Ashley Bono

Written by Ashley A. Bono, LPC, LMFT

  In the course of my clinical career as a therapist, I’ve seen many people present with different mental health diagnosis. By far one of the most perplexing mental health problems that I have worked with is self harm. Since I work mainly with children and adolescents, the problem of self harm is one that I come across on occasion. Each time a case of self harm presents itself, the following questions tend to come up: How did this happen? What made my child decide to hurt themselves? How do I respond to my child wanting to injure themselves? How do I get them to stop? While there is no clear cut answer to these questions, many professionals have undertaken the tremendous task of researching possible reasons behind the self harming behaviors. Listed below are some of the reasons that researchers have so far uncovered when it comes to self injury.

1. Low Emotional Affect. Whenever I ask young people why they tend to cut or try any form of self injury, the most common answer that I get is that they want to feel something. Many individuals who self injure tend to feel numb, or feel like their emotions are not working very well. Self harm tends to kick start an emotional response by putting the individual’s primary focus on the pain that the injury has (Hooley, J.M., & Franklin, J. C., 2018).

1. An increased desire to punish self. Many individuals who have self harming behaviors primarily do so with the idea to punish themselves for a perceived slight or wrong (Hooley, J.M., & Franklin, J. C., 2018). This is especially true in cases where the individual has undergone extensive trauma (Hooley, J.M., & Franklin, J. C., 2018).

1. Increased attention from others. While some individuals self injure to punish themselves, other do so in order to gain attention from loved ones or peers (Hooley, J.M., & Franklin, J. C., 2018). Because of the serious nature of self injury, the individual may get extra attention from people that they usually don’t get attention from due to the fact that they are deliberately putting themselves in a potentially dangerous situation (Hooley, J.M., & Franklin, J. C., 2018).

1. A desire to fit in. Believe it or not, individuals that self injure can be heavily influenced by peers that tend to self injure. Individuals who self injure often have a hard time making healthy connections with others, which drives them to be attracted to those who tend to show the same negative behaviors (Hooley, J.M., & Franklin, J. C., 2018).

While the possible reasons for self injury may vary there is one question that has yet to really be fully answered: How do we treat self injurious behavior? Some researchers agree that it is important to treat the self injury at its very source: an unbalanced mindset (Hooley, J. M., & St. Germain, S. A. (2014). Many individuals who self injure have a low self esteem to begin with, so it is essential to help the individual see the value that they possess as human beings in order to effectively treat the self injurious behaviors (Hooley, J. M., & St. Germain, S. A. (2014). It is also important to help the individual find healthy ways to cope with pain and activate a positive emotional response besides going for razor blade (Hooley, J. M., & St. Germain, S. A. (2014).

If you’re the parent of a child or teenager who has self injured or is currently self-injuring, you may be wondering what my role as a parent in all this is. First and foremost self injury is a sign of deep emotional pain. It does not necessarily mean that you’ve been a terrible parent or have not been there for your kids. In fact, there are times when kids tend to cut as a result of not getting too much support at school or in other environmental areas. This problem, however, requires extra vigilance on your part as a parent. If you’re dealing with a child or adolescent that is currently self harming, here are some tips to help you navigate this problem:

1. Don’t panic or punish your child for self-injury. As we said before, many individuals how self injure tend to do so to feel something other than a flat affect or numbness. Yelling at your child or panicking because they are self injuring often causes a child to retreat further in to themselves to the point where they may not want to disclose anything to you.

1. Don’t be afraid to have hard conversations with your kids about their self injury. There are instances when cutting can be a sign that your child or teen wants help. It is important to listen to what they are saying through their behavior, and also be willing to talk to them about what is really going on. Be mindful of their reactions as well as understand that your child may disclose something about you that you may not want to hear. However, if you let your child know that you will do your part as a parent to help change the situation, your child may end up being willing to open up to you more.

1. Be sure to put everything that your child could use to injure themselves out of their reach. If your child is self injuring it is important to ensure their safety first and foremost. This may mean that you have to do weekly room checks or check to see if any new injuries are coming up on them physically. This may also mean that you have to put away things that you use on a daily basis (i.e. knifes, razor blades, curling irons, etc.).

1. Work with your child to put together a plan of action for when they feel like cutting. Many children or teens don’t know how to effectively cope with painful feelings so they resort to cutting or other maladaptive behaviors. Having a coping plan of action helps build up the necessary skills that children need in order to adapt fully and in a healthy way to a difficult situation. This may mean, mom and dad, that you as a family have to get creative with coming up with skills that your child can practice. It also may be helpful to put together a list of skills and strategies up in your child’s room in order to help them remember what skills they agreed to.

While self injury may be a difficult problem to navigate, it is still possible to walk through it and come out the other side a little bit wiser. The key to navigating this problem is being willing to help your child or your family member who self injures find a way to express their emotions as well as allows them to feel their emotions in a healthy and genuine way.

As a therapist we hear lots of different things throughout our day. We don’t always hear “the best” of things in peoples lives. One thing that has always struck me though is when people will say “I don’t want people to think I’m crazy” or “I feel so bad being in counseling.” These statements strike me because here we are in the year of 2020 and mental health has made small steps forward in breaking the old thought pattern that “only crazy people go to counseling” or that “there has to be something very wrong with me to be in counseling.”

Counseling is not a sign of weakness, in fact, going to counseling and talking with an unbiased person is very healthy and a beneficial activity one can engage in. Yes, many times people enter into counseling for symptoms related to depression or anxiety, but also, individuals will seek out counseling to help with other aspects of their lives.

Learning to express your emotions and feelings in a healthy way has significant benefits for an individual. Individuals are not always taught healthy ways to express and deal with their emotions. Males, in particular, are not always taught that emotions and feelings are natural, many times they are taught to not to have emotions or feelings, or that the only ‘manly’ emotions to have is anger. Male clients can learn to express their emotions and feelings in a healthy manner. When an individual learns how to effectively express and manage their emotions individuals can feel build lasting relationships with others, it helps to reduce tension in the body, and improves your physical and mental health.

Individuals can also benefit from in counseling to gain an outsider’s perspective on issues. Sometimes we turn to friends or loved ones for guidance and opinions on what to do with problems that we are facing. While the intent from those individuals is good, sometimes a perspective from an unbiased individual provides a deeper understanding of the problem, we can gain a different perspective of how to resolve the problem, and one can gain a deeper understanding of repeated thinking errors that one engages in that can lead to repeated unhealthy behaviors.

Individuals can also gain coping skills for emotions or feelings that they struggle with. When an individual learns how to effectively manage their emotions and feelings, in particular, negative emotions and feelings like depression and anxiety on their own, individuals can gain a sense of confidence in themselves that can spill into other areas of one’s life. When someone learns how to effectively manage their emotions in a healthy way, they become more present in their life. They are able to laugh and enjoy time with their loved ones. They can be present at work and more productive.

Many times, couples come to counseling because of a problem that they can’t fix, but counseling can also be an effective tool before problems arise. Couples can learn how to communicate in a health manner, leading to a healthier and more fulfilled relationship. Couples can gain skills that allows each individual to communicate their needs, learn how to get their needs met, and in turn lead to a healthier more fulfilled relationship. Couples can also gain skills to argue in an effective way. Arguing is a natural event in relationships but learning to argue in a way that promotes growth is a skill that couples can obtain through counseling.

Counseling is an effective way to improve you as an individual or an effective activity couples can engage in to make their relationship stronger and more rewarding. Learning to think of counseling as activity to improve your overall health is an effective way of breaking the negative stigma counseling has. Counseling and therapy is no longer for individuals with something “wrong” but an activity that helps promote a healthy lifestyle just like going to the gym or going to the doctor for a yearly checkup.

Here is an easy and healthy organic recipe for soup in just 8 easy steps!

Ingredients:

· 8 cups of chopped fresh tomatoes

· 2 cups of chopped organic carrots

· 4 cloves of organic garlic

· ½ cup of chopped fresh basil

· 4 tbsp of organic olive oil

· 4 cups of organic chicken or vegetable stock

· ½ cup of heavy cream

· 1 tbsp of salt or more for taste

· Pepper to taste (optional)

· Fresh grated parmesan cheese for topping (optional)

Directions:

1. You first preheat the oven to 350 degrees.

2. in large mixing you, combine the tomatoes, carrots, garlic, and olive oil. Combine everything well so that all the ingredients are coated with olive oil.

3.Then spread onto a baking sheet so that all the ingredients are even spread out.

4. Roast the mixture for about an hour. At the 30 minute mark stir the mixture.

5. Once finished transfer the mixture into a blender and blend until the mixture is creamy.

6. In a large pot combine your blended mixture, stock, cream and salt and bring it to a boil.

7. Remove from heat and add your chopped basil. You can add additional salt and pepper to your liking.

8. Lastly serve and top it with fresh grated Parmesan cheese!

Written by Jason Watson, M. Ed., LPC, NCC, CCMHC – Therapist – San Antonio location

All humans crave order and calm in their lives and right now it is hard to find that space of calmness. Right now, so many things feel out of our control, but we can find areas of calmness and create a sense of control for ourselves.

Organize. Now that we are all being asked to stay home, now would be a great time to tackle some of those areas of the home that we keep putting off. Many times, organizing our lives physically can help calm some of the mental chaos. Organizing the closet that we keep putting off because ‘we just don’t have the time’, going through out stuff and clearing out that old stuff that we don’t need anymore, getting rid of clothes that we no longer wear or, sadly, outgrown is a good way of creating organization physically.

Mindfulness practice. Maybe you have always wanted to start a mindfulness practice but due to the daily demands we found ourselves saying “I don’t have time.” Learning to sit quietly with yourself for a few minutes a day and breathing can bring a sense of calmness. If you are like me and struggle with mindfulness there are some great FREE apps that can help. Insight Timer, Calm, or Headspace are some great apps for beginning of mindfulness practices. If you are home with your family, setting up a family mindfulness practice together is another great way to help calm some of the chaos.

Checking in socially. In the current time of advanced technology, we can check in with family and friends without being there in person. Using apps such as FaceTime, Skype, or Zoom are great ways to stay in touch with people and actually see them. Getting to actually see people while we aren’t supposed to be socially gathering is a great way to stay in touch with people and socialize with individuals and calming some of those worries that we have going through our heads at the moment.

Keeping a schedule. Right now, most people are finding themselves quarantined at home and having a lot of ‘time’ on their hands. Attempting to find and keep a schedule going will help when life returns to normal. Getting up at the same time every day, eating on a schedule, showering and going to be bed on a schedule helps to keep a sense a calmness when everything feels different.

Therapy. Even while we have to social distance ourselves, you can still reach out and get help mentally from your therapist. Counseling can be done online and is a great alternative to face-to-face counseling. Online counseling can be just as effective as face-to-face counseling. Remember, reaching out for help is not a sign of weakness but great strength to help manage the mental chaos that people can be experiencing during high stressful times that we are all experiencing during this time.

The biggest thing to help with the chaos right now is remembering you are not alone during this time of difference.

Is the Cabin Fever setting in? Here are some basic tips to help you move through this time with your beloved:

Check in with your partner: How are you feeling? What have I done in the past week that has been helpful? What have I done that was unhelpful? Do you need more or less of something from me in the following days? Reflectively listen and validate. Afterwards, if you’re the listening partner talk about what you can and can’t do – try to meet your partners needs as much as you can and stop when you know what you will give will breed resentment (or in other words know you’re giving too much). This requires checking in with yourself :).

Balance togetherness and separateness – COVID 19 or not, this is something that is important to a relationship, every relationship will have a different ratio of individual “me time” and “us time” at different times dependent on internal and external factors including stress levels, shifting psychological needs, life curveballs etc. Learning to create moments of space in a relationship can help make together time even more special and cherished. It also serves as a sense of independence and remember that there are parts of yourself that don’t involve your intimate partner.

Reach out beyond your couple bubble – Speaking of separateness – go on virtual friend dates, virtual family catch up, etc.

Express appreciation – In my clinical experience, this is the most underrated behavior that can make a huge impact. Catch your partner doing something good, no matter how big or small! For some, it is a vulnerable thing to express positive feelings. If that is the case, you can start with sticky notes, texts, personal IG story, write something on a whiteboard (if you have one), and work your way up to in-person comments.

Keep the communication as emotionally safe as possible- John Gottman, world’s leading couples researcher found there are 4 ways to escalate conflict and bring up our defenses: criticism, defensiveness, contempt, and stonewalling. Learn how to change a criticism into language that includes your needs and feelings. Give your partner’s behavior the benefit of the doubt and avoid judgment of character. Practice empathy – connecting to the emotion behind a behavior/experience instead of the trying to connect to experience. Remember you often have to give to get when it comes to compromising on our needs. Some will be core and non-negotiable while most of our needs are flexible and can be negotiated.

Get intimate! – Haven’t had the time to have sex as a priority? With the extra time one may have, it could be a great way to reaquaint yourself with you and your partner’s sex life. It’s also a great stress reliever as it combines bonding with your partner with exercise, two known stress relievers. Talk about preferences and new things you may want to try. Pleasure mapping is a way to improve your sex life via experiential learning. How do you do it?

1. Do some things to “get you in the mood” – things you already do with your partner to signal it is “sexy time” ex. Massage
2. Try exploring different techniques on your partner’s body in efforts to create pleasure, you might gather ideas from a movie you’ve seen, books you’ve read on sex, or the internet. Examples: gentle bite on the neck, a caress on a certain area of the body, etc
3. Your partner rates the pleasure on a 1-10 scale, this a no-shame zone, remember lower numbers don’t reflect your ability as a lover it just means it the rating of technique efficacy on your partner’s mind and body
4. Switch partners

You’ve got your pleasure map of your partner you can use in future sexual encounters!

Build the “friendship” part of your relationship – here are activities you can do to bond and build your friendship (even if it’s strong already):

Love Maps (using the free Gottman card decks app – https://www.gottman.com/couples/apps/)

Accept and Make Bids for Connection (which is fancy way of saying – recognize and say yes to your partner’s requests for bonding, humor, and attention as much as you can and communicate your own) Some ideas:

• Create a list of things you haven’t done together and want to do when COVID 19 is over
• Watch a movie together
• Get your favorite take out together and make an at home date night
• Take a virtual work out class together
• Read a book in the same room
• If your partner shares a funny meme/video, take a moment to look at it
• Watch your favorite show’s bloopers on Youtube, or type in bloopers into Youtube and have a laugh at all the videos
• Take a walk outside together (with the pups if you have them)

Reach out to a therapist if nothing else!

There is a wealth of knowledge on the Gottman Blog: https://www.gottman.com/blog/

Search for Gottman Institute on Instagram too – they’ve got some great daily content!

The Gottmans also have a podcast they recently started consisting of 5 min episodes for couples to listen to on tips to help improve their relationship. It’s called “Small Things Often”.

Take Care everyone!

Written by: Elizabeth Weber, LPC, LMFT – Therapist – San Marcos location

 

References:

Pleasure Mapping: An Easy and Effective Way to Create Amazing Sex

The Gottman Institute https://www.gottman.com

HELP!!!  The kids are home all day, our normal routine is nonexistent, we can’t go out, and I am now in charge of homeschooling my kids!!!!  Parents if you are feeling stressed out with all the new changes to “normal,” pause for a minute, take a deep breath, and know we are all in this together.  Remember, our children are looking to the adults around them to keep calm and try to embrace the time we have together as a family.  When we are on the other side of this pandemic, we will be back to “normal” with social commitments, playdates, extracurricular/sports activities, school, church, volunteering, and all the things in life that keep us Busy!!!    Here are some fun/creative activities you can do as a family, while we have this time to focus on our family.

1. Family Art Show

 Have each member of the family create a piece of art (that means Mom/Dad too).  This could be done with crayons, paint, playdough, legos,  instrument, etc.  After dinner, have each artist set up their art in different parts of the house, and as a family walk around and see everyone’s artistic creation.

2. Family Movie/ Game Night

As a family decide on a board game or movie and set up to have some fun!  If you choose a movie, pop some popcorn or get your favorite snack to watch the movie.  If it is a board game night, have a special incentive for the winner of the game, such as, extra video time or extended bedtime.

3. Family Spa Night

The family decides on a room in the house to transform into a spa….turn the lights down, play relaxing music, bring in scented candles or regular candles, have everyone in the family get into pj’s or comfy clothing.  Now the Spa is created!!!!  Have each member of the family give a hand/foot/neck massage to another family member (for younger kids set a timer for a few minutes  for older kids set a timer for 10 minutes) For the ladies in the family, perhaps give each other a mani/pedi.  Have fun and spend a few minutes as a family and relax!!!!!

4. Family Exercise Night

As a family come up with a plan to get out and off the cough and exercise.  This could be simple like taking a walk around the neighborhood, riding your bike/scooter, playing in the backyard together, (like tag, blowing bubbles in the backyard, practicing catching/throwing a ball, etc.)

5. Family Dinner Night

As a family, decide on a dinner that everyone enjoys and have each family member participate in some part of preparing the meal (of course supervised by Mom/Dad).  Some younger family members could mix/stir or bring ingredients to be prepared and older family members could learn to cook on the stove.  If the weather is nice, set up a family picnic outside to enjoy the meal and have a change of scenery.

Written by: Lynda Vlattas, LPC, LMFT,  – Therapist – San Antonio location