- Published on June 13, 2011 by Mark Goulston, M.D., F.A.P.A. in Just Listen
Immature love is loving someone for what they do right;
mature love is loving someone is spite of what they do wrong.
Couples therapy for dummies is like the series of the same name not to be disparaging, but to offer an approach to therapy that is accessible and doesn’t require deep thinking or deep insights (something that most people find too difficult to use and apply) to be effective (I wrote PTSD for Dummies for the very same reason). On the other hand it is not for couples who are so foolish as to deny it when they need help or too blameful to fight it when it is given to them. It is also not for newly trained therapists who feel they need to listen to and indulge finger pointing and stupidity for fear of ticking off their client.
After years of seeing partners who were too blaming and excuse making, or who saw themselves as victims with no responsibility for any of their problems… And after becoming exhausted at stepping in to stop them from acting on a self-destructive or couple destructive impulse, couples therapy has become much simpler and clearer. So much so, that I refer to it as Clarity Based Couples Therapy (CBCT).
CBCT is not for everyone. It is not for couples in whom rather than being committed to making their relationship stronger and better, each or either of the partners has to be right and has to get their way.
It’s natural for people to want to be right and get their way and to be disappointed when they don’t. It’s even natural for some people to needto be right and get their way and to be upset when they don’t. Each of those can be tolerated, talked through and even gotten over.
However whenever one or the other partner has to be right and get their way, anything that threatens them with either being wrong or not getting their way will be experienced as an assault and they will do anything they can to defend their position, resist and fight back.
The focus of therapy then becomes coaching each partner to react to the inevitable disagreements, disappointments, upsets and frustrations in their relationship by not becoming either upset or angry at or shut down or avoidant of each other. It also involves not beating up themselves.
Instead it involves teaching and coaching each partner on how to confront and fully resolve conflicts as they arise. As it turns out, most people avoid conflict not because they lack the will to deal with it, but because they lack a way to do it. Even more apropos, they believe that confronting conflict will only make it worse and have close to zero confidence that it will make it better.
As partners learn the skills to effectively deal with disagreement, disappointment, upset and make things better without making them worse, each develops emotional toughness, self-respect and self-esteem. Add to effective conflict resolution skills tools derived frommindfulness and positive psychology and any motivated and couple can move to a shared future that more than makes up for any emotional baggage they still have from their genes (nature) and child rearing (nurture).
Nature and nurture are still only two strikes
As they both share victories with each other and live into their shared future, they create and build a relationship that they both begin to take pride in. Within a short period of time others start to notice the positive changes and when you go from a couple who is embarrassed by each other to one that other couples want to emulate, the change is phenomenal.
But as I said at the beginning, it is not for everybody. People who have to be right and have to get their way need not apply.
Sitting in te hospital watching an HBO documentary, some scarey stuff around education.
ER Visits Persist for Children with Mental Health Problems Despite Regular Outpatient Care
Newswise, May 26, 2011 — Johns Hopkins Children’s Center scientists have found that having a regular outpatient mental health provider may not be enough to prevent children and teens with behavioral problems from repeatedly ending up in the emergency room. The study is published in the June 1 issue of the journal Psychiatric Services.
Analyzing more than 2,900 records of pediatric patients, ages 3 to 17, treated at the Hopkins Children’s ER for mental health crises over eight years, the investigators found that 338 of them (12 percent) returned to the ER within six months of their initial visit. The majority of the ER visits stemmed from behavioral problems or minor psychiatric crises, such as disruptive classroom behavior, verbal altercations and running away, the researchers said. Only a few involved severe psychotic episodes (3 percent of the visits) or suicide attempts (10 percent). Most importantly, the researchers found, two-thirds of patients (220) reported having an outpatient mental health provider at both visits, and 288 (85 percent) reported at the second visit that they have a regular mental health provider.
The findings are concerning, the researchers said, because they may signal that patients are not actually getting the care they need on an outpatient basis.
Mental health experts have traditionally emphasized the importance of outpatient care in managing non-emergency cases and have urged connecting such patients to outpatient mental health programs. Most ERs are neither designed nor staffed to deliver effective, coordinated mental health care, the investigators said.
“We think of the ER as a ‘front door to care,’ but our findings suggest otherwise as a significant number of patients repeatedly seek care in the ER despite being connected to an outpatient provider,” said lead author Emily Frosch, M.D., a pediatric psychiatrist at Hopkins Children’s.
The findings, Frosch said, raise more questions than they answer, and researchers have only begun to untangle the complex reasons behind recurrent ER visits for non-emergency psychiatric problems.
“We need to understand why families who are already connected to outpatient providers continue to seek ER care, why providers send patients to the ER and what role, if any, ERs may play in the continuum of care for non-psychotic, non-suicidal patients,” Frosch said. “It is possible that ERs fulfill an important function in that continuum for some patients.”
The researchers said one possible explanation is that patient families face barriers to routine outpatient psychiatric care, including limited office hours. Families who have had a positive experience in the ER in the past may be simply choosing to return there for subsequent problems, the researchers say. Also, some families may also find ER care less stigmatizing than outpatient mental health services. Frosch added that ER visits may be driven by some outpatient providers who may not have sufficient resources for optimal care and instead send patients to the ER.
The Hopkins team said future studies should explore more specifically the link between outpatient care and ER visits.
“Perhaps the most critical questions to ask are ‘When was the child’s latest outpatient visit?’ and ‘What exactly transpired between that visit and their subsequent trip to the ER?’” Frosch said.
Susan dosReis, Ph.D., also of Hopkins, was co-investigator in the study.
Source: Johns Hopkins Medicine
Wow, well I am motivated that I am using many of the programs that we have looked at in EC&I 834. I even made some students start a blog for their summer travels.
Super happy to be doing an afternoon of development around inquiry and technology…Thank-you Stu Harris
