Feeling Distressed Or Anxious? Techniques That Help You Feel Grounded

Certain thoughts and feelings can feel extremely overwhelming to us when we experience them and if we don’t learn to identify and manage them effectively, we give them the power to be debilitating.    Strong emotions, memories, or physical sensations tend to be associated with stress, anxiety, and abuse or violence and can result in flashbacks, nightmares, panic attacks, depersonalization, and derealization, which can be unsettling and frightening. 

Although we don’t always have control over aspects or triggers that cause us to experience stress or anxiety, we do have the ability to control our thoughts so that our feelings and behaviors are directly impacted.  It can take time to learn to reframe our core beliefs about who we are and how we think about the world we live in however there are some basic exercises we can implement in moments of stress and anxiety that can promote a sense of reality that often brings relief and comfort.   

These exercises are referred to as grounding techniques, as the purpose of them is to re-establish ourselves in the present moment when we find ourselves reliving a painful memory, worrying about the future, feeling panicked, or simply feeling stressed.  Research has shown a strong connection between our emotional, cognitive, and physical selves therefore changing one of these aspects of ourselves can influence the other parts.  

Here are some grounding techniques that have been found to be effective during moments of distress, stress, or anxiety:

1.     Orient yourself by identifying the current time of day, month, and year as well as your current location.

2.     Remind yourself about who you are (name, birthdate (age), occupation, close family members)

3.     Focus solely on your breathing by taking 4-5 deep breaths

4.     Use your five senses to identify what you are currently experiencing:

·      Sight: Name 1-3 objects you can see.

·      Sound: Focus on the sounds you hear.

·      Taste:  Do you notice any specific tastes in your mouth?

·      Touch: Feel something within your reach and identify the texture.

·      Smell: Pay attention to any odors you pick up on.

5.     Use your five senses to promote soothing and a sense of comfort:

·      Sight: Visualize a place or picture that is calming/comforting.

·      Sound: Listen to your favorite song or play music that is relaxing.

·      Taste: Eat or drink healthy food/drink options that have a calming

       effect.

·      Touch: Feel fabric or material that is soothing. 

·      Smell: Use essential oils or others scents that promote relaxation.

These techniques may seem pretty basic but the effect they can have on someone who is feeling out of control can be very powerful.  I always encourage my clients to practice these techniques during moments when they are not in distress for practice but also to have them experience how powerful being mindful can be. 

~ Cory Stege, M.S., LMFT

How To Get Your Needs Met By Focusing On Your Partner's Needs

It can be a common experience for couples to think and feel ‘‘my needs aren’t being met so why would I go out of my way to meet my partner’s needs?” This thought process highlights one of the major challenges of relationships: managing the needs of both partners to promote mutual satisfaction.   We tend to seek out and engage in relationships in order to fulfill specific needs we have, which tend to be made up of emotional, physical, spiritual, and social aspects of our lives.  When we find our relationships to be rewarding, it is generally because we are benefitting from them in some way, which tends to mean that one or more needs we have are being met. 

Along the same lines, we start to question our relationships when we feel less satisfied as a result of our needs not being met.  When this happens, we tend to express more complaints and place more demands on our partners, which often promotes emotional and physical disconnection and therefore creates the opposite effect of what we are seeking in our relationships.   It can often turn into the mindset of “which came first, the chicken or the egg” in which we think, “I would be willing to put in effort to meet my partner’s needs if they meet my needs first.”  This type of thinking can put barriers between partners rather than motivate partners to accommodate one another.

When we feel understood and cared for by those we are close with we tend to be more open to reciprocating that same process to others, even if it means that we may have to go outside of our comfort zones to do so.  So try applying this line of thinking to your relationship: whenever you are feeling like your needs are not being met by your partner, instead of nagging or making demands for your partner to do more of what you want, consider that your partner may be feeling similar.  Then challenge yourself to identify one or two specific needs that are important to your partner and make an effort to meet them.  For example, if quality time is important to your partner, arrange your schedule to spend uninterrupted one-on-one time together.  This action will send the message to your partner that you care about them because you understand what they need from you.  And like I previously stated, your partner will likely reciprocate by focusing on meeting your needs as a result of feeling understood and cared for by you. 

So the next time you are feeling unhappy, frustrated, or even resentful of your partner because your needs are not being met, consider refraining from acting on any urges to complain about it to them and instead make a genuine grand gesture by directing your attention and effort to meeting one of your partner’s needs.  Not only will you feel positive about doing something thoughtful for your partner, but you will also create opportunities for your partner to focus on how they can meet your needs.

~ Cory Stege, M.S., LMFT

Can't Make Up Your Mind? What To Consider When Feeling Ambivalent

Do you ever find yourself feeling stuck because you know you should change something in your life but you’re not quite sure you should take action? Have you ever considered ending a relationship, quitting a job, or making a lifestyle change but question whether that would be the right choice? Throughout our lives we are faced with situations that motivate us to consider making changes with the hopes of improvement.  However many of us experience some form of worry or fear about the unknown that change can bring, which prevents us from moving away from what we know, even if it is a negative situation.  This experience describes ambivalence, which can be defined as a state of mixed or conflicting thoughts and feelings about a situation, person, or thing. 

Ambivalence is associated with the change process and generally exists within the second stage of change, the contemplation stage.   During this stage, we have recognized that something is a problem for us and that we need to make a change however we are concerned about the potential implications of following through with it.  Usually we find ourselves going back and forth between our desire to make a change and our fear of changing.  We can find ourselves “catastrophizing” or thinking in a worst-case scenario mindset when we allow our fears to take over.  What if we end up regretting our decision to change because we either feel like a failure, it causes problems with others, or the situation does not improve? These are common fears that pop up for us when we are ambivalent. 

We can feel stuck in our ambivalence for long periods of time because time is usually required to achieve some form of resolution.  However there are some questions we can ask ourselves to help us clarify our willingness and intentions of making a change:

• What do you want to have happen and what potential benefits do you hope to achieve by making a change?
• Can you identify any potential constraints to being able to make a change?
• How might your life be different if you make a change?
• What might your life look like in a year if you don’t make a change?
• What are the factors that are motivating you to make a change?
• How do you feel about significant changes you have made in the past?
• What positive attributes, strengths, or traits do you have that you believe will help support you in making a change?
• On a scale of 1-10 (1 being not important and 10 being extremely important) how important is making a change to you? What would it take to make it extremely important?
• What are you willing to do to make a change?

It can be helpful to write out answers to the above questions as well as to organize your thoughts in a way that can help you compare and negotiate with yourself. I always encourage my clients to refrain from making a decision when they are feeling emotional and to instead take some time to evaluate and consider all aspects of their ambivalence before making a choice.

~ Cory Stege, M.S., LMFT

Tips For Surviving The Stress Of The Holidays

We are officially in the throes of the holiday season which is generally a time for joy, excitement, love, and occasions spent with friends and family.  The holidays have also been notorious for being a source of stress for some of us because of the pressures of gift-giving, traveling, family dynamics, time away from work, etc.  It can be easy to get caught up in all of the stress of the holiday season to the extent that it can prevent us from being able to enjoy it and focus on the true meaning of what this time of year bears.  Therefore it seems appropriate to offer some helpful tips for managing stress over this holiday season:

1.    Be aware of your triggers.  In order to be able to effectively manage our stress, we need to identify the specific events/situations that tend to promote or cause it.  It can be helpful to think about what was stressful for you during previous holiday seasons as a strategy for knowing what your triggers may be.  Once we know what our triggers are, we can plan for them by thinking about potential coping skills we can implement when we become triggered.                                                       
2.    Know your limits.  We often feel like we are stretched thin during the holiday season when we think about our time, energy, and finances.  There is a high potential for us to go overboard on planning get-togethers, buying gifts, traveling, and fulfilling traditions that can take time and energy and this can leave us feeling burned out or stressed.  In order to avoid this, we can be realistic and honest with ourselves about how much time, energy, and money we can budget for this time of year.  This means that we might have to say ‘no’ to some activities/invitations and uphold a budget for spending money on gifts and traveling so that we don’t end up regretting our decisions after the holidays end.                                                                                                                                            
3.    Engage in self-care.  The holidays are a time for us to focus on other people which can make it easy to forgo our own needs.  It may feel selfish for us to focus on ourselves during this time of year however if we don’t take care of ourselves, we likely will not do a great job of giving our full attention to those we love and care about.  Engaging in self-care activities is extremely vital to surviving the holidays which means we should aim to:

•    Maintain a consistent sleep-wake schedule so that we are getting adequate rest
•    Maintain a healthy diet
•    Engaging in regular exercise (20-minutes of walking a day can do wonders!)
•    Balance social time with alone time

4.    Find an outlet.  One of the most effective stress management tools we can develop is figuring out what activity we can engage in that allows us to release any negative thoughts, feelings, or tension that we carry around from day-to-day.  Having an outlet is a way for us to gain mental, emotional, and sometimes physical clarity.  Some examples of healthy outlets include:

•    journaling
•    painting
•    working out
•    listening to or playing music
•    playing or watching sports
•    yoga/Pilates
•    meditation
•    prayer

5.    Live in the moment.  Amidst all of the busyness of the holidays it can be easy to  get caught up in the chaos and lose sight of what is happening right in front of us.  When we worry about the future or ruminate on something that has happened in the past, it prevents us from living in the moment and instead promotes stress, anxiety, and depressive symptoms.  Therefore one strategy (which requires practice) is to be mindful about what is happening in the here-and-now and focusing on enjoying the moment.  Since the only control we have is on what is happening in the moment, that’s where our focus should be.

For most of us we have heard about these tips before and for some of us, we practice and incorporate these skills in our daily lives during the entire year.  However when the holidays roll around, it is even more crucial for us to put ourselves first by staying on top of our stress so that we experience this time of year as truly joyful, relaxing, and positive.  Happy holidays!

~ Cory Stege, M.S., LMFT

Does Emotional Intimacy Exist In Your Relationship?

Intimacy is a vital interpersonal aspect for any significant relationship and comes in many forms: physical, emotional, and social avenues. All three types of intimacy are fundamental in establishing and maintaining healthy and satisfying relationships however we are going to focus more closely on what makes up emotional intimacy and the role it plays for couples.  

So what exactly is emotional intimacy? It is the experience within a relationship in which a deep sense of connection exists through mutual closeness, loving and caring feelings, comfort, understanding, and feelings of affirmation. In order for some level of emotional intimacy to occur and subsist, the presence of a sense of mutual safety and security within the relationship must exist.  This means that partners are able to engage in openness and transparency with one another regarding personal beliefs, deep and honest feelings, fears, and dreams.  Couples who are able to be vulnerable with one another means that they have the ability to share and tolerate uncomfortable or intimidating thoughts and feelings without it threatening the integrity of the relationship.     

Emotional intimacy can be expressed through both verbal and nonverbal communication and is experienced to various degrees and intensity from relationship to relationship.   Simply engaging in regular conversation by sharing, listening, and supporting our partner can set the stage for closeness and connection.  Or engaging in a task or duty without being told can also indicate to our partner that we care about them.  

How can you measure whether emotional intimacy exists in your relationship and to what degree? Here are some helpful questions that can help you evaluate this?

•    Does my partner care about me? If so, how do I know?
•    Does my partner understand my thoughts and feelings? 
•    Do I feel affirmed by my partner? If so, how?
•    Is my partner willing to do whatever they need to in order to help me when I need it?
•    Does my partner accept me for who I am?
•    Do I feel comfortable sharing my thoughts and feelings with my partner, even if they are not always positive?

~ Cory Stege, M.S., LMFT

The Power Of Gratitude In Our Relationships

Since November is the month to give thanks, it seems appropriate to focus on the role that gratitude can play in a relationship.  It is probably safe to say that everyone likes to feel appreciated and receive positive feedback from others, especially from those people that we are close with.  However it can be easy to get caught up in the daily grind with routines and tasks that can direct our focus away from the things our partners do for us and to some extent, lead us into the habit of taking things for granted.  When the latter occurs, we can develop feelings of resentment and lack of appreciation, which can pull partners apart. 

Years of research has shown that the presence of gratitude within a relationship is a significant predictor in relationship satisfaction and has the power to help couples manage conflict more effectively than couples who do not express gratitude towards one another on a consistent basis.  In other words, the more we value our partner and feel appreciated, the more we are going to be open to seeing things from our partner’s perspective, which greatly influences the way we manage conflict.

Here are a few tips to incorporating gratitude in your relationship:

1.     Acknowledgement: Instead of pointing out the things that you do not like about your partner, shift your attention to the effort your partner engages in that you appreciate, however big or small.  This can include casually acknowledging that your partner put the toilet seat down or expressing acknowledgement for planning a surprise getaway.

2.     Say ‘thank you’: Simply stating ‘thank you’ to your partner after a gesture was made can go a long way.  This helps to reinforce to your partner what you like and appreciate about them, which will influence them to want to continue to do things for you because they know their effort is going into the right place.

3.     Give out compliments: Try to remind yourself about the traits that initially drew you to your partner and make it a point to verbalize these things to your partner.  These traits may be related to your partner’s personality, physical appearance, career, or a specific talent or ability.

4.     Focus on your partner’s love language: One of the most effective strategies we can use to express and show our partner gratitude and appreciation is through their (not your) love language.  This can include gift giving, spending quality time together, engaging in acts of service for them, providing words of affirmation, or providing physical touch to them.

5.     Public praise: Expressing gratitude and appreciation for your partner when it is just the two of you is essential however voicing your praise and compliments about your partner in front of other people will reinforce how proud you are to be with him/her. 

In addition, I always encourage my clients to challenge their criticisms of their partners by identifying at least 5 positive traits they appreciate about their partners for every 1 complaint before they air it.  This helps to promote positivity and softens couples when differences arise.  Just remember…when you are thinking about what you want, don’t forget about what you already have.

~ Cory Stege, M.S., LMFT  

Essential Daily Rituals For Couples

Early on in our intimate partner relationships, we tend to experience a “honeymoon” phase in which much of our time and attention is focused on our partner and we feel excited and optimistic about the future together. Our relationships progress over time and often involve marriage, children, and other life circumstances that unfortunately draw our attention away from our partners and instead on other priorities.  When this happens couples can morph into ‘autopilot’ regarding their interactions and experience a decrease in feelings of connection and intimacy.   When we are on autopilot we are generally following schedules and activities on a consistent and regular basis in order to manage everything, especially if children and work are involved.  

As I have reinforced in previous articles, relationship maintenance needs to be viewed in similar ways as we think about our physical and emotional health.  We take vitamins, follow a healthy diet and exercise regime, and engage in other habits in order to keep ourselves healthy.  Along those same lines, we can create daily rituals, or meaningful interactions, with our partners to keep our relationships strong and fulfilling.  When we think about what specific rituals we want to establish and engage in, there are some crucial ingredients to think about:

1.     Consistent and repeated occurrence. In order for a behavior or interaction to be considered a ritual, it has to take place more than one time and on a regular basis.

2.     Clear and mutual expectations about what to expect. Both partners need to understand and agree on when a ritual will take place, what happens during the ritual, how long it will last, and when it will end.

3.     Shared meaning. Both partners should feel that the ritual carries some form of emotional meaning to them that serves to promote emotional connection and intimacy.  

Every couple is different in terms of needs, preferences, and availability for the relationship, which will influence the type of rituals that are appropriate.  However, here are some common rituals that couples are encouraged to establish and engage in on a daily basis in order to foster connection and intimacy:

1.     Greeting/Reuniting ritual: Partners should consider how they would like to address one another after spending some time apart. This type of ritual helps to signify the transition from separateness to being together. This ritual tends to involve hugging or kissing for a brief time.

2.     Quality conversation ritual: Most of our days can be chaotic and requires our attention to be focused on tasks, which normally impacts a couple’s ability to engage in one-on-one time to talk.  Couples are encouraged to identify a time every day in which they can minimize distractions and focus on catching up and checking in with one another on a personal and emotional level.  This ritual can often be incorporated into a couple’s nighttime or bed routine and should not involve topics of conflict. 

3.     Physical intimacy ritual: Couples should discuss and negotiate when, if, and how they would like to engage in physical intimacy so that it meets each partner’s needs.  A physical intimacy ritual can help couples better understand what to expect as well as ensure that this part of the relationship is not being neglected.    

4.     Appreciation ritual: We tend to feel good when we give and receive positive feedback in our relationship.  Appreciation rituals allow couples to know how much each partner values and honors one another on a regular basis.  This ritual can involve love letters, gift giving, acts of service, or words of affirmation through text or post it notes.

5.     Spiritual ritual: For those couples who maintain some form of spirituality in their lives, creating a shared ritual that promotes reflection can foster emotional intimacy and connection.  Prayer, meditation, and visualization are examples of this type of ritual.

~ Cory Stege, M.S., LMFT

Setting SMART Goals

Goal setting is a healthy and effective tool that we can use to identify and visualize areas of life we want to develop and improve upon.  Whether we are focusing on our physical, emotional, or mental health or are thinking about our relationships or professional life, goal setting can help us focus and organize our thoughts and actions and promote hope and motivation to better ourselves and experience a more rewarding and fulfilling life. 

There are specific guidelines that we can follow in order to set realistic and attainable goals that can help set us up for success.  These guidelines are outlined in the SMART acronym, which makes it easy to remember which factors should be considered when setting goals. 

S:      Specific: Goals need to be identified in specific, not vague, terms.  In order to identify the details of the goal, answer the questions of what, where, why, when, who, and how much?  For example, what do you want to accomplish? Why do you want to accomplish this goal? What resources do you need to accomplish it? What requirements are needed to accomplish it? Are there any constraints or anticipated challenges to doing so? If so, how are these constraints going to be managed?           

M:     Measurable: In order to determine whether our goal has been met or progress has been made towards it, we need to be able to measure it.  The use of numbers, quantity or degrees of quality, completed tasks, and other units can be used to help us judge our progress.

A:      Achievable: In order to set ourselves up for success we need to think about our goals in realistic terms.  This means that we need to be mindful of our locus of control, resources, and the steps required to meet the goal.  It is important to avoid setting goals that are too high or complex that can end up making us feel like a failure.

R:     Relevant: When we think about a goal we need to answer whether it is consistent with other goals we have (both short and long term) as well as if it aligns with our overall vision of what we are working towards.  Deciding if a goal is relevant can be answered by considering if it is worthwhile, has value, and is appropriate considering the time and resources available to achieving it. 

T:      Time-bound: Effective goal setting involves regular reviews and revisions as well as a date, timeline, or schedule that we can follow to help us evaluate whether we are making progress or have achieved our goal.  Consider how long it will take to achieve the goal, when you will work on it, and what date you would like to complete it by.

~ Cory Stege, M.S., LMFT

The Benefits of Meditation and Visualization

Most of us lead busy and hectic lives that require time, attention, and effort towards work, children, relationships, and trying to squeeze in a social life and alone time. The demands that come with each of these significant areas of life can be challenging to juggle at times and can often lead to stress, anxiety, depression, insomnia, relationship problems, and health issues when we don’t manage them effectively.  Along with self-care skills, boundary setting, and other coping skills, meditation and visualization have been found to have multiple benefits on our mental and physical states and help us tackle our day-to-day lives in healthy ways.  

People often confuse meditation and visualization as the same process however they are in fact different.  Meditation is a process that aims to quiet the mind by directing it to a specific mental state that generally involves the ability to be fully present without allowing any external distractions to impede. Visualization is generally started through some form of meditation and is a process in which our minds repetitively send out commands to our physical and mental states to follow so that we end up making the messages a reality.  For example, when we focus on the belief that we are in a calm and relaxed state, we have the ability to train our bodies to believe that it is actually calm. This is very effective when we experience stress and anxiety since it helps to alter the physical sensations that are associated with it.  

When meditation and visualization are done on a consistent basis, we can train our minds and bodies to work for us instead of against us.  Here are some other benefits associated with these two practices:

•    Promotes emotional balance
•    Improves immunity fighting cells
•    Reduces blood pressure
•    Reduces insomnia
•    Promotes mental clarity
•    Strengthens mind-body connection and communication
•    Reduces somatic symptoms (headaches, stomachaches, muscle tension)
•    Improves circulation
•    Increases fertility

Like most skills, meditation and visualization takes time and practice to master however the benefits that can be reaped are extremely powerful.  Utilizing tools such as guided meditation and visualization or simple breathing exercises can be very effective to help start training our minds and bodies.  

~ Cory Stege, M.S., LMFT  

What Does A Healthy Relationship Look Like?

Every relationship is different and comes with its benefits and challenges however there are specific traits that can set healthy and functional relationships apart from unhealthy and dysfunctional relationships.  Relationships that are centered around power and control, dishonesty, blaming, poor communication, or abuse are dynamics that we should aim to avoid and instead we should strive to establish and maintain relationships that are grounded in respect and equality.  Here are some specific aspects associated with healthy relationships:

Respect: This means that partners accept one another for who they are and value one another’s thoughts, feelings, and opinions even if they are different from each other.  Respect can be exhibited through expression of appreciation for one another and does not involve demands for the other person to change who they are.

Shared power and responsibility: This means that decision-making within a relationship is mutual because each partner’s input is experienced as being equally valuable.  Partners are aware of one another’s needs and wants and maintain the position that a relationship requires ‘give and take.’ Couples who possess shared power within their relationship believe that the sum is greater than its parts, meaning that together they experience more benefit as a result of working together.

Negotiation and fairness:  When differences arise, partners are able to acknowledge each other’s viewpoints, wants, and needs and engage in a process of working together to reach mutually satisfying resolutions, which can sometimes be let’s ‘agree to disagree.’ Negotiation and fairness does not involve the belief that an argument needs to be won by one partner but rather is associated with the belief that the relationship is far more important than any single issue or disagreement.

Trust and accountability: This means that partners are able to take responsibility for their past and present behavior without blaming or providing excuses. Partners admit when they are wrong and follow through with what they say they are going to do.  Trust is established when couples feel secure in sharing intimate and private thoughts and feelings and can be vulnerable with one another.  Trust does not include jealousy or possessiveness.

Open and honest communication: Healthy communication occurs when partners are able to express their true thoughts and feelings in a non-threatening way even if their partner may disagree.  Openness and honesty mean that partners feel comfortable and safe expressing themselves with one another.

Physical and emotional intimacy: Intimacy requires vulnerability between partners and is established when partners show respect for each partner’s boundaries around privacy and preferences. 

~Cory Stege, M.S., LMFT

Stress: Understanding The Different Types

According to the Merriam-Webster’s dictionary, stress is “a state of mental tension and worry caused by problems in your life, work, relationships, etc.” Even though the word stress can be described as a state of being, stress is experienced differently from individual to individual and is often the result of a person’s perception about their ability, or lack thereof, to cope with specific triggers and situations.  In other words, stress can be thought of as negative emotional and psychological responses as a result of feeling unable to manage the demands being placed on an individual. 

However, what one person finds to be stressful may not be the case for someone else.  Even though stress is not experienced the same by all of us in the same manner, stress does tend to be experienced in some common forms: acute, episodic, and chronic.  Being able to identify the type of stress you are experiencing can be helpful in knowing how to best manage it. 

Acute stress:  This is the most common type of stress and is not necessarily associated with negative triggers.  Acute stress is short in duration and can often be intense.  At times, acute stress can be beneficial to us when it motivates us to take action on something.  However, when acute stress persists, it generally promotes short-term anger, irritability, depression, and anxiety.  An example of acute stress is preparing for a job interview or a work presentation.  Once the event is over, the stress associated usually subsides.

Episodic Acute Stress: This type of stress is associated with individuals who experience acute stress often and regularly.  This type of stress is also associated with chronic worriers and promotes irritability, short-tempers, tension, and anxiety.  Episodic acute stress is correlated with physical symptoms including headaches, stomachaches, high blood pressure, and heart disease.  Individuals who suffer from episodic acute stress tend to be Type A personalities and worry warts who are always running late and have a tendency to take on too much at one time.  Since this type of stress is often associated with a specific personality, effective management of it can be difficult and is often faced with resistance.

Chronic stress: This type of stress is the most damaging because it is experienced as long-term and never-ending.  Chronic stress is associated with situations in which people believe that there is no end in sight due to ongoing and demanding pressures that are too much to cope with.  Chronic stress can be deadly as a result of the impact it can have physically, emotionally, socially, and psychologically and is associated with severe depression, heart disease, suicide, violence, cancer, and stroke.  Chronic stress depletes an individuals resources and is can be very difficult to treat as a result of the long-term impact it carries.  

Whether you experience stress on a short-term or never-ending basis, being able to identify the triggers to it as well as engage in self-care activities are paramount to getting a handle on it.  Sleeping and eating well, engaging in physical exercise, connecting with friends and family, and participating in enjoyable and pleasurable activities can go a long way with stress management.  Professional help may be indicated, especially in the case of episodic acute and chronic stress.

~Cory Stege, M.S., LMFT

Baby Blues or Postpartum Depression?

One of the most significant life changing events a woman can experience is the birth of a child. Almost every part of a woman’s life is affected by childbirth, from physical and hormonal shifts to emotional, psychological, and identity changes…most of which happen within a very short period of time and all at once.  Childbirth comes with a bag of mixed emotions, some of which are unexpected while others show up unannounced.  Joy, excitement, fear, worry, and feeling overwhelmed are common emotions felt among new moms.  Within the first couple of days of childbirth, women often go through what is termed “baby blues”, which can be experienced through insomnia, mood swings, crying spells, irritability, lack of concentration, appetite issues, and anxiety.  “Baby blues” are typically short-term and subside within two weeks.  

However, about 3 million moms each year develop a more severe form of the “baby blues” after giving birth that mimics the symptoms of a major depressive disorder.  Postpartum depression should not be viewed as a sign of weakness in a female because a handful of the common causes are outside of a woman’s control.  For one, women’s bodies go through a substantial drop in estrogen and progesterone levels, which can lead to feelings of depression.  Secondly, the stressors that comes with caring for a newborn baby (lack of sleep, anxiety, decrease in feeling attractive, a sense of loss of control, and an identity crisis) can be very daunting and difficult for some women to manage effectively. 

So what are the symptoms of postpartum depression?
 
•    Sad or depressed mood
•    Excessive tearfulness
•    Difficulty bonding with your baby
•    Isolation from family and friends
•    Loss of appetite or eating much more than usual
•    Inability to sleep (insomnia) or sleeping too much
•    Fatigue or loss of energy
•    Reduced interest and pleasure in activities you used to enjoy
•    Feelings of irritability and anger
•    Feelings of worthlessness, shame, guilt or inadequacy
•    Diminished ability to think clearly, concentrate or make decisions
•    Severe anxiety and panic attacks
•    Thoughts of harming yourself or your baby
•    Recurrent thoughts of death or suicide
•    In some severe cases, psychosis (hallucinations, delusions, or paranoia) 
 
Often new moms assume that their symptoms are just the “baby blues”, especially in the days and weeks following childbirth; however once symptoms continue to last longer that two weeks and start to affect a woman’s ability to function and care for herself and her child appropriately, postpartum depression is likely a more appropriate case.  Postpartum depression can actually be experienced up to six months following childbirth, even if it is not felt immediately.  

Women who notice any of these more severe, longer lasting symptoms should be treated by a professional, whether it is through medication prescribed by an OBGYN or by a skilled therapist through counseling.  In less common cases, women who experience postpartum psychosis or thoughts of harm themselves or their child need to seek immediate treatment in order to ensure safety.  Women are encouraged to call the National Suicide Prevention Lifeline at 1-800-273-TALK; 911; their mental health or medical provider; or a family or friend. 

Regardless of whether new moms go through the “baby blues” or postpartum depression, self-care can go a long way.  This means getting enough rest, eliciting help from support systems, connecting with other moms, and avoiding substances that can alter moods.  

~ Cory Stege, M.S., LMFT

How To Keep Your Marriage Strong After Having Children

It is an understatement that once children enter the picture for most couples, life as as they know it will most never be the same.  Children can provide couples with a new meaning and purpose for love and life as a family however parenthood also comes with new types of stress and sacrifices that directly impact relationships.  Becoming parents means that priorities shift and thus time and attention that was previously directed at one another is now focused on meeting the needs of babies and children.  Lack of sleep, a decrease in intimacy, and a decrease in adult time and conversation often come with children and can promote emotional and physical distance in a marriage. Because of this, it can be very easy for couples to fall into routines centered around children that can result in neglect of the primary relationship.   According to the Relationship Research Institute in Seattle, two-thirds of couples reported that they experienced a decrease in relationship satisfaction within the first three years of parenthood.   The good news is that there are steps couples can take to combat the challenges and stressors that come with parenthood that can help promote feelings of connection, new meaning, and elevated levels of relationship satisfaction.  Here are few that may be helpful to implement:

Make your partner your priority. Children require couples to modify their priorities to better fit the needs of the family, however this means that it is even more important for couples to put in the time and effort to put each other in the forefront of day-to-day life.  Marriage is the foundation that lays the groundwork for a family system to be created therefore it must be tended to in order to prevent it from crumbling.  Simply greeting your spouse immediately with a hug and kiss or checking in with each other throughout the day just to reinforce thoughtfulness can go a long way and sets a positive example for children.  

Promote mutual parenting through respect and openness.  It can be easy to get caught up in micro-managing or undermining each other regarding how to parent especially for the primary caregiver however dictating how and when things should be done creates an imbalance of power and control within the marriage.  Instead, couples should aim towards allowing each parent to make decisions and to support one another with their chosen decisions.   However, safety is always a priority so when concerns arise regarding safety issues with children, couples should engage in open, respectful communication in order to identify an agreed upon course of action.  Children who experience their parents as cohesive and supportive of one another experience less confusion and stress and are more stable and secure in their relationships among the family.

Make emotional and physical intimacy a priority.  It is ironic that the very activity that couples engage in when the goal is to create a baby is usually the first thing to go after a baby is born.  Two critical aspects that helps to establish a strong and healthy relationship in the first place are emotional and physical intimacy; therefore even if it easier to focus on the children or come up with an excuse for why you cannot put in effort to connect with your partner, it needs to be done.  If it means that couples need to schedule in intimate times in order for it to happen, then so be it. This can often give couples something to look forward to amidst the chaos of their days.

Spend quality time together away from the children.  In order to prevent the role of parenthood to take over the role of husband and wife, it can be helpful for couples to continue to engage in activities that they engaged in before having children that they found enjoyable.  Couples who are able to spend alone time together generally experience an increase in both relationship and parenting satisfaction because quality time without children offers opportunities for couples to decompress and connect.  Quality time as a couple can also illustrate to their children the importance of nurturing a marriage, which will help create positive messages and meanings for children about relationships.

~ Cory Stege, M.S., LMFT

Attachment: Understanding How You Relate To Others

The specific way we relate to other people in our intimate relationships as adults is something that is established during the first two years of our lives as a result of the type of relationships our parents or primary caregivers fostered with us.  The type of attachment style we develop is determined by the ways our parents or caregivers responded to us in our early childhood, especially during times of distress and discomfort because it influences our social and emotional development.  Understanding our thoughts, feelings, and expectations regarding individuals we are in relationships with as adults as well as when we become parents ourselves can help us better manage these relationships by increasing insight and identifying areas of improvement in order to promote secure attachments.  So what is your attachment style?

Secure: Individuals who possess a secure sense of attachment to those they are close with exhibit a positive view of both themselves and the people they are in relationships with. Secure individuals place great value on both their independence as well as their close relationships.  Secure individuals most likely formed secure attachments to their parents or caregivers as infants and children as a result of being attuned to in a way that they felt confident in exploring the world because they were able to seek out and receive emotional support when needed.

Dismissive: Individuals who possess a dismissive sense of attachment to others tend to place little to no value in their relationships and prefer to be by themselves.  Dismissive individuals tend to suppress their feelings as well as avoid and distance themselves from others, especially when conflict arises.  Dismissive individuals most likely formed avoidant attachments as infants and children as a result of experiencing their parents or caregivers as insensitive and emotionally unavailable, especially during times of distress. Avoidant parents or caregivers send the message to children that their needs are not important and that they should be able to take care of themselves.

Preoccupied: Individuals who possess a preoccupied sense of attachment to others exhibit a negative view of themselves that is manifested through self-criticism and feelings of insecurity.  Preoccupied individuals tend to constantly seek out approval or validation from others however the desired responses are usually not rewarding for them.  Preoccupied individuals typically exhibit a lack of trust and a fear of rejection from other people, which can promote clinginess and dependency on other people.  Preoccupied adults most likely formed anxious and ambivalent attachments as infants and children as a result of experiencing their parents and caregivers as being inconsistent in their responses; at times they felt attuned to whereas other times they felt dismissed and never knew which response they would elicit.  Parents or caregivers who are unpredictable in his or her parenting behavior tend to promote suspicion, lack of trust, confusion, and feelings of insecurity in their children. 

Fearful-avoidant: Individuals who possess a fearful or avoidant sense of attachment to others tend to be emotionally detached from themselves even though they seek out relationships with other people. Once relationships reach a level of emotional intimacy, fearful-avoidant individuals usually become uncomfortable which triggers painful thoughts and feelings from his or her past and prevents them from being able to separate the past from the present situation.  Fearful-avoidant individuals most likely formed a disorganized sense of attachment to their parents and caregivers as infants and children.  Disorganized attachment is generally associated with parents or caregivers who are emotionally, physically, and/or sexually abusive towards their children, causing children to feel afraid of the individual who is supposed to provide safety and support. It is common for abused children to dissociate from themselves as a way to block out the trauma from their consciousness, which is a reason fearful-avoidant adults are detached from themselves and others.

After learning about the different types of attachment, hopefully it is obvious that secure attachments are the healthiest and most satisfying styles.  Even though the type of attachment we form during our childhood likely carries on to adulthood, it is possible to change it if it falls in the other three categories.  Because our attachments are formed within relationships, they must also be altered within relationships and usually requires professional support in doing so.  An experienced and well-qualified therapist can assist individuals with making sense out of their attachment history in order to begin to rewrite a new story that is more aligned with a sense of security, both individually and in our close relationships.

~Cory Stege, M.S., LMFT 

Ingredients For A Successful Marriage

As a follow-up to my previous article on Four Predictors of Divorce And How To Combat Them, which focused on Dr. John Gottman’s four horsemen, this article offers insight into what it takes to establish and maintain a long-term loving and rewarding marriage.   In his book The Seven Principles For Making Marriage Work (1999), Dr. Gottman shares his research-based concepts that are associated with healthy and satisfying marriages.  Dr. Gottman’s theory is based on the idea that couples must first establish a strong friendship, which lays the foundation for marriage and the other elements that come with it.  Through his work and research with thousands of couples, Dr. Gottman has found that in order for marriages to sustain, seven principles must be present:

1.     Enhance “love maps”: According to Dr. Gottman, “love maps” are how partners within a marriage store and reference information about one another’s life.  “Love maps” include information related to each partner’s fears, dreams/goals, history, beliefs systems, and other intimate information. The purpose of using “love maps” in a marriage is for partners to express understanding, fondness, and admiration of one another.

2.     Nurture fondness and admiration: It can be easy to focus on the aspects of a partner that is negative or problematic however that just breeds criticism and contempt, which are marriage killers.  Instead, Dr. Gottman believes that partners must focus on the specific factors, traits, and aspects that initially drew one another together in order to promote a culture of appreciation and caring within a marriage.

3.     Turn towards one another: In order to foster a sense of connection within a marriage, couples must look to one another instead of turning away.  This is especially necessary when partners make attempts to gain attention from one another through intimacy, affection, humor, or support during trying or stressful times.

4.     Accept influence: This principle means that partners seek out and welcome one another’s thoughts, feelings, and opinions even if they are not the same.  When couples allow for each partner to actively influence the other, it promotes shared decision-making and the sense of mutual power within a marriage.

5.     Solve solvable problems:  When couples utilize healthy conflict resolution techniques to address problems instead of attacking one another, it prevents the four horsemen (criticism, contempt, stonewalling, and defensiveness) from existing.  Dr. Gottman suggests that healthy conflict resolution involves softening the start-up (being direct in a positive manner); making and receiving repair attempts (comments/actions that prevent negativity and deescalate tension); the ability for both partners to self-soothe when feeling emotional; the ability to compromise (allowing influence of one another); and the ability to be accepting of one another’s shortcomings.

6.     Overcome gridlock:  Couples experience gridlock when they engage in ineffective and problematic conflict resolution techniques when an issue arises.  Gridlock leaves couples feeling rejected, polarized, disengaged, and unable to compromise.  However gridlock can be overcome when both partners within a marriage are motivated and willing to be open to identifying and addressing the underlying concerns that have caused the stalemate. 

7.     Create shared meaning:  When couples are able to identify and establish a deeper understanding of each partner’s roles and responsibilities within their marriage and family they can develop meaning and value to their relationship.  Shared meaning is often created and maintained through rituals or in a spiritual sense.  Shared meaning can promote a strong sense of connection and understanding, which is associated with minimal conflict and negativity within a marriage.

Although these principles may seem simple and straightforward, they each require a high degree of motivation and openness by both partners to achieve and maintain them.  Marriage can feel like a lot of work at times however if couples direct their attention and efforts in the appropriate ways, marriage can be one of the most rewarding and enjoyable aspects of one’s life.

~Cory Stege, M.S., LMFT  

Understanding The Change Process

Has anyone ever told you that you have a problem, whether it is a specific behavior, pattern of interaction, or coping mechanism but you don’t see it? Have you ever considered making changes in your life but are not sure it is worth it? Or have you decided that a change in your life is necessary in order to function more effectively?  Whatever the reason or motivation is, change does not simply occur overnight or in one step but rather takes place in stages over some period of time. 

Usually we are not willing to acknowledge that we need to consider making changes in our lives until it is apparent that our current decisions and behaviors are causing more harm than good where the consequences outweigh the benefits.   However, the process of change can begin before we are consciously aware of it and can evolve into action-oriented phases, which makes up the stages of change.  Read more about each of these stages:

1.     Pre-contemplation: The first stage of change involves lack of acknowledgment that a problem exists.  A person who is in the pre-contemplation stage of change often engages in defensiveness that he/she engages in any problematic behavior, especially when other people are telling him/her that they are.

2.     Contemplation: The second stage of change involves some degree of awareness and acknowledgement that a specific behavior causes some form of consequences.  A person who is in the contemplation stage of change is able and willing to think about a problematic behavior however they are ambivalent about making any changes.

3.     Preparation: The third stage of change involves a commitment to change a specific behavior.  A person in this stage of change is actively gathering information about his/her options for steps they can take towards achieving change. 

4.     Action: The fourth stage of change involves the implementation of specific steps towards achieving change.  A person in the action stage of change is using his/her motivation and willpower to overtly engage in various techniques that will result in change.

5.     Maintenance: The fifth stage of change involves the continuance of the new behavior or change.  A person in this stage of change maintains a commitment to avoid his/her previous problematic behavior by actively engaging in specific relapse prevention or other techniques in order to sustain the new desired behavior.

6.     Relapse: The sixth stage of change involves re-engagement in the problematic behavior.  This can be a natural part of the change process and does not always indicate regression however the evaluation of triggers should be conducted as well as a plan for more effective coping skills should be established.

The timetables for each stage varies from person to person depending on the behavior being changed as well as an individual’s support system, access to resources, strengths/resiliencies, and other stressors that may be present during the process.  Some common problematic behavior involves addiction, patterns of interaction within relationships, and poor coping mechanisms and the reasons and motivations for making changes differs from person to person.  People can often achieve successful changes in behavior on their own however some situations may indicate that professional help may be needed in order to provide support and guidance in navigating the change process. 

~Cory Stege, M.S., LMFT

Effective Co-Parenting After Divorce

Divorce is the termination of a spousal relationship however if children are involved, a new relationship of co-parenting between exes needs to be established and maintained.  Assuming the absence of high risk factors such as domestic violence, child abuse, substance use/abuse, and high conflict, co-parenting is necessary in order to promote emotional stability in children of divorced parents.  With divorce comes change, which can be extremely stressful, confusing, and difficult for everyone involved, especially children.  In order for children to go through healthy adjustments as a result of divorce, they need to maintain positive relationships with both parents, feel confident that their needs will be taken care of by both parents, understand that they had nothing to do with the divorce, and expect that they will not be placed in the middle of their parents’ conflict

So what does effective and healthy co-parenting look like?  For one, co-parenting may look different from family to family as a result of factors such as location of residence for each parent, work schedules and responsibilities, children’s ages, as well as the degree to which parents can communicate without conflict.  However, despite each different situation, there are some common aspects that each family should consider in order to develop and implement an effective co-parenting plan:

1.     What decisions need to be made regarding the children’s involvement with education, religion, extracurricular activities, medical and mental health treatment, sporting events, and social activities? 

2.     What avenue of communication will be used between parents as well as how often will communication occur? Will it be done over the phone or through text messages, emails, or done in-person?

3.     How will the exchange of children be completed? Will it happen in a neutral public place or will drop off/pick up happen at each parent’s house?

4.     How much time will children spend with each parent? What type of schedule will be established so that the children know what to expect?

5.     How will discipline be addressed with each parent?

6.     How will emergencies be handled? Which parent will be notified in cases in which an emergency happens outside of the home?

These are just a few decisions that need to be well thought out amongst parents in order for day-to-day life to run smoothly for everyone involved.  Solely developing a co-parenting plan is not enough but also requires each parent to follow through and maintain consistency with it in order for it to truly be effective.  Because life can change in an instant, it is also crucial for parents to be open to making adjustments to the plan when indicated.  Many divorcing parents benefit from seeking professional support with a therapist to better help them to address any issues as well as to identify, establish, and implement a co-parenting plan that satisfies everyone involved.

~ Cory Stege, M.S., LMFT

The Art of Boundary Setting

Most of us strive to establish and maintain healthy, long-term relationships with our intimate partners, friends, family, and co-workers and one of the most important, if not the most important, skill to achieve this relationship goal is to identify, implement, and uphold clear and direct boundaries.  So what are boundaries in the context of relationships?  Boundaries are the physical, mental, emotional, and spiritual limits we each identify in ourselves that indicate what we are able to tolerate as well as what causes us to experience feelings of resentment, stress, and discomfort.   Usually when we experience resentment or discomfort in our relationships it is because we are allowing ourselves to be pushed outside of our comfort zone and can be warning signs that we need to evaluate how we are managing these interactions so that we can make changes to better suit our needs. 

Here are some questions that can help you determine whether you can improve on your boundary setting skills:

1.     Do you feel guilty when you say ‘no’ to someone?

2.     Do you agree to things that you are not okay with just to please other people?

3.     Do you allow other people to treat you poorly without speaking up?

4.     Are you overly trusting of people you barely know?

5.     Do you expect other people to meet your needs at all times?

If you answered ‘yes’ to any of these questions, you may benefit from evaluating what areas you can consider making changes to. 

So what do healthy boundaries look like?  In order to establish and set limits in our relationships, we need to have self-awareness about our feelings and honor them as well as be clear about how we want others to treat us.  Healthy boundaries are associated with self-respect and the ability to make self-care a priority, even if these boundaries may not be the same for other people you care about or have to maintain a relationship with.   However, just having self-awareness and self-respect are not enough to actually doing the work of establishing and implementing healthy boundaries.  This important skill also requires open, direct, and respectful communication to verbalize and express your needs and limits to others.  This helps other people know where you stand and can promote awareness of what others can expect of you. Healthy boundaries also promote self-confidence, stability, being in touch with reality, as well as more satisfying and rewarding relationships.  

Boundary setting is an essential and vital aspect of establishing and maintaining healthy and fulfilling relationships however it is a skill that does not always come natural or easy to some of us.  Boundary setting takes ongoing practice and awareness in order for us to reap the benefits.  Professional help can be a source of support for individuals who may struggle with this crucial life skill by providing guidance and expertise to promote change.

~ Cory Stege, M.S., LMFT     

Marriage Maintenance

Like most objects or possessions that we aim to keep in good condition so that they will last a long time, marriage requires conscious attention and upkeep on a routine basis in order to reap the benefits of it.  Along the same lines, the things we tend to find the most rewarding and valuable in life are related to the hard work and effort we put into them, one of which is marriage.  Usually whatever we put into something is what we will get out of it therefore the more we can nurture and tend to our relationships, the more fulfilling they will be.  Likewise, if we neglect to check in and make adjustments as needed, our relationships will eventually reach their expiration date sooner than expected.  Just like we take our cars in for service or go to medical check-ups to make sure everything is running smoothly, there are some steps we can take in order to regularly maintain our marriages:

1.     Take a Temperature of Your Marriage.  Make an effort to check in with your spouse on a regular basis by identifying what is going well as well as areas of improvement.  This offers couples opportunities to make adjustments as well as address any concerns that can prevent bigger problems down the road.

2.     Maintain regular and ongoing communication. Make it a priority to talk with your spouse during the day in order to promote feelings of connection as well as identify and problem solve any issues that come up in the moment.  Allowing an irritation or complaint to build and go unaddressed is a recipe for resentment and marital problems. 

3.     Clarify expectations and modify as needed.  Couples who engage in regular conversations about what they expect of themselves and from one another tend to experience less conflict than couples who do not talk about expectations.  Couples can start out by respectfully requesting what needs each partner looks to be met in the marriage and then facilitate a negotiation of expectations in order to make it work for both partners.  Some areas of expectations couples are encouraged to talk about regularly are finances, household tasks, parenting, boundaries, and intimacy.

4.     Anticipate and plan for Disagreements.  It is inevitable that couples will disagree from time to time so being aware of “hot” topics or sources of potential conflict can be helpful in managing them when they do happen. In addition, couples should discuss specific tools or strategies that can be used to promote respectful communication and conflict resolution. 

5.     Balance alone time with couple time.  Having too much of or too little of one thing can be a bad thing, which goes along with how time is spent in a marriage.  In order to maintain feelings of connection as well as promote time to take care of individual needs (which includes spending time with others outside of our marriage), couples should discuss how each partner can have time and space to themselves as well as plan time that will be spent together.  As the saying goes, “distance makes the heart grow fonder” however couples need to agree on setting appropriate boundaries around time spent apart in order gain the most benefits. 

Oftentimes couples can struggle with the maintenance process and seek out professional help for support and assistance.  Marriage counseling can provide couples with new ways of thinking and relating within a relationship as well as offer effective tools and strategies to promote feelings of connection and satisfaction. 

~ Cory Stege, M.S., LMFT

Reasons Why Owning A Dog Can Be Good For Your Mental, Emotional, and Physical Health

Service, emotional support, and therapy dogs are on the rise for providing support to individuals who suffer from some form of emotional, physical, or mental health condition however any average dog owner can reap similar benefits.  Whether we are experiencing stress, problems in our relationships, medical issues, or are just trying to take care of ourselves, owning a dog can help soothe our minds, relax our bodies, and promote a sense of companionship.  Here are some specific mind, body, spirit benefits that owning a dog can provide:

Physical activity:  Since most dogs require some form of exercise, owners are more likely to get outside and move.  Being outside and in the sun promotes absorption of vitamin D, which helps improve our mood as well as fight physical and mental health conditions such as depression, anxiety, cancer, heart disease, and obesity.  Exercise also produces endorphins, which are the “feel good” chemicals in our brains that helps to elevate our mood and mental states.  And of course, there are endless benefits of exercise on our physical health including healthy blood pressure, cholesterol, and circulation.  Because our physical and mental states are connected, if we feel good physically, we are more likely to feel good mentally.

Stress reduction: Dogs are not the only ones benefitting from being pet and cuddled by their human owners.  Research has shown that petting a dog in a consistent and rhythmic manner promotes production of the relaxing hormone oxytocin in both humans and dogs.  This effect results in a sense of comfort and helps to decrease stress, anxiety, as well as high blood pressure and a high heart rate.

Healthy distraction:  Engaging with a dog and focusing on the interaction can offer a break from the worries and stressors of the day.  This type of distraction promotes our attention to stay in the present moment, which can boost mood and decrease negative thoughts and feelings.

Companionship: Owning a dog lessens feelings of loneliness as well as prevents isolation since they get us out and about and can promote social interaction with other dog lovers.  Most dogs seek out contact and affection from their owners as well as provide a sense of unconditional love. Dog owners often find themselves venting and talking to their dogs since the chance of receiving negative feedback is small.  Sometimes just the physical presence of a dog can provide comfort, feelings of loyalty, and a sense of security.

Sense of Purpose:  Owning a dog comes with responsibility and the ability to take care of something besides ourselves.  When we are feeling depressed or are having negative thoughts about some area of our life, taking care of a dog can help us get out of our heads by focusing on the dog’s needs, which can be very rewarding.

 Owning a pet is not for everyone, so if you are considering bringing a furry friend home make sure you are in the right place and have enough time and space for them to prevent them from being more of a stress than a stress reliever.  If you are a current dog owner, consider how you can increase your awareness of these benefits in your daily interactions. 

~Cory Stege, M.S., LMFT