Where’s My Person? Complexities of Adult Friendships

By Concentric Counselor Kelsey Lamm Rottmuller, LPC, NCC

How do I feel by the end of the day? / Are you sad because you're on your own? / No, I get by with a little help from my friends — With a Little Help from My Friends | The Beatles

There isn't anything I wouldn't do for you / We stick together and can see it through / 'Cause you've got a friend in me — You’ve Got a Friend in Me | Randy Newman

If you wanna be my lover, you gotta get with my friends / (Gotta get with my friends) / Make it last forever, friendship never ends — Wannabe | The Spice Girls

And as our lives change / Come whatever / We will still be / Friends forever — Graduation (Friends Forever) | Vitamin C

Having come of age listening to song lyrics like these, and wistfully witnessing the implausible but admirable portrayal of kinship in the 90s sitcom Friends, I,  like many adults, developed certain ideas and expectations about friendship. For example, I grew up believing one should have a best friend and know how to not only make friends but keep those friendships thriving into adulthood.

But what happens when making friends isn’t as simple as swapping parts of your lunch with a classmate, or performing in the school play together? Even in college, school and extracurricular activities provided fertile ground in which the seeds of friendship could blossom, helped along by common interests and schedules structured around shared classes. Once the structured environment of school is removed and we are left to choose our own adventures, the work of maintaining and definition of friendship seems to dramatically shift for many adults. What perhaps once came relatively easily, now actually takes planning, work, and dedication.

In her Psychology Today article 5 Lies About Adult Friendships, Dr. Miriam Kirmayer unpacks and debunks commonly-held myths about friendships in adulthood. Primarily among these is that “by early adulthood, we should know how to make friends and handle the challenges that come with these relationships; that these are skills we learn early in childhood and adolescence, and that by the time we leave college or even high school, we should have it ‘figured out.’ The problem is, not only is this belief untrue, it can make us feel like we’re the only person who struggles and leaves us feeling disappointed, ashamed, or alone. This, in turn, makes it much less likely that we will reach out for guidance or support if (or when) we do struggle.”

The Struggle is Real

I’ve heard from clients, colleagues and compadres alike how challenging it can be to keep friendships alive, reciprocated, and not feeling like one more thing on a never-ending to-do list. Despite all the best intentions, life as an adult becomes increasingly busy as we fill our time with work, family, continued education, and expanding responsibilities. People move away, start families, follow jobs and hustle hard to build a life. This can leave little time and space for what feels like the luxury of friendship.

A friend from college once told me (before moving away and starting a family) that “being friends as an adult means you take turns texting each other ‘we should get together soon’ repeatedly until you die.” While that statement seemed morbid and pessimistic at the time, it also resonated with me as one of the many struggles faced in adult friendships. Everyone is so busy. Not spending time investing in and invigorating friendships can simultaneously feel like an uphill battle and a source of regret or shame.

Then there are those ‘rites of passage’ in adulthood that can make the lack of a best friend or even close friends acutely apparent. In the 2009 buddy/romance film I Love You Man, we see played out the challenge that can arise when one finds a partner to whom they want to commit but struggles to identify a platonic companion to stand by their side. This film has come up in my work time and again when discussing the loneliness and isolation experienced by clients who struggle similarly to identify close companions outside of family or casual work acquaintances. But why do we feel so driven toward close friendships? Why doesn’t simply having a safe, stable life, perhaps even shared with a romantic partner seem like enough?

The Psychology

In his Psychosocial Development Theory, ego psychologist Erik Erikson posited that young adults (defined by Erikson as ages 19-40 yrs) enter the Intimacy vs. Isolation (Sixth Stage) of development, in which they seek to resolve developmental conflicts related to emotionally intimate relationships. These relationships may be romantic and/or platonic in nature. Erikson believed that failure to resolve said conflicts by establishing close relationships could result in an experience of isolation and loneliness. According to the psychology, this sharing of self with others drives not only our romantic partnering, but also our urge to host a game night, share a multi-hour brunch, or schedule that phone call to dissect the latest Star Wars movie with our World of Warcraft guild buddy.

Psychosocial theory also suggests that a strong sense of self enables us to form intimate interpersonal relationships. Hence, feeling disconnected or unclear about our identity during adolescence - who am I? - can contribute to the struggles faced when striving for friendships as young adults. Sequentially, failure to master the formation of lasting relationships can then additionally hinder us from ‘making our mark on the world’, which is the major task of Erikson’s Generativity vs. Stagnation (Seventh Stage) of development (ages 40-65 yrs).

With each developmental stage building or even hinging upon the completion of its predecessor, it makes sense that we would feel pressure to create and maintain friendships even if we are not sure why or tend to err on the side of introversion. How can I ever Pass Go and Collect $200 – or more so – contribute to the world at large and create greater fulfillment, if I don’t have any close friends?

What Can Be Done?

First and foremost, know that you are not alone. As Dr. Kirmayer notes, it is far from uncommon to struggle with friendship as an adult. Often times, our self-imposed beliefs about how a friendship should look, or roles we are meant to play as friends get in our way more than they motivate growth. If you notice yourself falling prey to the ‘shoulds’ and ‘have-tos’, it can be helpful to challenge and reframe those beliefs, by replacing “I really should call my college roommate back” to “I want to call them, I miss our connection”. Chances are, your friends are equally as busy and will be equally as understanding and appreciative to hear from you – even if just for a quick 10-minute catch-up while you finally fold that pile of clean laundry that’s been staring you down from atop the dresser for the past week. Small steps are ok.

A quick “I’m thinking” about you text – or even better, an actual card via snail mail still tells someone they are thought of and valued. It also goes much further than a “like” on social media or racking yourself with guilt to sustain the friendship. Lean into what brings you together rather than what pulls you apart. Did you first bond over a mutual love of quirky 80’s movies? Maybe it’s time for a movie night. You can debate the most quintessential piece of John Hughes’ filmography or how well or not The Breakfast Club translates to a post-baby-boomer demographic rather than bemoaning how you never see each other anymore despite living less than 30 minutes apart. It doesn’t have to be expensive. If going out for dinner or drinks is not in the budget while you save for a down payment on that first home or even just tickets to that music festival you’ve been pining for – perhaps split the cost of ingredients or encourage BYOB and host a make-your-own-pizza kind of night.

Finally, if you find yourself struggling with emotional intimacy in general or feel paralyzed by social anxiety or depression, consider reaching out to a trained therapist or a support group. There are those that want to help, if we let them and can find the courage to ask. It takes strength to reach out for help and trust someone – friend or otherwise – in which to confide.

Thank you for being a friend
Traveled down a road and back again
Your heart is true, you're a pal and a confidant

—Thank You for Being a Friend | Andrew Gold

Let's Talk About Complex Trauma

By Concentric Counselor Jordan Perlman, LPC, NCC

I imagine many people have heard of Post-Traumatic Stress Disorder (PTSD) but not nearly as many are familiar with Complex Post-Traumatic Stress Disorder (C-PTSD) which is lesser-known and unfortunately, not yet recognized in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V). And while an individual with a PTSD diagnosis, which is often the result of an isolated incident, a person who experienced complex or repeated traumas requires different considerations.

But first, it’s important to understand the differences between each:

PTSD

According to the DSM-V, PTSD is diagnosed when an individual meets the following criteria that create distress or functional impairment last more than one month, which is not a result of medication, substance use, or other illness. The individual was exposed to one of the following: 

• Death or threatened death 

• Actual or threatened serious injury

• Actual or threatened sexual violence 

• Witnessing trauma

• Learning that a relative or close friend was exposed to trauma 

Indirect exposure to aversive details of the trauma (usually in the course of professional duties), the individual must have at least one intrusive symptom that causes the persistent re-experience of the trauma in the following ways:

• Nightmares

• Flashbacks

• Emotional distress after exposure to traumatic reminders

• Physical reactivity after exposure to traumatic reminders

The individual must also experience avoidance of trauma-related stimuli after trauma either by trauma-related thoughts or feelings, or trauma-related external reminders.

Two negative alterations in cognitions and mood must be present where the negative thoughts or feelings began or worsened after trauma in the following ways:

• Inability to recall key features of the trauma

• Overly negative thoughts and assumptions about oneself or the world

• Exaggerated blame of self or others for causing trauma

• Negative affect

• Decreased interest in activities

• Feeling isolated

• Difficulty experiencing positive affect

 Lastly, there must be alterations in trauma-related arousal and reactivity that began or worsened after trauma in the following ways: 

• Irritability or aggression

• Risky or destructive behavior

• Hypervigilance

• Heightened startle reaction

• Difficulty concentrating

• Difficulty sleeping

 C-PTSD

Trauma typically associated with C-PTSD tends to be long-term, where the individual is generally held in a state of captivity, physically or emotionally. In these situations, the victim under the control of the perpetrator has little or no chance to get away or escape from the danger. Some examples might include:

• Long-term domestic violence

• Long-term child physical and/or sexual abuse

• Neglect

• Organized exploitation rings

• Concentration/Prisoner-of-War Camps

• Prostitution brothels

• Recruitment into armed conflict as a child

• Sex trafficking or slave trade

• Experiencing torture

• Exposure to genocide campaigns

• Other forms of organized violence

Some might be wondering, why is this difference important then? This is because of exposure to long-term or prolonged or repeated trauma results in a broad range of symptoms that go beyond the diagnostic criteria of PTSD, a.k.a “simple” PTSD.  As such, the basic symptoms of C-PTSD are:

• Somatization (physical problems, associated pain, and functional limitations)

• Dissociation (a division of the personality into one component that attempts to function in the everyday world and another that regresses and is fixed in the trauma, spacing out, daydreaming, or feeling strong sensations of being disconnected from one self or the world)

• Affect Dysregulation (difficulty with emotions, such as experiencing and/or expressing them, alteration in impulse control, attention and consciousness

• Self-Perception (experience of their own perspective tends to be drastically different from how others perceive them)

• Interpersonal Relationships (tend to be a struggle, difficulty with engaging with others, feeling distrustful of others)

• Perception of Perpetrators (can be skewed, or longing to be loved by their abuser)

• Systems of Meaning (doubt there is any goodness in the world, outlook on life can be dark)

Further, a 2018 study by Karatzias et al. found the most important factor in the diagnosis of C-PTSD was negative cognitions about the self, characterized by a “generalized negative view about the self and one’s trauma symptoms; attachment anxiety which is defined as involving a fear of interpersonal rejection or abandonment and/or distress if one’s partner is unresponsive or unavailable; and expressive suppression, conveyed by efforts to hide, inhibit, or reduce emotional expression.”

For those who may wonder why people affected by a long-term trauma “can’t just get over it,” the answer lies in the fact that even after a person is removed from the event, their brain may be permanently affected by that intense and prolonged trauma. And since a person’s nervous system is shaped by his or her experiences, stress and trauma over time, can lead to changes in the parts of the brain that control and manage feelings and the long-term effects are found on a physical and emotional level.  

Symptoms may manifest as:

• Eating disorders

• Substance abuse

• Alcoholism

• Promiscuity

• Chronic pain

• Cardiovascular and gastrointestinal problems

• Migraines

• Rage displayed through violence, destruction of property, or theft

• Depression, denial, fear of abandonment, thoughts of suicide, anger issues

• Flashbacks, memory repression, dissociation

• Shame, guilt, focusing on wanting revenge

• Low self-esteem, panic attacks, self-loathing

• Perfectionism, blaming others instead of dealing with the situation, selective memory

• Loss of faith in humanity, distrust, isolation, inability to form close personal relationships

Special Considerations for Survivors of C-PTSD from Childhood 

Many survivors of C-PTSD also experience Attachment Disorder which is a huge consequence of individuals who suffered complex trauma as children. Attachment Disorder is the result of a person growing up with primary caregivers who were regularly dangerous. Recurring abuse and neglect habituate children living in fear and sympathetic nervous system arousal, which over time creates them an easily triggerable abandonment mélange of overwhelming fear, shame, and depression. 

Because a child’s main attachment (to their primary caregiver) helps them learn to control their emotions and thoughts, when a caregiver’s responses are in tune with a child’s needs, the child feels secure. The child then uses this relationship pattern as a practice to build coping skills.

However, children who receive prolonged confusing or inconsistent responses from their primary caregiver are prone to be fussy, have a hard time calming down, may often withdraw from others and may have frequent tantrums. Unlike adults who have more tools to understand what is happening to them, children often do not possess these skills or have the ability to separate themselves from another’s unconscionable actions. Consequently, the resulting psychological and developmental implications become complexly woven and spun into who that child believes themselves to be, thereby creating a messy web of core beliefs that are harder to untangle than the flashbacks, nightmares and other posttraumatic symptoms that may surface later. Further, these disorganized attachments and mixed messages from those who are supposed to provide love, comfort, and safety - all in the periphery of extreme trauma - can create even more unique struggles that PTSD-sufferers alone don't always face.

Treatment Considerations 

While the symptoms can be daunting and the future seems bleak for someone who appears to be suffering from C-PTSD regardless of whether an individual has been diagnosed with a trauma-related disorder or not, there is help out there and there are ways to manage and help the individual cope. 

Treatment challenges include, Survivors:

• Avoiding thinking and talking about trauma-related topics because the feelings associated with the trauma are often overwhelming

• Relying on alcohol or other substances as a way to avoid and numb feelings and thoughts related to trauma

• Engaging in self-mutilation and other forms of self-harm

• Who have been abused repeatedly are sometimes mistaken as having a “weak character” or unjustly blamed for the symptoms they experience as a result of victimization and often have comorbid disorders such as dissociative identity disorder (DID), other specified dissociative disorder (OSDD), borderline personality disorder (BPD), depressive or bipolar disorders, anxiety disorders, obsessive-compulsive disorders, eating disorders, and substance abuse

Since many trauma specialists see Attachment Disorder as one of the key symptoms of C-PTSD, a relational, individual, approach will often be most beneficial for many of these clients. For many survivors, therapy is the first opportunity to have a safe and nurturing relationship.  Therefore, the therapist must be especially skilled to create the degree of safety that is needed to build trust or risk adding to the attachment trauma. Working with these clients is essential to the development of trust and relational healing and the four key qualities are empathy, authentic vulnerability, dialogically (when two people move fluidly and interchangeable between speaking and listening) and collaborative relationship repair. This makes therapy a teamwork approach where there is mutual brainstorming and problem-solving in a respectful way implying mutuality. All of these steps will provide the client with a “good enough secure attachment” to serve as a model for other relationships. 

However, and as expected, there is no “one size fits all” approach to working with individuals who have survived trauma, but one thing is for certain: recovery from Complex PTSD requires restoration of control and power for the traumatized person. Survivors can become empowered by healing relationships which create safety, allow for remembrance and mourning, and promote reconnection with everyday life. 

If you feel as though you have experienced complex trauma, it is important to know what happened to you was not your fault. While it is undeniable trauma changes the way we experience the world, I strongly believe like a phoenix, a person who suffered from trauma can arise from the ashes, stronger than ever before. This “stronger than ever before” is also known as “Post-Traumatic Growth.” Post-Traumatic Growth identifies a shift in personal strength and worldview as a consequence of trauma. Although you can’t change it, you can change what your life looks like going forward. One step you can take towards recovery is calling to schedule an appointment with a therapist who can help guide and support you on your healing journey. 

The Value of Vulnerability

By Concentric Counselor Christian Younginer, LPC, NCC

Life XXXV by Emily Dickinson

I CAN wade grief,

Whole pools of it,—

I ’m used to that.

But the least push of joy

Breaks up my feet,         5

And I tip—drunken.

Let no pebble smile,

’T was the new liquor,—

That was all!  

Power is only pain,         10

Stranded, through discipline,

Till weights will hang.

Give balm to giants,

And they ’ll wilt, like men.

Give Himmaleh,—         15

They ’ll carry him!

Emily Dickinson’s word choice in the first line sticks with me- she can “wade” grief. She can trudge through the thick, tarry mire of sadness, pain, loss, and sorrow. It really feels like that, doesn’t it? This viscous bog of grief, she’s “used to that”. It’s familiar for her. But joy is foreign. 

Although she can bear the pain of life, let life surprise her with joy and she will stumble, drunkenly. This voices a common human experience: Let something test our resolve, and we will meet that challenge. But let us be vulnerable, and we will dissolve.

It is easier to harden, than to soften. Give comfort and love to giants, and they will “wilt” into ordinary men, but ask them to carry mountains (‘Himmaleh’ is the archaic form of ‘the Himalayas’), and they will offer up themselves.

This brings us to the question of this post: How does a person allow themselves to be vulnerable, without wilting? How do they remain resilient when life gets hard, without hardening themselves?

What is vulnerability?

The insightful Brené Brown defines vulnerability as both “the birthplace of love, belonging, joy, courage, empathy and creativity”, but also as “uncertainty, risk and emotional exposure” (Daring Greatly). So, our options are: recoil at the latter and tell ourselves we don’t need the former OR accept the latter because we accept that we need the former.

There were times in my life where I clung to the idea that ‘ I don’t need others’- to avoid feeling exposed. That idea eventually spoiled, and I was faced with the reality that I DO need others. While I was aware of the fact, I had not yet accepted it. It was not until I accepted that I need others that my journey towards understanding vulnerability began.

Being vulnerable feels like the difference between writing in the 3rd person and 1st person. It is keeping others at a distance, to avoid the pain of feeling exposed- of not being accepted. If you notice, I switched from using “they” and “them” to “I” and “we”. As I wrote, I noticed feeling exposed, but I also noticed feeling satisfied with my self-awareness and honesty. That is, I felt joy in sharing this part of myself so that it might be of help to someone. It is this ‘trade-off’ that I believe Brené Brown is describing. If we can be ok with feeling a little exposed, we can receive wonderful gifts of acceptance, approval, validation, and love.

The Alternative.

In my pursuit of understanding vulnerability, I came to a choice. Would I rather feel uncomfortable or alone? My choice to embrace vulnerability and accept the possible “emotional exposure”, speaks to not only my desire for connection with others, but to the horror of the alternative: feeling alone. Jumping from a burning building does not mean that jumping is not scary, rather the alternative is too horrifying to consider.

Resilience.

What I am suggesting almost seems oxymoronic: Become vulnerable to become stronger. Invulnerability is not a superpower. Unless Superman exists and no one told me. Rather, accepting that we need others is the true superpower. One powerful result of letting ourselves connect is resilience. That is, if we temper ourselves in the furnace of vulnerability, we become stronger than we were. This is possible due to what Brené Brown references as the gifts of vulnerability: love, belonging, joy, courage, and empathy. Having these in our arsenal make us stronger humans, less prone to burnout and emotional distress.

Let us learn to enjoy the intoxicating effects of joy and not let it cause us to stumble. Carry the mountain if asked, because you are strong enough to shoulder it. But also do not wilt at receiving comfort or help. If we accept that we not only need others for support, but also that they have gifts to offer us, we become stronger. More resilient to carry the mountains when we need to and more courageous to be vulnerable when we just can’t carry anything else. It is the courage and strength to say: “ I’m not ok right now. But I will be.”

The Role of Anxiety in Living an Authentic Life

By Concentric Counselor Christian Younginer, LPC, NCC

To be brief, anxiety can suck. The persistent worry of imagined scenarios can plague the mind and exhaust the body. It can manifest as brief periods of pronounced worry, a baseline worry for all things, and even panic attacks. But I would like to offer a perspective that may be overlooked in coping with anxiety. That is, can my anxiety teach me something?

Specifically, can my anxiety teach me how to live an authentic, meaningful life? This question shapes Existential Therapy. At its broadest, existential therapy is the endeavor of understanding one’s existence in a therapeutic setting. This is done via an honest exploration of one’s freedom, choice, responsibility, meaning, and inevitable death. Existential psychotherapist Irvin Yalom conceptualizes much of anxiety as death-anxiety (Existential Psychotherapy, p.189). That is, persistent anxiety can be explained as an underlying worry about a life without meaning in the face of approaching death. Death is what allows life to have meaning. If there were no end, then for what should we live? The finiteness of life can motivate, intimidate, and terrify. However, it is this anxiety that can be the canary in the mine of our life.

As we work, study, sleep, parent, eat, play, drive, and journey through life, meaning and purpose can slip through the cracks. Anxiety can creep in, seeming to have no definable impetus. Often enough the death of a loved one, or a diagnostic medical scare can bring perspective -- wherein we confront our death. But one does not need to wait for such a moment to ask these questions, such as “Why am I here?”, “What does it mean to exist?”, and “What is my purpose?”.

Anxiety can be that canary that alerts us of an inauthentic life. It warns of the finiteness of life, and the importance of living a life with meaning. This often manifests as a vague sensation of “running out of time”. Without meaning, one can find life pointless or trite. The finiteness of life no longer motivates, it terrifies. But if we listen to what our anxiety is telling us, perhaps we can redirect our lives towards meaning.

How does one do this?

An example from philosophy may be of use. In Frederick Nietzsche’s The Gay Science, Nietzsche offers the reader an aphorism he titles ‘The Heaviest Burden’. He proceeds to ask the reader: if a demon were to order that you must live this life in eternal recurrence, every moment, detail, pain, and triumph- would you thank him or curse him? (The Gay Science, Aphorism #341). So, do I live my life in such a way that were I to re-live this life on repeat, I would praise the demon with gratitude for the opportunity? Or would this prospect bring about the abysmal dread of re-living a meaningless life? It is this precise idea where anxiety comes into play. Am I experiencing the anxiety and dread of a life not worth re-living?

It is this question that can help steer us towards meaning. Do I live in such a way that were I to re-live this life on repeat, would I be in joyful contentment or in abysmal dread? This is a tough question with which to be confronted. However, we can use this question as a beginning: the moment one begins to ask “does my life have meaning?”. Rather than be frozen by the possible dread this question instills, one can frame this as the moment in which a new life begins. As always, Confucius said it best, “ We have two lives, and the second begins when we realize we only have one.”

Determining WHAT is meaningful is a personal journey that can take time to uncover. But knowing thyself was important to Plato for a reason. It is this existential journey of a human confronted with death, through anxiety, uncovering that which gives their life meaning.

To conclude, yes, anxiety does suck. But as we work to cope with it, let us ask -- What is this anxiety trying to teach me?  Anxiety very well may lead us away from the existential dread of an unexamined life, and instead towards finding a meaningful life worthy of repeating.

Sexual Trauma, Triggers, & The 24-Hour News Cycle

By Concentric Counselor Katie Ho, LPC, NCC

You can hardly escape today’s current social and political climate - it’s on the news, in your social media, overheard at lunch, and even for therapists, themes in session. For those who have experienced trauma in their lifetime, past or ongoing, navigating topics like sexual assault can be overwhelming, scary, complicated and sometimes even powerful. How we take care of ourselves and the people around us who may be struggling with the complexity of their emotions has to be part of the larger conversation. It’s clear that avoiding or minimizing discussions on sexual violence and quieting the stories of survivors is not the path to atonement and reconciliation. But as we create space and lift up the voices of those who have suffered, we must also take inventory of what comes up in us and tend to those parts with kindness, care and nurturing.

The #MeToo movement, local and national advocacy groups and social justice organizations have been and continue to create a platform for those who have been victim to sexual harassment and assault. While the stories and accounts of these traumas seem to be daunting all of the sudden for those who have been unaware, statistics and experts have known for some time of these experiences. The National Sexual Violence Resource Center (NSVRC) estimates that 1 in 5 women will be raped in the United States in their lifetime, and that 1 in 3 women will experience some form of sexual violence. The majority of these acts are committed by acquaintances, partners or people who are known by the victim, and according to the Rape, Abuse & Incest National Network (RAINN), the majority of these events occur at or near the victim’s home. These of course are statistics, data and research gathered through reports from multidisciplinary agencies. There is undeniable value in knowing these numbers. And just as much, there is value in hearing the experiences and seeing the faces of survivors who have chosen to come forward.

As allegations and reports of sexual assault make the news, we are bombarded with information, opinions, commentary and even jokes on the matter. Survivors are subject to their own re-traumatization, which has an impact on psychological and physical health, triggered by both the details of these publicized allegations of assaults and non-believers who dismiss them.

In knowing that a trigger is a psychological stimulus that can be evoked through anything from sights, smells or sounds, it’s no wonder that the 24-hour news cycle is affecting so many people. Survivors are not alone in their strong reactions to the constant replaying and subsequent criticism, shaming or dismissing of survivor stories. Those who feel a connection or calling to the cause, whether it be through their empathic attunement or knowing a survivor, may also experience the distress and burnout that comes with the current climate.

So how do we take care? How do we balance the righteous anger and complexity of our other emotions, promote advocacy and change, all while healing and taking gentle care of ourselves? In doing this, one of the most important things to know is nothing can replace the support of others. So find someone, or a group of someones, who can help to support, validate and foster a safe environment for processing.

Find a tribe, or maybe even create one. Pay attention to your body, as our physical being can often tell us when stress is increasing and it’s time for tending and healing. Maybe that means physical exercise, movement, touch or a practice of progressive muscle relaxation (a quick YouTube search is all you need!). Set boundaries. Limit your intake of news and dialogue on the topic by knowing how much mental and emotional labor you’re able to give without overextending yourself. And if you find yourself overwhelmed, triggered or lost, use mindful grounding techniques to bring yourself back into your here and now. Feel your feet on the floor, describe and notice something around you, use your five senses to bring a consciousness into your physical environment and current moment in time and add in a quick reminder - “I am safe. I am in control. I am okay.”

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.

A Therapist's New Year's Resolution

By Concentric Owner & Counselor Jennifer Larson, LCPC, NCC

In only a few more days, 2017 will come to a close.  It will be a time to think ahead – many will ignite their New Year’s resolutions.  While I may not routinely come up with New Year’s resolutions, I do think about and write down my personal desires and goals throughout the year.  And, I have decided that I will come up with a New Year’s resolution for 2018.  Before I share my resolution, I would like to share part of my roadmap that has led me to this juncture.

As I have engaged in reflection, I found myself returning back to a perpetual theme that would emerge and re-emerge over this past year.  One particular theme is what I will name as the ‘non-self-disclosing' therapist vs. the 'self-disclosing' therapist wrestling match.  I have no idea when the sport of wrestling season begins and ends, but I can tell you this particular wrestling match has persisted season after season. And, my hope for 2018 is the self-disclosing therapist will take the lead and possibly bring the wrestling match to a close someday soon.     

Let’s start back when these 2 wrestlers first met.  Perhaps they were both first introduced way back when, before the days of graduate school as 'non-self-disclosing' me vs. 'self-disclosing' me.  In my formative years, I grappled with how much to disclose and how much not to disclose my vulnerabilities. And if I did, I chose wisely with a very select few.  Some would say this is normal as we need privacy and boundaries while others may offer a difference of opinion.  Now, let’s fast forward to when I enter into graduate school where I am confronted again with choosing and deciding on how much to disclose.  This time it is focused more on me as an emerging therapist, not me personally.  In the earlier stages of education, students learn about various theoretical orientations and the relevance and implications of non-disclosing and disclosing to one’s clients. 

Just after the start of the millennium, I recall being enthralled with the tug-of-war game that was played during a semester course on ethics.  Our instructor was instrumental in leading the charge on getting all of us graduate students to really explore how to handle ethical dilemmas that can and will mostly likely confront a professional counselor, social worker, or psychologist.  Depending on the topic, some students would sinuously form into 2 teams, tugging and vying for one end (yes, it’s okay to self-disclose to a client; yes, it’s okay to hug certain clients upon closing a session), while the other group pulled and vied in the other direction (no, it’s not okay to self-disclose and hug a client). It was one of my favorite graduate courses as our professor and the course curriculum gave us the space and freedom to think critically and to share our perspectives and beliefs.  Some topics called upon us to unequivocally unite together whereas other topics had students participating in the game of tug-of-war, and well some (ahem) left all of us pooling together in the middle, gray area -- scratching our heads saying, “It just depends, it’s not so black-and-white.”    

Does a therapist merely act as a ‘blank slate’ allowing for one to free associate more easily? Or does a therapist offer some disclosure about their experience and feelings in relation to one’s client (countertransference)?  As therapists, do we divulge some our personal, relatable experiences, such as, “I share the same fear of heights as you do – here are tools that have been helpful to me.”  To disclose or not became even further embedded post graduate school during professional training courses and consultation. And for good reason, this particular topic warrants so much attention in the world of psychotherapy.  I understand the clinical relevance and implications – I get it. 

Over the past 15 years with greater professional and personal life experiences, I have found myself continuing to think about the inquiry of the self-disclosing therapist. At times, I have put forth a tidbit of self-disclosure when I believed it to be ‘clinically appropriate’ or when it simply felt right.  The self-disclosing therapist is not uncommon for some psychotherapists, and it's probably still one of the more debated issues in the field.  Over the past year or so, the inquiry in my mind has expanded beyond the closed doors where therapist-client, supervisor-supervisee, and consultant-consultee relationships are formed, maintained and evolve.  

Questions continue to knock on my door, such as, do I as a therapist share my story (or stories) with others publicly?  Is there value in therapists who choose to open up in a more public forum?  How about us therapists taking our practice even further by exercising vulnerability and using our voice through other outlets?  Are age and credibility in the field some of the salient determinants when choosing to publicly divulge as a professional?  What is too much to self-disclose in written form? Could casting a wider net be detrimental to a therapist’s profession?

While these particular questions have lobbed around in my head for just over a year now; admittedly, they have not been all ‘heady’ taking up rent in my mind.  Sometimes (and many times), I would simply experience this feeling inside of me – near my heart or gut – nudging me to share more and to share with more people.  Stop thinking so much and just take action.  Take the leap and have faith.  Even a call to duty would emerge from within as well.  But why and for what purpose?  The answers didn’t seem readily available to me.  And then over the past few months, it all became clearer.

Earlier in 2017, I learned about On The Table and the #BreakTheSilence initiative by The Kennedy Forum.  I was immediately pulled in as I loved the mission and purpose of this initiative.  Bring people together to give people an opportunity and space to talk about mental health in effort to reduce the stigma that still hovers around and shrouds the already cocoon existence of mental health. The idea is that when more people talk about a topic – in this case mental health and addiction – a positive rippling effect can ensue. 

The more people talk about mental health…

• The easier it will be for all of us to talk about it.

• Better yet, the easier it will be for all of us to talk about it without feeling shame, crazy, or embarrassment.

• The more we will feel safe and free of judgment.

The more people talk about mental health, the more…

• People will seek out help.

• We will honor and view mental health as another facet of humanity and life, just as we do with other areas, such as our physical health.

• We will advocate for change across cultures, families, and even within the helping professional field.

• Opportunity for positive changes within the health care insurance industry.

The continual, cascading effect.  The more people talk about mental health and addiction…

• The more we will become intimate and experience love.

• The more we will be empathic and compassionate.

• The more we will be more understood and connected.

• The healthier we will all become and the more lives will be saved.

Who doesn’t want to experience these things for themselves and others? 

Concentric Counseling & Consulting hosted its first On The Table Discussion on May 16, 2017.  The turn out and experience was inspiring and moving. We even shared people’s stories, experiences and solutions for people to read in our blog.  However, the Concentric’s therapists served as hosts and guides – we were not active participants in this discussion.  No self-disclosing.  This is not a terrible thing, but the knocking on my door didn’t go away.  Should we have re-considered actively participating in this dialogue?  Sharing would mean ‘more people’ talked about mental health and addiction, right? 

There have been other initiatives and movements this year, including one of the more recent ones that started in October 2017. The #MeToo movement gained momentum and traction which has given people collective permission to break free of the shackles that have promoted and reinforced silence, inequality, sexual harassment, discrimination, and assault, shame, and for some, the cocoon existence of mental health. The #MeToo movement encouraged women to share their stories in effort to give people permission to break their silence to unite and to bring greater awareness about the prevalence of sexual misconduct.  The more people talk about their experiences and hardships, the same effects will occur as with the more people talk about mental health and addiction.  Movements like these promote the cascade effect which in turn promote movements – a positive feedback loop. 

All of these experiences along my personal roadtrip have touched and impacted me.  And, while I recognize that I am helping people, I have also recognized that choosing (more times than not) the non-self-disclosing therapist may just not be as helpful.  I believe in the importance of using one’s voice, honoring one’s experiences with integrity and respect, and I want to help become a part of the bigger picture.  I want to talk more about mental health and addiction publicly in effort to help achieve with many others a positive cascade effect.  It won’t be easy for me, that I know. Truthfully, I am not quite sure where to start, what I will disclose about and which platforms to traverse.  What I do know is I now have a clearer understanding of the persistent themes that knocked on my door.  My deeper desires and hopes for all by talking about mental health.

So, my New Year’s resolution for 2018 is for me as a therapist is to start leaning in, to become more of a self-disclosing therapist by sharing more publicly some of my own mental health challenges and triumphs.  Happy New Year Everyone!