Doing Life Together

ID-10087370Josh looked at his audience and began to panic. What if he humiliated himself? What if he forgot his speech? What if he bombed with his audience? His heart began to race, his hands became sweaty. Josh felt like he was about to faint and couldn’t think. His mind went blank. Josh was having a panic attack.

Panic can be frightening because of the intense physical and psychological symptoms associated with it. During a panic attack, you may feel as if you will die or lose total control. However, panic will not lead to a heart attack, suffocation, fainting, falling or you going crazy. You may feel as if these things are about to happen because of the physical sensations you experience. But the reality is these sensations will pass, and your health will not be endangered. Panic is very unpleasant, but not dangerous.

Here are a few practical tips to help overcome panic:

1) Know what triggers panic.  There may be a pattern or specific thing that brings on panic. For Josh, it was speaking in public. Try to record what happens prior to the attack and see if you can idenitify a common trigger. For example, panic may come every time you see your stepfather, feel enclosed, have to make a public speech, or take an important test.

2) Eliminate stimulants from your diet (caffeine, nicotine, medications). These can aggravate and trigger anxiety.

3) Don’t try to resist or avoid the panic symptoms. Instead recognize the symptoms and tell yourself you can handle them. They will pass. Avoiding just reinforces the fear and doesn’t help you master the symptoms. Working with panic means riding into the storm, not avoiding it.

4) Repeat a “Yes I can” statement over and over. For example, “God has not given me a spirit of fear. I can ride this out and be OK. Nothing terrible is going to happen to me. This will soon pass. I can take the hit.”

5) Go through the panic. Don’t try to escape, instead endure it and you will eventually see that nothing terrible happens.

The key to overcoming panic is exposing yourself to it and coming out on the other side. Take away your safely measures and be fully exposed. This is what releases most people from panic.  For example, if you panic going into an elevator, don’t keep taking the stairs (that is avoidance). Find a therapist who will help you face the fear and get on that elevator no matter how afraid you are. Then hit the button and down you go. It will feel terrible, but at the end, you realize you did it, you didn’t die or faint. This mastery will build your confidence to do it again and again until the panic is gone.




ID-100182125Before my mom passed away after years of serious health issues and treatment needs, it was like having a part time job. The toll of decision making, talking with doctors, flying home on a regular basis and taking care of multiple needs can be physically and emotionally exhausting. For me, it wasn’t an option not to do this. My mom took care of me when I needed her. Now it was my turn.

Even though you choose to give care, it can create an emotional strain. The National Family Caregivers Association reports that almost half of all caregivers suffer from depression; two-thirds regularly feel frustrated; and two of five feel “debilitated” due to the changes in family dynamics.

Ever since the term “sandwich generation” was born, self-help groups, facts and information abound on how to make and execute various practical tasks involved in care taking parents. But it is the emotional part of caregiving that takes a toll.

What are some of the emotional issues involved for the adult caretaker?

  • Your own mortality. Care taking an aging parent causes you to think about your own aging process and eventual death.
  • Who will take care of you if you need help some day? You may begin to think more about your own options and plans for care.
  • Unresolved parent-child problems. The hope of many is that taking care of a parent may reverse a damaged relationship. When this doesn’t happen it can be even more distressing for the adult child. For example, a daughter might find the father who never gave approval, still not giving his approval, or the mother who was depressed and emotionally unavailable, still emotionally distant.
  • Remorse about the past. You may have regrets that were never discussed.
  • Reversal of roles. You become the parent and the parent becomes the child. This reversal of roles requires adjustment for both child and parent.

All of this requires extra doses of patience, understanding and grace. Try to honor your parents no matter how difficult the care taking becomes. Remember their dignity. They desire to be independent and self-sufficient as long as possible. Aging parents often worry that they are a burden to their adult children. They are not used to their children having to do for them. Put yourself in their place, having to depend on others when they have lived a life of independence. This perspective helps.

Be aware of the emotional issues raised and then work to manage or resolve them if possible. If you need the help of a therapist, find one who will counsel you and who specializes in treatment with the aged. Take advantage of help and support so you don’t become one of the seriously stressed.

The positive side of caretaking is that you will be more aware of what you need to do in terms of your own planning, you become more self-confident in terms of your ability to deal with health care workers and you can end well with your parent, not having regrets about the end of their lives. So do what you can, watch your stress levels and get plenty of support along the way.


upsetJill was fed up with her mom. Her solution? Cut off the relationship so she could be her own person.

I can’t tell you the number of times I’ve heard, “I don’t want to talk to my family (substitute anyone else here). They are toxic and impossible to deal with–it’s better if I just leave and have little contact.” But is it?

The problem with this strategy is that it doesn’t work! In Jill’s case, she thought cutting off her relationship with her mom was a sign of independence. But cut off doesn’t teach her how to resolve issues. It only keeps her distant from her mom. And being distant is not independence. It is running away with your emotional baggage.

Emotional cut off is a learned pattern that follows you into other relationships. When problems erupt, avoiding or cutting off the relationship results in distance over and over again.

Cut off is an extreme reaction to the problem of balancing the emotional and intellectual self. It doesn’t teach you to talk, resolve conflicts, control your emotions or extend grace- skills you need to practice for healthy relationships.

Your ability to function as a separate person but still have an  emotional attachment with your original family sets the stage for all your other intimate relationships. If you cut off your family, you don’t develop the healthy separation you need in adult life. Healthy separation comes while maintaining connection.

So try to work through problems with your original family. When you do, you practice vital relationships skills (e.g., boundaries, assertiveness, etc.). The more you do the hard work of relationships, the better you will be as a spouse, parent or even friend.

Cut off may make you feel better in the moment, but doesn’t work as a strategy to build healthy relationships. You grow when you work within a relationship.

ID-100122426Rick and Sue announced their marital separation. As we talked, I asked, “Have you ever been to a couple’s therapist to try and work out your problems?” Their answer, “Yes, we tried, it didn’t work.”

“Can you give me a few details?”

“Well we went one time when we decided to separate. The therapist wanted to see us individually but we felt it was  too late.”

But was it? One of the main reasons couples divorce is because they wait too long to get help. Couples who need help, don’t get it. And those who could benefit, wait until they have already decided it is too late. And yet there is help that could possible prevent a number of divorces.

For example, let’s look at a few predictors of divorce and how those issues could be addressed:

1) Those couples who react strongly to disagreement and remain upset, have high stress levels. If they ruminate about arguments and can’t turn off their upset, they are more likely to divorce. Couples therapy teaches couples how to recognize the escalation of disagreement, calm it down and resolve conflict. This is a helpful skill no matter the relationship.

2) Negative communication is a sign of a failing relationship. Again we know that when couples engage in whining, criticism, irritation, resentment, accusations, etc., the relationship will turn negative. The escalation of negativity takes a progressive path towards emotional distance.  Emotional distance predicts divorce. A couple’s therapist knows how to reverse that and help the couple build back positivity in the relationship.

3) Receiving formal feedback regarding a couple’s progress in therapy has been shown to lower separation and divorce rates (Anker, Duncan &Sparks, 2009). This means going to counseling, working through issues with someone who can give feedback and comment on progress, helps work through issues.

4) Finding the right therapist matters. First you need someone trained in couples work. If they are a licensed marriage and family therapist (LMFT), they have to pass training and supervision requirements to be a couple’s therapist. Some therapist do couples work but have little training in that area. Also there is evidence supporting the idea that a couple’s therapist who places a positive versus neutral value on marriage commitment is a good choice. The person will be supportive of marriage. And there is a positive correlation between the therapist’s well-being and couple outcome. So finding the right therapist is extremely important.

Can couple’s therapy work? Yes, but couples have to agree to work on their relationship and apply what is being practiced in the sessions. Couples do best to engage in therapy before the distress is severe. The earlier the intervention, the better. Many divorces are preventable.