Couples Communication: The Four Horsemen

John Gottman, relationship guru and researcher, can predict with an astonishingly 91% accuracy rate if a marriage is headed toward divorce.  This was a surprising detail to learn in my couples training and it certainly influenced how I work with couples in counseling today. This man did 30 years of research to create and form the Gottman Method which is highly respected in the world of couples therapy. 

Today I will share one of the ways he predicts divorce using The Four Horsemen.  The Four Horsemen depict the communication styles that can be hurtful in a relationship if used too often.  I think it’s important to first understand if these types of interactions are coming into play in your relationship by being able to identify them.  Acknowledging and labeling a behavior for what it is can open your eyes to how it plays a role in the way you and your partner engage with each other. 

But don’t worry!  With each negative behavior that takes place in a relationship, there exists an Antidote to counter each Horseman.  Make sure to check back next month when our very own, Jenifer Costigan, will elaborate on those Antidotes! 

The Four Horsemen

Criticism

A partner often has the intention to bring a complaint to light but sometimes it comes out sounding hurtful or harsh.  It is good to differentiate between a criticism and a complaint.  A criticism is stating a problem but including an attack on a partner’s character trait.  So, it can sound something like, “I really wish you would use your brain before making plans with your friends.  You always do this!  I thought we were going to hang out.”  A complaint is more like, “I’m sad and disappointed that you made plans without me.  I really wish you would have checked with me first.” 

Defensiveness

This reaction is typically in response to criticism.  When someone feels attacked or criticized, they tend to want to protect themselves by providing reasons for why they said or did something.  However, this strategy often comes across as making excuses or deflecting from responsibility.  For instance, if a partner inquires about a chore left undone and the other partner responds with “Well you never do your chores when you say you will” or “I had more important things to do and if you want it done why don’t you do it yourself” those would be defensive statements.  Defensive remarks can often seem like the blame is shifted to the other partner. 

Contempt

This one is probably the most harmful of all.  Individuals who tend to express contempt to a partner have real negative thoughts and feelings about their partner.  Their verbal or nonverbal expressions communicate “I don’t like you very much, in fact, I despise you.”  Contempt is relayed through acts of sarcasm, ridiculing, mocking, and belittling.  Any action or verbal communication that displays disgust or position of superiority to a partner is considered contempt.  If partners are engaging in name calling and insult slinging, it’s a slippery slope toward a breakup or divorce. 

Stonewalling 

This behavior happens more often when a partner is feeling overwhelmed or hopeless in their relationship.  It is often seen in conjunction with criticism, defensiveness, and contempt.  An individual “checks out” as a way to disconnect from the stress of an argument.  Whether it is the intent or not, when a partner stonewalls it communicates lack of engagement or care for their partners position.  While an individual might perceive stonewalling to serve as a protective factor during conflict, it can slowly deteriorate trust and connection in a marriage. 

As a couple’s therapist, I see these styles of communication come into play between partners quite often.  Honestly, it is normal and common for these interactions to exist within a relationship, but how often are they showing up in yours?  Gottman strongly encourages a 5:1 ratio; this meaning that more often than not, we are choosing to engage with our partners in positive ways.

Nevertheless, those couples who thrive in marriage are the ones who practice the Antidotes most often.  The Antidotes are the true protective factors in a healthy relationship. So, tune back next month to learn about each Antidote so you can begin to focus on using those in your relationship!  And in the mean time, you can continue to reach out to us if you need couples counseling in the DFW area.

When Your Partner Is Going Through Anxiety

Anxiety Therapy in Fort Worth, Texas

Helping loved ones coping with anxiety

Our world is dealing with a lot of uncertainty and change right now due to COVID-19. Along with this pandemic comes so much fear, panic, anxiety, sadness, and anger. For many of us in the DFW area, we have had to face the adjustment from a fast-paced life to an “in shelter” lifestyle with all sorts of emotions, thoughts, reactions, and new realities.

For those who have coped by staying productive and are caring for your physical and emotional health, congrats! The other reality is that many people may not be ready to “sit with their feelings” or feel comfortable expressing their feelings. Some don’t even know what it is they are feeling. For a person with an anxiety disorder, the anxiety may have become worse by all the environmental changes we are currently facing.

We all experience and express our emotions differently. I want to remind you that that’s ok, we are all different and deserve to be respected and supported as we navigate and adjust to change.

The idea that we all react differently to change and how we all thrive when we receive emotional support, led me to write this article. There are many people right now struggling with anxiety, and on the other side of that many partners finding it challenging to provide emotional support during a stressful time. Here are a few tips on how to provide effective support when your partner is experiencing anxiety.

1.     Don’t Try to Fix Them

It may be your first reaction, as you’re seeing your partner get lost in their thoughts, beginning to isolate, or is displaying those symptoms you’ve seen before where you think “oh no, the anxiety is back.” Unfortunately, jumping in to solve the problem can be seen as dismissive or critical without truly listening to your partner.

When your partner is struggling with anxiety, they cannot be well for you. Anxiety can be debilitating and the last thing someone who is experiencing this disorder needs, is the feeling that they have failed you or that your love will be conditional based on their symptoms.

Instead, remind them that you want them to feel better soon because you love them and see how difficult it is for them to be experiencing anxiety.

2.     Avoid Proving to Them Why They Shouldn’t Be Afraid

Sure, anxiety is a normal body’s response to threatening situations some of which may be irrational or may not occur. For individuals struggling with anxiety, it is no longer about being afraid of something specific and weighing out the facts. Their anxiety has become too high and they are experiencing unpleasant physical, emotional, and cognitive symptoms.

Instead of challenging their fears, ask them specifics of what is upsetting to them. Allowing your partner to talk about their deep fear openly can often neutralize it, making it less threatening.

3.     Help Calm Them Down

As often as you are able to, remind your partner that they are lovable and that their anxiety will not change that. Let them know, “you’re not alone, we’re in this together.” If your partner is experiencing a panic attack, help them interrupt the attack by offering a distraction.

Helpful distractions can be as simple as breathing some fresh air outside or going for a walk. Learn more about breathing techniques specifically for anxiety, where you can practice them alongside with your partner. This will not only help alleviate your partner’s anxiety but will demonstrate your active support for your partner and your commitment to turn towards each other during difficult moments.

4.     Set Realistic Expectations

During times when your partner is struggling with their anxiety, they will not be themselves. Their energy, mood, demeanor will be different. You may be longing to share happy moments instead of evening talks about anxiety. Although it can be difficult to remain patient with your partner, remember to set realistic expectations of what your dynamic will be like during this time.

It’s ok to not be experiencing relational bliss in this moment. Consider setting the expectations that you both will practice behaviors that will provide you with rest, self-care, or professional support.

5.     Prioritize Self-care

Seeing your partner experience such dark moments can shift all the focus on their wellbeing. You may be tempted to refrain from sharing your personal stress from your partner in an attempt to not worry them further. Unfortunately, this creates a conflicting dynamic in the relationship. They may end up feeling like a fragile child, and you may end up feeling alone.

Remember the idea is to turn towards one another despite the challenges you are both facing. If your partner is unable to do this because her anxiety is interfering, practice other strategies that help you cope with your individual experience.

Practice journaling or talking to someone you trust. Allow yourself to do things that you enjoy that don’t stress you out. Dedicating time to yourself will help you cope with your individual stress as well as re-energize you for those times when your partner needs support.

It’s hard work to turn towards each other during difficult moments. My hope is that these tips will be helpful in providing you with new strategies to help someone you love and help you feel supported too!

One of my favorite quotes is by Dr. John Gottman, which I use in my work with couples. I especially believe it’s perfect for those of us wanting to be helpful to someone experiencing anxiety. Dr. Gottman says, “When you’re hurting, the world stops, and I listen.” 

Where Do You Wish To Meet?

Illustration by Sophia Schultz

Counseling in Fort Worth Texas

Meeting you where you are:

Abraham Maslow was a humanistic psychologist who developed a theory describing what motivates individuals and how they move along the lines of getting their needs met.  His concept, Hierarchy of Needs, is most often depicted in a pyramid to delineate each level. 

The bottom level, the foundation, represents the most basic necessities for human survival while the highest level demonstrates transcendent desires.  As a person reaches their goals in one level, he or she is able to move on to the next level. 

If an individual has yet to satisfy the needs for food and shelter one can assume this person is less likely motivated to fulfill their needs in other levels.

The 5 Stage Model includes:   

1.    Physiological Needs -  food, shelter, water, clothing

2.    Safety & Security -  health, employment, stability, security of  body

3.    Love & Belonging -  friendships, family, intimacy, connection

4.    Self-Esteem -  confidence, respect from others, achievement

5.    Self-Actualization -  spontaneity, creativity, lack of prejudice, realizing personal potential

While the hierarchy is depicted in an upward trajectory, it is not uncommon for people to fluctuate from one level to the next.  When changes arise such as divorce, death, breakups, or loss of employment, individuals can find themselves moving back and forth through the hierarchy. 

When the needs to be loved, to feel safe, to feel confident become threatened, it is human nature to make attempts, even if ineffective, to gain or maintain them. This can result in relationship conflict, anxiety, and other misunderstood effects.

In our practice, clients come to us from all different levels.  We do our best to listen to where our clients have been, find out where they are, and discover where they wish to be.  On whichever level you find yourself, we will meet you there.   

Rebuilding Your Relationship When Dealing with Addiction by Paige Johnson

Addiction ruins things. It can ruin your health, it can ruin your bank account, and it can ruin your reputation. One of the things many people see ruined by addiction is their relationships. While dealing with an addiction, you may do things that erode trust between you and your partner; things like infidelity. In fact, in a 2014 article published in the Journal of Studies on Alcohol and Drugs, almost half of the alcohol addicts surveyed had also gone through with a divorce at some point in their lives.

The sad truth is you may not be able to repair the damage done to your relationship. Your partner may feel too hurt with too much trust lost to go back to the way things were. If they decide to walk away, there’s nothing you can do about it with the exception of acceptance.

On the other hand, some people feel such a sense of guilt for the things they did due to their addiction, they want to end their relationship as a way of atonement. It’s important not to make any major life changes during your first year of recovery. This includes ending a major relationship such as your marriage as well as starting a new one. Your road to recovery may be the thing that helps save your marriage.

Know Things Have Changed

When you recover from addiction, there’s no going back to the way things used to be. While you may feel the desire to work toward a simpler time in the past, there’s no possible way to get there so accepting your position is crucial. You may not even realize all the ways your behavior has impacted your relationship.

Your partner had to grow and change to deal with watching your self-destruction. They may seem cold and callous when they were once warm and loving. It’s unfair for you to expect them to be the same after all this time, so accept the place they are at now.

Work to Mend What Is Broken

Chances are, you and your addiction did more than your fair share of destruction in your relationship. Some people miss important events or disappear for weeks at a time when they’re on a bender. Others stick around and show up, only to act irrationally and violently towards the ones they love. And some relationships have to face the ultimate test after one of the parties cheats on the other.

Infidelity is traumatizing. It causes the wronged party to question you, your relationship, and themselves. If you committed adultery and have come clean to your partner, it will take time to rebuild the trust that is now lost. To build this trust, you must be completely honest with your partner. This is difficult for many people as addicts have a hard time being honest with themselves. However, the work is necessary if you want to save your relationship.

Accept Responsibility for Your Actions

You will not be able to move on if you do not accept responsibility for the things you’ve done. This means you cannot play the victim when you relate to your partner why you’ve done said things. Life is tough; we all have to deal with our own traumas every day. Trying to use your own traumas as a scapegoat for your behavior only shows that you are not ready to be honest and move on from your addiction.

Listen to Your Partner

While you are going through recovery, you will be talking a lot. You talk to your therapist, you talk to your group, and you talk to your higher power. When it comes to rebuilding your romantic relationship, it is time to listen. Take in everything they have to say and ask questions when you need clarification. It may be difficult to have to listen to all the ways you hurt him or her, but the pain is a fraction of what they felt when you were doing it.

The key to rebuilding your relationship during recovery is acceptance. You must accept the continuation of time and how it changes people. You need to accept that the process will be long and arduous. You need to accept responsibility for what you’ve done and the communication your partner offers you. But in the end, you must also accept forgiveness from yourself. Forgiving yourself is the only way to truly open yourself to being forgiven by your partner so you can rebuild your loving relationship.

Paige Johnson calls herself a fitness nerd. She prides in doing strength training, cycling, and yoga. She is a personal trainer and regular contributor to LearnFit.org.

I Believe You!

While it is disheartening to hear the numerous accounts of women being violated and mistreated by the movie mogul, Harvey Weinstein, I am glad that this topic is being given the spotlight it deserves.  Each narrative serves as a reminder of the struggles that still exist for women today.  But in light of the deceptions that have occurred, it is also inspiring to see the number of individuals who are being brave enough to speak out against this magnate who has abused his power and authority for way too long. 

One thing that I noticed being advocated on social media was the #MeToo campaign.  I found it interesting how each time I logged into my FB page, there was yet another person posting #MeToo.  It was similar to the unraveling of the Weinstein debacle.  Every time I picked up my phone, I learned of another celebrity who had been affected by his vile behaviors.  It seemed as each person stepped forward to tell their story, others gained the confidence to follow suit.  Amazing! 

Revealing traumatizing incidents is not easy and many victims hold off on disclosing for fear of rejection, shame, embarrassment, among other reasons.  Silence perpetuates the cycle of nondisclosure making it more difficult to discuss after a period of time has passed.  Therefore, when an individual is ready to disclose that moment can be consequential to their healing. 

One woman on FB said she was surprised that the #MeToo campaign helped her see that she was not alone in her experience with sexual assault.  The more dialogue we have with each other about this topic, the more it provides us with understanding and connection.  Feeling alone is very common and can make the abused feel isolated. 

But in speaking, there is also listening.  So, while one person is ready to speak another may be unsure or leery of hearing.  They may feel uncertain of how to verbally respond in an empathic manner. Or the information being shared might put the listener in a position of responsibility.  Now you have this knowledge, and what do you do with it? There is bravery on both ends – speaker and the responsible listener. 

In the recent events, what has occurred is a movement that promotes validity.  Validity says “I believe you.”  Those who have spoken out against Weinstein include not only the individuals directly affected by him but those who have been witness to Weinstein’s poor character.  These people have stepped up to validate the numerous accounts that have been given, allowing for those who have been hurt to begin healing. 

I think what tends to happen is that this topic of sexual abuse can seem ugly and uncomfortable.  And it is.  However, it’s way too important to avoid it.  Silence only makes it stronger, and it’s our voices that will help us take a stand against sexual abuse.  And in that process, we find that there are people who can and will say, “I believe you.” And I can declare, “#MeToo.”

The Continuum of Addiction and When to Reach Out For Help

A lot of people have a difficult time truly understanding addiction and alcoholism and why some people become addicted to drugs and alcohol.  While there are some differences between the two, this article uses terms addiction and alcoholism interchangeably.  A lot of times you’ll hear people say things like, “Why don’t they just stop?” or “They said they want to stop so how come they just don’t?”  A lot of times people mistakenly think that it’s due to a lack in willpower, and that it is just a matter of choice.  Unfortunately, sometimes it is just not that easy and not that black and white. Drugs and alcohol can change the brain in ways that makes quitting drugs a lot harder than someone who drinks or uses recreationally.  Addiction is a very complicated disease that requires interventions beyond willpower.  Back in the 1950s, the American Medical Association classified alcoholism as a disease. Alcoholism is a progressive disease that has the potential to have devastating effects. While at the beginning of drug or alcohol use choosing to say no might be easy, to others further into the cycle it is not that easy.

 According to research, there are several stages in the continuum of addiction.  These stages are: abstinence, experimentation, abuse, dependence, addiction, and death. Here’s a quick explanation of the different stages:

Abstinence: The first stage in the progressive model of addiction is just simply not using at all. This is the time period prior to any type of use whatsoever.

Experimentation: This is the first time that people use and usually has to do with curiosity in social settings and is amplified with peer pressure. While some use because they are curious and for social reasons, others might use as a way of acting out.  Another potential reason is due to emotional problems, such as problems dealing with grief and loss or feeling lonely.   More often than not, the ones that use for the emotional reasons have a higher likelihood of progressing in this cycle.

Abuse: Substance abuse is simply the continued use despite negative consequences. These consequences can be a failure in fulfilling major role obligations at work, school, or home. It can also be continued use despite legal problems, despite persistent and recurrent social or interpersonal problems.

Dependence: A big shift happens in this stage and this is most notably defined with the onset of increased tolerance and withdrawals. The want becomes a need. Tolerance can be defined as the fact that it takes more and more to get the same effect.  For instance, 2 drinks to get a buzz now takes 4 drinks.  Tolerance can also be defined as a diminished effect.   The diminished effect can be that no matter how much the person uses they are no longer able to get the same desired effect. Withdrawals can be physiological and psychological. The withdrawal symptoms vary depending on the substance and as a general rule of thumb whatever effect a substance has going into the body will have the exact opposite effect going out of the body. 

Addiction:  This is when the substance takes priority. It is when the substance causes people to do things that they otherwise would not have ever done. Just because someone is “highly functioning” doesn’t mean that they cannot have a problem. Chronic drug use leads to individuals having a clouded perspective that shifts what is actually reality.  There's a good chance the “highly functioning” is not the work output the person would be doing if they were on their “A game”.

Death:  Unfortunately, addiction can lead to death and can have an extreme impact on individuals, families, and society as well. Whether it is from an accidental overdose, liver failure, heart attacks or other major health problems caused by chronic drug or alcohol use, thousands of people die every year from the fatal disease of addiction.

Here are some signs and symptoms that indicate a need to reach out for help:

• You cannot stop using the substance.

• Your drug or alcohol use has led to unsafe behavior and become impulsive.

• You are having withdrawal symptoms.

• You need the substance in order to function.

• Someone that cares about you or even a physician tells you that you should stop.

• Lying

• Spending too much money on your substance

• Problems at school or work

• Health problems

• Decreased hygiene

• Changes in behavior

• Continued use despite a desire to stop.

If you or a loved one is struggling, then I highly encourage you to reach out for help. Chances are if you are questioning whether or not you should reach out, then you should.  The severity of the presenting issues will dictate the type of substance abuse treatment that is needed. Treatment options range from inpatient treatment in a residential setting to outpatient therapy. The bottom line is that if it is causing problems in your life, I would highly encourage you to reach out to someone for help.  It all starts with a phone call and putting the right team in place to help you on your journey. When one door closes another one opens.

Rane Wallace, MS, LPC, LCDC has a huge passion for helping those still struggling with addiction and their families as well. He is a Licensed Professional Counselor and a Licensed Chemical Dependency Counselor. He has worked in the field of addiction for over 10 years and is the Owner at Fort Wellness, PLLC, an Associate at LifeSquared Counseling & Consulting, and a Counselor III for the Tarrant County Community Supervision & Corrections Department. www.fortwellness.com

Recommiting to Your New Year's Resolutions

We've all been there. We've made a list of New Year’s resolutions, which include a diet plan to lose weight, a new workout routine, or a complete resolve to stop eating the chocolate we stashed in our desks at work. Yet each year by the time February comes around, those ideas have already turned into next year’s resolution list.

Why do we put so much pressure on ourselves to suddenly make several significant life changes overnight? Change is possible, but the key to making lifelong adjustments is having the patience to adapt over time. So instead of waiting until next year for a fresh start, give yourself permission to start right now with a few simple, long-term ideas to start leading a healthier life.

Revise Your Resolutions

What were your New Year’s resolutions for your health? Don't throw them out completely, but use them as a broad vision statement of where you eventually want to be. Then, scale them back to a more manageable daily adjustment. For example, if your resolution was to join a gym and go five days a week, maybe start by just going one day a week. One small change can make a huge impact on your health over time. Then once you have consistently followed through with that goal, you can slowly added a new one. In time, you will be able to push past your limitations and take your health to a new level.

Healthy Habits

We all have our go-to comfort meals, our favorite sugary drinks, or our guilty sweet pleasures. If your goal is more important than indulging in these, try cutting back on some of them. Replace the habit with a few healthy foods or drinks that you still enjoy. If you are a hamburger lover, trying eating it without the bun. Replace a bag of chips with a bag of dried fruit. Drink unsweet tea instead of sweetened. Make sure that you fill your pantry with healthy foods that you like so that it will be easier to transition your taste buds toward craving healthier options.

Tips on Drinks

For the caffeine fiend or alcohol connoisseur, the idea of removing these drinks from your diet is very challenging. However, the benefits of lessening or removing them from your system entirely outweigh the temporary craving that your current habits call for. In fact, alcohol has a greater potential to cause harm to your body than to benefit you, and depending on your level of consumption, caffeine can do the same. In order to lessen the potential of addiction to either of these things, you will need to slowly decrease your intake over time. If your body is accustomed to alcohol or caffeine and you stop drinking them suddenly, you may experience severe withdrawal.

Why Health is Important

Longevity of life is at the top of the list of reasons to live healthily, but there is more to the picture than that. Healthy living not only has an impact on us physically, but mentally as well. Exercising and eating healthy can help with chronic pain, depression, and anxiety.

Our families, our friends, and all that we have worked for in our lives is worth the time and effort it takes to maintain our health. For those with children, consider creating healthy family habits, like cooking meals together as a family or creating a family workout plan. Teach them through your example that their life is worth the work it takes to be healthy. 

Your life can be as enjoyable and healthy as you will allow it to be. Consider all of these tips and other ways that you can incorporate healthier practices. Start by recommitting to your New Year’s resolutions and transforming them into a renewed lifestyle.

Paige Johnson calls herself a fitness nerd. She prides in doing strength training, cycling, and yoga. www.learnfit.org

The Dynamic Dr. Dixon

Brian Dixon, M.D.

As a therapist, I often find that clients are hesitant or skeptical about taking medications for mental health purposes.  Some individuals explain that medication in the past has not worked effectively while others share their distrust in psychiatrists or “pill pushers.”  So, I sat with Brian Dixon, M.D. recently to see if he could shed some light on his approach and process to psychiatry. 

What led you to practice psychiatry?  And how did you know it was right for you? 

I knew psychiatry was the ideal specialty after I completed a family medicine rotation in medical school and realized how mental health was a key component in treatment compliance. And when I learned that psychiatrists have more time to truly dig deeply, I knew it was the field for me.

What is your style or approach to working with your patients?

I fully believe in meeting patients where they are and helping them towards their best self; this only occurs when patients are ready for change so I establish people’s motivation for change early in the process.

What have you found to be the most difficult to treat?

My “waterloo” in psychiatry is likely eating disorders. I employ lots of behavioral techniques and though most eating disorders have a large behavioral component, the psychodynamics stretch me pretty thin and puts me at risk for compassion fatigue.

What is the biggest misconception about psychiatry that you have come across? 

That it’s fast and easy. Like a surgeon doing a Whipple procedure [a 10-hour delicate pancreas surgery] psychiatrists open up a person’s psyche and help them build insight into themselves. It’s a process that’s scary and complex and can’t be done in a session or two. Reminding the public that as physicians, psychiatrists are trained in all aspects of mental healthcare and building a comprehensive treatment plan takes training and patience and helping someone feel better is a process.

When you notice a patient is worried or anxious about the idea of taking medication, how do you move forward?

First and foremost, the first option is always no medication. As one of my training psychiatrists taught me – no one is born with a Ritalin deficiency – meaning that we use medications currently to bridge people to a time when they are feeling better. If people are interested in medications, I then walk them through all options explaining common risks, benefits, and side effects so that they get to choose the option that works best for them and their situation.

I understand you also see adolescents and children.  How young is too young? 

There’s a field of infant psychiatry so I’d say no one’s too young! My youngest is 3 and since there are very few medications approved for that age, I blend mainly behavior modification into my treatment plans.

And how do you adjust from working with an adult to working with a minor?

Training. The best part of being a psychiatrist is that you go through an intense residency program for 4-5 years.  During that time, you learn to juggle complex treatment choices that come at you from all angles. Thus, it’s not tough to adjust when it’s literally built into our training.

What do you recommend to those who are searching for a psychiatrist?  What questions should people ask?  What should they be looking for?  Or steering away from?

The most important and first question is “Are you ready for change?” It’s okay if someone isn’t ready for change but [instead] reaching towards possible medication (which many psychiatrists tend to use as part of a treatment plan.) If you’re ready to ask, the next question is specialty and focus. I remind patients that orthopedic surgeons are surgeons and could remove your gallbladder but you’d likely want a general surgeon to do it. The same goes for psychiatry. There are generalists and subspecialists, and both genres have focuses so be sure to ask if they’re a good fit. Online reviews are notoriously inaccurate so I encourage everyone to steer clear of what reviews they read in regards to the quality of mental health services in Fort Worth; I know many of the providers and they’re quite good.

In your line of work, it can be very demanding and challenging.  So, how do you find balance between tending to patients and taking care of your own self-care needs?

The hardest balance, strangely, isn’t practicing psychiatry (this is where my amazing training kicks in.) Honestly, running a small business is the tougher of the two endeavors, and self-care tends to take a back seat when there’s work to be done until the wee hours. I’m blessed to sing in a great chorus in Dallas and have fantastic friends in Fort Worth to keep me sane.

Lastly, I want to say congratulations on your recent recognitions for 40 under 40 by the Fort Worth Business Press AND Top Doc in Psychiatry by Fort Worth Magazine.  How awesome!  So, what’s next for you?  Can you tell us what you plan to accomplish next?

Thanks!  It’s quite an honor to be acknowledged for building a successful private practice both business wise and clinically.  My goal for 2017 is to tackle healthcare reform.  Our current system is broken as it’s based on commercial insurance.  I have a novel solution that returns healthcare to the local level and power to the citizens and I’m sharing it far and wide through all public and social media outlets.  My goal is to get my idea into the common discourse so that we can change healthcare starting today.

Something that comes across loud and clear when hanging out with Dr. Dixon is his friendly, down-to-earth disposition.  After the interview, Dr. Dixon shared with me his desire to make improvements in how mental health is not only treated but also perceived.  He is a man interested in helping others, however he understands and respects his limits.  He often integrates the expertise of other professionals to enhance his mental health plan for his patients. 

Your mental health is essential in your day-to-day living and making the decision to seek a psychiatrist is not always easy.  Some people have preconceived notions about meds and doctors that make it difficult to embrace a consultation with a psychiatrist.  I hope today's Q&A helps you gain a better understanding of what to expect when seeking help from a psychiatrist.  Thank you, Dr. Dixon, for sharing with us what you do and how you do it!  

Brian J. Dixon, M.D. is a Board-Certified Adult, Child & Adolescent Psychiatrist with an active private practice in Fort Worth, TX.  He believes in treating the whole patient using a unique blend of behavior modification and therapy while minimizing medications.  His practice’s goal is to reintegrate mental health into our modern lifestyles.  www.progressivepsychiatry.org

Let's End Child Abuse Together!

At the beginning of the month, we shared the importance of spreading awareness and becoming educated in ways to prevent and stop child abuse and neglect. You may have even seen blue pinwheels around town reminding us of our responsibility to prevent child abuse. Although the month of April is coming to a close, we will not end our efforts in preventing child abuse and neglect in our communities.

If you are in the DFW, I want to remind you of the alarming statistics of how this issue is one you should become involved in. The Texas Department of Family and Protective services found that Tarrant county has higher rates of confirmed child abuse than both Dallas county and the national average. It was also found that the Dallas-Fort Worth area made up about 26% of confirmed child abuse and neglect cases in comparison to other major cities in our state.

As marriage and family therapists we are trained to recognize the signs of child maltreatment and the various ways on how to report them. Yet, the fact is that we can’t do it alone! There will be families that you come into contact, which we will not get to work with. Communities that you are a part of that we may not know about. 

To report abuse you may do so by phone or online. You also have the right for your identity to stay confidential when reporting. 

Report by Phone:

1-800-4-A-Child (National Child Abuse Hotline)

1-800-252-5400 (Texas Abuse Hotline)

Report Online:   https://www.txabusehotline.org/ (Texas)

Information on recognizing signs of Child abuse

https://www.dfps.state.tx.us/Child_Protection/Child_Safety/recognize_abuse.asp

http://www.stopitnow.org/ohc-content/tip-sheet-7

For more resources and information on this topic be sure to check out this post as well: CHILD SEXUAL ABUSE DISCLOSURE Let’s work together to end child abuse! 

Telling The Children by Jerry Cosby

Once the level of suffering and pain has become intolerable, when dreams have been shattered and hope for the future has been lost, one or both of the parents may decide to divorce. Telling the children is an undertaking of great importance; lives will be changed.  After wrestling with this gut-wrenching decision to divorce, most parents desperately dread the idea of making the announcement. Some parents make the mistake of allowing the children to find out when one morning the children awake to a catastrophe - Dad and his belongings have disappeared into thin air. In any case, the children will remember this day for a lifetime and reassess the understanding of it at every stage of their development. Conversation, done fully and well, will ease the pain and comfort them.  Conversations done poorly will profoundly add to their confusion, anxiety, and pain. And this devastating conversation takes place at a time when the parents are angry, hurt, and in torment themselves. Here are several suggestions.

1.     Both parents and all the children of appropriate age should be present when communicating the decision to divorce. Do not meet with them one parent at a time as they need to see the two of you together and observe your body language and hear the inflection of your voice as each of you contributes to the discussion. Meeting with them alone invites favoritism and promotes confusion and suspicion.

2.     Speak slowly and simply.  Remember they will hear what you say, how you say it, and what you don’t say.

 3.     Choose a quiet time when you and they can have a lengthy conference without interruption. Turn off the TV, telephones, and computers. Watch out for the distractions and pressures of pending homework, business telephone calls, arriving guests, and other disturbances.

4.     Make sure that you frame the conversation as a final announcement, not a pending decision.  They will hope and fantasize that you will change your mind and will continue to do so for some years.

5.     Ask them what they understand about divorce and their friends’ experiences with it. As painful as it may be, encourage them to speak up about their fears, anger, and concerns; they may have some misconceptions that you can correct. Some children will be frozen into silence. Even so, their minds will be running at full speed. Expect that they may lie about how they feel to comfort you, especially if you have been crying during the discussion.  They may also be concerned about having little or no input into the decision-making process. Not paying enough attention to their wishes often leads to a combination of anger and powerlessness which can undermine their initiative later in life and can result in resentment that carries through deep into adulthood.

6.     Assure them that they did not cause the divorce nor can they fix it. Also, that they are still loved by both parents, that they are the best parts of the marriage, and that you will continue to take care of them until they are grown, just as you always would. 

7.     Schedule a follow-up meeting to discuss future plans after everyone has had a chance to think things over. At that meeting, promise to keep them informed with details of what’s happening currently and events that are coming.

8.     Arrange for a time to take them to the new surroundings. Remember to repeat some of the information as young minds can’t assimilate information on one or two hearings.

Knowing that this will be one of the worst days of their lives, will this plan of intelligently going through a family meeting counteract the effect of this massive disappointment for the children? No, it will not.  But, it will go far in reducing the fear, suffering, and loneliness of the crisis.

Jerry Cosby is an experienced mediator specializing in divorce who gives emphasis to the healing of the spouses and children. To find out more about his services, please visit www.texasmediationgroup.com.