This question often comes up in counseling. When fidelity has been breached, well-meaning friends often say this to the one who has been cheated on, along with the statement that they would never and could never stay with someone who did this to them.

All of this seems so right-until it happens to you. Now it’s your marriage, your family and your life on the bubble.

Amazingly, most women (I work primarily with the men) stay and work things out with their spouses. After having done this for 34 years, I can attest to the fact that the vast majority of men who participate in a program of recovery specific to this problem do become safe husbands and fathers!

This is because they needed help and, now receiving it, are much more likely to be able to be that integrous man they have desperately wanted to be.

The intensive individual therapy clears the forest of material that fuels the fire in the mans life, so that the group therapy can successfully suppress and control the embers of addiction- which are the habits wired into the brain (see Biology of Desire, Marc Lewis, PhD).

While I agree with the science of addiction, I can state with confidence that when a man or woman stops trying to recover alone, amazing things can and do happen because, you see, we are not defined only by our bad habits, but by the many good things God has built into us. The desire to be a man of integrity is one of those things and it can be supported and achieved if the choice is made to get help.

The following Caring Bridge entry is submitted in the hopes that it may encourage someone going through very hard times. For me, that has been cancer treatment and the loss of a child:

Further recent reflection leads to this attempt to document what seems to me to be significant learning about my life journey and my evolving relationship with our Heavenly Father.
I find that I’ve been attempting to reconcile His Love (which I do experience) with the journey our family has been on. I have never before felt the need to do this. I believe that the events of the last two years eventually forced me to face really hard questions.

One thing for sure: this is personal. This is no longer the kind of experience that can be neatly compartmentalized in some far away place. I can see the good in that because it forces a more personal, vital faith to match.

I am aware of some critical stages in the development of my faith:
I recall feeling at loose ends as a young adult. Jesus came to save the “lost.” That, in more ways than one, was me.
After finding anchorage in Him I could continue to grow as a person.
Probably the next big step was years ago when it ceased to be enough to call on God when help was needed. It became clear that everything needed to be turned over to Him daily and that there would no longer be a singular I or me- only a we; and he is the senior partner. (real Lordship I believe).
More recently, as I have journaled here before, the many challenges of the last two years (starting right around Nov., 2015) have led to a much closer relationship with Him. The time spent in meditation and prayer combined with the intense felt sense of need led to intimacy that has been special. I have experienced a greater trust and rest. Even though I’m weaker physically, I am stronger emotionally and spiritually. As my health has improved, I have endeavored to sustain the sweet closeness that was so hard-earned.

Losing David (6 month anniversary of his passing just recently) gave immediate relief from the day in and day out burden of caring for and worrying about him. As we adjusted to our new normal, some of the anger and disillusionment of the whole of his life condition and his end started to sink in.
As I struggled to understand why these circumstances had to be, I researched what Christian thinkers have come up with. Given the choices mankind has made to turn away from God, I can see how God would want to provide freedom of choice for every person and new generation. The fact that many say “no” to Him leads to problems to be sure, but I can understand that God wants our hearts to be for Him and thus, we must truly have a choice. This is a long and controversial discussion (see Lee Strobel, The Case for Faith). It has been vital to me to see that God entered into our mess through His only son (I had only one son) and that His son was also tortured by the circumstances of being here. Jesus truly suffered as he gave everything He had to us and for us while those who had chosen to say “no” to God were free to choose to persecute Him.

I have long believed and taught my children that Jesus came as a suffering servant to change our hearts, not our circumstances. But our circumstances can be a lot more troublesome than I ever knew possible. “How long, oh Lord (will we have to wait for the ruling reigning king)?”

Again, this is no longer just theology- it is real and personal. I must accept this. As I do, I see that God has elected to be present here primarily through people. He rarely sends floods or fire and brimstone down on planet earth. Instead he sends people- like those who have been there for us through thick and thin (we love you and appreciate you!).
Faith is not just about believing or living obedient lives, although those things are important. He relates to us through our and others’ changed hearts. This appears to be His way. I now understand the importance of aligning our hearts with His. 1 Corinthians 13:13…Faith, Hope and Love remain but the greatest of these is Love (paraphrase).

My heart, too, must change.
I will ask Him to help me be more intentionally present to Him: more of the time, in more ways and more deeply.
What a beautiful world it would be (think Louis Armstrong) if we all actively sought His heart to transform our hearts. “Oh Yeah.”
So, the gift coming from our journey seems to be the felt sense of His love- up close and personal because it is born of up close and personal battles.
Now that I reflect on it, all of the significant growth I just mentioned has come from up close and personal challenges.
I remind myself that, once we enter His presence, all of these “momentary afflictions” won’t matter.
In the meantime, they generate hard-won intimacy with God, amazing encounters with people and real peace inside.
Who wouldn’t want that?

In my blog on Mindfulness you will find rationale and technique, mostly as it relates to stress and anxiety reduction. Mindfulness is also used to get down to issues so they can be addressed.

We can categorize issues into three areas. Did the person feel safe, loved and valued? Each area is important and they work in order. If a person frequently felt frightened and unsafe growing up, work in that area will be most productive. If a person felt physically safe but not loved, work will be mostly useful in that area. Many people felt physically safe and loved but did not get the message that they brought much of value to the table. In that case, work should focus there.

Mindfulness helps us get down inside where these issues live so that the experiences that were formative can be altered in certain ways and the belief system (who I am) can be changed. In some ways it is quite amazing that this can be done. I once had a woman in her 70s work on a memory from 3 years of age. It needed to be done because the messages (what she had internalized about life and herself) were just as potent as they were 60 some years before-and they were not good for her.

It is never too late to change the narrative. We can’t change what happened or what we did but we can change what we take away from it and we can feel safer, more loved and more valuable, which frees us to live today!

Mindfulness (awareness of ourselves, our bodies) is a fantastic skill anyone can learn. Combine that with inquisitiveness and memories and skills we, our therapists and friends have to speak into our lives and the sky is the limit on the freedom that can be attained when the primary problems are experiential, not biological.

The following is a post I did for Caring Bridge just recently (end of April, 2016). For those who don’t know, I was diagnosed with a treatable form of cancer (GIST) in November of 2015 and was out of the office until April of 2016 due to complications and surgery for a small intestinal blockage. I am grateful to have survived and to be able to work.

Continue reading →

Timely and pithy article by a respected Psychiatrist:

A Psychiatrist’s Letter to Young People About 50 Shades of Grey

MIRIAM GROSSMAN, M.D.
There’s nothing gray about Fifty Shades of Grey. It’s all black.

I help people who are broken inside. I ask questions, and listen carefully to the answers.

One thing I’ve learned is that young people are utterly confused about love — finding it and keeping it. They make poor choices, and end up in lots of pain.

I don’t want you to suffer like the people I see in my office, so I’m warning you about a new movie called Fifty Shades of Grey. Even if you don’t see the film, its toxic message is seeping into our culture, and could plant dangerous ideas in your head.

Fifty Shades of Grey is being released for Valentine’s Day, so you’ll think it’s a romance, but don’t fall for it. The movie is actually about a sick, dangerous relationship filled with physical and emotional abuse. It seems glamorous, because the actors are gorgeous, have expensive cars and planes, and Beyonce is singing. You might conclude that Christian and Ana are cool, and that their relationship is acceptable.

Don’t allow yourself to be manipulated! The people behind the movie just want your money; they have no concern whatsoever about you and your dreams.

Abuse is not glamorous or cool. It is never OK, under any circumstances.

This is what you need to know about Fifty Shades of Grey: as a child, Christian Grey was terribly neglected. He is confused about love because he never experienced the real thing. In his mind, love is tangled up with bad feelings like pain and embarrassment. Christian enjoys hurting women in bizarre ways. Anastasia is an immature girl who falls for Christian’s looks and wealth, and foolishly goes along with his desires.

In the real world, this story would end badly, with Christian in jail, and Ana in a shelter — or morgue. Or Christian would continue beating Ana, and she’d stay and suffer. Either way, their lives would most definitely not be a fairy tale. Trust me on this one.

As a doctor, I’m urging you: DON’T see Fifty Shades of Grey. Get informed, learn the facts, and explain to your friends why they shouldn’t see it either.

Here are a few of the dangerous ideas promoted by Fifty Shades of Grey:

1. Girls want guys like Christian who order them around and get rough.

No! A psychologically healthy woman avoids pain. She wants to feel safe, respected and cared for by a man she can trust. She dreams about wedding gowns, not handcuffs.

2. Guys want a girl like Anastasia who is meek and insecure.

Wrong. A psychologically healthy man wants a woman who can stand up for herself. If he is out of line, he wants her to set him straight.

3. Anastasia exercises free choice when she consents to being hurt, so no one can judge her decision.

Flawed logic. Sure, Anastasia had free choice — and she chose poorly. A self-destructive decision is a bad decision.

4. Anastasia makes choices about Christian in a thoughtful and detached manner.

Doubtful. Christian constantly supplies Anastasia with alcohol, impairing her judgment. Also, Anastasia becomes sexually active with Christian — her first experience ever — soon after meeting him. Neuroscience suggests their intimacy could jump start her feelings of attachment and trust, before she’s certain he deserved them. Sex is a powerful experience — particularly the first time. Finally, Christian manipulates Anastasia into signing an agreement prohibiting her from telling anyone that he is a long time abuser.

Alcohol, sex, manipulation — hardly the ingredients of a thoughtful, detached decision.

5. Christian’s emotional problems are cured by Anastasia’s love.

Only in a movie. In the real world, Christian wouldn’t change to any significant degree. If Anastasia was fulfilled by helping emotionally disturbed people, she should have become a psychiatrist or social worker.

6. It’s good to experiment with sexuality.

The bottom line: the ideas of Fifty Shades of Grey are dangerous, and can lead to confusion and poor decisions about love.
Maybe for adults in a healthy, long term, committed, monogamous relationship, AKA “marriage”. Otherwise, you’re at high risk for STDs, pregnancy, and sexual assault. It’s wise to be very careful who you allow to get close to you, physically and emotionally, because just one encounter can throw you off track and change your life forever.

The bottom line: the ideas of Fifty Shades of Grey are dangerous, and can lead to confusion and poor decisions about love. There are vast differences between healthy and unhealthy relationships, but the movie blurs those differences, so you begin to wonder: “What’s healthy in a relationship? What’s sick? There are so many shades of grey — I’m not sure.”

Listen, it’s your safety and future we’re talking about here. There’s no room for doubt: An intimate relationship that includes violence, consensual or not, is completely unacceptable.

This is black and white. There are no shades of grey here. Not even one.

www.MiriamGrossmanMD.com/blog

www.facebook.com/MiriamGrossmanMd

The Christmas season brings great expectations…and pressures. Whew! While on the phone for technical support a couple of days ago, a woman said she couldn’t wait until Christmas was over for another year. I didn’t want to agree with that sentiment,  but I sure do understand it!

I sincerely hope you and your family had a great couple of weeks-and found some time to rest.

Because we have greater stress, we are more likely to have had some fractious encounters with loved ones!

It may be time to re-up on our conflict management skills!

Here are some tips from the highly regarded Psychologist John Gottman:

1) soft start up to any conflict that arises or that we must address
2) accept influence of others. Hear them and understand them.
3) use positive affect in the service of de-escalation
4) soothe yourself to stay calm
5) use apology and humor
6) create a dialogue. We don’t have to be “right”

How about picking just one of the above and working on it this new year?There’s amazing power in that kind of focussed effort!

Happy New Year!

When we hear someone say “take care,” it could be a friend saying goodbye, for now, as we part. Sometimes it’s meant seriously by someone who we are very close to. It could be that they want us to drive safely or get a little more rest.

In this hectic age we live in, Psychologists are inundated with people who suffer from anxiety, not infrequently to the point of suffering from panic attacks (shortness of breath or heart palpitations or fear of going crazy or dying, or nausea, or feelings of unreality or dissociation, as some of the symptoms).

As a result, many Psychologists are helping clients with Mindfulness training.

Dan Siegal has written a number of books on this subject (such as The Mindful Brain, Norton, 2007).

In my experience both personally and as a therapist, we experience stressful situations that we don’t have time to process or are afraid to process and or don’t know how to process. Our minds can add additional stress by focussing on things we can’t control, such as illness or our children’s issues. All of this unprocessed stress is like water behind a dam: eventually it goes over the top of the dam, resulting in conditions like depression, anxiety, illness, need to medicate and or anger issues.

Mindfulness by it’s nature trains us to stop adding to the stress and take time to detach and take care of ourselves. We move away mentally, for a few moments, from problem solving, to do lists and planning. We decide to take some time to take our emotional/physical “pulse” if you will. We become aware of our “state:” our breathing, heart rate, and tension in our muscles. This awareness puts us in the position to relax. Additionally, we can utilize techniques to open up channels for these stored energies to be released.

The technique I prefer for active releasing of stress (an additional technique) is called Brainspotting, but that discussion can be for another post. See my website: www.scottsdalecounseling.net; Arizona Brainspotting Center, for more on Brainspotting.

It can be remarkably helpful to know how to relax. We do this by learning to be mindful of our bodies. Once mindful, we can allow (not force) the body to return to it’s fundamental quiescent base, which is quite restorative!  What you’ll see below is called Autogenic Training. This is a technique we can do ourselves (hence “auto”). Since being trained in it decades ago, I have found it to be perpetually of great value (yes, for me also).

So…take a few minutes right now if you’re able, and take a moment to indulge in Self-care!

1. Clear your mind…leave the rim of the wheel where all your concerns are and go down inside to the hub…find God’s presence there…Be Still and Know That I Am God…detach from all worries…just be here and now. To the degree that we can accomplish this (sometimes no mean task), we do not add any new stress to the body while relaxing.

2. Once you are working on detachment (notice it’s something you keep doing) start the autogenic training:

Sink into your chair and intentionally relax all your muscles…go
through your body (body scan) to see where you might be holding tension
and release where you can
Then give yourself the following commands…Remember, you can’t
force compliance, but you can allow healthy responses. Stay Curious,
Open, Accepting and Loving:
My arms and legs are heavy and warm…let that be so…notice what
your body does with this and let it deepen. Blood flowing to the extremities brings weight and warmth.
My breathing is calm and regular…let your breathing be deeper,
slower and very regular if possible
My heart beat is calm and regular…notice your heart beat…let it slow
down…the goal is that there is no pounding or racing…if there is, that will be
part of our work later
My forehead is pleasantly cool (sometimes blood flow gets a little too
busy in the head)…use this if necessary

Take 10-15 minutes to feel where YOUR BODY relaxes and enjoy and deepen it by
continually repeating the commands above while allowing your body to respond.

Warning: you may not want to stop after 15 minutes!

For more information, see my website: www.scottsdalecounseling.net

How shocked we all were when we heard of Robin Williams’ passing. I liked what I heard Keith Ablow, MD, say on the news: while depression is a common malady and can be fatal, with education and awareness there is great hope. He went on to say that psychotherapy is the “gold standard” of treatment and that there are many medications which can be helpful. There are even novel medical treatments which are very promising for treatment-resistant depression and mood disorders.

We need to be talking about the signs of depression such as sadness, appetite and sleep disturbances, loss of interest in usual pleasures and other changes. We need to overcome the stigma of having depression by speaking out about it. Resources such as NAMI (National Alliance on Mental Illness) are free for the person suffering from the illness and the families suffering with him or her.

Often the family physician or clergyman is the first to hear of a person suffering from depression. They assess and refer to mental health professionals, such as psychologists, as they prescibe helpful medications. It is important to treat depression and other mood disorders when they are detected because of the damage to relationships, work functioning and of course the person’s health and or life that can occur.

There is hope. We must take advantage of our loss of a favorite celebrity to speak to others about this subject and what can be done about it. Sharing on this blog, for example is my way of doing that. As others respond to this post, we can create a valuable discussion about the subject that others, from the comfort and safety of their personal computers and devices, may benefit from in amazing ways.