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Posts tagged ‘therapy’

Counselling: Who Gets It? For What? Who Doesn’t? Why Not?

Here’s one perspective:

Trends and barriers to getting folks
the counselling they need.

adapted from Psychology Today, April 2013
Susan  Heitler, Ph.D. with Linda McKinzie

Reach Out. Just Do It.For what do folks seek help?

The pie chart above shows what kinds of emotional problems led over 1500 folks last year (2012) to seek help from Denver’s Maria Droste Counseling Center’s 30 or more counsellors.

Maria Droste’s analysis indicated that anxiety and depression together accounted for the primary troubles of almost 40% of people who sought help.  What triggered their anxious, stressed and depressed feelings?  The something going wrong in their lives, MDCC’s staff believes, has often included long-term or chronic unemployment.

When people face a life problem, which usually is about the work or the love aspects of their lives, they typically first feel anxious.  Looking ahead they feel uncertain about what if anything they can do about the problem.

After a period of anxiety, which they may refer to as stress, people become at increasing risk for feeling angry, blaming others for their dilemma, for depression with hopelessness about finding solutions, or for self-injurious habits like drinking and smoking, and for relationship problems.

Note that the two biggest reasons people seek help are depression and relationship troubles.  That should be a heads up that internalizing our thoughts and feelings is a societally widespread problem, desperately requiring more life-skills training earlier in life, and a perspective shift regarding the freedom to be ourselves and speak our truths without fear of judgement.

It’s probably a bad sign that there’s twice as many folks seeking help for depression as for anxiety.   Depression suggests that folks are giving up on finding a fix.  This disproportion could indicate that people wait out their difficulties while they are anxious rather than seeking help in response to this initial distressed feeling.

“Depression is the leading source of disability in Canada at a rate slightly higher than the world average.”
~ Bill Wilkerson, Business and Economic Roundtable on Mental Health

For many folks, it’s only when they have fallen into a dark hole of hopelessness that they finally feel so bad that they reach out  for professional mental health services.  Better late than never, and yet that’s sad because often it’s easier for folks to find solutions to their problems when they are still feeling anxious than after they’ve given up.

Intake workers at Maria Droste noted another unexpected factor when they looked at these statistics for the past year’s intake records.  They noticed an increase in calls about relationship issues.

Claudia Gray, Maria Droste Intake Manager, said, “This year in particular, we had a lot of people requesting couples and family therapy for a variety of reasons.”

“Mental health disorders represent the greatest business and public health challenge of the 21st century. We must understand that. And in a hurry.”
~ Bob Lord, Chairman of the Canadian Institute of Chartered Accountants

One of those reasons Gray speculates, has been the country’s economic downturn. “If couples are already struggling with insufficient communication skills for talking over their difficulties cooperatively and productively, and then you add the stress and struggle of economic and financial worries, weaknesses in communication become more pronounced.  Couples seek out counseling to help them find better ways to communicate with each other.”

Sue Kamler, Director of Maria Droste’s intake services, added that the calls coming in last year also seemed to be more complex. “For example, when someone called in saying they were experiencing depression and anxiety, during the assessment process we often discovered a history of childhood abuse or domestic violence. The depression and anxiety needed treatment, and at the same time it was important also to address their earlier issues of loss or abuse.”

Employees experiencing high work/life conflict have absenteeism rates three times those of employees with low work/life conflict.
~ Duxbury, Higgings: “Work-Life Balance in the New Millennium: Where Are We? Where Do We Need to Go?”, 2001

A recent study by compensation consultant Watson Wyatt Worldwide found the estimated direct cost of absenteeism to business is 7.1 per cent of the payroll, up from 5.6 per cent in 1997. Again, stress-related disorders accounted for the lion’s share. In 2000, the only year studied, there was an additional 10 per cent indirect cost for overtime, replacement personnel and loss of productivity.
~ The Globe and Mail, July 15, 2002

 Why don’t more folks reach out
for the help they need?

“Mental health is talked about more now than ever before.  With the high profile media coverage and analysis of incidents such as the Sandy Hook shootings, public forums such as Dr. Phil and Oprah, and corporate involvement to bring mental health issues to a more commonly recognized part of life (such as Bell Let’s Talk Day), it is now the subject of discussions at national through to community through to dinner table levels.

Yet only a small proportion of the people who would benefit from counselling actually seek it out.  Why??

Ms. McKinzie offers the following explanations for why many people delay seeking support:

“One major reason that many people, especially men, do not seek support and therefore needlessly suffer for long periods of time from emotional pain, anxiety, excessive anger, old resentments and depression, is their perceived stigma associated with receiving mental health care. They regard getting help as embarrassing, something others do but not themselves.  Better to grin and bear it than to admit that they need help.

“Another concern is expense.  Only one of the costs of meeting with a counsellor is paying for the sessions, which health insurance or extended benefits may or may not help to cover.  In addition, missing time at work for weekly daytime therapy sessions can be costly in terms of not getting work done, docked pay, and supervisor disapproval.  Evening and weekend sessions may require payment for babysitters.

“Finally, there is a documented shortage of affordable mental health care in most communities. If everyone who genuinely needs mental health help were to seek it, there would be far too few resources to meet the challenge. And, there needs to be more options for talk therapy readily acknowledged to meet both a person’s comfort level and financial level, such as community programs, clergy, and mentors.

“Mental health is fundamental to physical health as well as to experiencing life’s most positive blessings such as happiness, gratitude and supportive loving relationships.”

This was one of the key messages in the first-ever Surgeon General’s report on the topic of mental health and mental illness released way back in 1999. Now, 15 years later, we still have far to go in terms of getting mental/emotional/spiritual health support to all who need it.

What can give us hope?

Fortunately, there are more options being recognized for folks who are feeling that they just have to grin and bear it:  don’t know where to turn, think they can’t afford help, or fear the stigma of being labelled with an “inferior mind” or weak.  One of the most exciting new trends in our internet age has been the offering of SKYPE, phone and web-based mental health services in any form, from anywhere in the world.

The bottom line

Services are available far more broadly and less expensively than many might think.  If you are feeling down and out, mad or stressed, do consider giving mental health services a try!

When is talk-therapy useful?  Any time you:

Need someone on your side — someone who is knowledgeable

Are stuck and need help resolving a particular problem

Need coaching support to meet a specific goal, such as career, relationship or social

Have concerns about your relationship and want expert help to improve it, or to make decisions about the direction the relationship should take

Have a need for strict confidentiality in regard to your concern

Need a fresh look at your life and where it’s going

Are feeling depressed or stressed by specific events

Are sad, lonely, or anxious and don’t see a way out

Susan Heitler, Ph.D., is the author of many books, including From Conflict to Resolution and The Power of Two. She is a graduate of Harvard University and New York University.
Co-author Linda McKinzie, is executive director of Denver’s  Maria Droste Counseling Center.

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Co-Dependency 101

codependency_

by Pipa Gordon
The Raphael Project, 2010

Co-dependency essentially is another addiction that life can throw our way. It is a huge minefield and we are just going to scratch the surface here in order to open the door to conversation and thought. If it is something you you find yourself relating to, it might be a good idea to look deeper into it and/or seek some counselling.

A Co-dependent person is someone who is often more orientated to other people’s reality than their own. They have the ability to know and understand everyone elses’ needs but yet they can not tell you what they need for toffee. They are what is referred to as the finder and the fixer. From the outside, this person may come across as the modern day Mother Theresa, people may look at them and be inspired and wish they had it all together like she does but unfortunately, in this situation, when it is a co-dependent person acting out the role of everyone else’s fixer, they are hiding from their own pains and needs and getting their ego fix from being seen as the hero. Of course there is nothing wrong at all with being the good samaritan, but when this pattern of behaviour becomes someone’s identity and addiction, it is because of deeper issues at hand.

A Co-dependent relationship is perhaps best described as a non productive relationship that you are addicted to, feel bound to and can’t get out of your mind. These relationships can sneak up on us, are often the closest we have and are layered with guilt and “I should…” along the way. Unhealthy is an understatement as these relationships are emotionally imbalanced and leave you feeling drained; your thoughts and emotions go beyond those of normal healthy self-sacrifice and caring relationships and you feel beholden to keep up your side of the deal, often fearing that the other person might fall apart if you were to walk away – which even if it were the case, would be the making of you both. The healthy need of each other has gone beyond extremes and become an I need you to need me type of need which is suffocating and often causes the feeling of being trapped.

codependent4

Co-dependency doesn’t only occur between partners, but also often between parent and child. The longer it goes on for, the more the guilt and need runs deeply and almost feels like the life force of the relationship. Often you find that people in a co-dependent relationship are compeltely oblivious to it as they don’t know any different and often genuinely think they are caring for the other person. For example:

  1. a Mother is having a co-dependent relationship with her 32 year old son who still lives at home and is borrowing money, eating into her inheritance because she says he lost his job, again…..yet her allowing him to keep taking from her is feeding his not pulling himself together and acting responsibly and equally feeding her need to be needed.
  2. the Wife has a husband with a gambling problem so she’s working two jobs to make ends meet…she says he’s “trying to quit” but he’s not, because she’s making up the shortfall in their finances anyway.
  3. a Daughter phones her mother every day not because she wants to but because she feels she has to. She’s unable to make decisions without her Mother’s say so, is there at her Mother’s beck and call and carries guilt about being the perfect daughter even though she is married with her own family to look after. (nb, many daughters phone their mum regularly because they WANT to, this is perfectly healthy, we are talking about the feeling of “I need to” here).

So let’s break it down, what are the signs of a co-dependent relationship?

  • Secrets from the outside world
  • Guilt at not fixing their problemtoxic enter
  • Shame
  • Repressed Anger
  • Low Self-esteem
  • Compromising own values to avoid the other person’s rejection or anger
  • Power imbalance in a relationship

How do you know if you are a co-dependent person?

  • Do you get obsessed with fixing and rescuing needy people?
  • Are you easily absorbed in the pain and problems of other people? Do you find yourself feeling someone else’s pain beyond empathy?
  • Do you find yourself being controlling? Are you easily controlled within relationships?
  • Do you do more than your share….all of the time?
  • Are you always seeking approval and recognition? You need to be seen as important and integral?
  • Would you do anything to hold on to a relationship? Do you fear being abandoned?

Codependent support

Co-dependent women often burn out as they are entirely focused on the pain and suffering of someone else. There is a stark difference between a compassionate woman and a woman who is drawn to someone else’s pain as they feel that in being there to fix and help gives them a sense of worthiness.  There is also a difference between someone who works hard, and someone who is  a workaholic! Often you find co-dependent over achievers felt loved by  their parents because of what they DID, not who they were…and hence  they bring that learned behaviour into their adult lives and behave in  an almost martyr like fashion which not only is therefore wasted energy, but can also be damaging to their own spouse and children and the pattern becomes in danger of repeating itself.

Here’s a big one – you know he has a good side and you’re hoping that it will come back again….? Familiar? That’s a co-dependent relationship, you’re fixing him, you’re trying to change him, you’re hoping that one day things will get better and in the meantime are holding it all together. I know it’s a terribly painful realisation – it doesn’t mean the relationship is over, but it does mean that as long as you are protecting him and waiting for him to change, odds on, he won’t. You need to find your own independence, your own healthiness in this relationship and hope to goodness that he bounces back and does the same.

Neediness is an absolute red flag of co-dependency as one person’s happiness depends on having the other person right there, right now to the extent that their behaviour can become possessive, jealous and obsessive….calling them pointlessly throughout the day just to check up on what they are doing…. asking questions which have the underlying motivation  “Do you still love me? Am I still important?”…. these are all clear tell tales of a co-dependent relationship.

Repressed anger is also a deep one linked with shame. Often someone hasn’t been allowed to show their emotions as a child and so has never developed the ability to be rational with their reactions and feelings, their shame and low self esteem causes them to repress their anger as they don’t know what might happen to them if they were to express it.

neglected

What causes co-dependency? This can come from all angles of life! Often from childhood where the child has been loved for their actions rather than who they are, this in turn has built in a pattern, an integral belief that says “if I do good, I am loved” thus the over achieving fixer, mender, superhero over achiever is born. It can also be that as a child, the youngster wasn’t allowed to develop naturally into an independently thinking teen and young adult, perhaps because they were parented by an alcoholic, an abuser, someone with control issues or other family problems. This meant that their own mind was not allowed to function as they were controlled by their parents/care-givers telling them what to do, what to think, how to be, where to be, what is right, what is wrong etc, therefore, they have never learned how to be independent, but have literally been trained in co-dependency behaviour from the beginning.

As well as resulting from relationship issues; we also see that co-dependency can arise from mental illness such as depression, all types of abuse, chronic illness within the family, divorce, even moving home – any trauma without the correct support system around can also trigger and set the stage for codependency, this is because the natural reliance on oneself can become stuck which can then trigger an incomplete sense of self, a sense of inadequacy and an inability to stand on one’s own feet.  The person then feels vulnerable and begins to give with the motivation to receive stability and strength which somewhere along the line they lost.

How do we overcome co-dependency? We learn how to step across into inter-dependency. This is a healthy form of leaning on each other as an independent person, not a dependent one. There is a monumental difference between someone who is a free unconditional giving person versus one who gives because they need to feel needed.  The Mother Daughter relationship can often be co-dependent as it is naturally a very close bond but this is can be abused by emotional issues which can then create unhealthy links and bonds. A daughter can feel immensely guilty at wanting to break free from her Mother who has become all encompassing and involved in every decision in her daughter’s life. The Mother’s need has become larger than her ability to freely give and the daughter knows no different and so feels trapped.

change10

The first step with any addiction is of course to acknowledge it and then reach out for help. There are loads of books available but if you can, I would also opt for a course of counselling as as each case is intricate and different to the one before, it would be helpful to get a professional’s eye on the situation as this is a tough  nut to crack alone. What is very important is setting healthy boundaries and having a good support system because we are talking about changing the fundamental way that someone has done life so far.

There will be a small element of co-dependency in all of us, but you know heart of hearts if it is a problem. We touched on this lightly but do remember that co-dependency can arrive in your life at any given stage or equally can be the fruit of other things such as child abuse and bullying in those formative years. It’s always good to trace back as far as possible to find the root. We all know when weeding, that if you get the root, you’re laughing!

Pipa Gordon and the Raphael Project is a blog/site on wordpress, paraphrased as follows:

There are way too may people who walk this planet alone, who face trials of one degree or another singlehandedly. This is why I wanted to create a space where we can address all kinds of issues, some light some heavy, but those issues that we don’t always know how to deal with or where to go with. The ones that we’re not quite sure who to turn to about.
What this site is about is lifting the lid on life and discussing the lot! What makes it, how to survive it, how to look good whilst doing it but even better, how to do it fruitfully, happily and with one another. (Notice no use of the word successfully!).

For more info:  http://theraphaelproject.com/about

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