Uncertain times like these find most of us more and more stressed and especially in need of finding that calm center within ourselves and our relationships. Sometimes we could use a little help with that…
At Pathways to Wellness, we have experienced and well-trained therapists who offer individual, couples, and group counseling, and intensive couples marathon therapy for those coming from a distance or who want to jump-start their work. We work with addictions, do grief and trauma counseling, and offer pre- and post-marital counseling, We are long-time Voice Dialogue practitioners and trainers and are Certified in Gottman Couples Therapy, as ASL (Gottman Art & Science of Love) Workshop Leaders, and in EMDR.
We accept major credit cards and are glad to bill most major insurance companies as a courtesy to you if you have a PPO or a POS plan and not an HMO (HMOs have their own providers and will not pay out of network).
As life gets increasingly complex, occasionally we just need somebody to talk to… someone who cares, but who does not have a personal agenda with us… someone to bounce things off of, from whom we might acquire skills and tools that haven’t occurred to us, someone to walk with us as we sort things out. Individual counseling gently facilitates the exploration and resolution of personal concerns according to our own specific individual needs and goals.
We each cope with dying, death, loss, and grief in our own unique and idiosyncratic way. Even close members of the same family often each grieve differently. No matter how sophisticated and in tact we are, the death of a loved one—family or friend, brings us to a place of deep vulnerability that reverberates through the structures of our entire being: physical, psychological, social, and spiritual. How we cope with other life events and how we adapt (or fail to adapt) to our present and future are also affected during this period.
In addition to the death of someone close to us, there are so many other losses that may drop us into the grieving process as well. These may include: the loss of one’s homeland, friends, family, and language (for example, in the case of a move), the loss of security in one’s body (for example, ill-health, catastrophic illness, loss of a limb, loss of strength or beauty with age, etc.), the loss of a life dream (for example, that one will have children, that one’s children will be something they aren’t, that one had a happy childhood), the loss of a coping strategy (for example, the loss of alcohol, drugs, gambling, overeating, etc.), the loss of one’s possessions or one’s job and, thus one’s sense of security.
It used to be thought that “time heals all,” and it is true that often allowing ourselves to take our time to heal, and not pressuring ourselves to “just get over it already (!),”can be quite helpful. However, there are many ways in which therapists and grief counselors can support us and help us to make the process a much gentler one. In prolonged or complicated grief situations, therapy can help us find a way out of something that often seems bottomless. There are specialized techniques and tools that can help us move in a healthy and timely way to resolve conflicts of separation and move toward completion before the grief reaction manifests through some masked somatic or behavioral symptom or in an exaggerated emotional response that makes our lives even more difficult.
Traumatic experiences can come in many different shapes and sizes. Posttraumatic Stress Disorder (PTSD) is a medical diagnosis, established in 1980, defining symptoms that last at least a month after experiencing a major trauma. These symptoms may include remembering or reliving a traumatic experience when you do not choose to, heightened or intensified emotions, feeling numb (emotionally and/or cognitively) and withdrawn, avoidance of thoughts, people, locations, events, or feelings, having awful nightmares, daydreaming about the traumatic event, and experiencing types of anxiety that interfere with daily life. For a complete list of diagnostic criteria for PTSD, see www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_dsm_iv_tr.html.
When we store memories under conditions of intense trauma, they may be fragmented and incomplete and yet somehow we make decisions about what that experience means about us… in terms of control (I have no control, I am powerless), safety (I am unsafe, can’t protect myself), or responsibility (I am bad, shameful). And those decisions often follow us around, as assumptions that then guide our perceptions of experiences for years post-trauma.
Whether you have survived a single traumatic incident, such as a car accident, been a victim of a violent crime or a natural disaster, or witnessed a crime, whether you have been a survivor of multiple major traumas, such as experiencing military combat, domestic violence, child abuse, or taking care of a catastrophically ill child, or you have experienced an accumulation of lower intensity traumas, like bullying or prolonged verbal abuse, there are therapies that can help tremendously.
Cognitive-behavioral and Emotion-focused therapies are quite useful in relieving some symptoms, and EMDR (Eye-Movement Desensitization and Reprocessing) is currently the most widely-accepted specific modality for use in trauma work, see www.emdria.org/displaycommon.cfm?an=1&subarticlenbr=3. Dr. Young and Rupa Ward are both EMDRIA Certified therapists and Terry Maher and Stephenie Champlin have been trained and are currently completing their hours for certification.
Like other forms of biofeedback, NFT uses monitoring devices to provide moment-to-moment information to an individual on the state of their physiological functioning. The characteristic that distinguishes NFT from other biofeedback is its focus on the central nervous system. NFT is preceded by an objective assessment of brain activity and psychological status. During training, sensors are placed on the scalp and then connected to sensitive electronics and computer software that detect, amplify, and record specific brain activity. Resulting information is fed back to the trainee virtually instantaneously with the conceptual understanding that changes in the feedback signal indicate whether or not the trainee's brain activity is within the designated range. Based on this feedback, various principles of learning, and practitioner guidance, changes in brain patterns occur and are associated with positive changes in physical, emotional, and cognitive states. Often the trainee is not consciously aware of the mechanisms by which such changes are accomplished although people routinely acquire a "felt sense" of these positive changes and often are able to access these states outside the feedback session. Neurofeedback training (NFT) has its foundations in basic and applied neuroscience as well as data-based clinical practice. It takes into account behavioral, cognitive, and subjective aspects as well as brain activity. Thus, it meets the American Psychological Association's definition of an evidence-based intervention.
When our primary relationship is in trouble, we are in trouble… our minds, our bodies, our lives just don’t work right. We are not really at our best in any sphere of our lives. Why do we keep struggling to get it right and what is it, at the core, that moves us to continually seek romance and deep connection with that one special other person? In the movie Shall We Dance (2004), Beverly (the wife, played by Susan Sarandon) sums it up brilliantly to Devine (the private investigator she hires, played by Richard Jenkins):
We need a witness to our lives. There's a billion people on the planet... I mean, what does any one life really mean? But in a marriage, you're promising to care about everything. The good things, the bad things, the terrible things, the mundane things... all of it, all of the time, every day. You're saying “Your life will not go unnoticed because I will notice it. Your life will not go un-witnessed because I will be your witness.”
We need to make our primary relationship the very best it can be…
Why go to counseling when you are deliriously happy?
We keep getting married in hopes that we will “live happily ever after.” However, from the most conservative recent statistics, about 60% of all marriages that eventually end in divorce do so within the first ten years and those couples who married between in the early- to mid-1990s have, at best, only a 75% (college grads) or a 50% (non college grads) chance of staying together. (www.divorcereform.org/nyt05.html). The statisticians rate second marriages as a consistently worse gamble. So why, despite such sobering data, do we so fiercely maintain that we will be the lucky ones who make it?
Well, one reason is that, in the throes of early love (and planning weddings, etc.), our brains are flooded with dopamine, norepinephrine, and serotonin—all associated with arousal and euphoria. Brain areas governing craving, obsession, reward… and recklessness… are activated as we are driven to “win” the object of our passion. During this stage of love, we may find we can’t eat, sleep, or concentrate on anything but the beloved. We write bad poetry and happily sing out of tune. The dopamine gush in our brains is mildly hallucinogenic, causing “crystallization” of the beloved... Thus, rather like the branch of a tree that glistens when covered with ice and snow.
But this form of love is only sustained with a perfect ratio of hope to uncertainty and marriage is the ultimate form of reciprocation, hopefully eliminating uncertainty and, at some point within the six to eighteen months, the elevated levels of dopamine, norepinephrine, and serotonin will drop. It is then that “the honeymoon is over” and the experience of an oxytocin-based, attachment form of love may begin so long as the couple knows how to successfully maintain friendship and affection, navigate conflict productively, and work cooperatively to realize their (individual and collaborative) hopes and dreams. And yet, most of us have been given little, if any, training that could prepare us to “do the footwork” of a long term loving and passionate relationship.
We train and get tools for our professions… Why not do a bit of the same so we can do our best in love?
Why not get timely help when your relationship is having a heart attack?
The Gottman research has shown that we get ourselves to a cardiologist within two weeks after we notice we’re having chest pains, but it takes the average couple six years to seek therapy from the time they first notice there are problems in their relationship!
Dr. John Gottman has studied what he refers to as the “masters and disasters” of marriage, following closely well over 3,000 couples for over thirty years. His scientifically-based research, along with Dr. Julie Gottman’s three decades of clinical practice, combined to produce the first structured, goal-oriented, empirically-based couples therapy (see www.gottman.com). This model began with a quest to learn how to predict divorce… what behaviors, or lack thereof, were actually predictive of marital breakdown… and then led to studying couples who stayed together and were happy with their relationships and what they actually did to make their marriages flourish. The model is founded on the bit-by-bit analysis of videotaped footage and physiological data (pulse and heart rate monitors and other measures of physiological arousal) taken on couples while they did routine things, engaged in conflict discussions, and described the histories of their relationships. With this model, we are able to delineate the changes necessary to making a relationship work well.
Our therapists use the Gottman model, along with other extremely well-respected approaches to couples work such as the Emotion-Focused work of Dr. Sue Johnson, the Imago approach used by Dr. Harville Hendrix, and the Voice Dialogue framework and methods of Drs. Hal and Sidra Stone to give couples the best help available in making troubled relationships good and good relationships even better.
Dr. Young is a certified Gottman Couples Therapist and does both marathon and extended-session therapy for those whose schedules, situation, or geographic location make that easier than weekly therapy. She uses primarily the Gottman model for this work, but may intertwine other modalities as well depending on the needs and wishes of the particular couple.
Generally, the minimum commitment for marathon therapy is 10 hours, often over the course of two days, and prior couples have most often opted for more like 15 hours when they were coming in from out of town. Couples and individuals from the LA, Riverside, and San Diego areas, however, have done 10 hours in one day or asked for extended-session therapy (anywhere from 3 to 9 hours)… because they were able to come back for follow up work more easily.
For marathon and the longer extended-session therapy there is a deposit required to hold the time, since regular clients have to be juggled around to create a larger time block. They are generally booked about 4 to 8 weeks ahead of time unless there is a break in the schedule before that.
Approximately the first hour of this work is with both people, getting a relationship history and a brief summary of the couples’ strengths and concerns. The second and third hours (or so) are individual sessions with each of the partners, getting a personal family and relationship history. The fourth hour (or so) is spent going over the relationship questionnaires and everything in the first three (or so) hours and, together, setting the agenda for what the couple wants to work on. The rest of the time is spent working on those things specified. The reason Dr. Young can only approximate the schedule (“three or so hours”) is that each couple is different and brings to the work a different degree of complexity.