What Are Your Internal Dialogues Trying to Protect You From?

By Concentric Therapist Intern Mara Hundrieser-Acosta, B.A. (Clinical Mental Health Counselor M.A.)

I know I am not the only one that has internal conversations with different parts of myself. Just going back and forth with what I should have done, said, or even experienced. I recently lost my mother to cancer. When someone asks me “How are you doing? I answer with “ I am doing ok, just taking it one day at a time.” but on the inside, my brain is struggling. The actual answer in my mind is, “ I miss my mom, I wish I could see her.” and then another part of my mind answers “I have to cook dinner, wash clothes, put them away, and so much more to do, I feel so overwhelmed.” and another part says, “People will think you don’t have a handle on your life if you let them know how you truly feel.” So, I end up giving a generic answer and smile. 

The conversation inside my mind keeps going even though on the outside I am smiling and making small talk. Sometimes when we have been through hard times, we develop a strong voice that keeps us “in check.” When we view this through an Internal Family Systems (IFS) lens, it's called a Manager. We all have these internal conversations. No, there is nothing wrong with us; it’s just part of how we take care of ourselves internally. You might wonder what I mean about how we take care of ourselves internally. We all go back and forth with all of our parts to try to navigate our lives through stress, anxiety, depression, painful situations, and trauma. Through IFS we can learn what these parts need in order to feel at peace in our life. 

“IFS guides us to offer deep understanding and credible help to the critic and the innumerable other parts who populate our clients’ inner worlds, some of whom long to transform but are stuck in extreme, destructive roles.” -Schwartz & Sweezy (2020)

What is IFS?

Internal Family Systems (IFS), a model of therapy and an approach to better understand ourselves, was developed by Dr. Richard Schwartz. He has worked on the development of IFS for over 40 years.  Dr. Schwartz holds a Ph.D. in Marriage and Family Therapy and was trained to view and understand people through a systematic lens.  After years of working with families and individuals, Dr. Schwartz noticed how clients would speak about their different inner parts. Just like I shared my internal dialogue about being asked about me in relation to my mother. 

While in session with clients, Dr. Schwartz’s patients would share how they would go back and forth with different parts of themselves.  Dr. Schwartz noticed those parts also operate within a system similar to how a system of family operates. For example, a family system consists of different family members, roles or parts (e.g. parents, children) that interact with each other.  

If we look at humanity or systems with a very wide lens, we notice a system is always in place, starting with our solar system. Dr. Schwartz was able to recognize there is a system that consists of people’s inner parts.  These parts are called Managers, Firefighters, and Exiles. These parts have developed to protect us from harm, trauma, and difficult experiences that have left a wound inside our psyche. They all have a specific role that falls under a three-group system. All of our parts are good, even though they might seem mean or aggressive at times. 

The goal of IFS is to help people become Self-led, which means that their various parts feel loved by the Self and trust the Self’s leadership. IFS therapy has a gentle way to ease the pain of people’s experiences and parts and to help navigate the internal turmoil one often faces throughout life. 

The Roles of Parts: A Three-Group System

In order to understand further this three-group system we need to understand that each group or also called protective parts (Managers, Exiles, and Firefighters) doesn't have just one personality. There are different kinds of Managers; each one has its own role to play, as well as the Exiles and the Firefighters to protect us internally. These three-group systems work with each other and sometimes what feels like against each other in order to keep us safe internally. 

In other words…

One group tends to be highly protective, strategic, and interested in controlling the internal or external environment to keep things safe. In IFS, we call the members of this group Managers. 

A second group contains the most sensitive members of the system. When these parts feel injured or outraged, Managers will banish them for their own protection and the good of the whole system. We call them Exiles. 

A third group tries to stifle, anesthetize, or distract from the feelings of Exiles, reacting powerfully and automatically, without concern for consequences, to their distress as well as to the over-inhibition of Managers. We call these members Firefighters. 

Trauma & Internal Family Systems 

According to Schwartz & Sweezy (2020), internal systems (parts) that are responding to trauma not only divide into these roles, but the protective parts (Managers and Firefighters) also form alliances and get into conflicts with each other and can be very harsh or smothering with the Exile they are trying to protect or ward off. The sadder, more terrified, ashamed, rageful, or sexually charged an Exile is, the more protectors legitimately fear its release and the more extreme they become in their efforts to suppress and constrain them. In turn, the more an exile is suppressed, the more it tries to break out. In this way all three groups become victims of an escalating cycle of internecine* conflict. 

*internecine: destructive to both sides in a conflict.

Example: The more ashamed I feel about a traumatic event that happened to me the more scared the Managers and Firefighters are of me releasing or admitting this shame. So, the Managers and Firefighters will try really hard for me to suppress that shame. Which can mean one can begin to use drugs and alcohol to control that shame, or become very narcissistic in order to push it way down. The Managers and Firefighters believe that if one releases or admits this shame, it (the part) will ultimately fall apart. 

Childhood & Internal Family Systems

The Self can be forceful and protective. Children who have experienced developmental trauma or any abuse of their independence, spontaneity, leadership (or other traits that rely on courage themselves) begin to suppress their courageous side. It takes tremendous courage to go toward terrifying places in the psyche. Many protectors avoid stepping out of their roles because they believe the person would be weak and passive without them. Protectors always have intense fears about allowing clients to open the door to Exiles they locked away years ago in inner dark places. When a client says they are afraid to do something, we know a part in their inner world is speaking. But once the part understands the fearless nature of the Self, its fear (and emotional pain, shame, and rage) surrenders.

IFS Therapy has 4 Goals:

1. To liberate parts from the roles they have been forced into, freeing them to be who they were designed to be.

2. To restore faith in The Self and in Self-Leadership.

3. To re-harmonize the inner system.

4. To encourage the person or client to become increasingly Self-led in their interactions with the world.

So, What Does This All Mean? 

The intention of IFS is for the client to access, experience, and be Self-led, to feel safe, to learn their inner world, and understand how their parts work together or against each other in order to protect them. The more we learn and understand about our parts and what they are trying to tell us; it then becomes easier to identify when they get activated. Understanding who we are, where we have been, and what has hurt us, is what is going to give us the opportunities to heal ourselves. The end goal is to be able to be our own saviors, but to get there we must be willing to surrender and be open to learning. 

Once a person experiences faith in The Self and in Self-leadership, the IFS therapist seeks to help the client develop the Eight C’s. 

The Eight C’s

Curiosity: The client learns to be inquisitive, and have interest rather than be judgmental or fearful. This is where one comes with no agenda, one just wants to learn, know, and understand. There is a sense of feeling at ease and moving forward with wonder. There is a sense of safety that opens the door to vulnerability. 

Calm: After being in a high alert state, where one’s nervous system is often aroused, Self-leadership does the opposite by creating a sense of calm that is both physical and mental. The client is able to accept life on its own terms and there is a sense of resilience and assertiveness. 

Courage: When a client says they are afraid to do something in the inner world, we know a part is speaking. But once the part understands the fearless nature of The Self, its fear (and emotional pain, shame, and rage) surrenders. 

Confidence: The Self validates and comforts its Exiles bringing about an infectious air of confidence, conveying to protector parts that it is safe to relax instead of trying to “let it go and move on” (the typical protector advice that encourages people to abandon and isolate their burdened young parts), injuries can be healed. When Exiles are unburdened, the system becomes less delicate and less reactive, and protective parts are more inclined to trust Self-leadership. 

Connectedness: The Self, in its natural state, experiences the sense of connectedness. Instead of trying really hard to obtain a connection with someone, through trauma bonding.  The Self can now move through the world in harmony. Connectedness links with calm and confidence which altogether links up The Divine. 

The Divine: Through extensive research by Dr. Richard Schwartz this is what he describes as The Divine. “Though they used different words, all the esoteric traditions within the major religions – Buddhism, Hinduism, Christianity, Judaism, Islam – emphasized their same core belief: we are sparks of the eternal flame, manifestations of the absolute ground of being. It turns out that the Divine within – what the Christians call the soul or Christ Consciousness, Buddhists call Buddha Nature, the Hindus Atman, the Taoists Tao, the Sufis the Beloved, the Quakers the Inner Light.” 

Clarity: One can see things more clearly. The distortions are no longer in effect and the extreme beliefs ease as one can see authenticity. Our vision is clear when we see through the eyes of the Self versus when our vision is distorted through the eyes of extreme parts.

Creativity: It’s believed that once the inner turmoil and constant struggle start to quiet down and The Self becomes the leader (aka Self-led), creativity can emerge naturally. This means once the managers start to relax, we can problem-solve with greater ease which becomes second nature. 

Compassion:  Once a client finds some separation or healthy distance from their angry or scared part, they can now see these parts from a compassionate lens.  They can express how sad or sorry they are for those parts and are willing to help them heal. This inherent desire to help their suffering parts signifies and taps into compassion. 

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I hope that after reading all this information there is a part of you that feels compelled to explore IFS. I want to say to “the part” of you that has that interest, that feels like it has been lost, in pain, or any other unresolved feelings; you are important and you deserve to be seen and heard. If you are wondering which part that might be, I am talking to your Self-led part; the part that might be hiding in the shadows for a while. 

We live in a time where we are overworked, overwhelmed, on the go, not getting enough sleep, expecting to be everything and nothing at all, where we have to walk on eggshells, but make a difference. It’s no wonder that our Self-led part feels so overwhelmed and just lost. This is the time when we need to slow down and rebel; which translates to going inside, getting curious about your parts, and reconnecting to who we truly are meant to be.

I know it might sound like a big ask, yet if you go back and read about The Eight C’s and imagine experiencing them, I think it’s all worth the journey of healing. The idea of feeling liberated is what motivates me through the IFS lens. I wish for you and my clients to feel liberated from whatever has been holding you back from being your most authentic self and be connected to your Divine. 

So, next time you have those internal conversations bring awareness to what each part is saying, and ask them what they truly need. They are trying to protect you even if they might sound very harsh or act maladaptively; they just haven’t learned a better way, yet, to communicate with you. Even if you don’t think you have the power within you to heal, to reframe those inner dialogues; you actually do, it’s inside you.

Resources for Consideration

Books: IFS online store | IFS Institute 

Videos: Dr. Richard Schwartz explains Internal Family Systems (IFS) Dr. Richard Schwartz Has A Radical Approach To Healing

Podcast: Multiplicity of the Mind: An Approach To Healing the Inner Self | Dr. Richard Schwartz X Rich Roll

Heal!

By Concentric Counselor Jordan Perlman, LPC, NCC

The following post is based on the documentary "Heal", Written, Directed, and Produced by Kelly Noonan Gores and Produced by Adam Schomer. "Heal" can be streamed on Netflix and/or iTunes or purchased on DVD or book from www.healdocumentary.com.

What If Mind Over Matter Is True?

Contrary to what many of us have been told, the latest science supports the belief that we are far from victims of unchangeable genes. We can control our health and life by taking a holistic approach to healing. One that remembers just how intelligent the body is and the way our thoughts, emotions, and beliefs affect our overall health. Therefore, healing begins in the mind and can be extremely complex and deeply personal. To treat oneself, one needs to get to the root of what caused the imbalance in the first place.

According to Joan Borysenko, Ph.D., "90% of what takes people to the doctors is stress-related illnesses". "Stress" is a broad term and can be broken down into three primary sources, all of which can knock our brain and body out of balance:

• Physical (accidents, injuries, falls, physical traumas)

• Chemical (bacteria and viruses, hormones in food, heavy metals, hangovers, blood sugar levels)

• Emotional (family tragedies, loss, job, bullying, finances, emotional and sexual trauma, and neglect)  

Most interventions focus exclusively on physical and chemical sources of stress, leading doctors to overprescribe medications that treat the problem's symptoms without addressing the cause, which can often be emotional. A dependence on pharmaceuticals temporarily fixes the symptoms yet this approach neglects the root emotional cause. For many, this approach leads to the development of additional symptoms/diagnoses as a result of the untreated root imbalance. One way to combat this model's limitations is to focus on a holistic healing approach that emphasizes the internal environment that focuses on disease’s emotional causes. Therefore, every person is the architect of their healing and their destiny.

The Incredible Power of the Autonomic Nervous System

Our systems are incredibly smart and adaptive, and long ago, this primed us to face threats that we no longer meet in modern times. Although this function once served us well, it can cause us a bit of trouble in today's society. For example, the nervous system that once primed us for survival in the face of a Saber-Toothed Tiger looks more like an upcoming work meeting that we're anxious about or a fight with our partner. In either case, the untrained nervous system often can't tell the difference and releases Cortisol, Adrenaline, and Noradrenaline designed to mobilizes your energy to run away from and/or fight the predator. When that happens in response to incidents that don't require that level of response, we might be operating outside our windows of tolerance far more frequently than is sustainable.

According to Stem Cell Biologist and Author Bruce Lipton (Ph.D.), when you perceive a threat, your body activates the Adrenal System (fight or flight). Whether you're preparing for an exam or fighting off an attacker, the result is the same, and the Adrenal System is activated. When this starts in response to a relatively benign threat, often, it increases negative, disease-causing consequences. Over time, this chronically impairs your:

• Memory

• Concentration

• Digestion

• Elimination of toxins

• Immune system

This impairment is due to resources being mobilized from the gut, elimination system, immune system, and higher brain centers. The resources are reallocated into the muscles to fight/flight for your life, which is excellent when used in a true life or death situation. However, when this frequently happens, as a result of let’s say chronic stress, this can cause pH levels to rise. If pH levels are high, this leads to an acidic body. An acidic body causes inflammation that, in turn, destroys the body and causes disease. Therefore, it is vital to reduce stress in the body to reduce inflammation and reduce disease. 

The Placebo/Nocebo Effect on Healing

To access our full healing potential, we have to get our minds on board with the belief we can heal. One way to do this is to focus on creating tonic thoughts as tonic thoughts produce tonic chemicals, while toxic thoughts produce toxic chemicals. If we're not careful, our thoughts and beliefs can prevent us from healing even with the best medical intervention. Therefore, if I change my perception (the mind) and change my view about life (and healing), I change the signals adjusting the cells' function, which has enormous implications. 

Although the Placebo Effect is not entirely understood, a consensus assumes that our minds can control the body. The Placebo Effect relies on positive thinking or believing that an intervention can heal by being open to the possibility of getting better via a "treatment" without an actual chemical, physical intervention or remedy. Many have heard of the Placebo Effect (commonly discussed when looking at research). Yet, there is a lesser-known and equally influential phenomenon that also has the potential to alter your life, known as the Nocebo Effect.

The Nocebo Effect occurs from negative thinking, which can cause illness and disease and even cause death. As a result, the power of belief or "mind over matter", is almost everything. Whatever you are thinking and believing in a given moment, your immune system is either told to "stop working" because we have to respond to a stressor, or "everything is cool." In the first example, the Sympathetic Nervous System is activated and pulling resources from the body's other functions. The latter is a parasympathetic response, which puts the body in a mode ideal for rest/digest/healing; your beliefs toggle that switch.

The experience of Dr. Joe Dispenza illustrates an example of the incredible Placebo Effect in action (Read his full story here). In 1986, at the age of 23, Dr. Joe Dispenza was run over by an SUV while competing in a triathlon in Palm Springs, California, and was paralyzed. Instead of opting for the high-risk surgeries recommended to him by his doctors, he focused on using visualization to move his paralyzed limbs and imagined his shattered spine mending. By the power of his mind, Joe was able to make a full recovery, which further supports the notion that one's beliefs can shift biology. 

The Conscious/Subconscious Mind

The Placebo/Nocebo Effect also extends to Epigenetics, which tells us that our environment can select cells' genetic activity. Our beliefs affect our nervous system, and then our nervous system sends information about its environment. The cells adjust to interact with the world, which stems from consciousness, which is an interpretation of one’s perceived reality. Therefore, my mind is interpreting my environment; by changing the environment, or the perception of their environment, one can control their genetic activity. This takes people from a space of being victims of hereditary to a master of gene activity capable of creating a different reality. 

All of this sounds relatively simple, right? Wrong. The majority of this process is unconscious, which complicates things exponentially. We know that our Conscious Mind and our Subconscious Mind are two interdependent minds that work together. When the conscious mind is engaged in thinking, the subconscious mind is the autopilot's default program, carrying out whatever chore needs doing. The subconscious mind is comprised of downloading (mostly) other people's behaviors. Think of your Mother, Father, siblings, and community during the first seven years of your life when you're essentially a sponge to the world, absorbing other's patterns with little discretion. When our environment growing up is healthy, that's excellent news. However, that's not the reality for many who grew up with less than ideal upbringings.

Regardless of your situation, we all developed blueprints on coping and processing emotions based on what we saw growing up. For some, these memories may not have fully developed, leading to reexperiencing that unprocessed memory every time we get triggered as if it's happening for the first time. One can attempt to outrun the subconscious mind. Though to heal, it's crucial to face it, see the problem, and recognize the systems and stressors as meaningful and intelligent and necessary to wake us up to our patterns to choose a different way. These unconscious beliefs are often running our lives. By asking, "what is this pain or disease trying to tell me?" you can create space for answers to come (Pro-tip: you can use that trick with any thought, feeling, memory, behavior, and you might be surprised what might come up). Additionally, therapy can help make the unconscious conscious, helping release stuck energy trapped in the body via processing previously unprocessed emotions and memories. 

Factors Scientifically Proven to Contribute to Healing

So now that you know you're more in control of your healing than perhaps previously thought, what can YOU do about it? First and foremost, healing cannot occur while you're chronically operating in a state of Sympathetic Nervous System (fight/flight) activation. One must move into the Parasympathetic Nervous System (rest/digest) to heal. There are a variety of ways to do this, and some of them are listed below.

Meditation

Based on the research by Dr. Herbert Benson, meditation is said to "shut down fight or flight response and stimulate the parasympathetic (relaxing) nervous system of the body. Meditation has the potential to relieve stress, purify the mind, and purify consciousness. Meditation connects us to our core being or core consciousness (soul or Self). While in meditation, the Pituitary Gland releases Oxytocin, Dopamine, Relaxant, Serotonin, Endorphins when making a spiritual connection. It's an internal process that can switch on like a light switch when we take a moment to connect.

If meditation isn't your jam, try going for a walk in nature or another activity that shuts off your mind and causes breathing to slow to a feeling of unshakable peace. Even something as simple as imagining someone is sending you love, helping you, holding you, can help you heal. By visualization alone, your body releases Oxytocin which is associated with increased natural killer cells and increased white blood cells (which trigger an immune response) necessary for healing.

Support Systems

Surround yourself with people that provide support and love versus adding to your fear. For those in your life that contribute to fear, can you explore healthy boundaries to support more beneficial relationships? As tricky as relationships can be, humans are hard-wired for connection. It’s essential to establish and nourish healthy relationships with others.

Gratitude

Gratitude can help boost your immune system, cause feelings of happiness, and help you shift your world view; think Placebo Effect! When we learn lousy news, a common emotion is fear or sadness. Regardless of what is said, if you fear, a positive thought will never reach the body. Fear triggers fight/flight response in the brainstem, which takes our emotional state out of alignment and offline. Suppose you can change your emotional state into one of gratitude. In that case, you believe whatever you're grateful for has already happened. Primed with gratitude, when you say the thought or new belief, your body can receive it, and your body responds accordingly. The more we can feel the feeling as if the feeling is, our body is triggered to grow the nerve cells to make the connections to trigger the brain chemistry to reflect the healing.          

You might consider starting a gratitude practice. For some, this can look like writing down a few things you are grateful for each day. For others, you might pair mentally recalling things you're thankful for while doing an activity such as showering or brushing your teeth.

9 Healing Factors Associated with Radical Remissions 

Kelly Turner, Ph.D. (researcher, author) discovered in her research studying case studies and interviews from those around the world who experienced radical remissions from their illnesses, the nine key healing factors (listed below). Dr. Turner found radical remissions for every single type of cancer occurring in various stages. She found over 75 different things that people have tried to get well, though not everyone used all 75 factors. In her research, she discovered that everyone who got well used these 9 (note only 2 of the following are physical, the rest are mental, emotional, and spiritual):

1. Radically changing your diet

2. Taking control of your health

3. Following your intuition

4. Using herbs and supplements

5. Releasing suppressed emotions

6. Increased positive emotions

7. Embracing social support

8. Deepening your spiritual connection

9. Has a strong reason for living

Counseling

Specifically, to explore patterns (the way our thoughts, feelings, behaviors all influence each other) and shadow (subconscious) work. It's beneficial to have a trusted confidant outside your social network to: vent to, sort through feelings, identify unhealed wounds, process emotions in a healthy way, work to implement behavior changes, find healthier coping mechanisms, assess and enforce healthier boundaries, and help you identify areas where you can move from a space of surviving to thriving.

Conclusion

In conclusion, by doing different things, making other choices, getting beyond certain emotions, and overcoming limited thinking, more possibilities begin to open up. That's when magical things start to happen in a person's life. That tells us that seemingly incurable illnesses are reversible by focusing on the whole person and root causes of disease versus symptoms, which traditional Western medicine tends to focus on. Conventional medicine relies on the old belief system stating illness is tied to genetics and biochemistry, requiring prescriptions to treat these ailments. However, many believe that very few diseases are truly organic (as a result of genetics). The rest is due to the consequences of dealing with chronic stress. According to Dr. Deepak Chopra, medicine is useful in 10% of acute illnesses (physical traumas, emergency, injuries, infections). He recommends a holistic approach to treat chronic diseases (cancer, heart disease, auto-immune diseases. A holistic approach treats the mind, body, emotions, and energetic body, shifting your experience of mind, body, emotions. 

Remember, we regulate ourselves with the choices we make in our lives. Based on what we think, feel, believe, and specifically, the emotions we choose to respond to create what life brings us. It pays to make your mind a healthy place to be. 

Utilizing The Transtheoretical Model or ‘Stages of Change’ to Better Understand Your Addiction

By Concentric Counselor Charles Weiss, LCPC

If the dopaminergic receptors in my brain didn’t make me feel so good when stimulated and weren’t so intertwined as well as interwoven with my serotonin levels and that my GABA receptors didn’t inhibit my nerve transmission leading to my brain activity level to be depressed, I would have never used in the first place.  Do people who suffer from addictions really think like this?  Do they really understand the intricacies on how drugs affect the brain and other physiological aspects of their bodies?  If they had that insight or answers, would they still want to get high, continue rationalizing the reasons in which they use or actually seek out help?

For the change process of the individual to be effective and impactful, it is helpful to better understand how certain drugs affect the brain.  Different drugs when taken affect different aspects of our brain functioning.  For example, alcohol is a depressant, which slows down or depresses our Central Nervous System, which helps reduce anxiety and inhibit relaxation in our body.  It slows down brain activity through binding with GABA receptors to help with minimizing racing thoughts, rapid breathing and quick pulse.  Substances like opioids and stimulants, that target the pleasure center in our brain, which involves the Dopamine neurotransmitter, provide us with that “feel good response” that makes it more difficult for people who are addicted to want to quit.  Let’s not forget the cannabinoid receptors that are naturally occurring neurotransmitters that our brain produces, which Tetrahydrocannabinol (THC) and cannabidiol latches onto.  When this occurs, we often experience a more euphoric feeling and our sensory perceptions are often enhanced, which also increases the level of dopamine that is being produced in our brain.  This list is just to name a few of the more widely used substances individuals can become addicted too. 

Substances have the propensity to be both psychologically and physiologically addicting, meaning either the body and/or our mind needs the drug to avoid potential withdrawal.  Not everyone who tries a substance for the first time will become instantly addicted, however, it can increase their risk of them wanting to try it again because of how it made them feel. 

It is not just the neurochemistry in the brain that makes a person struggling with addiction want to use, but the stages of the change they are in can have an impact and effect into the chronicity of their use.  Prochaska and DiClemente postulated a Transtheoretical Model or what many might know as the “Stages of Changes” that people can experience when it comes to their understanding their addiction and their willingness to cease it. 

This model has 5 stages that an addict can experience, with a sixth called Relapse, which I will discuss later, that indicate the individual’s willingness of wanting to continue or cease the use of the substance(s). This model can also apply to a wide range of other behavioral challenges that individuals are having an arduous time in overcoming, not such substance use, abuse, or dependence. 

Stage 1- Precontemplation

Pre-contemplation is when an individual doesn’t think they have a problem with the drug and/or substance they are using and aren’t willing to change their behavior.  Oftentimes these individuals are in denial that their addiction is a problem, they have not connected the experience of the negative consequences of their addiction or understand the severity of their addiction at this time.  They are currently enjoying and appreciating the positive and pleasurable effected of their addiction, the “high” and positive aspects of the substance they are using due to neurotransmitters that substance targets to cause this affect.  It often isn’t until the individual begins to experience more of the negative aspects of the substance (i.e.: withdrawals, negative consequences from their addiction), will the individual begin to consider they might have a problem and move from pre-contemplation to the contemplation stage.

Stage 2 - Contemplation   

Contemplation stage typically occurs when individuals have the self-talk about the challenges and struggles in wanting to make a behavior change, yet are unable to pull the trigger at this stage and follow through with their thoughts of wanting to change or cut down their use.  Individuals are typically open to listening to advice on how they can change their behavior, to gain a bit more insight into their addiction, understanding the consequences of their addiction, but have not established and/or developed a specific plan on how they would like to change their behavior.  Utilizing a non-judgmental attitude and motivational approaches to encourage change, such as beginning to teach individuals a harm reduction approach, can help propel the individual towards the preparation stage of change.

Stage 3 – Preparation

During this stage of change, individuals are starting to become more committed into wanting to change their behavior and develop plans on how they can begin minimizing the frequency and occurrence in which they are using substances.  Individuals start to gain more insight into the impact and effects the substances have on their level of functioning and the dysregulation of neurochemistry in their brain through collecting and gathering resources either provided to them or investigating these resources for themselves.  They become more cognizant of their triggers and begin learning more effective strategies to minimize the occurrence of them as well as seeking out and developing healthier support systems to aide in their recovery.  Individuals begin to gain more insight into the consequences their addiction is having on their level of functioning.

Stage 4 – Action

As the insight and introspection into their addiction becomes more “front and center”, individuals are able to begin developing plans to implement to aide in their recovery.  Now all the preparation that was exerted and exhibited in the previous stage can be put into motion.  As stressful as this stage can be, it is the best time when interventions such as seeking out a Certified Drug and Alcohol Counselor (CADC), licensed therapist or going to a substance abuse or detox center can be most impactful and continue to move as well as guide the individual towards their recovery.  With a trained and licensed professional, appropriate and realistic goals can be established to be addressed gradually as well as developing more adaptive over maladaptive coping skills that are taught to help move the individual towards the maintenance stage.

Stage 5 & 6 – Maintenance/Relapse

After the strenuous time it takes into in acknowledging, accepting and putting into motion plans that become action, maintenance follows.  This is time in which the individual is able to maintain sobriety for at least 6 months of implementing everything they have learned in treatment and progress on the goals they have developed for themselves.  During this time, individuals might begin to feel complacent or feel like there is some plateau they have reached with their progress, that defaulting into their maladaptive habits might be inevitable.  However, with the continual commitment and support to their recovery, maintenance can be an obtainable long-term goal. 

Part of any recovery can be relapse, although not everyone experiences relapse(s).  When an individual relapses, they don’t necessary default back to Stage 1 - Precontemplation.  If the individual is committed and with ongoing positive support they have created for themselves, they might only fall back a stage to Action and/or potentially Preparation Stage.  It unfortunately might take an individual several relapses before they are fully committed to the change process.  The goal is never to give up and continuing reinforcing yourself of your commitment of wanting to make the behavior change in being able to abstain from one’s substance of choice, such as alcohol or illicit substances.

If you or a loved one is struggling with any addiction, please seek out professional help. There are countless resources available that can help and aide you in your recovery.  Change doesn’t happen overnight, but understanding as well as acknowledging that you might have a problem is the first step in your journey to change and living a healthier and more fulfilling lifestyle.  This Transtheoretical Model or Stages of Change by Prochaska and DiClemente might not be applicable to everyone, but it can be applied broadly to anyone who is willing and wanting make the necessary change to improve their overall lifestyle and to be a better you. 

Asking for Help - Not Waving but Drowning

By Concentric Counselor Christian Younginer, LPC, NCC

Not Waving but Drowning

By STEVIE SMITH

Nobody heard him, the dead man,   

But still he lay moaning:

I was much further out than you thought   

And not waving but drowning.

Poor chap, he always loved larking

And now he’s dead

It must have been too cold for him his heart gave way,   

They said.

Oh, no no no, it was too cold always   

(Still the dead one lay moaning)   

I was much too far out all my life   

And not waving but drowning.

I believe this poem verbalizes well a common societal pressure. That is, the need to be happy externally, even if drowning internally. As we go through our day, met with multiple “How’s it going?”, we invariably are trained to answer “fine” or “great”, without the slightest thought. The question we’re left with is: how would anyone know I’m drowning, when I always give them a friendly wave?

Asking for help can be deceptively difficult. Frequently I hear from clients that asking for help shows weakness, or is shameful, or too vulnerable. So, we strengthen our resolve, buckle down, and soldier on at the expense of our wellness and happiness. We become run down, exhausted, and deflated. Imagine a balloon trying to remain the same size, while its air slowly leaks. We receive messages from our families of origin, our employers, and consumer culture that tell us to harden. But the harder we get, the more brittle we become. Rather than naming our need for help, we’re now drowning with work, emotions, schedules, and isolation. 

Ultimately, this issue of asking for help comes down to a person’s struggle with taking care of themselves. Wellness, self-care, asking for help, boundary setting, etc all live in the same neighborhood: taking care of the self. A former supervisor of mine offered this metaphor:

You board an airplane, take your seat, and the flight attendant begins the safety protocols speech. They get to the section on the oxygen mask. They say, ‘please secure your own mask before attempting to assist anyone else.”

Why is that? Well, you can’t help anyone if you’re dead. The same concept applies here, albeit with less grim consequences. How can we expect to function, let alone help others, when we run ourselves ragged?

To return to the topic at hand, one way of taking care of the self is asking for help. Seeking therapy is a form of this. I often name the courage it takes for a client to find a therapist. As we know, it’s hard to find help for ourselves- especially for our mental health. As if the unfortunate stigma isn’t enough, busy schedules and work demands can get in the way. If therapy is two steps too far for you, there are smaller ways to open ourselves to the help of others.

We don’t have to instantly open up and adopt this idea. Rather we can take smaller steps that feel safer. For example, if we have created a default answer of “fine” when asked “how are you?” by random people, then that may have filtered into closer relationships. Those relationships where it may feel safer saying “Actually, I’m struggling.” So, what if we remove the automatic ‘fine’ from our vocabulary? Rather, when asked by a close friend or family member, “how are you?”, we take that question for what it is: an out-stretched hand to a drowning person.

 I think it is unfair to view this poem as an indictment of those who misread the author’s anguish. Rather, I believe it is a call to stop waving when we’re drowning. To let those looking out for our safety, save us. Only from this place of moaning, cold death does the author finally feel safe saying she was much too far out all of her life. If only we, the onlookers, knew this we could’ve helped.

 It is ok to feel you’re too far out. It is ok to feel like you’re drowning. There are those who want to help us, but only if we let them. When we don’t ask for help, we deny our friends and family the gift of being able to help someone they love.

Men, Loneliness, and the Substance Substitute

By Concentric Counselor Myron Nelson, LCPC

We know it is true when we take stock of our lives, although it is easier to simply ignore. We do not have the same number of friends that we used to. We definitely do not have the same number of close friends, friends we could call in an emergency. Whether it is technology taking up more of our time, a culture that promotes handling problems on your own, or some other reason, it is clear we do not connect in the same way.

Due to factors that will be explored in this blog post, half of the population is more vulnerable to the Great Friend Migration. Men, myself included, are bombarded with societal forces that encourage segregation. We are instructed to cope with problems silently, internally. Isolate yourself or be shamed. We are taught to detest emotions, push them down or aside but do not let them grow. Best to not spend time with other people if we are in an emotional state.

Consequently, our problems grow bigger, the stress becomes heavier, and the emotions continue to build up until we are neck deep. Keeping quiet and keeping it to ourselves, we fall deeper into our own thoughts. Expecting that other people do not want to be burdened with our issues. We drift apart from friends because we do not know how our problems could possibly fit into their lives.

What’s next? We turn to something that can help. Something that makes us feel better, it’s reliable, it’s dependable, it does not judge us, and it does not share our secrets. Alcohol and other drugs can become a refuge for emotional pain. They can buffer feelings of anxiety or depression and temporarily give us the mask we want to keep the facade going.

Alcohol and drugs can slowly become something we depend on but that dependency is dangerous. What starts as a solution to the problem becomes its own problem. Substances attempt to fill the void that other people used to, but they will never be enough. Substances can never talk back to us and make us feel cared for and understood. They cannot debate options with us and challenge us to be better. Substances offer complacency but relationships give us acceptance and growth. It takes courage and a leap of faith to connect with another man and share your problems but it is truest the solution.

The irony is, that we all want to lean on each other but are scared to lean first. It is society’s expectation about men and men’s expectations about society that propel this problem into an epidemic. When we let our predictions go and venture into reality, it’s clear that other men feel the same way we do and we can meet each other with compassion and caring.

Men are not inherently isolating and society is not inherently cold. Expect that other people feel the way you feel. Expect that as a man you will experience things that other men experience. Expect that others want to know about your struggles because they want to be able to lean on you too.

If you find yourself experiencing The Great Friend Migration, convincing yourself that filling your loneliness with substances is better than the alternative - opening up, reaching out, and relying on a male friend, I encourage you to stand up to your shame, choose connection, and lean it to a friend.

Simple Meditation Steps For All Ages

By Concentric Counselor Michelle Taufmann, LCSW

These are the instructions for the basic meditation on the breath that I teach clients. Meditation on the breath is a simple, classic form of meditation that has been used for thousands of years to strengthen one’s focus and ability to sustain full awareness.

First, sit on the floor on a meditation pillow, or in a chair. Sit in a comfortable position with your back straight, but not rigid. If you are sitting in a chair it is best to sit forward with your back away from the back of the chair (rather than leaning back into the chair). You want
to assume a posture that facilitates being alert, yet relaxed. Next, close your eyes, or if you prefer, lower your to a gaze about a foot in front of your feet on the floor. The purpose of closed eyes (or lowered gaze) is to remove visual distractions from the field of perception. Now, take a moment to relax your head, neck, shoulders and arms by rotating them, tensing and releasing them, and/or shaking them out; these parts of the body tend to hold a lot of
tension.

You are now ready to begin the meditation on the breath. Start by noticing your breath as it comes into and out of your body. The experience of the breath coming into or out of the body is most noticeable in the following areas of the body: at the nostrils (the sensation of the breath going into and out of the nostrils), at the chest (the sensation of the chest rising and falling, and at the abdomen (the sensation of the abdomen rising and falling). Choose one of these areas on which to observe the breath. It usually works best to choose the area of the body where the sensation of breathing is the strongest for you. Now, simply attend to the breath. Think of it as being present to the experience of breathing. Your attention on the
breath should be light; you do not want to concentrate or think about the breath.

Once you have stabilized your attention on your breath, sit in this way for the designated amount of time. Ten minutes is the recommended amount of time for beginners. If you are like most people, you will fairly soon notice that your mind has wandered. When you notice
this, gently let go of the distraction, whether it is a thought, sound, or  internal sensation, and bring your attention back to your breath. Continue in this way, returning your mind to your breath each time you become aware that it has wandered. Remember to do this with
patience and gentleness.

Try not to become frustrated or judge yourself if your attention wanders frequently. Frequent mind-wandering is normal and to be expected, especially for beginners. Becoming frustrated or judging yourself for not being able to sustain attention on the breath is simply further distraction from your meditation practice and should be dropped as quickly and gently as other distractions are dropped during your practice. 

With practice, mediation of the breath will strengthen your focus and ability to sustain full awareness.

Your Voice Matters: Honest Discussion about Mental Health and Addiction

By Concentric Counselor Jennifer Larson, LCPC, NCC

It’s been about 3 months since Concentric Counseling & Consulting hosted its first On The Table 2017 conversation, and I am still impacted by the experience.  First let me backpedal to how I first learned about The Kennedy Forum, one of the co-sponsors of On The Table. 

It was the Fall of 2015 and I was having a conversation with my friend Caroline McAteer about various social issues and she had asked me if I heard of The Kennedy Forum.  Much to my chagrin, I had sheepishly told her that I hadn’t.  She told me about The Kennedy Forum’s mission and details of their annual meeting.  I was instantly intrigued and had to dig in.

Of the many things learned, one of them was Patrick Kennedy of The Kennedy Forum and his involvement with The Mental Health and Addiction Parity Act of 2008; he is still putting forth advocacy efforts to have The Act enforced on a national level.  I remember the buzz just before The Act went into federal law as I knew all too well the red tape and consequences people, including my own therapy clients, faced with limited mental health sessions imposed by insurance companies.

Fast forward to Spring 2017, and I learned about On The Table initiatives (co-sponsored by The Kennedy Forum and The Chicago Community Trust). Once again, I was intrigued.  On The Table initiative is about having people host open and honest conversations about mental health and addiction in effort to #BreakTheSilence and eliminate the stigma around mental illness and addiction that still greatly exists. 

As a counselor, I regularly encourage my clients to use their voice whether it is to share, increase vulnerability or intimacy, honor or advocate for oneself, and to work through the shame that often plagues people with mental illness and addiction. 

The focus of psychotherapy with my clients typically entails understanding and resolving challenges with one’s intrapsychic and interpersonal relationships (represented by inner concentric circles, hence the name Concentric) versus the larger, social systems (outer concentric circles).  Participating and joining forces with other hosts to help end the stigma associated with mental health and addiction while giving people an opportunity to use their voice fit Concentric’s mission with helping others to your their voice – but this time on a macro level.    

On May 16, 2017, the therapists at Concentric Counseling & Consulting hosted its first On The Table 2017 conversation in Millennium Park, across the street from our office.  It was an unseasonably warm and windy day, and our topic was "Your Voice Matters: Mental Health and Addiction.  Honest Discussion About Why More People Don't Seek Out Help." 

We had an incredibly diverse group of people who actively participated.  It was such an honor to hear people’s stories and ideas about why more people don’t seek out help.  So many stories and barriers were shared.  Common themes emerged and were extracted.  Follows are some of the common themes people described that either prevented them or others they know from seeking services:

• Stigma, embarrassment, and shame. Seeking help is seen as a weakness. What will my family and friends really think about me? Will I be seen as a ‘nutcase?’ Denial about having a problem or my ego getting in the way.

• Financial burden and obligations. Lacking financial resources all together. Treatment is a privilege for only those who can afford it. Lack or poor insurance coverage. All of the convoluted layers to insurance coverage.

• Lack of information and available resources on how and where to find mental health and addiction services. Example given was local university offered free counseling services to its students but was not aware of services until his senior year of college. Not knowing how to access services or where to start. Location and other barriers to gaining access to solid services.

• Cultural barriers and roadblocks, including families of certain cultures not supportive of mental health services. Experience with providers who lack cultural, gender identity, and sexual orientation competence. Religious barriers and lack of supports within religious communities.

It is a reminder to all of that us that suffering from mental illness and/or addition is hard in of itself, not to mention having to endure additional barriers that get in the way of seeking and accessing help.  Some of the solutions shared were not only to address or remove the aforementioned barriers and roadblocks, but to focus on the equity of mental and physical health. 

People remarked how it is much easier and more acceptable to talk about their physical ailments, but not their mental health.  Let’s look at people wholistically and give the mental health side the same due attention and respect.  Another solution shared was to target childhood prevention. 

One of the guests remarked in early childhood, we learn the importance of daily hygiene, such as brushing our teeth daily.  Why not introduce conversation around mental health care at an early age or make mental health education mandatory in schools.   Also, when providing education on mental illness and addiction, don’t use extreme or scare tactics, such as the “This is Your Brain” drug campaign did in the 1980s.  Guests remarked it only silences people more. Instead, provide a spectrum of information that can resonate with or speak to a variety of people across all ages and cultures.

My hope is that the information shared from our diverse group in Chicago can continue to be shared with others. And importantly, inspire all of us to participate in more active conversations about mental health and addiction whether it’s in your home, at work, in your community or as an On The Table host.  Because Your Voice Does Matter!