Thursday, December 17, 2020

Dr. Alan Singer Achieves Certification As a Discernment Counselor


Discernment counseling is a protocol for treating mixed-agenda couples where one is leaning out of the relationship and is reluctant to work on it in therapy, and the other wants to save the relationship. Studies suggest that as many of 30% of couples presenting for couples therapy fall into the mixed-agenda category, and they present a significant challenge for couple’s therapists because our models assume a basic willingness to try therapy and to stay in the relationship for the time being. Discernment counseling is intended for couples who once made a lifetime commitment, whether legally married or not. It’s not for couples considering whether to commit.

Goal: greater clarity and confidence in their decision making about the future of their marriage, based on a deeper understanding of what’s happened to their marriage and each person’s contributions to the problems.

2. A clear distinction between discernment counseling and couples therapy. No couple interventions occur in discernment counseling and no experiential enactments during sessions. The “deeper” work occurs during one-to-one conversations with each partner.

3. Distinctive structure: • Short term: 1-5 sessions. Preferably weekly. A decision made each time whether to meet again. • Two hour opening session. 1.5 hour follow up sessions. Both partners come for all sessions. • Session flow: first part with the couple, then separate conversations with each partner followed by a brief sharing of something learned during the individual time, and then couple together at the end. Confidentiality guideline for individual conversation: the discernment counselor does not share the specifics of what each spouse says, but is free to share impressions and reactions to each spouse when talking to the other. • Insist that both spouses come for each session, even though they each spend part of the session in the waiting room.

4. Focus on decision making about three paths: the marriage as it has been (path one), separation/ divorce (path two), or a six month reconciliation period with an all-out effort in couples therapy (and using other resources), with divorce off the table—and then a decision about the long term future (path three)

5. Use different approaches with leaning in and leaning out partners • Leaning out: Help them make a decision based on more a complex understanding of the marriage and their own role in its problems and potential future • Leaning in: Help them bring best self to the crisis, not make things worse, get what the other spouse is saying, and work on self. 

6. Outcomes: Path three: launching couples therapy (usually but not always with the discernment counselor); Path two: move towards divorce; or Path one: stay on hold for now—neither divorce nor start couples therapy 

7. Study of 100 consecutive discernment counseling cases: 48% chose path three, 42% path two, 12% path one. About 40% of the total sample were still married two years after discernment counseling. Ref. Doherty, Harris, & Wilde (2016)

 

 


Wednesday, December 16, 2020

Marital Survival Guide (by the letters) Second Installment

Following my first essay on AISH.com, I received several requests for a continuation of the alphabet. Below are the E, F, G, and H of the fifty day Marital Survival Guide. Your comments are greatly appreciated. 

E

Empathy:    It is normal to want to help your spouse soothe when they are upset. Telling them to “calm down” doesn’t work. It is simply another way of conveying that you feel they are overreacting. Dr. John Mordechai Gottman suggests that the goal is not to try to fix your spouse's feelings but to communicate that you understand and accept them. This is empathy.    

Ears:     There is a well-known question: Why did God give us two ears and one mouth? The answer: so that we can listen twice as much as we speak. Here is sound advice for productive conversations: be interested, not interesting.  

Easy:    Men, do you want to make regular deposits in the Care Bank? Ask your wife each morning what you can do to make her day easier.

Eliminate    the “D” word entirely from your discussions and disagreements. Why? It is like hitting the reset button and waiting for your computer to slowly reboot. With all couples on-the-brink who come to see me for counseling, I ask them to commit to two or three months of weekly therapy sessions - with the D word completely off the table. Otherwise, progress is nearly impossible.  

Enforce     a no-phone zone at family meals. Researchers found evidence that mobile phones have negative effects on closeness, connection, and conversation quality. (See G section below _ Google) Przybylski and Weinstein, May 6, 2013.   

Engage       the services of a qualified pro-marriage therapist earlier than the norm of two years that most couples wait before seeking professional help. Why pro-marriage? Because some therapists will proudly proclaim, "I'm not about saving marriages, I'm about helping people".  My slogan is the opposite:  “I'll be the last person in the room to give up on your marriage".  

 F

Failed Bids:    What do couples argue about most often? Nothing. It turns out that most arguments are not about topics; they are about failed bids to connect. That’s fancy wording for "nothing" says Gottman as illustrated in this example using the television remote control. The husband is changing channels on the remote as they’re watching television together on the couch. The wife says, “leave it on that channel.” The husband responds, “I will, but let me just see what else is on.” She counters “no----leave it on that channel.” He says, “Fine!” Finally she declares...”Well the way that you said "fine" hurt my feelings.” He effectively ends the discussion by retorting, “I don't even want to watch television with you now.” What was this couple arguing about? Nothing, or like stated above, failed bids to connect.

Family:    The greatest danger of having a child-centered family is that when the children leave home, often the marriage does too. Empty nesters know this well. Second is the danger that even if the couple stays together after the children leave home, they may feel diminished as a couple. One couple that I counsel told their adult children "We were a great mom-dad team but a lousy husband-wife team." The third danger is benign but still regrettable. Some couples work on fixing their marriage after the children leave home and make significant progress. This is positive but sad for two reasons: many years of unmet marital potential, and even more important is the lack of good marital role models for their children (Dr. Bill Doherty).   

Father:     The most important thing a father can do for his children is to love their mother (Theodore Newburgh).   

Feeling:     You are not going to feel "in love" all the time. If you want to recapture that magic from when you were in love, be loving (Dr. Frank Pittman obm).   

Forgive:     You hear the phrase forgive and forget so often that the two become equated with one another, when in fact, they have nothing to do with each other. Just because you have forgiven someone and given up the desire to take revenge, does not mean that you have forgotten the event ever happened (Michelle W. Davis).  The weak can never forgive; forgiveness is the attribute of the strong (Mahatma Gandhi).  

Friendship:     This is a combination of affection, loyalty, love, respect, and trust (Oxford Dictionary). Friendship is an infinitely more stabilizing basis for marriage then romance. Get good at friendship before you even think about falling in love (Pittman).  

                                                                     G

Gaze:     Men and women tend to experience intimacy differently according to Anthropologist Dr. Helen Fisher. Women experience intimacy from face-to-face contact; they use the "anchoring gaze". This comes from thousands of years of mothers holding their babies in front of their face. Women tend to draw closer, face each other, lock eyes, and proceed to reveal their hopes, worries, and details of their lives. Men are not going to look deeply into another's eyes because this is foreign to them. Men experience intimacy by working or gaming side-by-side. This male approach to intimacy probably also dates back thousands of years. Picture ancestral males gathering behind a bush, quietly staring across the prairies in hopes of killing a passing buffalo in order to provide food for several families. Fisher suggests that in order to build intimacy with a man, a woman should do things with him that are side-by-side so that he isn't threatened by her gaze.  

Grand:       Gestures like diamond rings and weekends in the Caribbean are not as effective as smaller daily gestures.  

Gradual     is the key to successful change. Drastic change like huge swings of a pendulum tend not to be enduring.   

Grammar:     Surprisingly, correcting your spouse's grammar in the middle of a disagreement, can be considered contempt which is the most harmful form of communication. Who’d have thunk it?

Grudge Bearing:      Rabbi Dr. Abraham Twerski heard this at an Alcoholics Anonymous meeting and it helped him to rid himself of resentment. “Harboring resentment is like allowing someone you don't like to live inside your head without pay rent....and I'm not that nice a guy.”  

Google "phubbing definition" and pay attention to what you find.  

H

Happiness:     The happiest people don't have the best of everything, they make the best of everything (Old Adage).  

Marriage     is not supposed to make you happy; it is supposed to make you married. And once you are safely and totally married, then you have a structure of security and support from which you are free to make yourself happy rather than wasting your adulthood looking for structure (Pittman).  


Holler:      
I never met a woman yet who wants her husband to raise his voice to her. It is contemptuous because the husband feels and acts superior. It is putting oneself on a higher plane looking down from a position of authority, with an attitude of I am better/ smarter/ neater/ more punctual than you. Gottman asserts that contempt is the single best predictor of relationship dissolution. It is for this reason that I give every husband who I counsel permission to yell only these three words at his wife (when applicable) “Fire-Get-Out!”

Hope:  Think hopeful      Speak hopeful   Act hopeful

Rabbi Yissocher Frand explains that "despair" is indeed a grave sin. According to the legendary Chassidic master Rabbi Aharon Karliner, it is the most destructive of all sins, because when hope is lost, all is lost. 

Be hopeful that all your efforts at nurturing your marriage will bring you true and lasting Shalom Bayis.  


Wednesday, April 22, 2020

Your Fifty Day Marital Survival Guide by Dr. Alan Singer

 

Join me in taking an aggressive approach to saving marriages during this seemingly endless coronavirus pandemic. Many U.S. scientists believe that the peak has passed and in fifty days our lives should significantly improve. Fact? No. But whatever we’re short with facts, let’s make up for in optimism. There are no assurances about when social distancing will end. 
 
Our collective loss of control escalates our anxiety level. Heightened anxiety fans the sparks of disagreement and can magnify them into full scale arguments. One of the couples that I counsel commented, "Fifty more days...it will be a miracle if our marriage last fifty more minutes!"
 
Rest assured that if you threaten divorce (or actually initiate divorce steps) in the midst of this tragic pandemic, you will most likely regret it down the road. Blow off some steam by doubling your exercise regimen on the step-master, not by abruptly reversing the most important decision of your life - your marital commitment. Here it is, short and blunt: the ABC's of sustaining your marriage for the next fifty days. 
 
Ø > > A < < <
 
Avoid judgmental questions and harsh start-ups effective today.
Here is a neutral question: Debbie what time is it?
Here is a judgmental question: Is this how much coffee you normally drink at work? The difference is clear. Maintain some distance between you and your spouse during work hours and avoid snooping around or being nosey.  
 
Avoid “you” statements because they evoke defensiveness. Use “I” statements because they evoke empathy.  
Try this: I am overwhelmed and can use your help now. 
Not this: You never lift a finger to help me.  
 
Use A soft start-up like this: I feel like I've been stuck in the kitchen alone all week rather than a harsh and judgmental one such as: I'd faint if you ever helped me make dinner.   
 
Avoid disagreement escalation. Use repair attempts such as "Wait, let me rephrase that." Dr. Eileen Feliciano wisely suggests, "Don't show up at every argument that you are invited to".  
 
A winning rule of thumb: If your goal is family well-being in a respectful partnership, then before you say or do something to your spouse ask yourself, is what I am about to say or do going to bring me closer or further from my goal? If further---STOP Yourself (Michelle Weiner Davis).  
 
Ø > > B < < <
 
Be the first to use these three words and use them liberally: Appreciation – Affection – Admiration. These words are a win-win for marriage.  
 
B is for respecting boundaries and one another’s space. Anthropologist Dr. Helen Fisher suggested last week "Creating a safe space can help people to feel in control so they feel happy instead of helpless...or even hostile" (NY Times 4-13-20). Another superb Fisher-ism is: Don't invoke the golden rule (Do unto Others) rather use the platinum rule---Do unto your spouse as she wants to have done for her.  
 
Space is more than just having elbow room. "Space and privacy have emerged as a class divide; more valuable than ever to those who have it and potentially fatal to those who don't (NY Times 4-13-20).   
 
The final B is to give your spouse the Benefit of the doubt.  Whether you call it "money in your emotional bank account" or "positive sentiment override" (Dr. John Gottman) your go-to position needs to be: My spouse means well; these are dreadful circumstances that we are in together. They’re not mean intentions.  
 
Ø > > C < < <
 
I am calling for a fifty day moratorium on Criticism of each other's character! We must stop ourselves. If you have a complaint about a specific behavior of your spouse, state that simply and civilly.  
Say this: We need to work together for thirty minutes daily to keep order here. 
Not this: I never realized how big a slob you are. 
 
Commit yourselves and your children to a daily routine.  
 
Commit yourselves to the triangle of health----Sleep-Nutrition-Exercise. 
These aren't suggestions...they are essential!
 
Couples don’t need to think alike…but they need to think together (R. Ralph Pelcovitz, obm).
Ø > > D < < <  
 
Decide that you will put meaningful effort into your marriage and keep the “D” word off the table and out of any conversations. Now is the time to protect your marriage; there will be plenty of time later if you choose the “D” route. 
 
Do the best that you can; Don't keep score.
 
Don't institute or eliminate any major rules especially with children.  
 
Don't make any major decisions especially something as substantial as whether or not to have another child in the future.  
 
Do seek out professional marital advice using video counseling from a licensed therapist. Don't wait out the fifty days thinking that things might work themselves out; they just might not.  
 
Most importantly---DO BE Forgiving. Whether you are married three years or three decades, you must understand and actualize this: Forgiveness is not a feeling - it is a decision!
 
###
 

Sunday, April 12, 2020

Mental Health Wellness Tips for the Corona Quarantine

I hope you find this description of coping as useful as I do.
CORONA-VIRUS: HOW TO COPE    by Eileen M Feliciano, PsyD
MENTAL HEALTH WELLNESS TIPS FOR QUARANTINE
1. Stick to a routine. Go to sleep and wake up at a reasonable time, write a schedule that is varied and includes time for work as well as self-care.
2. Dress for the social life you want, not the social life you have. Get showered and dressed in comfortable clothes, wash your face, brush your teeth. Take the time to do a bath or a facial. Put on some bright colors. It is amazing how our dress can impact our mood.
3. Get out at least once a day, for at least thirty minutes. If you are concerned of contact, try first thing in the morning, or later in the evening, and try less traveled streets and avenues. If you are high risk or living with those who are high risk, open the windows and blast the fan. It is amazing how much fresh air can do for spirits.
4. Find some time to move each day, again daily for at least thirty minutes. If you don’t feel comfortable going outside, there are many YouTube videos that offer free movement classes, and if all else fails, turn on the music and have a dance party!
5. Reach out to others, you guessed it, at least once daily for thirty minutes. Try to do FaceTime, Skype, phone calls, texting—connect with other people to seek and provide support. Don’t forget to do this for your children as well. Set up virtual playdates with friends daily via FaceTime, Facebook Messenger Kids, Zoom, etc—your kids miss their friends, too!
6. Stay hydrated and eat well. This one may seem obvious, but stress and eating often don’t mix well, and we find ourselves over-indulging, forgetting to eat, and avoiding food. Drink plenty of water, eat some good and nutritious foods, and challenge yourself to learn how to cook something new!
7. Develop a self-care toolkit. This can look different for everyone. A lot of successful self-care strategies involve a sensory component (seven senses: touch, taste, sight, hearing, smell, vestibular (movement) and proprioceptive (comforting pressure). An idea for each: a soft blanket or stuffed animal, a hot chocolate, photos of vacations, comforting music, lavender or eucalyptus oil, a small swing or rocking chair, a weighted blanket. A journal, an inspirational book, or a mandala coloring book is wonderful, bubbles to blow or blowing watercolor on paper through a straw are visually appealing as well as work on controlled breath. Mint gum, Listerine strips, ginger ale, ice packs, and cold are also good for anxiety regulation. For children, it is great to help them create a self-regulation comfort box (often a shoe-box or bin they can decorate) that they can use on the ready for first-aid when overwhelmed.
8. Spend extra time playing with children. Children will rarely communicate how they are feeling, but will often make a bid for attention and communication through play. Don’t be surprised to see therapeutic themes of illness, doctor visits, and isolation play through. Understand that play is cathartic and helpful for children—it is how they process their world and problem solve, and there’s a lot they are seeing and experiencing in the now.
9. Give everyone the benefit of the doubt, and a wide berth. A lot of cooped up time can bring out the worst in everyone. Each person will have moments when they will not be at their best. It is important to move with grace through blowups, to not show up to every argument you are invited to, and to not hold grudges and continue disagreements. Everyone is doing the best they can to make it through this.
10. Everyone find their own retreat space. Space is at a premium, particularly with city living. It is important that people think through their own separate space for work and for relaxation. For children, help them identify a place where they can go to retreat when stressed. You can make this place cozy by using blankets, pillows, cushions, scarves, beanbags, tents, and “forts”. It is good to know that even when we are on top of each other, we have our own special place to go to be alone.
11. Expect behavioral issues in children, and respond gently. We are all struggling with disruption in routine, none more than children, who rely on routines constructed by others to make them feel safe and to know what comes next. Expect increased anxiety, worries and fears, nightmares, difficulty separating or sleeping, testing limits, and meltdowns. Do not introduce major behavioral plans or consequences at this time—hold stable and focus on emotional connection.
12. Focus on safety and attachment. We are going to be living for a bit with the unprecedented demand of meeting all work deadlines, homeschooling children, running a sterile household, and making a whole lot of entertainment in confinement. We can get wrapped up in meeting expectations in all domains, but we must remember that these are scary and unpredictable times for children. Focus on strengthening the connection through time spent following their lead, through physical touch, through play, through therapeutic books, and via verbal reassurances that you will be there for them in this time.
13. Lower expectations and practice radical self-acceptance. This idea is connected with #12. We are doing too many things in this moment, under fear and stress. This does not make a formula for excellence. Instead, give yourself what psychologists call “radical self-acceptance”: accepting everything about yourself, your current situation, and your life without question, blame, or pushback. You cannot fail at this—there is no roadmap, no precedent for this, and we are all truly doing the best we can in an impossible situation.
14. Limit social media and COVID conversation, especially around children. One can find tons of information on COVID-19 to consume, and it changes minute to minute. The information is often sensationalized, negatively skewed, and alarmist. Find a few trusted sources that you can check in with consistently, limit it to a few times a day, and set a time limit for yourself on how much you consume (again 30 minutes tops, 2-3 times daily). Keep news and alarming conversations out of earshot from children—they see and hear everything, and can become very frightened by what they hear.
15. Notice the good in the world, the helpers. There is a lot of scary, negative, and overwhelming information to take in regarding this pandemic. There are also a ton of stories of people sacrificing, donating, and supporting one another in miraculous ways. It is important to counter-balance the heavy information with the hopeful information.
16. Help others. Find ways, big and small, to give back to others. Support restaurants, offer to grocery shop, check in with elderly neighbors, write psychological wellness tips for others—helping others gives us a sense of agency when things seem out of control.
17. Find something you can control, and control the heck out of it. In moments of big uncertainty and overwhelm, control your little corner of the world. Organize your bookshelf, purge your closet, put together that furniture, and group your toys. It helps to anchor and ground us when the bigger things are chaotic.
18. Find a long-term project to dive into. Now is the time to learn how to play the keyboard, put together a huge jigsaw puzzle, start a 15 hour game of Risk, paint a picture, read the Harry Potter series, binge watch an 8-season show, crochet a blanket, solve a Rubix cube, or develop a new town in Animal Crossing. Find something that will keep you busy, distracted, and engaged to take breaks from what is going on in the outside world.
19. Engage in repetitive movements and left-right movements. Research has shown that repetitive movement (knitting, coloring, painting, clay sculpting, jump roping etc) especially left-right movement (running, drumming, skating, hopping) can be effective at self-soothing and maintaining self-regulation in moments of distress.
20. Find an expressive art and go for it. Our emotional brain is very receptive to the creative arts, and it is a direct portal for release of feeling. Find something that is creative (sculpting, drawing, dancing, music, singing, playing) and give it your all. See how relieved you can feel. It is a very effective way of helping kids to emote and communicate as well!
21. Find lightness and humor in each day. There is a lot to be worried about, and with good reason. Counterbalance this heaviness with something funny each day: cat videos on YouTube, a stand-up show on Netflix, a funny movie—we all need a little comedic relief in our day, every day.
22. Reach out for help—your team is there for you. If you have a therapist or psychiatrist, they are available to you, even at a distance. Keep up your medications and your therapy sessions the best you can. If you are having difficulty coping, seek out help for the first time. There are mental health people on the ready to help you through this crisis. Your children’s teachers and related service providers will do anything within their power to help, especially for those parents tasked with the difficult task of being a whole treatment team to their child with special challenges. Seek support groups of fellow home-schoolers, parents, and neighbors to feel connected. There is help and support out there, any time of the day—although we are physically distant, we can always connect virtually.
23. “Chunk” your quarantine, take it moment by moment. We have no road map for this. We don’t know what this will look like in 1 day, 1 week, or 1 month from now. Often, when I work with patients who have anxiety around overwhelming issues, I suggest that they engage in a strategy called “chunking”—focusing on whatever bite-sized piece of a challenge that feels manageable. Whether that be 5 minutes, a day, or a week at a time—find what feels doable for you, and set a time stamp for how far ahead in the future you will let yourself worry. Take each chunk one at a time, and move through stress in pieces.
24. Remind yourself daily that this is temporary. It seems in the midst of this quarantine that it will never end. It is terrifying to think of the road stretching ahead of us. Please take time to remind yourself that although this is very scary and difficult, and will go on for an undetermined amount of time, it is a season of life and it will pass. We will return to feeing free, safe, busy, and connected in the days ahead.
25. Find the lesson. This whole crisis can seem sad, senseless, and at times, avoidable. When psychologists work with trauma, a key feature to helping someone work through said trauma is to help them find their agency, the potential positive outcomes they can effect, the meaning and construction that can come out of destruction. What can each of us learn here, in big and small ways, from this crisis? What needs to change in ourselves, our homes, our communities, our nation, and our world?
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