Tag Archive - MFT

Warning Signs: When Couples Should Seek Professional Counseling Help

Striving for a healthy, thriving marriage–and simply trying to avoid divorce are two very different goals for therapy.

One is proactive and the other is reactive.

I’ve noticed that the proactive group is often quicker to get professional help for their marriage than the latter group.  The reactive group often finds themselves in the counseling office as a last resort.

Being proactive–being intentional about your marriage makes all the difference in the world.

I have been asked quite frequently recently, “When should a couple go to counseling?  What are some warning signs that we should seek professional help?”

As I have thought about this question I have come up with a few suggestions (some based on my own experience as a married person and on my experience as a therapist; and some based on other professional’s advice). Here are ten reasons when a couple should go seek professional counseling help. There are many more, but this is a start:

  1. Do premarital counseling.  If you are married and you didn’t do this, well, it’s water under the bridge.  But if you aren’t married at this point, I would highly recommend this as good premarital counseling can help couples bring issues to awareness that are often avoided, and can help equip couples to work through the conflict.
  2. Go to counseling when there aren’t any issues/As an opportunity for growth. In reality there are always issues that we can address in our marriages, but it’s better to seek help before issues gain a stronghold in your marriage.  See counseling as an opportunity to learn and grow, rather than a place to try and fix.
  3. When the Four Horsemen make an appearance (Criticism, Contempt, Defensiveness, Stonewalling). Marriage researcher John Gottman talks about the Four Horsemen at length in his book The Seven Principles for Making Marriage Work.  Gottman talks about these as being predictors of divorce in couples, and so it is best to get help before any of these become habitual in your marriage.
  4. When you notice resentment towards your partner. Resentment is one of those feelings that if not dealt with quickly can slowly, but surely creep into your relationship and become a cancer.
  5. When you are experiencing a major life transition. Life transitions such as marriage, birth of children, loss of loved one, beginning/loss of a vocation can bring about all kinds of emotions and challenges.  It can be helpful to have someone help you sort through these things.
  6. Barriers to communication. At various points in our relationships certain barriers arise that inhibit effective verbal communication.  I say verbal, because the reality is, we are always communicating to one another.  Having a professional help you work through the barriers to effectively communicating is a great reason to seek help.
  7. Lack of intimacy in the relationship. There are various kinds of intimacy in a relationship (see previous post), but if you notice a tapering off, or absence of intimacy in the relationship, it can be advantageous to have someone help you work through the problem.
  8. Focus is taken off of marriage and placed onto other things (i.e. vocation, children, friends, etc.). Anytime a couple moves their focus away from working on and having a strong and healthy marriage, other aspects of their lives suffer.  Lots of couples become so focused on other things that the marriage begins to deteriorate.
  9. When you become too busy. Lots of couples make the excuse of busyness as a reason to not be able to come into counseling.  When you become too busy to work on your marriage, then you know you have a problem.
  10. Whenever your partner suggests you do marriage counseling. Lots and lots of therapist’s offices are filled with couples where one suggested counseling 2-3 years ago, but the other partner resisted or thought it was not necessary.  Now they are in counseling because the partner who initiated it years ago has had enough and is ready to leave.  Don’t wait that long.

What reasons would you suggest for when a couple should seek professional counseling help?

Boundaries, Boundaries, Boundaries…Boundaries


“Without truth there can be no intimacy, because without truth you wind up sharing lies or delusions. Without intimacy there can be no relationship. When two partners share their true selves, protecting self and others by the correct practice of boundaries, the miracle of spirituality is present.” (The Intimacy Factor, pp. xvi)

Those words are from Pia Mellody, renowned clinician in the area of codependency and boundaries in relationships, childhood trauma, and many, many other things. I had the chance to see her speak last week and was so blown away by her three hour presentation, Coming into Balance: Addressing Issues of Value, Power and Abundance….that I still can’t stop thinking about it.

If you are looking for a wonderful book to read, I recommend, The Intimacy Factor: The Ground Rules for Overcoming the Obstacles to Truth, Respect, and Lasting Love

“Without boundaries, there is no relationship. Without relationship there is no intimacy. Without intimacy there is no love, and without love the spiritual path is hidden from us.

Boundaries create the experience of truth and respect in which love can grow. We recognize that our inherent worth cannot be taken away from us by the display of our authentic selves. We are human and only that. We are born with inherent worth and it coexists with all our human flaws. (The Intimacy Factor, pp. 118)

Upcoming Trip to Haiti: Nothing to Offer But Our Vulnerable Selves


Last week I wrote about some of my initial thoughts on my upcoming trip to Haiti, and with each passing day I’m getting more and more excited, and a bit more nervous as well. One of the really exciting things is the coming together and completion of the team I will be serving with. The team is being sent out by Adventures in Missions, and is composed of Anne Jackson, Tim Schmoyer, Adam McLane, Mark Oestreicher, Seth Barnes, Jeremy Zach, Lars Rood, Clint Bokelman, Ian Robertson and myself. This is a great team of people and I’m excited to serve alongside of them in Haiti.

There are lots of things we will be doing on this trip, and there are still many unknowns, and like any trip abroad, we will just have to be flexible when opportunities arise. Mark Oestreicher has a good break down of some of the work that awaits us, as well as some of the things we will be doing among the Haitian pastors. What I do know is that we will be serving the people in Haiti and doing a lot of work with those who have fled out of Port au Prince and who are currently living in refugee camps.

One of the things that we have been asked to do along with serving the people of Haiti, is to also bring awareness to not only the situation that all of you are witnessing on the nightly news, but to also tell the stories of our personal experiences, and in doing so, hopefully encourage you, as well as further laying the foundation for future teams to follow after us, and serve long after Haiti is not the top story in the nightly news. If you are interested in following our journey you can do so at our team Facebook page, our team Twitter feed, or just stay tuned to this blog or my personal Facebook page. You have lots of options. I hope to do a good job of keeping you all updated through writing and video.

Offering Our Presence
I’m not a doctor, I’m not an engineer, and I’m not a professional in disaster relief, but I’m hoping and praying that my experience as a pastor and as a marriage and family therapist will come in handy as I work among the Haitians. And no, I’m not preaching sermons on performing therapy, but my work in those fields has given me the opportunity to travel the world and provide relief in the area of mental health. I was blessed to live for three months in Guatemala where I volunteered at Obras Sociales del Santo Hermano Pedro; I’ve been able to serve at the Sisters of Charity in Calcutta, India (the week of Mother Theresa’s funeral); I’ve been able to serve on several occasions at the Sisters of Charity in Mexico City. And my work as a college pastor allowed me the privilege to lead numerous trips during my eight years at Bel Air Presbyterian Church in Los Angeles. One of the real exciting things for me is that I’m not leading this trip, but just get to be a part of an amazing team. Continue Reading…

iPhone + Ustream = Therapy on the Go

apple iphoneOne of the things I have been thinking about for the last six months is the idea of doing therapy on the go through mobile technology. Though I believe strongly in the benefits of in person, face to face therapy, I think technology is making available new avenues for us to explore the benefits of therapy through a mediated technological tool.

I have only been thinking about it…

And then I saw this tweet by DJ Chuang yesterday:

wow! this is revolutionary – live streaming video from an iPhone 3g ! see me work at http://ow.ly/KM24

Ustream and its Live Broadcaster app is the first app to stream live video from your iPhone to the internet.

I could see therapists using this feature for clients who are traveling especially.

It could be done iPhone to iPhone. iPhone to computer. Etc.

Just thinking out loud.

What do you think? Could you imagine receiving therapy via live video streaming from the iPhone?

33% OFF Online Therapy Till January 1, 2010

100761143_226e540b49
[image by oddsock]


I’ve been talking a lot about online therapy on this blog, and now it’s time to make you a GREAT offer!

From now until January 1, 2010, I will be offering online therapy at 33% reduced rate. So instead of $75, you only pay $50.

If you, or someone you know is interested in this offer, please contact me.

Does Therapy Need to be Face to Face, In Person to be Beneficial?

2091503475_71ae83cdc9
[image by Wrote]

It was inevitable that with the emergence of more and more of our lives online that the field of therapy would see more and more benefit from doing therapy online, but even still, lots of questions remain for both practitioners and clients. In an article from Monday (thanks to John Saddington for pointing me to the article) the title says it all, Therapy online: Good as face to face? The article begins by talking about a study on the topic of depression:

Participants were randomly assigned to either receive online cognitive behavioral therapy in addition to usual physician care — which may include antidepressant medication — or to continue their usual care and be placed on a waiting list. The intervention consisted of up to 10 55-minute sessions, five of which were expected to be completed by the four-month follow-up.

Of the 113 people who did online therapy, 38 percent recovered from depression after four months, compared with 24 percent of people in the control group. The benefits were maintained at eight months, with 42 percent of the online therapy group and 26 percent of the control group having recovered.

The level of benefit shown in the study is about the same as could be expected from traditional therapy, although the researchers did not compare the two as part of the experiment, said Dr. Gregory Simon, a psychiatrist and researcher at Group Health Cooperative in Seattle, Washington, who wrote the editorial that accompanied the study.

Benefits of Online Therapy
This article and a slew of other articles out there talk about the many benefits of doing therapy online. Things such as:

  1. Providing therapy to those with limited/no access to see a therapist.
  2. Some studies show that therapy over the internet allows clients to put down their guard, be more open and vulnerable than in person.
  3. Often the stigma of going into see a therapist is removed.
  4. According to some studies, like the one above, the benefit of therapy online is similar to that in person.

These are just a few of the more common benefits.

What other benefits can you think of?

Limitations of Online Therapy

  1. Some experts say that online therapy limits some of the visual cues in gesture, as well as “speech intonations.”
  2. Some see a limitation in rapport building when not done in person. Continue Reading…

Is Your Addiction to Technology Transforming Your Life

2806065042_3837337b13
[image by David R. Carroll]

Do you remember what life was like before your cell phone, or before you had an internet connection in your house? It seems like such a long time ago. We even wonder at times how we could have lived life without them. The scary thing is that it wasn’t that long ago, yet in several short years these technological tools have rewired the way we interact, communicate and relate.

I sent my first email message in college, probably around January of 1994. It was so slow going through at the time that it didn’t even really seem worth sending another. I bought my first cell phone in 1998. I think it had only like 150 minutes per month on it which was enough because there were very few people I could call at that time who had a cell phone. In 2005 I put internet in our new house after we got married, which was really the first time I had had internet in my home before. Now I wonder how I got anything done. These personal discoveries encompass a time of around the last 4—15 years, yet at 34 I sometimes wonder how I lived without them.

What at one point were things that I felt like I could not live without, I’ve been contemplating if they are worth living with? Or if I even tried to live without them, would that even be possible. You see, I’m starting to wonder if I’m addicted to my technology. I’m not the first to wonder this question but I have been thinking about it a lot more this week as news on the opening of reSTART Internet Addiction Recovery Program near Seattle, WA has been widely discussed online. Ben Parr wrote an article on Mashable where he stated:

“It’s getting tougher and tougher to argue that there is no such thing as Internet Addiction Disorder, especially if you watched the CNN video above. The sad truth is that it’s possible to become addicted to just about anything, and that the web (and World of Warcraft) has sucked many people in so deep that they ignore social interactions and forget real-world obligations.

Does a rehab center for extreme cases make sense? Yes, especially if reSTART can provide scientific proof of success in breaking the addictions of its patients. Still, rehab doesn’t work for all drug addicts, and it probably won’t work for all Internet addicts. And unlike drug addiction, you can’t simply avoid and abstain from using the web; it’s too central to our economy, our work, our education, and our lives to be ignored.”

In case you were curious, here are the “signs and symptoms” of technology addiction:
Here is what to look for (3-4 yes responses suggest abuse; 5 or more suggest addiction)
Increasing amounts of time spent on computer and internet activities

  • Failed attempts to control behavior
  • Heightened sense of euphoria while involved in computer and internet activities
  • Craving more time on the computer and internet
  • Neglecting friends and family
  • Feeling restless when not engaged in the activity
  • Being dishonest with others
  • Computer use interfering with job/school performance
  • Feeling guilty, ashamed, anxious, or depressed as a result of behavior
  • Changes in sleep patterns
  • Physical changes such as weight gain or loss, backaches, headaches, carpal tunnel syndrome
  • Withdrawing from other pleasurable activities

And if you still aren’t sure, you can take the Are you addicted? survey.

Working With Addicts
For about a year in 2006 and 2007 I spent time working with addicts at a community mental health clinic in Los Angeles. The addictions were primarily related to substance abuse (drugs and alcohol) and I did everything that I could do to better understand the world of addictions. I took classes, I went to some Alcoholics Anonymous and Overeaters Anonymous groups, and I co-facilitated a 12 Steps group for 9 months a group that was mandatory for individuals if they wanted to stay out of jail. From that time a few of observations have really stuck out to me in regards to addiction:

  1. Compulsions
  2. Rationalizing behavior/choices
  3. Re-arranges, transforms relationships Continue Reading…

Some Practical Tips for Dealing with Depression

If you haven’t noticed yet, I have been covering the topic of depression quite a bit the last couple of weeks. This is going to be the last post on this topic for a while, but I wanted to leave you with an article that I thought had some great practical tips, and coping skills for dealing with depression.

Check out the article here, and if you have any questions, please feel free to contact me.

Depression and Burnout: Anne Jackson Interview, Part 2

Yesterday I posted the first of two interviews I did with Anne Jackson back in January of 2009. Check out part of the interview below, and read the rest of it here.

From your own perspective, what is at the root behind the stigma of counseling and therapy in the Church? What would you say to Christians who think that we should not take medications for depression and anxiety?

It has always been difficult for me to say I needed to be in counseling to the extent I was, or to say that I have been on a myriad of anti-depressants or anti-anxiety medicine because I’ve heard countless times people question my salvation or my authority to work out God’s calling in my life. Most people think that something is wrong with my spiritual walk if I have to use these “crutches.” I think that the people who are judgmental about these things live in a bubble that desperately needs to be popped. That means they have stayed safe and comfortable their whole life…and there is nothing about Christianity or redemption that is safe or comfortable.

Depression and Burnout: Anne Jackson Interview, Part 1

I had the privilege of interviewing Anne Jackson back in January 2009 on the topic of depression and burnout, especially as it relates to ministry and the church. Since I have been writing about depression over the last week I wanted to link again to her interview. Here is a piece of the interview below, but check out the full post here.

One of the reasons I wanted to interview you as you know, is that not many Christians are forthright on the topic of depression, anxiety and what I would describe as adjustment disorders….so why did you decide to be more vulnerable about this issue in such a public forum such as your blog and book?

I remember feeling so alone as I struggled with anxiety and depression…especially in the church world. I would go to services at my church or even as I would hang out with other staff members, it seemed like everyone was so happy and put together.

Those issues became so bad, I had to take a three week leave of absence from work where I started some medication and went to see a counselor. Talking about it with her made me feel so free. Go figure…the truth will set you free…that sounds familiar, doesn’t it?

As I began to share what was really going on with my friends and coworkers, many times those same people would share with me their own struggles with anxiety, depression or other issues.

I realize when other people share their struggles with me, it builds an instant bridge of trust. I know I can talk with them because they’ve walked in my shoes. It also makes a “me too” moment. I think it was Rob Bell who said the words “me too” are the two most comforting words in the English language.

Again, just starting that conversation and allowing others the permission to share knowing they will be welcomed with grace and trust and love – unconditionally, is why I am so passionate about talking about these things.

Page 1 of 41234»