I love to do family therapy. It’s rich and full of possibilities. Getting more than just the identified patient into the process often leads to speedier resolution of symptoms. It gives me a clearer picture of how the client is perceived by others and treated by others. It enables the family to get a better understanding of the client’s concerns. Having an objective therapist in the room helps to defuse cruelty and anger and allow for more helpful communication. It is naive to believe that others should automatically understand our wants and needs, our joys and sadness. We’re all similar, but in ways very different. Best to learn how to communicate our desires clearly and respectfully to those of importance in our lives.
With family therapy, I can enlist the family’s help in resolving the client’s issues; draw upon their support and resources for the client. Family cutoffs are rarely wise and create wounds and scars which become hardened over the years and do tons of damage to the parties involved.
Some family members cannot be seen together in joint sessions and must be seen separately or consulted with by phone or mail.
We don’t get to choose our families, but we can choose how to treat them and set boundaries for acceptable treatment by them. Many family wars are the result of misinformation and that can be corrected and healed.
I am equally as happy to see gay and lesbian couples as heterosexual couples, dating or married couples. I have seen newly married couples as well as couples for pre-marital counseling. They get a good shot at marital success. All relationships change over time and can be painful when the romance dims a bit. That’s just the beginning of learning how to really negotiate hard and painful issues. We all have to do just that. How sad to always be looking for a new partner when we hit a rough spot in a relationship. Best to give it your best shot at understanding and owning your part of the problem and to give your earnest efforts to resolution before running away from someone you might have seen as “the love of your life.”
I treat adolescents and their families, individuals and couples. I refer those who need group therapy. I sometimes do both individual and couple therapy with the same people, with one rule firmly at play, ie. Anything we discuss in individual therapy is available to disclose in the couple therapy. If we’re doing couple therapy, the couple becomes the client and I do not take sides with either or keep secrets for them. Secrets are toxic in intimate relationships.
Confidentiality can be broken if the client is a danger to himself or to others and I am mandated to report such risk factors.
I am a licensed social worker, not a physician. I cannot prescribe medications. Some conditions such as bi-polar disorders, severe depressions, anxiety disorders, some eating disorders, schizophrenia and some anger management issues either require or are best treated with medication and counseling together. I have a large network of physicians and psychiatrists to whom I can refer the patient for medication while they continue in counseling with me. I willingly collaborate with physicians on behalf of my patients. If hospitalization becomes necessary, I can facilitate that. Support groups and recovery groups can be very powerful in healing.
Some people suffer from multiple disorders at the same time or alternately. These disorders tend to run in families but like any other ‘gift of genetics‘, not all family members will get them. Bi-polar disorder, obsessive compulsive disorder and other anxiety disorders and major or chronic depressions and eating disorders do tend to run in families. Often the specific medications which help a close family member will also be helpful to my client. Certainly, family members modeling such behaviors have a profound effect upon the rest of the family. Children learn what they live.
It is unwise to fail to treat any of these illnesses. Just like you would get medical treatment for pneumonia or a heart condition, you should do the same for mental and emotional problems. There should be no reason for shame or fear of being labeled inadequate or crazy because you need some help. Mental health issues can be just as crippling and often dangerous if left untreated as physical health issues. After all, the brain and the body are a unit, what affects one affects the other.
Eating disorders seem to be anxiety, OCD & phobias running wild. Depression typically is a part of the picture. These tend to be addictive. The more you practice them, the more you feel the need to do so. Just like drugs and alcohol, the compulsion and addiction grows. It is critically important to find ways to interrupt the process and re-develop healthy lifestyles. Like alcohol and drug addictions, 12-step programs are helpful. Inpatient or intensive outpatient or step-down treatment are often needed in addition to ongoing counseling. Medications are often used. If the condition is not life threatening, it can still permanently impair the rest of your life. Anorexia, bulimia, compulsive overeating, drug and alcohol addiction wreck lives everyday. Unresolved, life gets miserable and out of control, and those who survive but don’t resolve the addiction cannot lead full and satisfying lives. The addiction rules. Denial and dishonesty are common. Relationships suffer or fail. Jobs or promotions are lost. They require so much mental energy, the person isn’t able to prioritize for what really matters most in life. The craving for the fix is in charge of their decision-making.