both sides of the insurance divide that can help you.

I HOPE YOU HAVE A BETTER UNDERSTANDING ABOUT WHY I HAVE DECIDED TO CHOOSE THE 50/50/❤️ MODEL!

50/50/ ❤️= 50% SELF PAY 50% INSURANCE ❤️SLIDING SCALE FEE

Call or TEXT with any questions:

📱#813-240-3237 or ***Book Now: —> ❤️

Nonviolent Communication for Anger

“The cause of anger lies in our thinking – in thoughts of blame and judgment.”

– Marshall B. Rosenberg, PhD.

Many people want to know how to use Nonviolent Communication for anger because it can be such a scary emotion for so many people. Feeling it, expressing it — and being on the receiving end of it — can be extremely unsettling!

Nonviolent Communication (NVC) helps us navigate anger in a holistic way. Using NVC for anger is a healthy and empowering way to rewire our responses to this powerful emotion.

Because anger is so often associated with violence, it’s common for people to avoid anger — as they might avoid conflict — out of their need for safety.

But anger itself is simply an emotion.

How we choose to handle it — including how we hold it within ourselves and how we express it — can make all the difference.

Just as importantly, how we handle another person’s anger, especially when it is directed toward us, can also make the difference between conflict and connection. Let’s take a deeper look at how Nonviolent Communication for anger works with our internal dialogues….

Healthy Ways to Handle Anger Inside Ourselves

Nonviolent Communication gives us healthy ways to handle anger inside ourselves.

Employing Nonviolent Communication for anger first requires acknowledging that this is an incredibly powerful emotion, and that we probably need to find more healthy ways to handle it inside ourselves.

One of the main challenges to finding healthy ways to deal with anger inside ourselves is that by the time anger arises we have usually already lost control.

By using Nonviolent Communication for anger, we rewire our capacity and skills for handling anger constructively. At first, our attention centers on how soon we can recover from an anger episode, and with what intention and how soon do we engage in any necessary relationship repair and clean-up.

As we cultivate healthy ways to handle our anger, we begin to catch it sooner. We start to notice subtle shifts and changes before we’ve erupted in anger! We can notice where we’ve made an assumption or an interpretation that in the past would have led to us feeling angry. This helps us calm down and deconstruct the story that has led to anger. It also gives us the opportunity to question it or check it out with others, before lashing out in anger.

As we cultivate healthy ways to handle anger inside ourselves, we begin to discern the deeper Universal Human Needs and values that underlie an expression of anger. Once a person has connected with their own (and/or others’) underlying needs and values, what we find is that the emotion shifts. At that point it’s usually not anger anymore. The shift from right/wrong thinking to connection with the underlying needs or values comes with a shift in the feeling which now might be frustration or sorrow, but no longer anger.

When we connect with our feelings and needs, and we allow our feelings to flow in a space of presence, healing begins to happen. At this point, we are getting closer to a place of mourning, forgiveness, and self-forgiveness.

Healthy Ways to Deal with Anger from Other People

Learning healthy ways to handle anger inside ourselves is only one part of how Nonviolent Communication and anger relate. Another part involves learning healthy ways to deal with anger from other people. Being on the receiving end of anger can be incredibly scary for reasons of our emotional, mental, and physical safety.

In these situations, besides high-level NVC skills, we want reassurance that we will be safe. (See the distinction between protective and punitive use of force.)

If we are certain of our physical safety, sometimes another’s anger is disconcerting for other reasons:
They have judgments of us which are hard to hear and/or,
We are taking responsibility for their feelings, telling ourselves that we made this person feel bad, and/or,
We’re concerned about some damage to an important relationship, as well as all that that can mean and imply.

The tools of NVC come in handy when cultivating healthy ways to deal with anger from other people. These tools include self-empathy, empathy toward others, and the ability to express truthfully or authentically with the intention to create a connection and refraining from using words that would cause more harm.

Imagine working on anger — your own or receiving others’ — to the point where you felt safe and comfortable around it, and knew how to handle it confidently and effectively, able to defuse conflicts and guide them toward more connection!

How does this look in an everyday context?

Let’s consult Dr. Marshall Rosenberg on NVC and anger to find out….

Dr. Marshall Rosenberg on NVC for Anger

Dr. Marshall Rosenberg, Ph.D. had revolutionary insight on the relationship between NVC and anger. According to Dr. Rosenberg, anger means we are disconnected from our needs. He taught us that anger is one of the four emotions that are disconnected from needs because of what we are telling ourselves. (The other three are shame, guilt, and depression).

In a practical context, these are the types of questions we can ask ourselves to see if we are progressing on using NVC for anger:

When someone speaks to me in anger, do I stay self-connected? Can I give myself self-empathy rather than judge them back or blame myself?

When someone speaks to me in anger, how soon does my attention go to what their needs might be? Am I able to give them empathic presence (perhaps after giving myself self-empathy) rather than judge them back or blame myself?

When someone speaks to me in anger, to what degree am I able to hang in there with the conversation? Am I able to express my honesty from the heart, my feelings and my needs — perhaps in addition to empathic presence, possibly with moments of self-empathy throughout — rather than judge them, blame myself, lash out, disconnect, or rush to a solution for short term relief?

To what extent can I hang in there in a tough conversation for the possibility of deeper connection and a mutually satisfying outcome?

If I notice we’re both angry, and both want to be heard at the same time, can I call a time-out in a way that we can get support in order to come back to the conversation?

With NVC for anger, we also learn how to own the causes and express anger fully. This means deconstructing the story we have and getting to the underlying needs. When we do this we can express what we value and cherish — rather than focusing on our judgments of others or becoming entrenched in who was right or wrong. In this way, NVC for anger helps us shift the feeling of anger to other, more life-connected feelings.

Content by PuddleDancer Press. Use of content okay with attribution. Please visitwww.nonviolentcommunication.comto learn more about Nonviolent Communication.

Nonviolent Communication Skills in Intimate Relationships

“NVC requires us to be continually conscious of the beauty within ourselves and other people. ”

– Marshall B. Rosenberg, PhD.

The connection between Nonviolent Communication and Intimate Relationships is strong and vital — and perhaps not obvious to those unfamiliar with NVC.

For those of us with NVC skills who are also in intimate relationships, we can’t imagine being in a relationship without NVC!

Intimate relationships are some of the most meaningful connections with the people who are most important to us.

This is why when disconnection happens it can be more painful than in other types of relationships.

In intimate relationships the stakes are higher, in part because our emotional investment is greater.

For all these reasons and more, learning NVC skills to prevent and resolve misunderstandings and conflicts in intimate relationships can help us deepen and enjoy those relationships more fully!

The Importance of Communication in Intimate Relationships

An intimate relationship without communication is like a bird without wings, or a tree without leaves. Communication is one of the primary mediums for connection, and without connection how intimate can a relationship be?

The importance of communication in intimate relationships — now, today —can be summed up by the proverb: “dig your well before you’re thirsty.”

What does this mean?

In this metaphor, thirst is the need for connection, for mutual understanding, for the trust and good will that take us to mutually satisfying ways of living. The well would be access to NVC tools and the practice to become skillful with them.

Your NVC skills can take you to mutual understanding and deeper connection — consistently!

However — there is a big difference between having a tool and being skillful with it.

Can you understand why it might serve NOT to wait until you’re in a full-blown conflict to decide that you want to develop your communication skills?

Communication helps us each know where we’re at, what we’re each feeling, what’s important to us, and what we would like.

There’s another apt proverb here: “An ounce of prevention equals a pound of cure.”

The importance of communication in intimate relationships goes way beyond resolving conflicts.

As you develop your skills you begin to prevent misunderstandings and conflicts. And this allows you to conserve mental and emotional energy, and prevent angst and suffering.

Beyond misunderstandings and conflicts, the importance of communication in intimate relationship is that it contributes to an ongoing deepening of your most important connections.

Common Communication Problems in Relationships

There are many common communication problems in relationships.

Fortunately, NVC has principles, insights, and tools that address every one of them!

One of the most common communication problems in relationships is when we listen to respond rather than to understand.

When you are present, and listening to understand, you will still have a chance to respond later! But first, help the other person experience being understood. This is not the same as agreement; simply understanding.

When the other person feels understood they are much more open to hearing you out! And the dynamic of hearing each other deeply as each person reveals vulnerably, allows the conversation to deepen to a place of authentic connection in which conflicts often resolve themselves.

Sometimes you might be in a conversation that is going just fine, and a little while into it you and the other person find yourselves in a very uncomfortable place — a disagreement, a disconnection, or even a full-blown conflict — and you’re wondering, how did we get here?

This is actually quite a common experience, and is related to the previous communication problem. Sometimes there is even a slight miscommunication — for example one person says red and the other hears blue — and nobody notices.

These situations easily lead to misunderstandings which can lead to conflicts.

A true-life example: a woman said to her male partner, “I don’t want to be so wifey.”

What she meant: “I don’t want to be the only one doing the housework.”

What he heard: “I don’t want to be married to you anymore.”

This couple ended up divorcing — true story — and is an example of a small miscommunication that can spiral out of control quickly if we don’t catch it. So slowing down, listening to understand, and asking clarifying questions can save us all a lot of heartbreak! (In the example of the couple above, their large group of friends also went through a form of heartbreak.)

Another common communication problem in relationships is rushing to a solution in a way that skips the connection. Often the person who does this has positive intentions of wanting to resolve an issue or fix a problem.

However, when we skip the connection the other person rarely feels included in the solution. Furthermore, we have little guarantee that the solution will meet their needs because we haven’t taken the time to find out what they are! NVC encourages us to connect first — get clear on each person’s observations, feelings, needs, and requests — and then, once the needs are clear and there is mutual understanding, together arrive at a strategy that meets all or most of the needs.

Connection before solution!

Nonviolent Communication is also known as life-connected, life-serving communication. As such, it has its opposite: life-disconnected, life-alienating communication, which is defined as the type of thinking and language which takes us away from the quality of connection for which we are seeking.

Most of the common communication problems in relationships can be identified in this life-disconnected thinking and language. These include:

Diagnosing others: This includes judgments, name-calling, and criticism. Diagnoses also include assuming we know what another person is thinking, feeling, or needing. (“You’re obviously very angry about that!”) And they include any static language that would explain why someone is acting the way they are (the problem with you is you are [an egomaniac; an Aries; a troubled soul; a rebel, etc.]).

Denying responsibility: This includes any language that implies that we lack choice. I had to. I had no choice. You made me. I can’t. This does not mean that we always like the options of which we’re aware. Sometimes we dislike every option, and yet, within that we still have choice. And sometimes we’re not aware of other possibilities because we are in a “crisis of imagination.” Rather than owning our choices we act as if we are powerless. I have no choice, it’s (the law, company policy, superiors’ orders). Accusatory blame would fit in this category.

Placing demands on others: In NVC we take responsibility for what we are wanting by expressing clear requests. In a request, the other person’s needs matter too, and so no is an option. In a demand, ‘no’ is not an option. In a demand, by definition, the other person’s needs do not matter equally to the person issuing the demand. The reason this hurts relationships is that, if I am on the receiving end of demands it communicates that my needs don’t matter. This, in turn, leads to resentment and disconnection. Over time, it is quite likely that the needs of the person placing the demands cease to matter to the person on the receiving end.

Life-alienated motivations: The key insight here can be summarized by a phrase often emphasized by Dr. Marshall Rosenberg, creator of NVC: The energy with which we do anything for each other is just as important as the action itself. Life-alienated motivations include fear, guilt, shame, duty/obligation, to obtain an extrinsic reward, to avoid punishment, or acting out of “shoulds” or have-tos.” When we do something for each other out of these motivations, it creates disconnection, resentment, and serves to break down trust. We want to do things for each other when we are connected to how it serves life, how it also contributes to our needs.

Using Compassionate Communication in Relationships

The key to using Compassionate Communication in relationships consists of remembering three things: Purpose, Intention, and Attention.

It’s extremely helpful to remember that the purpose of Compassionate Communication (another name for NVC) is to create a high quality of connection out of which people naturally and spontaneously enjoy contributing to one another’s well-being. This is how we find win-win or mutually satisfying outcomes: out of the connection.

The purpose is not to get others to do what you want, or to get your way, or to get a particular thing to happen!

So when you enter a conversation or are in an interaction, remember that the purpose is first to connect.

And so it helps if this is our intention.

When connecting with another, check your intention. What do I want here? Is my intention to be right? Am I willing to let go of being right and my preferred outcome in order to connect first? Do I trust that once we connect we can together find a mutually agreeable outcome?

And one of the outcomes of developing in NVC is skillful deployment of your attention.

Using Compassionate Communication in relationships means being able to put our attention on feelings and needs, rather than on who’s right and who’s wrong. It means putting our attention on our own, and the other person’s, humanity in order to connect and find a way of being with each other that is mutually fulfilling.

This is how using Compassionate Communication in relationships teaches us to use purpose, intention, and attention to create deeper and more satisfying relationships.

Using NVC to Improve Communication in a Relationship

Using compassionate communication in relationships is simple, though it is not necessarily easy.

The reason is that it helps us become aware of and re-configure old, unconscious patterns that get in the way of the quality of connection we’re looking for. Sometimes discovering these old patterns is painful, and shifting them can take time.

The good news is that as you get better at it, it becomes more fluid and takes less time.

How do we do it?

First, a clarification. We can think about communication in intimate relationships as consisting of a spectrum:

In this simple diagram, we can see that informal NVC could be indistinguishable from a normal conversation. That’s because connection is happening — which after all is the purpose of NVC.

At the other end of the spectrum we see “formal” NVC, which has certain key differentiations and follows a particular structure and syntax. Formal NVC keeps our communication extra clear, and helps us keep the key differentiations clear in our mind.

The dance of connection refers to the steps we take to move toward connection. A simple mnemonic device is ABABAB, referring to person “A” and person “B.”

Here’s how “the dance of connection” works:

1) Person A speaks with honesty from the heart.

2) Person B reflects back their understanding of what Person A said.

3) Person A confirms they were heard accurately.

4) Person B speaks with honesty from the heart.

5) Person A reflects back their understanding of what Person B said.

6) Person B confirms they were heard accurately.

7) Return to the top, to #1. This process is continued until the two people feel connected and they trust that they are understood by the other. Then they can proceed to brainstorm or propose strategies and/or solutions.

Though somewhat of an oversimplification, this illustrates the process we undergo to allow a conversation to wind deeper and deeper, until there is a high quality of connection out of which people co-create mutually satisfying outcomes.

Dr. Marshall Rosenberg on Nonviolent Communication Skills in Relationships

There is so much we can learn from Dr. Marshall Rosenberg on Nonviolent Communication Skills in relationships.

He knew that intimate relationships are some of the most important relationships — and sometimes some of the most challenging ones.

Dr. Rosenberg explained that if you meet your needs at the expense of another, your needs will also not be met. Anytime you create a win-lose, you also lose — because we are all interconnected, interrelated, and interdependent.

When we coerce others or place demands on them, the quality of the connection suffers.

When we can let go of being right and put our attention on making life more wonderful, then we can create a high quality of connection out of which it’s easy to explore outcomes, solutions, and ways of living that are mutually satisfying.

Content by PuddleDancer Press. Use of content okay with attribution. Please visitwww.nonviolentcommunication.comto learn more about Nonviolent Communication.

Voice Dialogue

Voice Dialogue is the main intervention used in a modality called the Psychology of the Selves developed by psychologists Hal and Sidra Stone, who had such diverse influences as Jung, Skinner, Kazantzakis and Hermann Hesse. Their theory suggests that various parts of self coexist within each of us and determine our thoughts, behaviors and relationships with others.

Each of us "contains multitudes". We are made up of many selves, identifying with some and rejecting others. This over-identification with some selves and the loss of wholeness that comes from the rejection of others, can create imbalances and blind spots. This work is about embracing all the selves. This dance of the selves is an amazing process and we see the dynamics of the world around us shift as our internal world changes.

Rather than making choices based on a given criteria (the most rational, what feels right, what other people want, etc.), Voice Dialogue encourages a discussion between the parts of self at odds with one another. The understanding and expression of these selves helps us increase our self-awareness and even function better within a relationship. Although it does turn a couple into a group rather quickly.

1. When would a clinician use Voice Dialogue?

When there is a sense that the client has a feeling that he or she has different selves or parts.  For example, let us say that John goes to a party that he doesn't really feel like going to.  Once there he has a few drinks and soon he is the life of the party.  In the middle of the night when he awakens he is a bit depressed. In his session he may say something like:  "I don't understand how I get into these things.  I really didn't feeling like going and again it is as if something just takes over and there I am again doing something I don't really feel like doing."  In a situation like this Voice Dialogue could be a very effective intervention.

2. What does it look like?

The therapist might say: "It really does sound like there are two very different ways of being or value systems that are operating in you.  There is you the party person, the more extraverted self who generally needs some alcohol or drug to get him going.  On the other side is a more introverted part of you trying to come out and be heard but he seems to have less authority than the other one.  How would you feel about my talking to these two feelings or ways of being in the world to see if this might help clarify some of the conflict that you are describing?"

The therapist starts always with the self that is the more primary, that leads his life in the world.  For this the client actually moves over physically to a different position and the conversation or interview begins.  When finished John would go back to the center for a discussion of the work so far.  In this, or the next session, the therapist might have a conversation with the less developed, often totally disowned self.

3. How does it help the client?

It helps the client in three ways.  First he gets to hear in a very objective way what these different "voices" or selves have to say, what they want and need, how they developed -- the family forces that shaped them. Just knowing that the voices are real can be a total revelation.  A woman might say that she can't stand looking in the mirror in the morning. To discover that she has a voice in her, the Inner Critic, that embodies all of her self criticism can initiate a major shift in her life.  

Secondly, the therapist helps to develop a new place between the opposites, a place that can help the client hold the introversion with one hand and the extraversion with the other.  It is a new "center" of personality that we call the Aware Ego.  It is this Aware Ego Process that can learn to embrace the vast system of opposites that live within each of us.  

The third advantage is that from this Aware Ego Process the client is in a better position to make conscious choices.  A conscious choice is one that honors both sides of the conflict no matter which choice is actually made.

4. In your opinion what makes Voice Dialogue a cool intervention?

First of all it is way of working that is fun and alive and brings in all kinds of different thoughts, feelings and emotions.  It is impossible as a therapist to be bored or tired doing this work.  It the therapist gets tired or bored it is because he or she has fallen into a pattern of being overly responsible or overly mental or some primary self that limits possibilities of enjoying the work.  

Secondly there is the constant excitement of new discovery.  Discovering and separating from a primary self is like waking up from a dream and discovering whole new worlds of possibility.  

Thirdly, what you judge in the world are generally expressions of selves in you that have been shut down or rejected over time.  What a ride it is and how relationships do change as you begin to learn how to catch hold of these judgments.  

Fourthly, how different it is to learn how to allow your own vulnerability to live in the world of relationship.  So many people look for more meaning in their lives. Learning how to use vulnerability in a conscious way is really the royal highway to a more deeply felt and experienced life.

The Miracle Question!

The Miracle Question – an old standby for many different types of therapy! This question can be used in individual therapy as well as couples therapy, and it can be applied to a wide range of situations, issues, or problems.

The general idea of this technique is to both help the client (or couple) explicate their needs or desires and help the therapist better understand what his or her client(s) is hoping to achieve in therapy. It is especially helpful for those who have never really taken the time to clarify what they want out of their relationship, either for themselves or for their partners.

This question can generally be worded as such (Howes, 2010):

“Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?”

Even if one or both clients give describe a scenario that is absolutely impossible to achieve, their answer can still be useful for understanding their goals. In the scenario of an impossible ideal future state, the therapist can dig deeper into the couple’s “miracle” by asking, “How would that make a difference?” (Howes, 2010).

This question helps the couple believe in a more positive future for themselves, a future in which their problems are solved. This exercise can result in greater motivation to work at improving their relationship, enhanced confidence in the efficacy of couples therapy, and even instantaneous (but incremental) improvement in interactions between the two people.

Solution Focused Therapy (aka Brief Therapy) emerged in the 1980's as a branch of the systems therapies. A married therapist couple from Milwaukee, Steve de Shazer and Insoo Kim Berg, are credited with the name and basic practice of SFT. The theory focuses not on the past, but on what the client wants to achieve today. By making conscious all the ways the client is creating their ideal future and encouraging forward progress, clinicians point clients toward their goals rather than the problems that drove them to therapy. 

The Miracle Question fits perfectly with this model. Imagining an ideal future and connecting it to the present immediately actualizes the work. Clients are challenged to look past their obstacles and hopelessness and focus on the possibilities.

It's cool because it's a relatively simple intervention that can have a powerful impact. Just take a look at the question (response #2). You're probably crafting your response already. It's creative, bold, healing, a bit mysterious and definitely has a cool name. The Top Ten designation is well deserved. 

Don't just listen to me, hear it from an expert. Linda Metcalf, Ph.D. is founder of the Solution Focused Institute of Fort Worth, Texas and author of ten books including The Miracle Question: Answer It and Change Your Life. Beyond writing and therapy, she speaks internationally to schools, agencies and universities. She was kind enough to share her wisdom with us today. 

1. When would a clinician use the Miracle Question?

The Miracle Question is a goal setting question that is useful when a client simply does not know what a preferred future would look like. It can be used with individuals to set the course for therapy, with couples, to clarify what each person needs from each other and with families, who too often see one person as the culprit. By using the Miracle Question and asking each person what a better life would look like, it is apparent, perhaps for the first time, what others need from each other.

2. What does it look like?

"Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?"

The therapist stays with the question even if the client describes an "impossible" solution, such as a deceased person being alive, and acknowledges that wish and then asks "how would that make a difference in your life?"  Then as the client describes that he/she might feel as if they have their companion back again, the therapist asks "how would that make a difference?"  With that, the client may say, "I would have someone to confide in and support me."  From there, the therapist would ask the client to think of others in the client's life who could begin to be a confidant in a very small manner.

3. How does it help the client?

It catapults the client from a problem saturated context into a visionary context where he/she has a moment of freedom, to step out of the problem story and into a story where they are more problem free. But, more importantly, it helps the therapist to know exactly what the client wants from therapy...and this is what makes Solution Focused Therapy so efficient and brief.

4. In your opinion, what makes the Miracle Question a cool intervention?

It helps the therapist see where the client wants to go. Too often, therapists assume that a client needs to grieve, leave their spouse, quit their job, after the client describes why he/she has come to therapy. The Miracle Question helps the client and therapist to address exactly what the client wants, not what the therapist thinks is best.