Family: Can’t live with out ’em, can’t shoot ’em

From my favorite Awkward Family Photos

How many of us are packing our swimsuits, stuffing our cars and traveling hours in traffic to meet up at some get-away destination with our extended families?  It may be an annual summer event or a big family reunion that happens every decade or so.  Whatever the case we all have  them, a family that is.

Our families can provide us with laughter and memories that only a family can appreciate.  Sharing your history, watching each other’s children grow and reminiscing about that time that  Uncle Frank crashed the motorboat can not be replaced.

There is also a sense of anxiety when we gather with our families.  Old wounds and resentments that can be hard to forgive,   siblings that have grown apart or in-laws that once introduced into the clan can make for challenging relationships.  Again, who hasn’t these  common experiences?  My grandmother used to say “family is like fish, after four days they start to stink”.

How do we negotiate these ambivalent feelings? Can we find a way to enjoy this one week off we have all summer family vacation despite the anxiety and aggravation of so-called family?

As a family therapist, I have worked with many people struggling with these issues.   One of my biggest suggestions is to have clear boundaries.   A boundary is an imaginary wall surrounding you.     There are those who have trouble respecting that wall, they crash through, push you into a corner and are unable to hear what it is that you are saying.   For example, your third cousin who doesn’t have children wants to take your kids to a midnight movie the day before you are scheduled to go on an (already paid for) excursion.   This is when your boundaries need to be strong.   You gently say, “No thank you, my kids need their rest.   I know they would love spend time with you, maybe we could do an afternoon movie on a different day.”   Many people struggle with setting this boundary.  They  don’t want to offend the generous offer of the cousin, everyone knows what a blast it will be, but you know your kids best and you know they will be a wreck for the excursion the next day.

I also recommend to my clients that they make sure they take some time for themselves. Go on a walk, read a book, sit by the lake; whatever works in your world, but make sure you carve out time for you amidst the meals, chaos and well, family.

Family is great.  Who knows you better and loves you warts and all?  Being aware of some of the pitfalls can make for a much more fun and calming vacation.   Enjoy! Have fun, and don’t forget the sunscreen.


An uncomfortable topic: Depression and Suicide

I have been asked to help my synagogue with a program that educates teenagers about depression and suicide.  I met with the Religious School Director, a professional from Jewish Social Services of Northern Virginia and another volunteer mental health worker  to learn about the program.  The curriculum has been written by an outside agency; our task is to be trained and discuss how we want to present it to the teenagers that attend our religious school. The structure is such that we will meet one evening during religious school for 90 minutes with the teenagers (9th-12th grades) and their parents.  Two of us will meet with the parents and two with the teens.

I found the curriculum to be interesting, thought provoking and important. I noted that during our training discussion, there was concern as to whether some of the material was too harsh, or would the parents be taken aback.   The other mental health provider and I were adamant that these serious and scary subjects need to be addressed, there was to be no beating around the bush.  It made sense that those more involved with the politics of both the synagogue and the community would be sensitive to the tone of the the program, a.k.a. complaining calls and emails about such touchy subject material.

We have to be candid with these kids.  We want it to be safe for them to talk about times that they feel sad, anxious, depressed or  even suicidal.  There is a lot of pressure for teens to be  happy and perky. I have many clients tell me that they “fake” it around their friends and at school because they don’t want people to know that they are really sad and struggling inside. I hope we can create a space where the teens can not only  gather some information, but also realize that they are not alone with these “taboo” feelings.  I hope that they will be able to reach out to either their peers or the adults and share what may be on their hearts.

 The curriculum includes  handouts, written material and a DVD.  The DVD  has three vignettes of teens acting: a girl that has broken up with her boyfriend who is feeling hopeless, a boy stressed about grades and college and feels life isn’t worth living and a boy that is being bullied in school. Interspersed with the somewhat “cheesy” dramatizations are real life people sharing their stories which are powerful and emotional (compensating for, in my opinion,  the “cheese” factor of the dramatizations).  One boy talks about jumping out of a window and both his physical and emotional recovery.  A girl talks about her struggle with her parents divorce,  drug addiction and a suicide attempt and how she has pulled her life together and now feels very hopeful.  The story that was most difficult to watch was that of a girl’s family and friends following her death from suicide.  The friends talked repeatedly about missing the warning signs, ignoring her cries for help and not doing enough to help her.

The program has a strong focus on what to do if a friend shares that s/he is feeling hopeless or suicidal and requests that you not tell anyone.  I have had many of my teenage clients share this exact predicament with me in their therapy sessions.  Their initial concern is that they want to be a loyal friend. I emphasize the importance of safety with these teenage clients. I inform them that being a loyal friend is telling a trusted adult like their parent, teacher or guidance counselor to keep their friend safe.  I tell my clients that it is better to have their friend mad at them and alive than have their friend die.

The parent group will be separate from their sons and daughters.  The teens are more apt to open up if they are not with their parents.  The parents will also view the DVD and be instructed on warning signs of teen depression and suicide.  I hope to create a dialogue with the parents around issues such as supporting their teens, when it is necessary to get professional help and also helping them tap into their own feelings of depression, anxiety or other mental health concerns.

This is a troubling and scary issue, one that we don’t  want to have to think about, and yet we must.  I am including some links if you want to read more about this issue, and as always, I am here to help.


Teen Depression

Warning Signs of Suicide

American Association of Suicidology

The Power of Connection

I had a wonderful connecting weekend.  A dear friend who moved out of state came to visit and we created our own girls’ weekend with two other local friends.  The original plan had been to  meet in the middle of our two states, but logistics didn’t allow for that, so we created our own resort right here at home.

The first night consisted of cocktails and hor dourves in the resort’s flowing gardens  my kitchen,  followed by a fantastic Indian meal in, none other than, downtown Herndon.   We then gathered  back at the resort, aka my living room for silly silly talk and dessert.  When I am with these women, I laugh until my stomach hurts, again and again.  We finally rolled into bed (grown  up sleepover) at about 1:00 am.

Saturday  morning we walked to our local farm market, bought peaches, yogurt and scones and enjoyed  breakfast on Lake Anne.  We later found ourselves in Arlington sitting outside at a cute little Mexican place amongst the 20-something pierced and tattoo-ed crowd.  We held our own as 40-something moms toasting our margaritas and enjoying our time together.  This meal involved some heavy talk; ailing parents, finances and parenting our own children.   We  were completely comfortable sharing  our most private thoughts and concerns amongst the safety of our group.  We have built a strong trust amongst ourselves as we have weathered many collective life challenges and celebrations to  include one difficult pregnancy and subsequent wonderful birth, two adoptions,  a scary childhood mental health issue and a tragic death of a parent as well as four Bar Mitzvahs, countless birthday parties and the first of many high school graduations. This is who we are and what we do; we connect, we laugh and we cry together.

I work with many women who enjoy close connecting friendships, but I have worked with many who struggle with loneliness and isolation. Some of these women do have close friends, but are uncomfortable with showing vulnerability so holdback in the friendship. I try to help them  become comfortable with their  insecurities and realize that by sharing with a close friend, not only do their insecurities lose much of their power because the friend is accepting, loving and validating, but also the friendship reaches a richer understanding and closeness.

Other women find that they don’t have good female companions.  They may be new in the area, are prone to isolating or just lack a comfort level necessary to seek out a friendship.  With those clients I try to help them to identify what it is that  keeps them solitary and what would help them to ease into a close and mutual friendship.   Many times it can be as simple as reaching out to a neighbor, asking a co-worker to lunch or joining a group at one’s synagogue or church. Many women find that they can make friends via their children’s schools with other parents. Often, what seems simple to one woman can be an anxiety filled ordeal for others.  “How do I reach out?”, “What if they don’t like me?”, “They already have friends, why would they want to spend time with me?”   In therapy we  gently examine these fears and explore what it is about one’s emotional core that encourages such self-doubt.  This can be scary and overwhelming, like most big issues in therapy, but the end result can be the birth of an amazing experience: a true friend, someone with whom  you can laugh, cry and share, one of the true gems in life.

Our day ended with a much needed trip to DSW and TJ Maxx to be silly and help to boost the local economy:

Some crazy orange shoes that did NOT come home with us

More shoes that no one could walk in

A local star spotted in TJ Maxx

My hope for you is to celebrate your friendships for they are truly a gift.  If you are one of the many that are seeking a close and wonderful relationship with a friend, but aren’t sure how to start, give me a call, I would love to help  get you on your way.


Let’s Talk About Anxiety

Anxiety. We all get it in one form or another.  The anxious moments before the first day of school/new job, that jittery feeling before a big project or exam or just some butterflies in your stomach for no apparent reason.  That is anxiety; a normal dose of healthy anxiety.  Sometimes a little anxiety can even be helpful.  It can motivate you to study, prepare for a presentation or even train for an athletic event.  It’s when it becomes too intense that it can be problematic.

Anxiety can be a beast.  It can be big, bad and grizzly and can infiltrate your every cell.  Anxiety can be debilitating; some people find that their anxiety keeps them from functioning in every day life.   I have worked with several teenagers  who have so much anxiety that they are unable to attend school.  They become nauseas, tearful or panic stricken; sometimes they can not even enter the school building.

The insidious thing about anxiety is that it can also manifest itself via physical symptoms.  Many times migraine headaches, Irritable Bowel Syndrome,  eczema or rashes are brought on by anxiety.  Our body is a very smart organism; if we are feeling intense anxiety and not releasing it, it can build up and cause these physical ailments.

With my clients, I often ask them to first label where they feel their anxiety.  They look at me like I am crazy  with questioning eyes until I specify my request.  “Where in your body do you feel the anxiety?”  Answers have varied: stomach, head, jaw, heart, chest, even fists (“I clench my fists and want to punch someone”).  We talk about when they notice  the pain, pressure or sensation in that part of the body to pause and be aware.  Sometimes they have the physical feeling of discomfort without being in  touch with the fact that they are “feeling” anxious. Being aware is the first step to healing.

In my office (have I mentioned that I’m a little obsessed with my awesome space?) I do many different exercises with my clients to help ease their anxiety.   Many times after someone has rushed out of work, sat in traffic and just barely  made it to their appointment on time, I ask them to sit still for a moment and take some deep breaths.     Often, they will take quick shallow breaths and announce they are fine (clenched jaw and all).  I then encourage them to close their eyes, really breathe in to expand their lungs and then completely empty their lungs repeating the process at least three times.  They find that when doing the breathing properly they see that they really can slow down, be calm and focus on their session.

Other breathing techniques that I have found to really help with anxiety are for the clients to resume that deep breathing exercise for 5-7 minutes during a later part of the session.  I help them to count for six seconds while they inhale and the same for the exhale while continuously  focusing  on their breath.   Once they are able to sustain that rhythm, we will do some guided meditation work.  I ask them while keeping their eyes closed and continuing the deep breathing to picture a calm setting like the ocean, mountains, or often (especially for teenagers) their comfy cozy bed.  I ask them to imagine being in that place while also maintaining the breathing, I ask them to imagine the surroundings, the sounds, smells and feel of this calm place.  As they connect to this image, I ask them to store it in their memory.  My hope is that when they are feeling waves of anxiety they can return to this place; their image, their breathing and the stored memory of all of the calm cues that they practiced in the meditation.

I tell my clients that, like anything, this technique works best with practice.  Like building muscles at the gym, it requires work, repetition and patience.  If you become anxious one day, close your eyes and command yourself to relax hoping for a “Serenity Now” experience, the technique will not only fail, it will probably make you even more anxious.  I ask my clients to practice this on a daily basis when they are NOT feeling anxious; this can often be incorporated into your (or your child’s) bedtime ritual, or after a hectic day at work, any time when you are committed to being still for  a few moments.

When you find that you are being overwhelmed with anxiety (remember it often starts in those places in your body that had been previously identified) and  have been practicing the exercise becoming  familiar with your particular  process of breath and calming images,  the anxiety can be quelled.   I have had many clients report back to me following a difficult week that the technique does work and they were able to extinguish the feelings of anxiety during a stressful situation.

If you or anyone you know is suffering in this way,  please  contact  me  (or pass this post along). Anxiety can be  very uncomfortable or downright unbearable. No one should have to suffer in this way. There is relief, sometimes we just don’t know where to find it.  I would be happy to help facilitate the process with you.



A recharging during the summer storm

My husband always teases me about needing to be by the tv during our big snow storms. I have the need to see what is going on, listen to every reporter tell us about the lines at the grocery store, the slush along the road and what schools are closed.

Enter June 29, 2012.  Who would have thought the need for storm central would be so, well, central?  Of course, I had heard rumblings of it on WTOP,  my “up to the date news station with traffic and weather on the 8’s”, but what flew by here was not what any of us had expected.

I was  am truly grateful that I was one of the few that didn’t lose power. I didn’t realize the extent of the storm until I was driving around the next morning, talking to people and seeing the many trees down in my neighborhood.

I was reminded of the beauty of community as we went through the weekend.  Of course, this kind of community comes with the age of the internet.  Although many of us were without cell service, internet and electricity, there was enough of it bleeping in and out to create connections and let the locals know who did  and who didn’t have power.

Saturday afternoon, I had my first visitor.  One would assume that with the record high heat, the friend would be looking for some cool air and maybe a cold drink.   WRONG.  I drove up to my house to see this dear friend sitting on my front stoop charging his phone and iPod from my outside outlet.  Hello?

Sunday, we had a full house.  Three different families, by this point having had two nights of very hot sleeping conditions, came by  looking for relief from the heat, and, you  guessed it, plugs.  They all had to charge their phones, laptops, iPads etc.  We joked that we would be charging them by the kilowatt.

What started as a relief from the heat, and the need to “recharge” turned into a lovely and bonding afternoon.  We ate a lot of popcorn, watched the Eurocup Finals (a real live Spaniard and soccer fan in the crew) and had a great spontaneous afternoon, one in which we could “recharge” our friendships and relationships while our iPhones had a charging of their own.

How did you fare the storm?