Holiday Tips from a Family Therapist

Fir Branch With Pine Cone And Snow Flakes

 

Each year around this time, conversations with clients turn to the predictable stress of time with family over the holidays.

Like ghosts in the night, old issues, long dormant, reappear at holiday time. How is it that an adult with partner and children can walk into their parents’ home and instantly feel 10 years old again? The anticipation of a holiday encounter can lead any adult to feel slightly unhinged in a way that few other situations do.

Let’s face it, no one can upset you like a family member.

Here are some ideas to try on this holiday season. They are born of basic tenets of family therapy theory and are utterly applicable to a variety of anticipated holiday situations:


1. Plan and be strategic. 

It’s always a good idea to warn someone that you are going to make a change before you actually do:

“I was thinking about the holiday, and this year I might do something a bit different.”

You don’t even have to be sure of what specific change you’re going to make, the point is to warn others first. That way, you can attempt to avoid their shock and surprise when you decide not to follow the family script – you know, ‘the way it’s always been and everyone (but you) wants to continue’.

This can be particularly useful when, for example, you have young children and want to begin to create your own traditions around the holidays. Perhaps you feel the stress of traveling with small children in an effort to please everyone, or because ‘you’ve done it every year, and they’re counting on you.’ So let people know in advance and find allies to support your change.

Which brings me to the next point.

2. Expect a reaction.

It is true that relationships have much in common with physics: for every action there is a reaction. Families attempt to maintain a homeostasis – a state of balance, maintained by familiar patterns and expectations. Think of the tremendous impact it has upon relationships when a family member joins or leaves the system; these points of normative developmental crises, birth, adolescence, marriage, or death, each require a renegotiation of previous roles and rules in the family system. Holiday traditions are valued as markers of continuity, so changes, however minor, can feel disruptive and unsettling.

3. Focus on yourself.  

You can change only your behavior, not the behavior of others.

Admittedly, this is a tough one. It’s the balancing act between giving up the dream of what can be, and accepting what is. There is much integrity in changing one’s own behaviors in a respectful and compassionate way, and it’s sad to realize that, for now, others may just not be who you want them to be.

Developing a curiosity about yourself may help. This might be a good time to entertain the questions:  Why does this person still hold so much power over me?  Why do I still need my mother/father/sibling to compliment or recognize me? How is it that I have come to this place in my life carrying that old wound?

4. There’s always next year.

Your opportunities to practice being different in your family are boundless. Try to think of this as one of many steps toward change. It will most likely take more than one conversation and there can be complicating factors: addiction, trauma, divorce, remarriage. Relationships take time, so keep in mind the long term; families are full of surprises and unpredictability as the family life cycle inevitably moves into the future.

When I hear a person in their 20’s or 30’s say “I’ll never have a relationship with my brother, I respond, “Well, let’s think about this for a moment. If you both live until you’re 80, are you telling me nothing will happen over the next 50 years? Most likely, your parents will predecease you, and you and he will together become the oldest living generation in the family. You may each partner with someone, and perhaps become aunt and uncle to each other’s children.”

There are endless circumstances that create opportunities for us to evolve in our family system.

Lastly, I try to remember at this time of abundance and giving thanks, that to even think about the quality of relationship is, of itself,  both a blessing and a privilege.

With all my best to you and yours during this special season,

Jacqueline Hudak

 

 

Emotional Cutoffs in Families

I had a wonderful time presenting to physicians, nurses, social workers and psychologists at The Reading Hospital this spring.

The audience wanted to understand the meaning of emotional cutoff and the impact of this process on development and family relationships over the course of the life cycle.

Always true to my training as a family therapist, I began with my family genogram, and a story about my father’s cutoff from his family of origin. This happened when I was two years old and shaped the events in our family for many years to come. His alienation from his own family became the landscape of our life; it was always present. At certain times, like holidays, or life cycle events, like death, the impact was more acute. This relational rupture shaped how he was viewed by us, his immediate family members, influenced decisions, and had a grave impact on his health.

Father and daughter

Emotional cutoffs are the natural mechanisms people use to counter high anxiety or high emotional fusion, also known as ‘too much closeness.’ A cutoff can look like physical or emotional withdrawal, avoidance of sensitive topics, physically moving away from family members or rarely going home.

Relationships may look “better” if people cutoff to manage them, but the problems remain, and are dormant.

Although people reduce the tensions of family relationships by cutting off, they risk making their new relationships too important. For example, the more a man cuts off from his family of origin, the more he may look to his spouse, children, and friends to meet his needs. This makes him vulnerable to pressuring them to be certain ways for him or accommodating too much to their expectations of him out of fear of jeopardizing the relationship.

Not all cutoffs are unwarranted, however.  In some cases they are necessary, or preferred, as in the case of emotional or physical abuse.

There are circumstances when someone may be coached to ‘cut off.’ For example, consider the concept of ‘tough love’ or ‘letting someone hit bottom’ that is often suggested when a loved one is suffering with addiction. Post divorce families also struggle with physical and emotional cutoffs as issues of loyalty are prominent.

The words “cut off” imply a static state – a lack of motion or movement.   However, to remain angry or to hold a grudge are in fact, actions.

Consider these verbs: to harbor bitter feelings, resent, brood, or stew.  

Indeed, it is possible to become so wrapped up in the wrong that’s been done to you that you can’t enjoy the present. And there are significant health consequences. Anger, frustration and sadness increase the stress hormone, cortisol.

Experiencing these negative emotions instinctually prepares the body to fight.  A prolonged state of fight increases levels of protein in the bloodstream which promote cardiovascular disease and stroke. But here’s the good news: Studies have found that the act of forgiveness can reap huge rewards for your health, lowering the risk of heart attack, improving cholesterol levels and sleep, reducing pain, blood pressure, and levels of anxiety, depression and stress. And research points to an increase in the forgiveness-health connection as you age.

Chronic anger puts you into a fight or flight mode, which results in numerous changes in heart rate, blood pressure and immune response.  Those changes then increase the risk of depression, heart disease and diabetes, among other conditions.  Forgiveness, however, calms stress levels, and leads to improved health.

Perhaps in the next post I’ll write about the work of forgiveness and repair.  But for now, a return to my own family story.

About ten years into the cutoff, around the death of my paternal grandparents, my father’s siblings began to contact him.  These vaguely familiar men, my uncles, were welcomed into our home, and celebrated.

My father’s expansive capacity for forgiveness has stayed with me, and brought valuable lessons which I apply in clinical work with families: that despite dire circumstances, change can happen, and usually does.

We just need to take the long view – that is, a family life cycle perspective. We are constantly negotiating closeness and distance in our relationships over time; we readjust   according to the phase of the life cycle.  The warmth and closeness around the time of birth is juxtaposed with the ‘letting go’ required for launching into young adulthood.

The practice of compassion and forgiveness, for ourselves as well as those we love, will enhance our health and nourish our spirits as we face the challenges that will inevitably come.

 

Engaging Family Supports: Free Online Videoconference

 

Join us for the next CPSP
“Community Psychiatry Forum*”
In Collaboration with
The American Association of Community Psychiatrists

Engaging Family Supports

Learning Objectives – Participants will be better able to:

  • Identify strategies and barriers to engage family members as supportive members of recovery team
  • Enable people in recovery to identify and connect with potential sources of support in the community
  • Describe issues commonly concerning family members and other natural supports and potential approaches for addressing them

CME: You can earn 1.25 CME credits

When: Thursday, April 21, 2016
11:45 am – 1:00 pm EDT

Course Directors: Wesley Sowers, MD
Robert Marin, MD

Guest Experts:

Ellen Berman, MD, Clinical Professor of Psychiatry, Perelman School of Medicine, and Founder and Director of Training, Center for Couples and Adult Families, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA

John Sargent, MD, Director, Division of Child and Adolescent Psychiatry, Tufts Medical Center and Professor of Psychiatry and Pediatrics, Tufts University School of Medicine, Boston, MA


*Community Psychiatry Forum: Free online videoconference offered twice each month. Continuing Medical Education credits

Three Perspectives on Marriage

Every so often I read something that speaks to a yet unarticulated thought or idea about my work with couples and families. Such was the case when I read NY Times columnist David Brooks’s article “Three Views of Marriage.”

He describes three prevailing perspectives on marriage: the psychological, the romantic, and, what he calls the moral view.

It was Brooks’s description of the moral view that spoke to me.

As a couple and family therapist, I am witness to the transformational power of love. I see individuals attempt to put aside their own agenda for the ‘greater good.’ This greater good is often the third dimension: the marriage itself. In my work I endeavor to give voice to this relational arena.  I try to make this otherwise silent and invisible domain come alive and use all the leverage that love and bonding bestow – to create something larger than the sum of two individuals.

“In this view marriage isn’t about 2 individuals trying to satisfy their own needs; it’s a partnership of mutual self giving for the purpose of moral growth…..(this is the) view of marriage as a binding moral project.”

Indeed, I have observed this in my work with couples, but didn’t have the words to describe what was happening.  It is a feeling of surrender, a letting go, only to find themselves part of something larger.  I see my clients delight in this experience.

Brooks also provides a lovely depiction of the inevitable trajectory of romantic love:

“…you need a few years of passionate love to fuse you together so you’ll stay together when times get hard. It’s a process beautifully described by a character in Louis de Bernières’s novel “Corelli’s Mandolin”:

“Love itself is what is left over when being in love has burned away, and this is both an art and fortunate accident. Your mother and I had it. We had roots that grew toward each other underground, and when all the pretty blossoms had fallen from our branches we found that we were one tree and not two.”

I admire a writer like Brooks who can so eloquently describe the mysteries of relationship and love.  And, who can articulate the feelings suspended in the air in my small sunny office that I can sense, but cannot yet put into words.

Read the full article here

Generosity and Kindness: Key Ingredients of a Long Lasting Relationship

At CCAF, we are committed to bring research about relationships and family life to the public.  In this spirit, I share the article, “Masters of Love” from this month’s Atlantic Magazine.

The article traces the 30 year history of research on marriage; the work of John and Julie Gottman of The Gottman Institute is featured.  Their work is noteworthy for their capacity to  predict, with up to 94% certainty, which couples will be broken up, together and unhappy, or together and happy several years later.

“Much of it comes down to the spirit couples bring to the relationship.”

That’s where kindness and generosity come in.  Those couples who accept each other’s ‘bids’ for contact, who ‘turn toward’ each other, do better in the long term:

“People who are focused on criticizing their partners miss a whopping 50 percent of positive things their partners are doing and they see negativity when it’s not there.”

Gottman found that the more physiologically active the couples were in the lab, the quicker their relationships deteriorated over time. The problem was that these relationships, called the ‘disasters’ showed all the signs of arousal; they were in fact in ‘fight-or-flight mode’—in their relationships. In these highly reactive couples, it was virtually impossible to have a conversation, express feelings, and be heard.

“Having a conversation sitting next to their spouse was, to their bodies, like facing off with a saber-toothed tiger.”

Fortunately, Couple and Family Therapists are trained to coach couples to shift to a less emotionally reactive posture.  In this way, couples can begin to express feelings and desires more effectively, and communicate how their partner’s behavior impacts them.

Read the full article here and learn about how to become more masterful at love.

Dr. Ellen Berman with Marty Moss-Coane and Ron Lieber: “Families and Money”

326aMoskowStudio    CCAF Founder, Dr. Ellen Berman was a guest on WHYY’s Fresh Air  with author Ron Lieber yesterday.  They had a lively and informative conversation about Families and Money.  Ellen and Ron  answer some of the more vexing questions about this important, delicate, and often very difficult to discuss topic.

“Money is all about values,” says Dr. Berman, who draws upon 30+ years of clinical experience with couples and families.  She talks specifically about the cultural shifts that impact ‘adult’ children, and offers clear, specific advice about how to avoid pitfalls and seize opportunities when dealing with the thorny issue of money and the family.

 

 

Welcome to our new CCAF Clinical Faculty Member, Michelle Jackson, MSS, LCSW

Welcome to our new CCAF Clinical Faculty Member, Michelle Jackson, MSS, LCSW

The Center for Couples and Adult Families extends a warm welcome to Michelle Jackson, a seasoned Couple and Family therapist who joined our Clinical Faculty last month.

There are many reasons I’m thrilled to have Ms. Jackson aboard, not the least of which is our ability to serve more couples and families at CCAF. Her arrival is evidence of our growth; clearly the word is out that there is couple and family therapy available at Penn.

Ms. Jackson’s sensitivity to issues of diversity in clinical work is in concert with the CCAF mission, as well as our curriculum in Culture and the Family that takes place across all four years of residency training in psychiatry.

Ms. Jackson’s life trajectory informs her fluency with individuals who have chosen or invisible identities, or who are part of biracial/bicultural couples, and multi-racial families. Her work provides a context in which to normalize alternative developmental pathways and strengthen resilience in the absence of cultural validation.

Welcome to CCAF, Michelle!

I’m so happy to have you as part of our team, and know that couples and families will be enriched through their work with you.  I look forward to a long collaboration together at CCAF.

To schedule a meeting with Ms. Jackson, please call Bryn Farrelly, 215-746-5900.

Read Ms. Jackson’s full bio