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Toxic Workplaces that Trigger Family of Origin Issues

I am often hear from clients about ongoing issues at the workplace. I hear reports of environments that are toxic and dysfunctional, unkind and unsupportive bosses or difficulties with peers at work. According to Lisa Ferentz (2012), we stay in these places of employment because it feels similar to our own family growing up. What we forget is that we are not little and scared anymore. We actually have the power to make a change.

The simple question to clients — “Where else have you felt this way in your life” – encourages to turning off the “autopilot” switch and to being more mindful of what is really happening in the present. I often use Ferentz’s exercise in teasing out these dynamics (Ferentz, 2012).

Her suggestion is quite simple. Take one sheet of paper and divide vertically – – labeling one side Family Dynamics and the other side Workplace. Under each side, she suggests thinking/writing about 4 different topics. Feelings growing up (validated/invalidate/understood/misunderstood etc.), home life expectations(reasonable/unreasonable, etc.), boundaries (appropriate/inappropriate), and lastly — what was the atmosphere of the environment (cooperative/competitive, calm/chaotic, etc.). Clients are expected to chose one of the descriptive words. For example:

  • invalidated, inappropriate boundaries, chaotic, etc…

After choosing the two descriptive words for each category and placing them under each title — Family Dynamics and Workplace, see if you can notice any similarities or differences. What has been duplicated from your family of origin and within the current place of employment. Has anything changed?

It is pretty amazing what is revealed in this exercise with clients. Most importantly, the emerging mindfulness of the past and the present, is powerful. This connection allows people to become unstuck, restores hopefulness, and provides energy to make a change if they chose.

 

Information taken from the book Treating Self Destructive Behaviors in Trauma Survivors by Lisa Ferentz (2012).

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Thought Stopping Strategies for Trauma Survivors

Lisa Ferentz talks about many successful ways to support trauma survivors. Two techniques that I utilize in my treatment of survivors are the “Not Now” and “Roller Paint Brush” Techniques.

The “Not Now” tip encourages clients to use their hands to push away intrusive negative thoughts, rather than fight them. Ferentz describes clients actually using their arms, with palms facing outward and pushing the unwanted, negative thoughts away. This sends a non verbal message to the brain that these thoughts are on hold (2012).

Ferentz’s second tip that I love is the paint brush strategy. The idea is to visualize rolling over the difficult thought — covering the thought over and over until you can’t see the words anymore. Clients are encouraged to follow with their eyes, going over and over the thoughts — even breathing through out, but not engaging in a power struggle over them.

These tips and more help trauma survivors stop the “loop of negativity” that often derails their recovery.

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Survival Tips for PPD moms who experienced a past sexual trauma

Here is a recent blog post by Postpartum Progress written by Karen Morelli, LPC. She shares tips for new mom’s surviving past sexual trauma. As a clinician that works with survivors of trauma everyday, I found this piece important and one that is often not shared. See below.

“Childhood sexual abuse and a woman’s subsequent reproductive years, including menstruation, pregnancy, birth and ongoing sexuality, occurs years or even decades apart. Yet, in my clinical practice, I have found these issues to be intertwined. Sexual themes resonate with… a woman on multiple levels: within her body, her emotions and her psychology. And distress from childhood sexual abuse can resurface during the emotionally and hormonally charged time of pregnancy and postpartum. What research exists, finds that women who suffered from childhood sexual abuse have an elevated risk of postpartum depression, besides other physical and emotional symptoms. Related triggers around reproductive health:

During Pregnancy Body-based feelings in pregnancy can be re-triggering to a woman who has deep, somatic memories of childhood sexual abuse. Simple things such as the position of your body during vaginal exams can bring back emotional memories of past abuse. The baby moving inside your body might cause intense joy, but might also create an underlying uneasiness.

During Birth Childbirth is an intense experience; a time of hormonal, physical and emotional exertion. Early trauma can be triggered by a particular scent for example, or a body position. If you feel powerless, not heard, or disregarded by your healthcare providers during childbirth, it can activate the symptoms of post-traumatic stress and flashbacks of your past trauma.

During Postpartum There are many physical, emotional and psychological factors feeding your emotional health during this time. And it’s true that a pre-existing personal depressive or anxiety disorder, or pre-existing PTSD, sets your body up for another episode postpartum. Intense physical and hormonal changes, plus adjusting to a new lifestyle caring for an infant is physically and emotionally challenging. Feelings of frustration emerge as you adjust your schedule to accommodate your baby. The endless touching may leave you feeling like your body isn’t your own anymore. Breastfeeding may feel triggering to some, as it too may cause confusing sexual feelings.

So what can you do to proactively manage your mental health during these phases of motherhood? First, I want you to know that your childhood sexual abusive does NOT define you. Your past does NOT have to be your destiny. With perseverance, you can move beyond being a survivor towards thriving and blooming beautifully. It’s not an easy task, but your self-esteem is worth the fight! Managing the effects of an abusive childhood is an on-going deeply personal experience. It’s honorable life work, and highly individualized. As you move along your healing path, you’ll choose what’s right for you.

Tips to help enhance your experience of pregnancy, birth and postpartum:

1.Recognize that post-traumatic stress is a real disorder, not some fake diagnosis.

2.Practice Self-Love. Self-love is not just an empty clich , it’s something worth fighting for. Allow yourself to rest and be gentle with yourself during all three stages of motherhood.

3.Try to make time to get help with a licensed mental health professional before pregnancy. It’s best to put in your emotional work before starting a family, but it can also be done if you are already pregnant or postpartum (see below.) It’s never too late to begin.

4.Face your fears and past, at your own pace, in a safe and professional environment.

5.Work with a gynecologist/obstetrics/midwifery provider with whom you feel comfortable enough to discuss your history of trauma. Investigate the hospital or birth center where your provider practices to make sure it’s the right fit for you. If your provider or institution don’t meet your needs, you are empowered to find another. It’s important to advocate for your own health care.

6.Find an experienced childbirth educator who is accepting of your personal choices. Birthing and breastfeeding classes really do help on an emotional level as well.

7.Remember that birth is an unpredictable experience. If your birth experience doesn’t follow your birth plan, you can still feel good about it. You are not less of a woman or mother, no matter how your birth happens.

8.Honor the achievement of childbirth and motherhood. You are growing a life! That is a huge accomplishment.

9.Understand that your hormonal balance takes at least three months after birth to come back to pre-pregnancy levels.

10.Honor and protect yourself during ”the fourth trimester” and beyond, as your body shift towards balance:

  • Rest; develop the mindset of being, not doing.
  • Practice good nutrition with whole foods and good supplements.
  • Get help. If you can afford it, set up some time with a postpartum doula or a baby nurse so you can rest. Enlist the help of family or friends. You don’t have to do this on your own.
  • Don’t underestimate the power of sleep. Work out a sleep plan. Even if you are breastfeeding, don’t be the only one getting up to feed the baby.
  • Practice mindfulness and relaxation to counteract the inevitable challenges of caring for a newborn and the emotional change of identity in motherhood
  • Nurture yourself with complementary care. Safe touch such as shiatsu and acupuncture can re-balance your body and mind.Expect some emotional ups and downs and realize these are normal.
  • Social support is important. Women who ”Tend and Befriend” in real life and online feel supported.
  • If you feel very sad or anxious, there is a lot of professional help available to you. You are not less of a mother if you see a doctor or therapist. Taking care of you makes you a better mother. A beautiful book about healing from child sexual abuse that I highly recommend is ”A River of Forgetting” by Jane Rowan.
  • If you had the experience of childhood sexual abuse, know that post-traumatic growth is possible. Don’t wait to honor yourself by doing the emotional work. You can ask for and get help. You and your family are worth it. And know that you are not alone.

-Karen Morelli,LPC

Reference: Perez-Fuentes, G., Olfson, M., Villegas, L., Morcillo, C., Wang, S. & Blanco, C., (2013). Prevalence and correlates of child sexual abuse: a national study. Comprehensive Psychiatry, 5(1), 16-27.

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Surviving and Enjoying the Holidays

As the Holidays are fast approaching, I have spent much of my time during sessions preparing clients for visiting and enjoying their time with their families and loved ones. Most vacations away visiting families or staying home are wonderful and full of long lasting positive memories. Sometimes, this is not the case with all families or all trips. One idea to help navigate through potential troubled waters, is to create a mini traveling survivlal kit that will help soften some of the intense feelings that occur after a family trigger. Trauma Expert, Janine Fischer suggests this with people who are at risk for self harm, but I have found that this idea helps many people cope in all situations. We are always packing for EVERYTHING–why not “pack” a kit that will help you cope with potential family triggers. Triggers can occur in any sensory experience: sight, taste, smell and auditory.

The contents of the kit depends on YOU and the details surrounding the trip. To prepare, you must think about potential pit falls and triggers, as well as, the events that you really want to ENJOY! With this in mind, pay attention to how you are feeling when thinking of the triggers — how intense are they? where are you feeling them in your body? Now — what are some things that might help you cope IF this situation occurs during your home holiday or your vacation away. Some suggestions are: exercise, going to the movies, listening to a great song list, knitting/sewing, reading a book that is pleasurable, calling/texting a friend…. . Make list and practice preparing to use it. You can literally create a box to bring or even something in a separate bag that would also include your favorite quote, stones or other “grounding” objects.

When faced with difficult family situations, this survival kit gives you a plan to help control feelings that can be overwhelming and can cause you to feel flooded. Most importantly, the goal is to ENJOY the events that are important to you and not remain STUCK in the emotional storm. Hope this tip helps you in enjoy your holiday.

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PTSD Memories: The Body Always Remembers

Most of us have had feelings of nostalgia once in a while. We might see yellow school buses go by and think of our children long ago getting on the bus for the first time. Maybe it is when the weather changes, we remember our college days or hear an old song that reminds of times past. Sometimes we can’t remember exactly in detail the event, but our body and brain reminds us of that particular time in our lives.

When people experience a trauma, the body and brain also remember. People recovering from traumas can witness in themselves very intense feelings or ”memories” of the situation that occurred (Fisher, 2013). This onset is often triggered by any sensory experience: sight, smell, auditory, and so on.

What outsiders may not realize is that these emotions can be very scary and overwhelming. Everyone has heard that saying ”it is like riding a bike ’ you will remember what to do”. Well’this is the way the body is reminding the survivor — but it is the type of muscle memory one must learn to cope successfully with.

 

Some examples of experiences are: feelings of panic, apprehension, shame, depression, numbness, sense of abandonment, impulses to run or leave, self mutilation, shakiness, rapid heartbeat, and suicidal ideations. All of these reactions or feelings is the body’s way of remembering what happened. Very often, clients will say to me ’ ”I don’t really remember all the details”, ”there are lapses in my memory from growing up”. Yet, the body is recalling ’ communicating in feelings and behaviors.

Having this cognitive understanding, allows clients to begin strengthening their ability to tolerate this hyper or hypo arousal state that is so very uncomfortable (Fisher, 2013). They can then remind themselves they are in the present day. This helps build new muscle memory that the feelings – aka- the memories, can be tolerated with new coping skills. The goal is to change the default setting — to tolerance ’and hopefulness.

(Fisher, 2013)

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Sandwich Generation: My contribution to a recent article in PARENTING magazine: May 2013 issue

More commonly, moms and dads are caring for their kids and their parents. Read about what’s it like to live together as an extended family

By Janene Mascarella

”There was a day where I was nursing a baby during a conference call and simultaneously searching for ramp installers online,” says Mona Shand of Brighton, MI. She and her husband help care for her 81-year-old father, who is wheelchair-bound and suffers from Parkinson’s disease, and their three children, ages 5, 3, and 1, while balancing full-time jobs.

The Shands are members of the sandwich generation, a colloquial term for those caring for kids and aging family members simultaneously. It’s a demographic that’s becoming increasingly crowded. In a recent poll from A Place for Mom, Inc. (APFM), the nation’s largest senior-living referral information service, more than half of the respondents (95 percent of whom were parents) said an older family member is either already living in their home or expected to within the next five years. It’s a statistic I can relate to. While my 84-year-old father-in-law is active and self-sufficient, it’s understood that sometime in the not-so-distant future, he will move in with us. That would bring us to two kids, two Betta fish, a dog, a bearded dragon, and Grandpa.

Caring for an older relative is nothing new, but dual caregiving is a relatively recent phenomenon due to advances in medicine, longer life spans, and starting families later in life. The recession’and the shrinking retirement savings it created’served only to cement the trend.

In the end, multigenerational caregiving presents a complicated family landscape to navigate. It’s no wonder the sandwich generation finds itself, well, squeezed.

Stuck in the Middle

”I knew I was in the sandwich generation when in the course of one week, my elderly dad said to me, ”I hate you, I wish you weren’t my son,’ and my daughter said, ”I wish you weren’t my father,’” says Herb Lin, a father of one in Washington, DC. ”I responded to them both the same way: ”I’m sorry you feel that way, but I love you and you’re stuck with me.’” Lin says his father and 11-year-old daughter were not close, which he attributes to a cultural and generational divide. (Lin’s father was a Chinese man who came to the U.S. as an adult, and did not acclimate well to American culture.)

One of Lin’s biggest challenges was shaking the feeling that he was neglecting one while spending time with the other. ”My priority was my daughter, who I felt needed me more, but I had to respond to my dad’s emergencies quite often,” he says. ”I was able to reduce the stress only by compartmentalizing’dealing with each one separately rather than trying to integrate the relationships under one family umbrella.”

For those taking a cue from Lin, make sure some of that compartmentalizing qualifies as quality time, advises Meredith Gelman, a licensed clinical social worker and psychotherapist in Fairfax, VA. ”In these situations, it’s important for parents and kids to spend time alone,” explains Gelman. ”A simple, inexpensive afternoon together can remind them that they are still an intact family.”

Alot of sandwich generationers feel pressure to do everything for everyone in their nest. That’s a first-class ticket to a guilt trip, says Dana Dorfman, Ph.D., a psychotherapist and family counselor in New York City. ”Guilt is a normal response, but in order to help either generation,” says Dorfman, ”you have to meet your own needs.” Find an outlet: exercise, plan a regular girls’ night out, find private time with your spouse. ”Prioritize your own physical and mental health first.” To avoid burnout, suggests Gelman, don’t just ask friends and family for help; ask them to help with specific tasks.

Hand-Me-Down Life Lessons

While the challenges are great, there are benefits’for all generations. In the APFM survey, nearly 41 percent cited the opportunity to reciprocate the care they received growing up as a plus. ”A lot of people say it must be very hard taking care of my mother, my daughter, and my business,” says Monika Hengesbach, who owns a tax practice in Pleasant Hill, CA. ”But knowing that my mom doesn’t have to worry about being alone when she’s sick is the greatest gift I can give her.”

When the time comes for my family, my kids will witness empathy in action and caring come full circle, a lesson that’s not lost on Fitton’s children. ”My kids have a greater understanding of love and responsibility,” Fitton explains. ”They see that sometimes parents and grandparents need help, and because we love them, we do whatever we can to take care of them.”

It’s bonding on a whole new level, Gelman explains. ”These situations really expand a child’s mind-set and avail them to think a little less about themselves,” she says, ”if only for a moment.”

 

 

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Washington Post: Making Sense of Hurricane Sandy

Posted at 07:00 AM ET, 10/31/2012 Oct 31, 2012 11:00 AM EDT
The Washington Post

Making sense of Hurricane Sandy

By Janice D’Arcy

Our region missed the brunt of the storm. But many of us have friends and family who were deluged by Hurricane Sandy. Even those without direct connections witnessed scenes of flooding and devastation in and on the news.

(Scott McDermott) Adults may be used to these occasional bouts with Mother Nature, but to a child the unpredictability of natural disasters can bring a special sort of anxiety. They watched their parents preparing, sometimes frantically, and now they see that those who did prepare may still have suffered.

Elmo may have said it best when the muppet took to the radio on WNYC to help reassure kids in the New York area. ”Elmo was a little scared.”

http://www.wnyc.org/shows/bl/2012/oct/30/elmo-explains-hurricane-sandy/?utm_source=local&utm_media=treatment&utm_campaign=daMost&utm_content=damostlistened

Fairfax therapist Meredith Gelman, who specializes in family counseling, suggests that parents seize the chance to discuss weather unpredictability, especially because it seems we’re fielding an increasing number of intense events.

”In recent months children have been exposed to more natural disasters with serious outcomes. Children often become very frightened by all the unknowns around the impending storms, especially when children are participating in more prep drills for the unexpected. I encourage parents to talk to their children about the upcoming storms and their unpredictability,” Gelman said.

(Justin Lane – EPA) ”When difficult feelings come up for children, I encourage parents to validate those feelings. Validating allows the children to actually feel safe, to feel heard and to be able to cope with the unknown.

”Validated kids are willing to talk about how to prepare ’ just like studying for tests and drilling for potential fires at school. What are the safety plans?”

Most importantly talk about what things and people they can count on that are predictable. Reassure them that you as the parents will keep them safe the best way you can. Their teachers, coaches and leaders will do their best to keep them safe.”

Meanwhile, Dr. David Schonfeld, a member of the American Academy of Pediatrics Disaster Preparedness Advisory Council reiterated that trying to shield children can cause confusion. Honesty is better.

”If children ask whether or not a storm like this could occur in their community, realize that the underlying question is not whether or not is possible, but rather whether it is likely that such an event will occur. The recent storm is highly unusual in terms of the extent of the storm and the amount of damage that it caused,” he said.

”Reassure children of what is being done to keep them safe and help them appreciate that the chance of a storm of this magnitude occurring in the near future in their community is relatively small. Yes, storms are likely to occur, but they are likely to have far less adverse impact ’ help them tell the difference between the storm that is present in their community now or is likely to occur from the recent storm that had devastating impact.

”But don’t provide false reassurance or deny actual risk.

”Sometimes it is best to help children deal with troubling concerns that are legitimate concerns rather than trying to convince them not to be worried when their concerns are legitimate. Share with them your concerns and your strategies for coping with those concerns. Children will be more likely to learn coping strategies when they are modeled and taught by adults who care for them. Learning how to cope with distress provides a lifelong skill they will, unfortunately, have other opportunity to use.”

Gelman also added on a more upbeat note, that parents can remind children of the good times that minor storms bring: ”Game playing by flashlight, family read-a-thons or family movie night with a battery operated DVD player decreases anxiety and increases coping skills and resiliency for future storms. Natural disasters pose a great deal of unpredictability, but there is a lot in our children’s lives that are stable and predictable and that they can count on.”

How are you explaining to kids the damage from Hurricane Sandy?

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Social Anxiety in Adolescent Girl

”I just wanted to order a hamburger, but I was too scared to even tell the waitress my order. My eyes began to water, my heart was racing, my face was beet red, and my throat was closing up. I just shook my head no ’meaning nothing for me today.”

That was one moment in the day of a life of a 15 year old girl struggling with a form of a phobia called social phobia or social anxiety. Often adolescents, who suffer from this type of anxiety, experience the above difficulty, as well as the fear of raising their hand in class, making spontaneous conversations with peers or new friends, making presentations in school, joining a new sport or social clubs, and more. Sometimes their physical symptoms can even lead to panic attacks.

According to the ADAA (Anxiety Disorder Association of America)

  • About 15 million American adults have social anxiety disorder
  • Typical age of onset: 13 years old
  • 36 percent of people with social anxiety disorder report symptoms for 10 or more years before seeking help

When asking about beginning a conversation with someone, socially anxious adolescent girls state they worry they won’t know what to say and then they will embarrass themselves.

It sounds trivial but it is not for those experiencing this type of anxiety. This fear and anxiety is so overwhelming that they resort to retreating, having few friends, and limited social experiences. The small number of social experiences they do participate in are ONLY with those who they know very well.

There are many ways to approach coping with social anxiety. I often begin with encouraging an increase in awareness of the different types of feelings one is experiencing at that time of their flooding worries.

Where in their body are they feeling these overwhelming physical sensations?

What is exactly happening?

How long is this occurring?

What situations are you most triggered?

Having this awareness of the different sensations and feelings that are occurring, when, and the duration, often allows individuals some control and allows us to begin to create achievable goals.

After one can understand and name what is happening, it is time to develop coping strategies to handle these intense feelings and transition back into the social world. I often use a combination of Cognitive Behavioral Techniques (CBT) and Exposure Therapy as a way to nurture this new skill set in adolescents.

CBT focuses on identifying, understanding, and changing thinking and behavior patterns. Exposure therapy is where a person is gradually exposed to a feared situation or object, learning to become less fearful over time.

I also teach girls to employ other ways to cope with the uncomfortable, scary feelings (either through ways of relaxing, visualization, or the introduction of grounding objects). These techniques distract the brain and prevent the flooding of too many intense feelings.

Small exposures over time combined with awareness and challenging negative thoughts help lessen this type of anxiety. If you or someone you know is struggling with social anxiety, contact a mental health professional today to gain more information and insight on ways cope.