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Why?

Many clients come to therapy asking, “why is this happening” or “why am I like this.”  The search often leads nowhere, or at least nowhere productive in the hunt to feel better.  I think this question is an interesting one; but it doesn’t really affect change in a meaningful way.  The why question is often quite simple to answer.  Perhaps your brain experienced a trauma which impacted your brain on many levels.  Trauma impacts the emotional center of your brain (amygdala), the area of your brain controlling memory (hippocampus), and your emotional control center (prefrontal cortex).  Simply put, trauma sends your brain into a state of hypervigilance, traps you in a state of strong emotional reactivity and suppresses your memory and impulse control.  Trigger memories become actual threats.*  Then there’s generational trauma . . . but don’t get me started on that; it’s a blog post all on it’s own!

Maybe you didn’t experience trauma at all, maybe you were simply born this way.  Genome-wide associations studies have found genetic markers present in research of five major disorders:  ADHD, bipolar disorder, major depressive disorder, schizophrenia and autism.  Specifically, the CACNA1C and CACNB2 genes.**  Though the study showed significance, they really only account for a small amount of risk.  It is widely accepted that the genes put people at risk; but other environmental factors will contribute to the development of mental illness.  Still, it presents one theory to the “why” question.

It is possible that a negative behavior was reinforced and, thus, you developed a pattern of behavior based on that reinforcement.  For example, as a young child you threw a temper tantrum in the grocery store because you wanted a candy bar.  Your mom, in order to avoid the public humiliation of a toddler meltdown in public, gave you the candy bar.  She inadvertently reinforced the negative behavior.  Because we are born as intelligent beings, you remember that you got what you wanted with a tantrum, and tried it again. Assuming that your parents became immune to your level 1 meltdown, you had to move to a level 2 meltdown before they finally caved in.  On an on it went until you figured out you could simply avoid moving from level 1 to 2 to 3 and so on; and started at a level 10 every single time you wanted something.  Over time, you automatically respond to situations with extreme emotional response in order to attempt to get what you need. 

But does knowing the “why” change anything at all?  You accept that you experienced trauma or that you had negative responses reinforced.  But now what?  What is where therapy work begins.  Therapists are trained to understand the “why” and to work with clients on the “what.”  What can you do to change the negative impact on your life based on the why that got you to the therapists office?

There are multiple evidenced based therapeutic methods that have been created, researched, tested, researched again, and learned by therapists in order to give you the opportunity to move through your why.  Adhering to psychological approaches and techniques which are based on scientific evidence separates our profession from non-licensed and unregulated coaches, guru’s, mentos, advisors and tutors.  Based on your specific presentation, your therapist will work with you to tailor a plan to reach your personal goals.  If trauma appears to be your why, your therapist may recommend a Common Elements Treatment Approach, Eye Movement Desensitization and Reprocessing or Trauma Focused Cognitive Behavioral Therapy; for example.  Someone who appears to have a biological or genetic presentation, may be referred for medication assisted treatment while utilizing a narrative therapy approach or a behavioral methodology for symptom management.  Cognitive behavioral therapy or dialectical behavioral therapy works well as one approach for different types of learned behaviors.

Of course, these examples represent only the tip of the iceberg of possible therapeutic interventions.  Years of graduate school, internship hours and continued education can’t possibly fit into a 750 word blog!  Be wary of non-licensed professionals offering a “quick fix” or to self-help books that make promises of outcomes.  Establishing a trusting relationship with your therapist is the first step toward empowerment, transformation and growth. Only then can you begin to work on the “what.”

By: Marla Y. Johns, MS MHP LMHC

*Traumatic stress: effects on the brain – PMC (nih.gov)

** Lancet. 2013 Feb 27. pii: S0140-6736(12)62129-1. doi: 10.1016/S0140-6736(12)62129-1. [Epub ahead of print]. PMID: 23453885

What If We Ask for What We Want?

For some reason, we have learned it is impolite, abrasive or selfish to ask for what we need.  Instead, we hint and hope that the people in our lives will somehow magically know what it is that we want.  Of course, as a kid making a Christmas list it is easy; “I want the Red Rider carbine bb gun with the compass in the stock.”  As an adult, we may still find it a little easier to tell someone what item we want, “I want a pair of diamond earrings for my birthday;” but I wonder, how different our relationship experiences would be if we asked specifically for what we wanted on every level.

This applies not just to romantic relationships; but we can start there.  Often, couples seek counseling because they don’t seem to be communicating in a way that their needs are being met.  When probing, however, I find that they aren’t typically asking for what they need; but assuming their partner will somehow magically just know.  If you say to your partner, for example, “you don’t help around the house” your partner is likely to get defensive and list all the ways they, in fact, feel they are being helpful.  A more helpful way to communicate your need is to say, “I am feeling overwhelmed.  Will you please cook dinner tonight?”  Your partner then has three possible responses:  yes I will, no I cannot, I am not sure if I am able to do that so I would like to discuss another solution with you.

A conversation with couples often starts with, “tell me specifically how you know that someone loves you.”  Think about this question for a moment.  For most people, it is harder to answer than at first glance.  Specifically . . . how do you know?  To try and wiggle out of the answer, many will say something like, “I just feel it.”  If you have sat in my therapist office though, you know I never let you off that easy!  Again, specifically, what does someone DO that causes you to believe they love you?

I like to use a personal example to illustrate what I am meaning.  When I had been married a short time, the stomach flu when through our house.  My husband got it first and was in bed miserable for a day or so.  I waited for him to ask for something he wanted and gave him peace, space, and quiet to rest and feel better.  A couple of days later, it was my turn.  It felt like every few minutes he was asking me what he could get me.  He was bringing me something.  He was doting on me.  Fast forward a few days when we were both feeling better, I realized there was some tension between us.  After talking, we realized that we were both doing for the other person what we actually wanted them to do for us; but we hadn’t taken the time to really listen to what one another’s personal needs were.  My husband wanted me to dote on him and felt neglected when I didn’t.  I felt overwhelmed and annoyed with a lot of attention when he was simply trying to care for me in the way he wanted cared for.  How much easier it would have been if we had both asked, specifically, for what we wanted.

This tactic applies to every relationship in your life.  Take, for example. Your relationship with your boss.  You have been given a project to complete and you are running out of time.  Believing she is helping you, your boss sends you two interns to help you complete the project.  You have found that explaining things to the interns is taking twice as long and you really need to have uninterrupted time alone in order to complete the assignment.  Your boss is trying to be helpful and is providing you with, likely, what would be helpful to them.  If you don’t clearly ask for your needs, you will be left resentful and overwhelmed. 

Recently, I was talking with someone about having taken a new job.  The training program was not at all leaving them feeling as if they would be successful at learning and prepared for the tasks of the job.  Together, we developed a script which allowed the employee to outline their learning style for their manager and gave an option of a plan that the employee felt would work for them.  When presented to their manager, not all of the suggestions were implemented, but they had a very productive conversation, created and implemented a training plan for the employee that worked for everyone involved.

The next time you find yourself saying, “they should just know” or “I wish they understood” instead ask yourself, “have I clearly articulated what I need?”  You just might get the answer you want!

By: Marla Y. Johns, MS MHP LMHC