Transitioning from adolescence to young adulthood is difficult. You usually don’t want to be told what to do – and most likely aren’t reading this article. But parents of young adults might be because you are struggling to help your child grow and figure out how to navigate life away from the nest. Depression, anxiety, pornography, drug use, issues with school or work and issues with significant others are among many difficulties young adults face during that transition from high school to college or from serving a Church mission to being back in college. Over the years, as a counselor in Orem, Utah, I’ve noticed a few things that parents do who successfully help their child navigate this period. First, they give them space. Your child is going to make mistakes. Giving them space to do so shows that you trust them and honor their ‘adulthood’. This doesn’t mean, however, that you run the other way and cut them off. They need a safe place to come back to, in a consultative manner. They still need you to be there so they can process what is going on. They might not come right away, but they do come eventually. Make yourself available and reach out to them. You can’t force them to share, but you can invite them. You can say to them, ‘You might not want to talk, but just know that I am here for you and I care about you. I’m happy to listen if you want to share’. Second, they create emotional safety. When your child does share with you, you want to ‘hold emotional space’ for them by accepting, validating and reflecting what they are saying rather than telling them what to do. You might not agree with what they are doing or saying, but telling them they are wrong and then telling them what to do will close the door of them sharing at all. You want to help them figure things out rather than force them to think the way you do. You can, for example, validate the emotions they feel rather than the actions they are doing. Saying, ‘I can see that breaking up has really been painful for you’, rather than, ‘Stopping going to church just because you broke up isn’t going to help. You just need to keep going’ can be helpful. You might not agree with their choices/actions, but you can certainly empathize and understand their emotions (that then led to certain actions).

Anxiety is a problem most of us face at some point or another. It isn’t a question of ‘if’ we will experience it, but ‘when’. Anxiety comes in many forms. It can be difficult to cope with when it is severe and difficult to detect when it is mild. There is a situation when anxiety is actually covering up, and is a reaction to, other emotions. Let’s talk about how and when that is the case. There are primary emotions and secondary emotions. Primary emotions are our natural emotions to a situation. For example, feeling sad when you get a divorce is a primary emotion. In this example, you might also feel other emotions such as hurt, fear, confusion, betrayal, desperation, abandonment, despair, hopelessness, overwhelmed, etc. When these other emotions, in addition to feeling sad, become too much, a secondary emotion can come in to take the role of blanketing them so that you distance yourself or numb yourself from them. It covers them up so that you don’t see them and seemingly don’t have to deal with them. Anger is a good example of a secondary emotion. Anxiety, at times, can be, but isn’t necessarily always, a secondary emotion as well. When you are feeling all of those things, anxiety can come and make you buzz so you don’t feel them. In this case, it is secondary to what is actually going on. The trick, then, is to ask yourself, ‘what am I really feeling’ and recognize, feel and cope with your primary emotions. Dealing with anxiety alone won’t be enough as it isn’t the root of what is going on.

My four-year-old daughter placed herself in the middle of our living room to play with blocks. She was so engrossed with building a wooden castle that she didn’t notice her two-year-old sister walking towards her with her right arm stretched far back to slap her older sister across the head. When that slap came, my older daughter went from happy to surprise to anger and then lots of tears. She ran towards me seeking justice. “Mommy, she hit me!” My younger daughter remained still, looking innocent. I immediately walked over to her with my older daughter in hand and said, “Hands are not for hitting. Say sorry for hitting please.”  I’m sure many parents can relate to this scenario. Teaching our children the skills for making amends is an important life skill and is not so much about saying the words “I’m sorry”.  

There is a belief amongst some parents that enforcing premature apologies on children is not effective. Their reasoning is that premature apologies teach children to lie and encourage insincerity. It also creates shame and embarrassment. Other studies show that young children have the ability to be empathetic even before they can speak; therefore, parents should encourage apologies (Smith, Chen, Harris; 2010). As I reflected on my research and my knowledge as a Marriage and Family Therapist, I recognized several things we can do as parents to create productive apologies: 

1. Keep yourself in check: It’s frustrating to see your children fight, especially when it happens at inconvenient times. However, it’s important to remain calm and model for your children how to handle frustration.   
2. Be immediate when possible: When you see an incident occur between your children, address it. The best time for learning and growth is when the incident is still fresh in their minds. However, when there are time constraints and the issue cannot be addressed right away, it is important to tell your children when and where it will be addressed. Be consistent when using the alternative and follow through.  
3. Ask instead of tell: Avoid lecturing. Ask questions instead. “Tell me what happened?” “What were you feeling when you hit your sister?” Validate the expressed emotion and help them to understand that it is okay to feel frustration and sadness; however, it is not okay to hit or throw things. Help them to also make the connection between emotion and action. “Look at her face, how do you think she’s feeling right now?” Asking these types of questions enhances empathy. 
4. Problem Solve: Ask questions about what they think they should do when they feel frustrated or sad. Help them to come up with solutions.  Ask questions about how they can make things better with their sibling/s. 
5. Have them practice a do-over: When your child identifies the solution, have them practice it with the other sibling/s. Praise them for their efforts at the end.    

What is more important than the phrase “I’m sorry” is what children take away from the experience. We can facilitate and enhance learning opportunities by not focusing on the phrase “I’m sorry” but instead more on what can be learned from this situation and how can we improve.  

Originally posted here: http://www.provofamilies.com/2018/02/07/forced-apologies/

I am often asked the question, “Do I need medication?” As a counselor in Utah County, I work with couples, families, individuals suffering from depression, anxiety, pornography use, drug and alcohol use and other issues – all of which might need medication at some point. As a counselor, I am not trained to prescribe medication or do medication management, however, I often collaborate with practioners (i.e., MD’s, nurse practioners) who are. Together we are able to help many individuals overcome anxiety or depression. Talk therapy (couples counseling or individual therapy) and medication are often a good combination to combat the issues that bring most people into therapy.

My colleagues who prescribe medications often tell me how medications act like crutches. They aren’t meant for long term use or to be a ‘fix-all’, but rather, they are meant to give support so that an individual can gain strength. Once strong enough, the crutches are discarded and the individual moves on under their own power.

So, when clients ask if medication is warranted, I refer them to someone trained in this type of treatment. Medication is not always the answer, but there are times when it is best practice, however, to use medication and traditional talk therapy together (i.e., Bipolar disorder treatment). I refer them to see an MD, psychiatrist or nurse practioner. I encourage them to meet with someone who does Genetic testing for medications. This is a method where an individual submits a DNA sample which is sent to a lab for testing. The results show the individual and prescribing professional which meds are most likely to work with the individuals genetic structure (usually for anxiety or depression medications). My nurse practitioner colleague tells me that this ‘takes the guess work out of medication management’. Given that the typical experience for individuals trying medications is months of trial and error, this is a relief to many.

Secrets fuel addiction. As I’ve mentioned before in previous posts, addictions, such as pornography addictions, are a shame based experience. This means that when someone uses pornography they feel as if they are a bad person, rather than feeling that they are a good person despite making a mistake. When someone feels shame, they often compartmentalize what they have done – they hid it and separate it from who they think they really are, or, think that that mistake totally defines who they really are.

This is where secrets come into play. Over time, a man (or woman – I’ve worked with both in therapy for pornography issues) who has been using pornography and feeling shame because of it will gather many secrets. He won’t want to tell anyone what he is doing, or won’t want to tell them all that he is doing. He might only present the best parts of himself or just tell enough about his mistakes to others to appease them or to feel like he is being open. But, in fact, he is keeping secrets. These secrets start to bury him and make him feel more shame. They take effort to maintain and keep hidden. They cause him stress and to feel disconnected from others. All of these things can lead to more addictive acting out.

Being transparent is key. This, in part, is why in the 12-step model of recovery (for alcohol, sexual addiction or substance addiction) addicts are asked to write a fearless moral inventory and to share it. Being open with others can feel uncomfortable and embarrassing. Many would say, “It’s in the past – let it stay there” or, “I don’t want to hurt her, so I’m not going to tell her about it”. These mindsets only make things worse for someone using pornography and their spouse/family. Telling others and being transparent is on the path towards recovery.

Pornography counseling offers a venue to be transparent and honest with yourself and with your loved ones. A good therapist will help you through this process in a way that might be painful, but certainly not shameful.

Family therapy is an effective way to deal with problems regarding adolescents, parenting, addiction, depression, anxiety and much more. When a mother and father bring in their 15-year-old son because he is drinking, using drugs, has a bad attitude, is failing out of school and is involved in risky behavior – I ask the parents to participate in counseling with him to be a part of the solution. The relationship between mom and dad, the relationship between mom and son and the relationship between dad and son matter in regard to this young man’s healthy life style choices. As a therapist of adolescents for over a decade now, I have found that more often than not, when success happens for adolescents in therapy it is accompanied with a mom and dad who are involved and willing.

Most adolescents don’t want to do counseling. They often make excuses and say that they don’t want to follow the rules and that f their parents loved them that they wouldn’t give them a curfew. The ironic thing is that children push back against boundaries and rules, but thrive within them. They need them to feel safe and loved. They often test the boundaries to see if mom and dad are there and if they care. Its hard to tell, however, because they say that they don’t want their parents to tell them what to do.

One of the developmental tasks of adolescence is to learn how to become your own individual while still remaining a part of a group (i.e., a family, church or school). It often feels like trying to mix oil and water for teenagers in this position. Learning that they don’t have to do the opposite of what their parents say in order to be independent or their own individual is key. Rather, following the family rules and making choices on their own that are complimentary help them develop their sense of being their own person.

One of the developmental tasks of parenthood is learning how to parent a child differently as they grow. Parenting a 5 year old is different than parenting a 15 year old. I see, however, many parents not making this transition and feeling stuck with their adolescent. They hover over their teenager, for example, in an effort to not let them make mistakes. Its ok for teenagers to make mistakes. Parents don’t have to (and can’t!) protect them from all of life misfortunes. Teenagers need space to make mistakes and have an open relationship with their parents to talk about them.

So, if you are a parent struggling with a teenager remember that changing your parenting style to match their age matters. Engaging in therapy, when needed, can help you and your child become healthy and happy.

It might seize you in the middle of the night, or perhaps at the beginning of a work meeting, or maybe while driving your kids to soccer practice. Wherever it happens, it can overwhelm you. Your mind won’t stop running. Your body is tense. Your heart is racing. You can’t breathe! You can’t relax and enjoy yourself. If you have ever felt a combination of these sensations, you have probably felt anxiety—a common experience among adults and adolescents. Whether you accept it or not, anxiety is part of a normal, healthy life. Diagnosable anxiety disorders, however, are different than normal, everyday anxieties. A hallmark characteristic of an anxiety disorder is excessive fear or anxiety about a real or perceived threat (DSM-V).

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 40 million people in the United States suffer from an anxiety disorder in a given year. That’s 18 percent of the population! Specific anxiety disorders include generalized anxiety disorder, selective mutism (failure to speak in social situations even when able to speak in other situations), specific phobias (fear of animals, objects, etc.), social anxiety disorder, panic disorder, or agoraphobia (fear of having a panic attack or other embarrassing symptoms in locations such as public transportation, standing in a line, etc.). Some anxiety disorders, such as phobias and generalized anxiety disorder, most often begin in childhood around 11 years old and can continue into adulthood if left untreated. These two disorders are the most common anxiety disorders in adulthood according to SAMHSA.

Because of their belief that things will not change, or that they just need to get over it, many suffering with an anxiety disorder do not seek treatment. The good news is that anxiety is treatable! Your biology has a lot to do with an anxiety disorder; therefore, a first step in reducing anxiety includes dealing with the body’s physical response to stress.

Diaphragmatic Breathing

Your body’s internal organ regulator, your autonomic nervous system (ANS), has two applicable parts of the solution. First is the sympathetic nervous system (SNS), which is in charge of your fight-or-flight responses. This part, for example, pumps up the mailman’s body so she can outrun that dog hiding in the bushes. Second is the parasympathetic nervous system (PNS), which aids in calming your body. This part helps her body deescalate after she has escaped that dog so she can return to delivering the mail as usual.

When you feel anxious, your SNS is engaged. To help calm your body in these moments, the key is to activate your PNS. The exercise outlined below (partially adopted from The Anxious Brain: The Neurobiological Basis of Anxiety Disorders and How to Effectively Treat Them) triggers this part of your ANS.

How to do it:

1. Lie down, stand, or sit in a comfortable position. Make sure you are “grounded” by creating an open posture with both feet on the floor and your back against a chair or bed. If you are crying, in the fetal position, or hunched over, this technique is difficult to do.
2. Breathe in deeply. Picture a water balloon being filled with water as you first fill up your abdomen with air and then your chest. Feel the warmth and the weight of the air as you breathe in.
3. Breathe out with an elongated breath—longer than it took you to breathe in. Purse your lips as you breathe out. This will slow your breathing. Breathing out slowly will help activate the PNS, which helps calm your body—the whole purpose of this breathing technique.
4. As you breathe in and out, focus on the physical sensations you experience. Focus on your feet touching the ground, your abdomen and lungs expanding and contracting, the feel of air rushing over your tongue and through your pursed lips. Notice how your head, arms and hands feel. Doing this will help you be present and in-the-moment.
5. Practice! This is a skill that must be developed. Try doing it while you are at work, stopped at a traffic light, or at home. Do each cycle (breathing in and breathing out) ten times or more, as you learn to engage your PNS.
6. If you feel dizzy, light headed or out of breath, do not continue this technique. If your breathing is restricted or obstructed there may be other issues to consider. Speak with a therapist or doctor about the appropriateness of this exercise for you. This technique is a good start to help reduce anxiety in the moment, but is most successful when done in conjunction with therapy.

Anxiety disorders affect millions. Those who suffer with anxiety often feel there is no solution. But basic biology tells us differently. Activating our PNS through breathing techniques really does work—give it a try next time you feel anxiety creeping in. You might be surprised at how effective these simple breathing techniques can be!

Originally published on Utah Valley Health and Wellness Magazine

Written by Dr. Triston Morgan

All of us, from cradle to grave, are happiest when life is organized as a series of excursions, long or short, from the secure base provided by our attachment figures. – Dr. John Bowlby

Have we really cracked the code on love and romantic bonding? Perhaps. Scientists, poets, and lovers have long grappled with the question: “What makes romantic love work?” Through the work of Dr. Sue Johnson and the development of Emotionally Focused Therapy, it looks like we have an answer.

Through decades of research on the importance of emotional bonding and what it is like to feel disconnected, isolated, and alone, relationship researchers are starting to unravel the mystery of love and adult romantic bonding and how to mend loving ties. The truth is, we are all hard-wired to connect to one another. This drive to connect is infinitely stronger in family and romantic relationships. To be emotionally isolated is harsh on our brains. Loving connections offer us a safe haven to go to where we can maintain our emotional balance, deal with stress, and respond more lovingly to our romantic partners. Essentially, when those connections are secure and strong, love is safe; love flourishes.

Unfortunately, disconnections between couples do happen and frustration, sadness, and anger are all too common in marital relationships. When those secure and loving bonds are threatened, emotional “primal panic” and a cycle of negative interactions ensues. These wounds can be difficult to repair for couples when left to their own abilities, and therapy is often the last step before looking to end the relationship. Unfortunately, many well-meaning therapists utilize their individual-based, time-tested techniques and attempt to apply them to relational interactions, which usually has little effect in restoring their loving bonds. In addition, many therapeutic techniques focus on helping partners change behaviors or thoughts, or teaching them communication skills. The common result from these approaches and techniques is that they usually struggle to gain traction, and the couple leaves therapy with less hope than before.

But there is hope. Within the last 25 years, a substantial amount of research has emerged that gives hope to couples on the brink and helps them tune in to their underlying emotions, identify their negative patterns of interaction, repair their attachment, and eventually create new patterns of bonding and positive interactions. This model is Emotionally Focused Therapy.

Grounded in the theory of attachment, Emotionally Focused Therapy (EFT) is an experiential, short term, structured, and tested model of therapy designed to help couples identify their negative communication patterns, interrupt this pattern, and create more positive, bonding, and secure emotional patterns. EFT does not see individuals as “sick” or unskilled, but rather “stuck in habitual ways of dealing with emotions with others in key moments.” As the title reflects, priority is given to emotion as a key organizer of inner experiences. EFT looks within the emotional experience of the couples and how they navigate their emotional connectedness. Dr. Sue Johnson has said, “The EFT therapist has a map. A map to relationships and how they work. A map to how they go wrong. And map to what is needed to put them right.”

A substantial body of research has shown promising results of the effectiveness of EFT. Research studies find that 70-75 percent of couples move from distress to recovery and approximately 90% show significant improvements. EFT is being used with many different kinds of couples in private practice, university training centers and hospital clinics, and many different cultural groups throughout the world. These distressed couples include partners suffering from disorders such as depression, post-traumatic stress disorders and chronic illness.

In my work with couples, EFT has resonated with them on many levels. No longer are couples focused on fights and long-standing disagreements about specific content or trying to change the other person. When couples go through the process of EFT, perpetual problems are framed as negative disconnections that are about protests by each partner for a more loving connection and emotional safety. EFT takes the blame out of conflict and resentment and moves to fighting together against a common enemy—the negative pattern. As couples progress through the stages and steps of EFT and begin to accesses deeper emotions that underlie their struggle for connection, a new interaction emerges as individual partners see and experience each other differently. When partners experience each other as more accessible, responsive, and engaged, old wounds and negative patterns are healed, and love and emotional safety thrives.

Originally published by Utah Valley Health and Wellness Magazine

Written by Dr. Jeremy Boden

As I work with individuals and couples, I like to educate them on how our brains and our bodies impact our relationships. Understanding the correlation between these elements seems easy enough, however, I often get the question, “How do I change my brain?” The answer to this question is a great starting point to create healing and allow new interactions to take place.

Our brains are wired for connection. Each interaction we have either strengthens or weakens the connections in our brains, thus influencing the relationships with those around us. The ability to allow one or two more heartbeats before reacting or responding to one’s partner is the ultimate goal. The better you are able to emotionally regulate (by allowing more heartbeats before reacting), the more positive your interactions with others can be.

There are many ways you can impact emotion regulation and the ability to create new experiences that improve relationship interactions. Some are easier than others, and some have been targeted to help with other areas of life. I’d like to highlight two very important ways to help increase heart rate variability and improve cognitive functioning so you are better prepared the next time you might want to fly off the handle. They are exercise and sleep.

Everyone knows that exercise is good for physical health, but it also has great implications for mental health and relationship health. Increased exercise impacts the way your heart pumps blood. Long-term exercise increases your heart’s efficiency in pumping blood to the body. It doesn’t have to work so hard, and this increases heart rate variability, or the amount of time in between heart beats in a given minute. Increased heart rate variability means more regulation (more parasympathetic, or calming, influences) on the heart, and thus, more flexibility in emotional responses. This means that you have more capacity to keep the breaks on when your fight or flight response is triggered, allowing you more time to thinking critically, solve problems, or socially engage before flying off the handle and reacting to environmental stimuli.

Additionally, exercise increases the volume of the prefrontal cortex—the area in the brain associated with learning and memory. Exercise also stimulates the growth of cells by releasing chemicals in the brain. These new cells are then cleaned, solidified, and bonded together to create new memories for individuals.

We have all heard that sleep is important and should be a priority. Sleep does a lot of thing for us—it helps with creativity, remembering physical tasks, and making decisions. Sleep also does two important things in the brain: creates and consolidates memories and clears out toxins. As neurons fire together (and therefore wire together), sleep helps to connect recent memories with earlier memories. This allows individuals to remember how they reacted in past situations, and react differently next time if they desire a different outcome.

Cleaning out toxins in the brain increases attention and memory, helps individuals think clearly, and even impacts the regulation of insulin. Not getting enough sleep inhibits the ability to clear out the toxins, which can be harmful to the connections that are trying to take place in the brain. Sleeping allows us the opportunity to create new and improved experiences each day.

There are many ways individuals can have more influence on emotional responses. These are only two, but by changing our brains and our physiology in the body, we are prepping ourselves for better interactions. Being mindful of how we can impact the physiology of our bodies allows us more control over how we interact with those around us. We increase our capacity to engage more positively and be more satisfied in our relationships.

Originally published by Utah Valley Health and Wellness

Written by Dr. Kayla Mennenga

“Could you make sure to clean the kitchen today?” My wife asked, eyebrows raised. I hesitated trying to think of something to say. I felt my chest tighten and my breathing get shallow. She cocked her head, “What’s wrong?” I stumbled to explain everything I had to do that day without actually saying “No.” Tension began to fill the room. I knew she was comparing her structured nine to five job to my odd therapy schedule that gives me more time at home. I knew she was wondering why more didn’t get done around the house, and I thought about what it must look like from her perspective, to leave in the morning with me at my computer, and come home eight hours later to find me in the same place. How hard is it to fold some laundry, after all? Her forehead crinkled, “I don’t understand why you can’t put thirty minutes aside and clean the kitchen.”

This is a pretty mundane example of the type of things married people argue about. It seems like a pretty simple matter on the surface. The discussion was about doing chores. So why did I feel cornered? Why did something as simple as cleaning the kitchen make me feel so much anxiety? This argument was about more than simply cleaning the kitchen. I felt torn between two demands of great importance: my career or my wife’s good will. I keenly felt the burden of my family’s future resting on my shoulders, and what seemed like an endless to-do list. How could I stop working on that to do something as trivial as cleaning? What good was a clean kitchen if we were drowning in student loan debt? But not cleaning the kitchen meant the evaporation of marital bliss. How could I focus on my work with an upset wife on my mind? Either way, I was in trouble.

Any fly on the wall seeing our argument probably would have thought the issue was as simple as a lazy husband not wanting to do chores. But as in almost every argument, there was something deeper going on below the surface. To my wife, this was not merely a matter of having a clean kitchen. For her, it was about peace of mind. Coming home to a messy house after a hard day adds more stress. When the house is messy, it makes her mind feel chaotic and disordered too. Not only that, but a dirty house reminds her of the instability of growing up with a father who had bipolar disorder and refused to take his medicine. The issue of cleaning the kitchen was proxy for some deeper concerns. For me it was about earning enough to take care of my wife and to prepare for children. For my wife it was about feeling safety and peace in her own home.

Arguments can draw a couple closer together, or they can drive a wedge between them. What makes the difference? That question has a few answers, but one of the big things is whether we ever get to the deeper meanings under the surface of the fight. If we stay on the surface, we may have conclusion, but we won’t have resolution; whether I did the cleaning or not, I would have had stress and felt disconnected from my wife. That’s because what I needed, and what every person needs, is to know and feel that their partner understands and respects them. The reason we had an argument had nothing to do with cleaning at all, it was really about her basic need for safety, and my basic need for competence. We couldn’t fix the problem until we acknowledged the source of our strong emotions and what the fight was really about.

The moment we feel understood by our partner, we can think clearly, and then it’s easy to do problem solving. Next time you’re arguing and feeling upset, ask yourself about the deeper issue behind the disagreement. Find out from your partner what their position means to them. Empathize with their thoughts and feelings, and see how much easier it is to resolve arguments.

Originally published on Utah Valley Health and Wellness

Written by: Kenneth Jeppesen, LAMFT, MMFT

Kenneth is a therapist at the American Fork Center for Couples and Families and is a licensed associate marriage and family therapist. He enjoys helping individuals and couples find peace and happiness and spends the rest of his time learning about everything!