How to get unhooked from difficult thoughts and emotions with ACT

By: Kaitlin Lowey, MHCI

You’ve likely heard the phrase uttered by Benjamin Franklin, “...in this world nothing can be said to be certain, except death and taxes.” As a mental health professional (and fellow human being), I would add one other inevitability: experiencing uncomfortable thoughts and emotions. 

“I’m not good enough.” “It’s breaking my heart.” “I totally freeze.” “Something feels off in my gut.” “What is wrong with me?” “I feel depressed.” “I’m so scared.” “What if I get it wrong?” “Do they actually like me?” “Why did I say that?” “What if I fail?” “What if I end up alone?”

Our difficult thoughts and emotions are 100% normal.

Many psychologists and counselors, especially those practicing Acceptance and Commitment Therapy (ACT), would argue that experiencing such thoughts and emotions is just part of being a human. In fact, emotions like anxiety serve a purpose – they protect us from threats (like a charging lion or a dimly-lit alley). Uncomfortable emotions only become a problem when they show up in non-adaptive ways and stick around long past when they’ve served their purpose – in other words, when the degree of emotion we feel outsizes the actual threat. Our emotional responses are both innate (such as fear of snakes) and learned (such as fear of touching a hot stove). Some emotional wounds experienced in childhood, particularly those related to relationships, can continue to impact our emotional responses well into adulthood. 

So, what do our minds do when we experience these emotions? They view the emotion as a problem to be solved – to be gotten rid of. Again, the mind’s problem-solving nature is normal. It’s how humans have survived and adapted for thousands of years. For instance, humans built homes to shelter us from animals and the elements. We created the wheel to transport objects more easily. We even invented the remote control to save us from the inconvenience of having to move to turn up the volume on the TV. Our brains are hard-wired to problem-solve, and that’s usually a great thing! However, it’s not so great when our brains’ well-intentioned but ill-fated attempts to get rid of uncomfortable feelings only makes those feelings stronger. 

So, what happens when our emotional response and our problem-solving are both operating on overdrive? Russ Harris, the author of ACT made simple: An easy-to-read primer on acceptance and commitment therapy, describes the effect as getting hooked. Getting hooked means our brains automatically label the thoughts as a threat, something we have to act on, or something requiring all of our attention (what ACT theorists call cognitive fusion). We may do everything in our power to get rid of them (what ACT theorists call experiential avoidance). In addition, we might start to fuse these thoughts with our self-concept (e.g., If I keep thinking I’m bad, then I must be a terrible person.) We can also lose contact with the present moment, instead narrowing our focus on the thing that’s making us uncomfortable, disconnecting from our experience, or disengaging. Ultimately, we can lose sight of our values (what we care about and want out of our lives) and instead attempt and reattempt the same ineffective strategies to gain control over our thoughts and feelings. In other words, we use just about every strategy we can to banish our discomfort. This might look like denial, obsessively ruminating on whether or not our thoughts and feelings are true, procrastinating, engaging in addictive substances, and other attempts to control and escape. 

The problem with these strategies is that they are not likely to work. Not only do they not solve our emotional discomfort in the long run – they actually move us away from the kind of life we want to lead. And to top it all off, they often result in a spiral of shame and self-loathing. It’s a vicious cycle. 

At this point, I want to pause and remind readers that it’s not our fault our brains are wired this way – it’s extremely normal and entirely human! And, once we accept this, we can begin to make changes that help our minds work for us, instead of against us.  

So, what’s a human to do? And how can ACT help?

ACT proposes an alternate strategy (with many concepts borrowed from Yogic and Zen principles) to deal with our emotionally uncomfortable thoughts and feelings: accepting them. What if, instead of fighting our emotions and accompanying thoughts, we accepted them for what they are: our bodies’ and minds’ attempts to protect us? What if, instead of living our lives constantly running away from our discomfort, we were able to view our discomfort as separate from ourselves, accept that feeling discomfort is normal in the situation we are in, and make choices that are workable and that move us in the direction we want? In other words, what if we were able to get unhooked?

Several tools from ACT can help us unhook from uncomfortable thoughts and feelings. For instance, mindfulness strategies work to reduce emotional intensity by enabling us to attend to our emotions and the present moment with compassion and acceptance. They can also get us into the habit of viewing our thoughts and emotions as things we are experiencing in this moment, rather than the absolute truth or indicative of who we are. 

One of my favorite ACT tools involves the concept of workability versus absolute truth. As Harris states, ACT isn’t interested in whether thoughts are true – the concept of truth could be endlessly debated. Instead, ACT is interested in whether our thoughts and what we do with them are workable. If a thought or a behavior is workable, it has worked for us in the past and/or is likely to work for us in the future. It will move us closer to our long-term goal. This is a simple question we can ask ourselves when we find ourselves getting hooked and in auto-problem-solving mode: is this thought or behavior workable? Or will it be ineffective or cause other problems? 

Finally, ACT asks us to get really clear on our values. What kinds of concepts (such as love, compassion, resilience, integrity, and authenticity, for example) do we want to guide our actions? If our problems did not exist, how would we operate? Once we know our values, we can endeavor to live in alignment with them. And living in alignment with our values results in less emotional discomfort, improved self-concept, and greater fulfillment. 

Who can benefit from ACT? 

Evidence shows that ACT can be effective for a myriad of mental health problems, including anxiety, obsessive-compulsive disorder, depression, stress, phobias, chronic pain, addictions, and adjustment. But I believe that just about anyone can find usefulness in the approach. As Harris writes, 

“Who wouldn’t benefit from being more psychologically present; more in touch with their values; more able to make room for the inevitable pain of life; more able to defuse from unhelpful thoughts, beliefs and memories; more able to take effective action in the face of emotional discomfort; more able to engage fully in what they’re doing; and more able to appreciate each moment of their life, no matter how they’re feeling?” (Harris, p. 36) 

There is much more to ACT – more than can fit in this article. But I hope this post provides a basic understanding of how ACT can help us humans get unstuck and live a more meaningful, fulfilling life. 

By: Kaitlin Lowey, MHCI

Kaitlin joins her clients as they find relief, healing, hope, clarity, and transformation. She has helped individuals experiencing struggles with anxiety, stress, relationships, life changes, obsessive-compulsive disorder, intrusive thoughts, grief and loss, fertility and postpartum, motherhood and parenthood, athletic and career performance, perfectionism, identity, and self-worth. As an integrative therapist, Kaitlin collaborates with her clients to identify goals and choose research-supported therapeutic approaches that fit best. She offers in-person and online appointments.

Book with Kaitlin Lowey, MHCI here: https://SouthTampaTherapyBOOKAPPT.as.me/KaitlinLowey

Why anxiety is so hard to get rid of

By: Kaitlin Lowey, MHCI

Most people coming to therapy for anxiety have one goal: get rid of it. Anxiety is uncomfortable at best and debilitating at its worst, and it’s incessant. It can feel like the constant what ifs, watch outs, and you can’ts have taken over your mind. They don’t want to feel anxious, but they feel powerless against it. Some even feel defective – like something is wrong with them.

Here’s the thing: anxiety is often labeled as bad, but it’s not necessarily always a bad thing. I know, I know, it sounds counterintuitive – but hear me out. Anxiety plays a critical function in our lives. From an evolutionary perspective, anxiety was essential in pre-modern times. It told us to be on guard for possible bear attacks, poisonous berries, and other potentially life-threatening situations. Those who were vigilant and prepared for threats survived. 

Similarly, anxiety plays a protective role by helping us avoid real threats we’ve experienced in the past or have seen others experience. For instance, it tells us to use caution when driving in heavy traffic or prepare in advance for an important meeting. In other words, anxiety is an adaptive trait!

The problem is, anxiety can sometimes become overactive – like an overly-sensitive brain detector that goes off loudly at the slightest hint of possible danger. Why does this happen? Anxiety is associated with the oldest, most primal parts of the brain that are deeply connected with our body. Our body sends signals to our brain when it senses danger, and vice-versa. When anxiety is in high gear, we can’t reason with this part of the brain. It’s reactive and emotionally-driven. We enter flight, fight, or freeze mode – which is also referred to as being in a state of sympathetic nervous system engagement. When we are in this mode, our prefrontal cortex, which is the part of our brain associated with reasoning and executive functions, becomes less active or shuts down entirely. 

The question becomes, how do you get rid of your anxiety? 

There are many different schools of thought when it comes to addressing anxiety. These are just a few of the hundreds of therapeutic approaches, and the explanations are pared-down for brevity, but I hope they provide a high-level understanding.

A modern psychodynamic approach is based on uncovering unconscious thoughts and feelings contributing to the anxiety, and bringing them into awareness where they can be addressed. This often involves examining competing desires (such as the need for both freedom and closeness) as well as the influence of early experiences on expectations and beliefs. 

Humanistic counseling emphasizes the strength of client-therapist bond and puts the client in the driver’s seat. By reflecting the client’s thoughts and feelings with unconditional positive regard and acceptance, the counselor can help the client gain understanding and insight – and ultimately transform. 

In Cognitive Behavioral Therapy (CBT), clients identify patterns of thoughts, feelings, and behaviors associated with their anxiety – and the relationship between them. Then, they can enact a number of techniques to stop, reduce, or replace their unhelpful thoughts and learned behaviors with more helpful ones. 

Dialectical Behavior Therapy (DBT) was born out of CBT and has many similarities. However, the approach balances the behavioral change-focused aspects of CBT with acceptance of thoughts and emotions.

Using an Acceptance and Commitment Therapy Approach, clients seek to accept that anxiety is a natural part of life and use a variety of strategies to “unhook” themselves from difficult thoughts and feelings. They also identify their values and identify strategies to move in the direction of their values and long-term goals. 

In exposure therapy, clients learn to reduce their fear response through slow, controlled, and measured exposure (either imagined or real) to the thing that scares them. This approach is often used to address OCD and phobias. 

What all of these approaches have in common is the belief that once we have greater insight into ourselves, we can help our minds work for us, instead of against us.  

So, what approach is best for you? The answer is, it depends. Therapy is not one-size-fits all. Different strokes work for different folks. And many counselors choose to take an integrative approach, where they pull tools from different theories, based on what will work best for each client. 

Individuals seeking treatment should talk with their mental health professional about their goals and collaborate with their provider to create a treatment plan that feels right. And remember – anxiety is a totally normal human experience. There’s nothing wrong with you! And there is hope. 

I am honored to have Kaitlin Lowey, MHCI as a colleague on our multidisciplinary team at South Tampa Therapy!

Kaitlin joins her clients as they find relief, healing, hope, clarity, and transformation. She has helped individuals experiencing struggles with anxiety, stress, relationships, life changes, obsessive-compulsive disorder, intrusive thoughts, grief and loss, fertility and postpartum, motherhood and parenthood, athletic and career performance, perfectionism, identity, and self-worth. As an integrative therapist, Kaitlin collaborates with her clients to identify goals and choose research-supported therapeutic approaches that fit best. She offers in-person and online appointments.

Book with Kaitlin Lowey, MHCI here: https://SouthTampaTherapyBOOKAPPT.as.me/KaitlinLowey

The Steps and Stages of Emotionally Focused Therapy for Couples

EFT for Couples is a three stage nine step process that takes a couple out of their negative repetitive fights that are causing a couple distress, anguish and pain and into a new place of bonding and connection where the fights are resolvable and solutions can be found. It was created by Dr. Susan Johnson and based on research in attachment theory and emotion, as well as, on systems, humanistic, and experiential treatment models. As a model itself, it has been validated by research to help about 70% of couples achieve some long term gain.

Stage One - Stabilization (assessment and de-escalation) 

In stage one of EFT, the therapist works empathically with the couple helping them identify and break the negative cycle, pattern or what Dr. Johnson calls the dance that keeps them separated and in emotional distress. During this stage of therapy, the therapist helps the couple begin to get more in touch with the underlying feelings, fears, and unmet relationship longings driving the negative dance. Experiencing these emotions and seeing their partner experience them, helps the couple to start to feel close again. Things at home start to go along more smoothly. There is a sense of calm and hope. Finally, in this stage, as de-escalation begins to take root, the individuals in the couple pair begin to see, feel, and understand that together they have created this dance of distress. Each person begins to understand more deeply the effect of his or her behavior on the other. Couple learns to work together as a team to stop the cycle.

Step 1: 
Assessment: Delineate conflict issues. Assess how these issues express core conflicts in the areas of separateness/ connectedness and dependence/ independence.
​
​Step 2:
Identify the negative interaction pattern or cycle.

Step 3:
Dive more deeply into and feel and share the emotions underlying and fueling each partners position in the cycle. 

Step 4:
Develop an understanding and experience of the problem (reframe) in terms of the cycle, the underlying emotions driving the cycle and the attachment needs which are normal and longing to be meant.

Stage Two - Bonding 

Once the couple begins to understand the dance they do together and is able to step back and stop it or repair it when it gets going at home, they are ready for stage two of EFT. Stage two essentially involves bonding moments where the couple begins to learn how to communicate their vulnerabilities to each other in a new and non-reactive manner. They are supported by the therapist to take risks in expressing their core sense of self, in asking for the other to be there for them and in requesting understanding and acceptance. Partners take turns reaching out to each other in vulnerability and responding back with empathy creating a new sense of togetherness and secure attachment.

Step 5:
Delve into and identify disowned needs and aspects of self that have been hidden for each partner.

​Step 6:
Promote acceptance of these tender and hidden parts, aspects of self and new ways of relating.

​Step 7:
Facilitate the expression of needs and wants, and restructure the interaction to create true emotional engagement.
​

Stage 3 - Consolidation of Change

After the couple has finished the bonding and restructuring events of stage two, they will begin to feel more secure with each other. During stage three, they feel like a team again. The narrative of their relationship has shifted to one where the distress and conflict is understood, resolved, and just part of the story.

Step 8:
Facilitate the emergence of new solutions to old problematic relationship issues.

Step 9:
Consolidate new positions and cycles of emotional closeness and attachment.

Sure, people still fight and sometimes even go back into their cycle. This is normal and will happen especially during times of stress. However, they are able to pull themselves out of it and be there for each other because their sense of self and experience of the relationship has changed. Because of this new ability and sense and during stage three, the focus is more practical and mostly involves consolidating gains and problem solving.

How Psychotherapy Retrains the Brain to Expect (and Feel) Better!

People enter psychotherapy with the desire to feel better, but they are often unsure how therapy will help them accomplish this goal. A common refrain from people hesitant to enter therapy is, “How is talking going to help?” People are used to talking to other people to get practical solutions to problems, and while problem-solving does have a place in therapy, change also occurs on a much deeper and unconscious level. This process has to do with the way the human brain is programmed and cannot easily be mimicked outside of a relationship with a psychotherapist.

Our brains are always evolving unconsciously through our relationships. People who experienced painful relationships growing up have been trained to expect hurtful experiences with others. It takes a new type of relationship—in particular, a therapeutic relationship—to retrain the brain to expect more positive experiences, which is a big part of ultimately feeling better. 

WHY CAN’T A THERAPIST JUST TELL ME WHAT TO DO?

To understand why the therapeutic relationship can be so valuable and cannot be mimicked by, for example, advice in a self-help book, it is instructive to look at how the human brain has evolved. Broadly, there are three parts of the human brain that represent different phases of evolution: There is the reptilian brain, which evolved first and is responsible for the automatic control of vital bodily functions such as breathing; the limbic brain, which evolved second and is responsible for the regulation of emotion and behavior; and the neocortex, which evolved last and is responsible for higher-order functions such as symbolic thought, language, and reasoning.

When a person asks their therapist or a friend what they should do about something, they are essentially asking for a neocorticol solution—something that is rational and can be consciously implemented. Often, however, their problems are a result of hurtful experiences in their earlier relationships that have caused changes in their limbic brain, and only a new type of relationship can alter their limbic brain to produce fewer negative emotions and more positive ones.

BRAIN WIRING IN OUR YOUTH: HOW EMOTIONAL ISSUES BEGIN

Our emotions are meant to help us survive in a world in which we need the help of others. Over time, our limbic brains evolved to automatically create emotions, such as anger and sadness, that are meant to help us navigate the social world. When someone mistreats us, evolution has programmed us to become angry to try and change their behavior. When someone rejects us, we feel sad so we can mourn the loss of what we wanted with them and move forward with our lives.

However, when we are young and particularly dependent on others for survival, whether our emotions actually help us navigate the world has a lot to do with how other people—our parents in particular—respond to them. A child who responds to unfair or disappointing experiences with anger and is further punished for doing so may, over time, come to unconsciously pair the expression of anger with pain. As this occurs, rather than directly experiencing anger at times of unfair treatment or disappointment, they may instead experience anxiety about having anger because their brain has been trained by their social environment to expect that anger will hurt rather than help. Their limbic system is in effect attempting to prevent further emotional pain in the form of being punished, but the cost is another type of emotional pain in the form of persistent anxiety. This can be particularly problematic when people enter into new relationships (friendships, romantic relationships) where there would not be the same costs associated with the open expression of an emotion like anger, but earlier experiences still create anxiety and inhibit its expression.

RETRAINING THE BRAIN WITH PSYCHOTHERAPY

A psychotherapy relationship allows a person to essentially retrain their limbic system to no longer expect negative reactions to the expression of certain emotional experiences, and in doing so can alleviate the anxiety and unconscious emotional suppression their earlier experiences programmed into them. The therapeutic relationship does this in part because the parameters of psychotherapy recreate the type of relationship in which a person was first forced to suppress their emotions: one where they are dependent on another person to meet their needs.

A successful course of therapy helps restore a person’s emotional flexibility and empowerment so they can have greater agency in their relationships.

Just as a parent has a daunting task in meeting all of a child’s needs, so too does a psychotherapist, especially since many people arrive to therapy wanting a conscious, rational solution to their problems when such a solution often does not exist. Therapy presents a unique opportunity to heal and feel better by the way the therapist solicits and responds to feelings such as disappointment, anger, and sadness that emerge over the course of treatment. Rather than punishing a person for having these emotional experiences in the same way that may have occurred when they were younger, a therapist can actively solicit, explore, and normalize their feelings. This helps to retrain a person’s limbic system to no longer pair the expression of those emotions with punishment. As this de-coupling unconsciously occurs, the person becomes more easily able to tolerate the experience and expression of emotions.

THRIVING IN ADULTHOOD

This shift in tolerance for emotions naturally causes a person’s anxiety level to diminish because their mind is no longer fighting to ward off their innate emotional impulses. In addition to symptom relief, the beautiful part of this process is it restores a person’s ability to constructively access their emotions for their original purpose—as a way of helping to navigate the social world. It is hard to thrive in relationships when we have been programmed to believe we must accept the mistreatment of others or that we cannot show others when we are hurting and in need of care. As adults, this is often no longer the case, but our early experiences may make such underlying beliefs unconsciously feel true.

A successful course of therapy helps restore a person’s emotional flexibility and empowerment so they can have greater agency in their relationships. The result can be genuinely transformative, and studies suggest people who have been through therapy show less activity in the areas of the brain responsible for creating negative emotions. Talking, it turns out, can help quite a bit when the person you are talking to is a skilled and compassionate therapist.

If you’re struggling, reach out to a therapist in your area for help.

References:

1. Bowlby, J. (2005). A secure base: Clinical applications of attachment theory (Vol. 393). UK: Taylor & Francis.

2. Cozolino, L. (2010). The neuroscience of psychotherapy: Healing the social brain. New York, NY: W.W. Norton & Company.

3. Damasio, A. R. (2006). Descartes’ error. New York, NY: Random House.

4. Grecucci, A., Theuninck, A., Frederickson, J., & Job, R. (2015). Mechanisms of social emotion regulation: From neuroscience to psychotherapy. In Emotion regulation: Processes, cognitive effects and social consequences, pp.57-84.

5. Karlsson, H. (2011). How psychotherapy changes the brain: Understanding the mechanisms. Psychiatric Times, 21.

6. Lewis, T., Amini, F., & Lannon, R. (2007). A general theory of love. New York, NY: Vintage.

7. MacLean, P. D. (1990). The triune brain in evolution: Role in paleocerebral functions. Berlin: Springer Science & Business Media.

Narcissistic Abuse: Tips for Recognizing and Recovering

When I bring up the word “Abuse” with my clients I notice they are prone to discount their experience because they don’t’ see their situation as being “real abuse.” Abuse is a spectrum, and the word doesn’t do justice to describe the many forms of subtle and overt abusive behaviors and toxic relational dynamics. Narcissistic abuse is a very real form of abuse. The power and control dynamics might not include physical or sexual violence, although they can, but the psychological, emotional, interpersonal, and spiritual effects devastate individuals who find themselves trapped in the narcissistic abuse cycle. This post intends to do two things: 

1. Describe the Narcissistic Cycle of Abuse to help those suffering recognize they are not “crazy.” This is a definable pattern that many others are experiencing.

2. Provide some practical tools and tips to cope and eventually recover from said abuse.

The narcissistic abuse cycle can be defined as a “pattern of highs and lows in which the narcissist confuses their partner through manipulation and calculated behaviors aimed at making their partner question themselves” (Hammond, 2015). I want to make it clear that your partner does not have to have an official diagnosis of “narcissist” for your situation to be a valid case of narcissistic abuse. Media and pop culture usually only portray the most extreme examples of narcissism thus exacerbating the problem and preventing victims from getting help. 

The cycle involves three phases that work in tandem with each other. 

The first stage is Idealization. 

This is the stage where your partner makes you feel like the most special person in the world. The term “love bombing” comes to mind. You might feel as if you’ve never been loved or adored for like this before. The pursuer will become vigilant in giving attention to you and will shower their “target” with gifts, compliments, and promises. 

The idealization phase may include: 

• Love-bombing

• A lot of attention given to partner

• Grandiose gestures

• Elaborate gifts and dates

• Discussing marriage

• Lack of boundaries

• Attempts to isolate partner in the name of love

• Quickly moving into intimacy

• Creates a sense of ownership of partner and the relationship (Hammond, 2015).

The second phase is devaluation.

During this stage, you might start to notice your partner acting one way with you and one way in public which makes it hard to understand which person they really are. If you express concern, you might be labeled as “jealous” or “needy” or a “nag,” The disillusionment at this stage makes some cling harder to the memory of when things were ideal. You might have an intuitive feeling that something is wrong but because of the hot and cold nature of their affection for a time, it is easier to push that voice down. A huge red flag is that you begin to doubt yourself. You begin to see the real person for who they are, and you notice more incongruency in their behavior. This is where the abuse really starts to hurt and many start to exhibit anxiety, depression, obsessive thoughts, develop a trauma bond, amongst other symptoms. Visit this resource to learn more. This is where people get trapped because they are so beaten down and confused, it seems easier to just stay for fear of what might happen or what threats might be made.  

The devaluation phase might include:  

• Attempting to change their partner

• Increasing criticism and insults

• Gaslighting

• Physical threats

• Poor communication

• Increased violation of boundaries

• Triangulation

• More isolation or control over their partner

• Withholding physical, emotional, and sexual intimacy (Hammond, 2015).

Finally, the third phase is rejection. 

In this phase, the narcissistic partner rejects their partner and essentially places complete blame of the downfall of the relationship on their partner. In healthy relationships conflicts and disagreements are navigated with patience, grace, and the use of helpful problem solving skills. In narcissistic abuse relationships, there are no compromises. It is if the victimized partner doesn’t even exist, and they begin to lose any power or autonomy. Sometimes the cycle repeats itself over and over. Sometimes, once the phases are complete, the abuser become disinterested and finds another partner to begin another cycle with. 

The rejection phase may include: 

• Feelings of contempt and rage

• Betraying the relationship

• Invalidating their partner’s emotions and placing all the blame on them

• Playing the victim

• Physical, emotional, and verbal abuse

• Ending the relationship permanently or temporarily with attempts to continue this cycle of abuse (Hammond, 2015).

Now that I have described, briefly, common signs and symptoms of the narcissistic abuse, I will provide some tips for coping. At the end of the article, I have provided additional resources for you to begin your journey to safety and recovery. 

1. Label the Abuse

Once you recognize the abuse and have educated yourself about it labeling it is a vital step towards healing. Consider communicating what you are learning out loud to a trusted person.  

2. End the relationship if you haven’t already done that.

Get in touch with a trusted person, a professional, or your family to create a safety plan if necessary before you leave. 

3. Set Clear and Specific Boundaries

Setting clear boundaries requires discipline but it is vital to protect you from getting manipulated or tricked again. If you share children with your ex-partner and must make contact, make sure you have clear boundaries and a safety plan.  

4. Seek Support

The resources attached to this blog are a great way to find support during this hard time. Additionally, reaching out to a therapist will help you tell your side of the story, be validated, and learn how to grief. A therapist can support you in creating new patterns of living and implement new coping skills. 

5. Rediscover Yourself

In many cases, the abusive relationship has taken over your mind, emotions, physical health, and schedule. Once you are ready it is important you take the time to rediscover who you are, what you want, what you like, what you enjoy, what you need, and how you want to see yourself. This can seem daunting but there is not rush. Rediscovering ourselves is a life long process and we change throughout life. The key is that you recognize you have been deprived of your voice and allow yourself to rediscover it. 

There is no way I can describe all that narcissistic abuse is and how to recover in this short blog but my hope for you is that you feel validated and affirmed if you or someone you know is suffering or trapped in this cycle. There is hope, people can leave their partner, grief the loss, and heal. If you are unsure if you want to start therapy as a part of your healing, I offer free consultations and it would be a pleasure to hear your story and get to know you!

By Shaundra McGuire, MFTI Book With Shaundra: https://SouthTampaTherapyBOOKAPPT.as.me/ShaundraMcguireMFTI

Additional Resources: 

Stages of Narcissistic Abuse - Narcissist Abuse Support

https://narcissisticabusevictims.org/

You Are Not Alone - Educate Yourself - Find Support - Get Healed - Find Peace Again - Narcissist Abuse Support

What is the Gottman Method for Couples, Relationships, and Families?

What is the Gottman Approach to therapy and counseling? 

I’ll explain~

I absolutely love the Gottman’s therapeutic approach! There is so much that can be said about this method. If you have never heard about this couple’s approach in therapy, then let me give you a little bit of insight. The Gottman Method aims "to disarm conflicting verbal communication; increase intimacy, respect, and affection; remove barriers that create a feeling of stagnancy, and create a heightened sense of empathy and understanding within the context of the relationship." Interventions used in the Gottman Method are research-based and grounded in the Sound Relationship House theory, which specifies nine elements of a healthy relationship. Imagine a house with seven floors and two weight bearing walls.

Floor 1 - Build Love Maps.

Love maps are important because the whole relationship begins on the firm foundation of truly knowing one another. Each partner knows the ins and outs of their partner. In an ideal relationship, you and your partner know one another better than anyone else.

Floor 2 – Share Fondness and Admiration.

We all love to hear something nice about ourselves, right? This is a need, and it means the most when it comes from your loved one. Vocalizing your admiration for one another and being able to articulate the big and little reasons you love each other is huge!

Floor 3 – Turn Towards.

When you need attention, support, and comfort from your partner, you more than likely say or do something to elicit a response from your partner. This what is referred to as a “bid”. When your partner replies with what you need, this is them turning toward. Turning away from one another, or AGAINST each other is asking for trouble. Turning away disrupts the safe space you both need to express yourselves and needs.

Floor 4 – The Positive Perspective.

Your outlook on life and on your relationship is shaped so much by your perspectives and cognitions. When in a healthy relationship, couples see the best in each other and don’t jump to conclusions filled with judgement and criticism if one partner forgets to pick up their socks or give you a kiss goodbye. Truly believing you both are on the same team strengthens the relationship from inside out.

Floor 5 – Manage Conflict.

Conflict is going to happen! It’s inevitable but knowing what to do when it presents itself is key. You need to accept partner’s influence, communicate about the conflict, and be able to self-soothe.

Floor 6 – Make Life Dreams Come True.

Healthy relationships involve having a partner in life who encourages and helps you reach your goals. Making each other’s life dreams come true shows your partner that you want the best possible life for them and are willing to do what it takes to make that dream happen.

Floor 7 – Create Shared Meaning.

Congratulations, you have reached the top floor. This is where you build and understand an inner world as a COUPLE. The Gottman’s believe that developing your own culture of symbols and rituals is what expresses WHO you are as a TEAM. It continues to deepen your connection together. These are referred to as Rituals of Connection and they define you as a unit. The best part of this is that you create them together.

Weight Bearing Walls – Trust and Commitment. Without trust and commitment, the 7 floors can’t hold together, and it will fall apart.

In a healthy and supportive relationship, the partners are CHOOSING to have faith in one another and to be committed to each other. There is no force, and you are freely loving one another and pledging to help that love grow.

 

Author: Crystin Nichols, MFTI

Book With Me: https://southtampatherapybookappt.as.me/CrystinNicholsMFTI

Resources

1. About The Gottman Method. The Gottman Institute. 2021.

2. What is The Sound Relationship House? The Gottman Institute. 2022.

Couples Therapy: Like you’ve never experienced before…

In a Nutshell, What Is Couples Counseling?

If you're reading this, your relationship is likely struggling right now. You might even be considering divorce.. Let me start by telling you I'm sorry to hear that you're going through such a difficult time.

If you're like most couples I see, you've probably come across an online article claiming that all of your relationship's difficulties can be traced to communication breakdowns.. If you could effectively communicate with your partner, you would be able to fix things.… 

And that’s true! I have the tools to teach you how.

That's the problem: it is ineffective advice when you're in the middle of a disaster.. Obviously, if you could communicate better, your relationship would be better. But you can’t, so it’s not. 

But there is hope! I will guide you in session and give you evidence based tools to use between sessions, to apply 4 easy steps to communicate to get to the root of the issues.

Whenever you and your partner try to communicate – Even deciding what to have for dinner can be tough, You may as well forget about trying to have an actually meaningful conversation. – it just turns into another fight, nothing gets resolved, and makes everything even worse.

Then it is just brushed under the rug to linger... until the next argument. Ugh... How exhausting! 

And sure, that might be because your partner is trying to pick a fight (not realizing that all attacks are unskilled ways of trying to get a need met). And more than likely, there was an emotional injury at some point in time that went unaddressed – a crack in your friendship that never healed. Over time, you’ve grown more distant and further apart, until you’re constantly feeling resentful, annoyed, frustrated, hurt, disappointed, and down right angry.

Oftentimes, we know something is wrong but can't seem to put our finger on the problem. If this is where you're at, don't worry.

I am here for you both! I want to help you uncover the root of the problem, rekindle your relationship, and equipped you with the right tools for future success. most likely, the issues are learned behaviors. The beauty of working with learned behaviors is that we can learn how to SHOW UP in our relationships with ourselves and our partner in a much healthier and powerful way.

4 Ways Couples Therapy Is Different with Me:

1. I get to the CORE of the issue.

Too often, couples therapists begin couples work without adequately assessing for each person’s background and the couple’s joint history related to the presenting problems. 

This is where the Gottman Assessment really helps me to conceptualize the problem to formulate a game plan from the get-go!

If you only go to therapy and talk about the problems you're having RIGHT NOW, it's like putting a band aid on a wound when the actual problem is internal bleeding. If you want to work through your problems more effectively, we’ll get to the root cause of the issues you’re experiencing based on each of your needs. 

When we work together, I will begin by asking you to tell me more about:

• your individual narratives

• your family dynamics and how you saw your parents argue (or not)

• your communication styles when fighting

• how your relationship started

• the current state of your relationship and how you got here

• what your ideal relationship looks like (among other questions)

I hear it time and time again from clients about how the assessment procedure was beneficial to them, how it helped everything click for them to finally start seeing a difference in their relationship. 

I also understand that talking about your history might make you feel vulnerable and taking this step requires bravery, but I assure you it's worth it..

2. I equip you with the tools and know-how to achieve long-term relationship success..

Oftentimes, clients come to me and say that couples therapy has failed them in the past because it didn't provide concrete tools for long term success and accountability. While addressing particular issues or complaints can be beneficial, without the necessary communication and listening abilities to interact with one another empathically – and listen compassionately - any discussions we have about your challenges will be ineffective.

So, we start working on specific skills. Such as:

• How to initiate a conversation in a softened way

• How to repair or de-escalate heated conversations

• How to emotionally self-regulate when you feel triggered

• How to come into dialogue in a productive way

• How to compromise based on feelings and needs

Couples are surprised at how quickly they’re able to talk with each other in a calm, compassionate, and respectful manner.

Once you and your partner have worked through some tension and built up resentment in an emotionally safe way, you will be able to understand each other on a much deeper level. Trust builds when we learn how to implement compassionate communication (NVC).

“Well,” you may ask, “Isn't it rather simple? Why haven't we been able to solve this on our own"? "Please understand, this isn't your fault".

When you've been stuck in this vicious cycle and these patterns are ingrained, you may tend to keep creating these predictable bad habits of how you deal with conflict. You start to make assumptions about your partner, your armor goes up and you go into self-protection and defensiveness mode. It becomes less and less easy to give each other the benefit of the doubt that is necessary to sustain a long-term compassionate relationship.

My goal is to help you rediscover that grace, that softness. And ultimately, to help you hit the rest button to INTENTIONALLY create the relationship that you desire and rediscover yourselves too.

3. I help you recognize and understand the role comorbidity (anxiety, depression, ADHD, trauma, addiction, etc) may play in your relationship. 

Basically, comorbidity means your brain is wired a little differently.

And honestly, the more I learn about comorbidity, the more I see just how common it is. Yet so often, it is either not acknowledged, or is seen as something that is wrong – something to blame. 

Even if you don’t have comorbidity in your relationship, this approach is still highly applicable. The basis of comorbidity couples counseling is to help each partner understand, accept, and embrace their differences while working together as a team to overcome obstacles together without blame. 

Comorbidity or not, in working with me your way of seeing the world will be acknowledged, not criticized. 

For many couples I see, discovering comorbidity may be a freeing discovery. It allows them to reframe their relationship, and everything begins to make sense. 

With my trainings in both the Gottman Method, Compassionate Communication, and Comorbidity Couples Counseling, I’m able to provide an organized framework for you to work within, while still flexibly tailoring my approach to your specific relationship needs. 

4. We don’t have to stop at the 50 minute mark. I offer add-on time to customize sessions to meet your needs

You can choose to do 90- 150 minute sessions (or more), not just 50-minute sessions. 

If you've been to couples counseling before, then you know the drill. You describe the problem, communicate your feelings, make steps in the right direction… but just when you really start to dig into it, and peel back the layers~ time's up. You have so much left to say. And by next week’s session, you’ve lost your train of thought, and there are new and more pressing issues to address. 

By offering longer sessions, I’m able to devote the time needed for you to see real progress each week.

We're able to take on large-ticket items and actually reach a resolution that you may put into practice immediately.

What Makes You Feel Loved In Your Relationship?

Love Languages

Do you know what makes you feel loved in a relationship? Many times, we may think we know what makes us feel loved yet when we ask for things out of our partner, our needs are still not being met. This could be because what you think is your love language, may not actually be what makes you feel loved. Knowing your love language and your partner's love language is important in a relationship. When you both know what makes the other person feel truly loved, then both of you can actively participate in those forms of love for one another. More times than not, the way one person is showing their love towards you is the exact way that they are wanting to be loved by you.

There are 5 main love languages: words of affirmation, acts of service, receiving gifts, quality time, and physical touch. Knowing what your partner needs to feel loved by you and taking the initiative to actively provide that for them can strengthen and deepen the connection between the two of you. I like to have my couples that I work with take a short quiz to discover how each language of love ranks for them individually. I ask them to take this quiz separately and to be completely honest with themselves while taking it. Once they both have done this, I ask them to bring their results into our session so we can go over the results.

The reason I like to go over the results with the couples is because each love language can look different to every person. For example, the love language "quality time" can look very different for each partner. So, if one person scores high in this area, then it is a good idea to define what quality time looks like for the person who scored high. This way there is no confusion and a mutual understanding moving forward. If this is something you may be interested in, either individually or as a couple, then I recommend taking this quiz https://5lovelanguages.com/quizzes/love-language. The results may surprise you!

Author: Crystin Nichols, MFTI

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.

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 co-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: —> ❤️

Clear Communication!

You are not allowed to complain about not getting something that you never asked for.

Read that again^.

Do you find yourself getting upset at your partner for things you never communicated to them?

Take this scenario for example: you get home and make your partner a delicious dinner. You put so much time and thought into it—they’re bound to help you with the dishes, right? But they don’t do the dishes, and now you’re upset with them. They notice and ask you what’s wrong, but you respond with a sour, “Nothing.” They should know that you expected them to clean up after dinner.

Is this starting to sound a bit “off”? Your partner can’t read your mind.

You must ask for what you want in order to receive it.

There’s many ways to ask for what you want, and some work better than others. Learn more about putting your feelings into words without contempt or criticism. Book an appointment to deepen your connection, build trust and commitment, and communicate more openly with tools and exercises designed to bring you and your partner closer together.

The next time you get angry about your partner not doing something, ask yourself, “Did I verbally ask them to do this?”

Communicating your needs with your partner can clear up misunderstandings and help avoid hurt feelings.

You’ve probably done this before.

You come home from a long day at work, and nothing sounds better to you than a nice back scratch. You snuggle up to your partner so that their hands are placed perfectly on your back. You roll your shoulders in a motion that universally signals, “scratch my back.” But they don’t get the hint.

Slightly frustrated, but not yet defeated, you position yourself behind them and start scratching their back. As soon as you’re finished, they turn to you and say, “Gee, thanks, honey. That was sure sweet of you.”

And then, nothing. They don’t return the favor.

Wait. What?

You feel hurt and resentful. They broke the #1 rule every logical person should know! If someone scratches your back, you must scratch theirs!

Back scratching isn’t the only area where you see this kind of nonverbal agreement that one would think shouldn’t have to be spoken and everyone should just know.

For example:

• If you buy your partner flowers and chocolate, they’ll want to have sex with you, right?

• If you spend the evening making a delicious dinner for your partner, they’re bound to help you with the dishes, right?

Is this starting to sound a bit ridiculous? Your spouse can’t read your mind.

You have to ask for what you need

Why is it so hard to ask for what you want? Like, with spoken and specific words—not just unspoken signals or secret codes?

One evening, I was babysitting my sister’s adorable two-year-old girl. It was time for her to go to bed, and I was helping her to put on her jammies.

“I want the purple ones.”

“No problem! Purple jammies it is!”

“Read stories.”

“Alright, let’s read a book!”

After we read of few of her favorites, which she had no hesitation pointing out to me, I placed her in her crib to go to sleep. She immediately grabbed my arm and said, “Ang-uh-winn sing song?” in her adorable voice.

As I started singing her a lullaby, she said, “Scratch my back?” I started scratching her back while singing her a song, and it wasn’t too long before she fell asleep.

That little girl, at two years old, let me know exactly what she wanted from me in order to go to sleep peacefully. She set me up for success by expressing her needs in a clear and positive way so that I could fulfill them.

But what happens when we get older?

Sadly, the older my niece gets, people won’t be so kind or willing when she asks them what she wants. She might ask someone to scratch her back and they’ll tell her, “No.”

In fact, people might start telling her that asking for what she wants is selfish or rude. There may come a time when she thinks to herself, “It’s best if I just keep quiet.”

There was a time in your life when this happened to you, too. You asked for something you wanted and got rejected. You learned how bad it can hurt when someone willfully dismisses your request, especially if it’s important to you. You learned that it can be scary to ask for what you want, and that makes you vulnerable to let someone in on your hopes and desires.

No wonder it’s hard to ask for what you want! The second a request leaves your mouth, it’s up to the other person to decide whether or not to grant that request. It’s out of your control. And who likes to feel out of control?

Instead, you keep your mouth shut. If your partner doesn’t pick up on your subtle clues, at least you don’t have to admit that it was something you wanted in the first place. Instead, you’re just secretly angry at them while they wonder what they did wrong.  

Though it softens the blow of the rejection when you don’t speak up about what you need, it also doesn’t leave you any less resentful over not getting what you want. Plus, it practically guarantees that you WON’T get what you want.

What would be a better alternative to secret cues, signals, and non-verbal agreements that leave us disappointed and set our partners up for failure?

Simple. Learn to ask for what you want!

Use your words, and use them well

Nate and I have a motto in our marriage that came from Terry Real’s book, “The New Rules of Marriage.”

“You have no right to complain about not getting what you never asked for.”

You are not allowed to complain about not getting something that you never asked for.  The next time you get angry about your partner not doing something, I want you to ask yourself, “Did I verbally ask them to do this?”

Now, there are many ways to ask for something that you want, and let’s just say that some ways work better than others. Let’s use an example such as doing the dishes by yourself while your partner watches TV.

“I’m always cooking your dinner and you never help me with the dishes. You always just sit there in front of the TV while I do it? Why don’t you help me for a change?”

Woof. Using words like “always” or “never” is a surefire way of putting your spouse on the defense. This example of asking isn’t really asking at all. It’s criticizing your partner, and heavily so. This puts all the attention on how they’re the bad guy, instead of choosing to be vulnerable and respectfully expressing what you really want.

I can see this turning into a never-ending argument of, “Oh yeah? Well, you always do this, and you never do that,” going back and forth until the dishes get moldy and you forget about them entirely.

“Maybe, you know, you could help me with the dishes, if you want.”

Or, “If you have time, if it’s convenient for you, maybe you could try and help me with the dishes?”

Or even more classic, “Do you want to help me with the dishes, or would you rather just watch TV?”

These are all different ways of saying the same thing. In this situation, you are not expressing what you want. Instead, you are implying with your request that it is actually your partner who wants it, that it’s actually their idea. It takes the pressure off of you, and it puts the blame on them for not fulfilling a promise they never made.

This reminds me of a time we were helping with a social gathering at a neighbor’s house. Nate was in charge of putting out the snacks. He had left them in their original plastic container and just set them on the table.

The host of the party came to the snack table, turned to Nate, and in that passive-aggressive sing-song voice we all know said, “Do you want to put these treats on a separate platter?”

Nate replied, “No, I think they are fine in the plastic.”

She looked at him like he had just slapped her in the face.  He quickly realized his error and said, “I mean, yeah, of course, I want to put them on a separate platter. There’s nothing more in this world that I want than to have these treats on a platter!”

It was awkward.

The answer to the question she asked him was, indeed, “No.”

No, he didn’t want to put them on a separate platter. He didn’t see the need to do so.

But, that wasn’t the question she was really asking, was it?

Can you see how it would have been so much easier if she had just said, “Hey, I’d love it if you put these on a separate platter so that it looks nicer for the guests.” Nate would have known exactly what she wanted and would have happily fulfilled her request.

“Can you please help me with the dishes?”

This example is better than the first two, and it’s a good place to start. Saying “please” is wonderful, respectful, and it makes it much easier for your spouse to want to help.

However, the request falls a little, well, flat. It doesn’t get across how much it would mean to you to receive that help you are asking for.

I can see getting a response like, “Sure honey, just let me finish this game first” or “How about we just do them in the morning?”

There’s still too much room for failure with this example. You’ll need to communicate why you need the help, or how it’s important to you to receive help from your partner.

“Honey, I’d love some help with the dishes. I worked hard on making dinner tonight and I’d appreciate it if you helped clean up. Can we do the dishes together? It would really make me feel loved.”

This hits the nail on the head. First, you make your desire known—you’d really love some help with the dishes.

Second, you tell them why you’d like to help with the dishes, because you worked really hard on dinner!

You give your partner clear expectations on when you’d like it done right now.

And lastly, you tell them what it would do for you if they granted your request. It would help you feel loved.

How to set your partner (and you) up for success

Can you see why this would make it much easier for your spouse to say yes to your request? You’re giving them everything they need to give you what you need. You’re setting them up for success!

Mastering the skill of asking for what you want effectively, efficiently, and respectfully is one of the greatest gifts you can give to your partner.

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.

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.

Non-Violent Communication Videos

Marshall Rosenberg, PhD has been effectively mediating conflicts throughout the world for more than 40 years. His method, Nonviolent Communication, has broug...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...

This is the video The Basics of Non Violent Communication with Marshall Rosenberg (founder of Nonviolent Communication). Nonviolent Communication is not abo...