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10/6/2024 0 Comments 7 Lane HighwaysOne of the things that led me to a career as a therapist was my fascination with how the brain functions. In my first psychology class, I watched a dog trainer guide a dog through the learning process of using the light switch. The dog had never entered that building before, and within 30-minutes, she could turn the lights on and off on command. Inspired by this feat, I went home and attempted to teach my dog the same trick. It took him around 3 days to understand the task. 5 years later, all I had to say was, “Drake, lights!”, and the room lit up in moments.
The way Drake, and all animals (including humans), managed to learn this trick was through repetition and reward. This process creates what are called neuronal pathways. Simply put, a neuronal pathway is the connection from one neuron to another; neuronal pathways are what creates thoughts, feelings, and behaviors. The more we do something, the stronger that connection becomes, which is what helps us form patterns and habits; good and bad. I established a career that largely revolves around helping clients change those patterns of behavior. And, while nearly all of my clients enter the therapeutic space motivated to do just that, the time and energy they spend often does not produce desired results. I often have clients come to me after several weeks saying things like, “I’ve been doing everything I can, but I always seem to fall back into the same pattern”. Naturally, this leads to a lot of frustrated clients! The thing is, there is a reason that behavioral change takes such a long time. In graduate school, I was taught about “resistant clients”, or those who appear to not want to make changes. I often equated “resistant” to “unmotivated” or “stubborn”. But the more I’ve worked with clients, the more I’ve realized that resistance is more often caused by a process called Homeostasis. Homeostasis exists in all organisms and systems. The function of homeostasis is to keep things running smoothly by making things as consistent and predictable as possible. In order to maintain consistency the system in questions is naturally resistant to change. This means that when a client, couple, or family system shows up in my therapy room, they arrive with a pattern of behavior that is working very hard to remain consistent, despite interference or introduction of new components. Imagine a family in which one member has developed issues managing their drinking, which is leading to conflict and discord within the family. One day, that family member decides to stop drinking. You would think that would lead to harmony between family members. But because of homeostasis, the family has become used to conflict. This means it is more likely the family will find other things to fight about, in order to maintain their usual way of existing. This is, of course, not how the family wishes to behave; but it is reflective of a system resistant to change. When clients seem discouraged or frustrated that they can’t seem to make progress, I introduce them to the ideas of neuronal pathways and homeostasis. Therapeutically, I find the use of metaphors to be the easiest approach to explaining therapeutic techniques. The following is my favorite metaphor for helping clients understand why behavioral change can be so difficult. A neuronal pathway becomes easier and more developed the longer it is used. Eventually, it’s like a 7-lane highway. It’s easy to drive on, and you drive on it so often that you know it like the back of your hand. I, as your therapist, have acknowledged that the highway exists, but I am asking you to build a dirt road off of that highway, thus beginning to form a new neuronal pathway. The dirt road is unfamiliar, harder to drive on, and you’re not quite sure where it will lead. And the WHOLE time we are building that dirt road, your brain is telling you “why don’t you just use the highway?? It’s already there and you know it SO well!”. Essentially, the whole time you are in therapy working toward behavioral change, your brain is encouraging you to continue following the neuronal pathways that already exist, in order to maintain homeostasis. It resists change because, simply put, change is hard. So, while it can be done, we have to acknowledge that building that dirt road is going to take time, repetition, and reward. But eventually, it will end up being a new 7-lane highway that leads to a much more desirable destination. It may seem strange to acknowledge resistance to change, but doing so makes it real. It becomes an entity in the room clients can acknowledge and empathize with. “I see you trying to make me stay the same, but changing this pattern will make me/us feel better” is a lot kinder of a thought than, “I must just not be good enough or want it bad enough”. If I can hope for anything, it is that as you read this, you are able to develop empathy for the parts of you that are just trying to make things run smoothly. Our natural, biological mechanisms for existing are not always the most helpful, but their intentions are pure.
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9/5/2024 0 Comments Let's Talk About SexLots of people come to me wondering why it is so hard and scary to talk about sex. Generally, this is a question that is easy to answer, but so difficult to understand. You see, in a sexual relationship, both (or all) partners have the same desire; to experience an abundance of pleasure. But, because of what our cultures have taught us, the endeavor to seek and benefit from pleasure seems to happen in secret.
I have the distinct pleasure of working with couples, triads, and individuals who come to me with the question, “what if I’m not touching/pleasing my partner the right way?”. Usually, when I am asked this question, I interpret it as; “What if my partner is faking it, and I’m not actually as good as I think I am?”. Our lifelong exposure to contrived, performed, inauthentic sexually explicit media (pornography, television, photographs, etc.) has informed us about how to make sex look and sound like it feels good. Unfortunately, we have very minimal education on how to make it feel good. It’s almost like we walk into our shared sex lives with a handbook of all of the “right ways” to be sexual. The problem is that most people have a handbook that differs when compared to their partner. So, when one partner asks for a specific sexual act and it is not in their partner’s manual, a rift may appear in the sexual experience. Generally, in a situation like this, two things happen. 1.) The person who wants the sexual act described above feels weird or awkward for wanting to try something new. 2.) The partner who does not have that sexual experience in their handbook feels inadequate or unprepared. Both partners are concerned that a new experience may be disruptive to their compatibility, so the subject may be ignored or overlooked. My aim as a sex therapist is to empower my clients to have conversations about sex that are future-focused and very low stakes. In the past, I have written blogs about how communication intensifies to a breaking point when the stakes are high. If you want to try a new sex act (let’s say dirty talk), and you walk into the experience thinking you have to be suave and sexy and perfect on the first try, the stakes are so high that it becomes a pass/fail test. The pressure of this standard is quite likely to reduce pleasure for both partners. If instead, partners go into a new sexual experience together understanding that it may be weird or awkward or funny, they can agree that no matter what happens, they are playing together and the play experience doesn’t have to be ruined because things didn’t go as planned. In the event that a client comes into therapy with very high expectations of relatively new abilities, My challenge to my clients is to give them permission to start off “bad” at new things and improve from there. As far as “knowing” that your partner is experiencing the pleasure they would like to have during sex, I like to quote Emily Nagoski, author of Come As You Are and Come Together. At a 2019 conference called Pleasure is the Measure, Emily stated that, “Your orgasm is your responsibility”. While it may be difficult to understand this, given present day sex education, it is not your partner’s job to “just know” how to pleasure you. Partners can empower one another to provide the best pleasure by knowing how they like to be touched and loved and sharing that. While I could geek out on this topic for days I will leave off this blog with just a few tips for how to reduce the stakes, increase the play, and take responsibility for your pleasure! Study your own body: Self-pleasure is such a beautiful thing, whether you are enjoying a hot shower, a wonderful book, or a lovely solo session with your hand or your favorite toy. You are giving yourself permission to explore without the need to “perform” pleasure for someone else. Self-pleasure is an opportunity to explore all of your “yes” spots, so you can educate your partner on your pleasure. Talk about sex early: When you meet a new partner, starting a conversation about sex early establishes the precedent that “in this relationship, sex is a safe topic”. Knowing that sets a welcoming stage and reduces stress and anxiety about the conversation. Forget the “other voices”: There is a lot of background noise that can show up during sexual experiences. Whether it’s church, friends and family, sex education, or mainstream media, there is a lot of information about what sex “should” look and feel like that may not fit for you. Prioritizing what works for you and your partner should outweigh any external voices. Reduce the stakes: Sex is play. It’s not a performance, nor is it a test! It’s not an activity we go into with the intention of measuring our value as a person… at least it shouldn’t be. If you are playing with your partner, you have permission to make mistakes and fumble, without failing or “ruining” the experience. My mantra for clients trying new things is “we’re either going to laugh or cum… or both”. Communicate often: In a lot of unhealthy sexual relationships, the conversations about sex only come up when there is a problem. Problem-focused communication is very likely to create guilt, embarrassment, and/or resentment, and may set partners up as adversaries. If conversation about sex is welcome at any time, partners may get used to talking about fantasy, creativity, and play, so that if feedback comes their way, they know it is given with the intention of improving mutual connection, rather than educating one “problem person”. Becoming a sex therapist has been (mostly) an incredible experience. I have the privilege of walking alongside clients who are struggling with intimacy and relationships, whether it is due to trauma, poor communication, or a desire for exploration. I am honored when clients report feeling excited and empowered to engage in healthy, bountiful intimate lives as a result of their hard work.
Unfortunately, no career is without its drawbacks. In my line of work, I am also exposed to the harmful effects of inadequate sex education, which can lead to disillusionment, fear, and shame among many other side effects. Many clients need to unlearn harmful beliefs before we have the opportunity to discuss healthy sex. While helping clients rewrite these narratives can be an incredibly rewarding experience, it also saddens me that so many of them have endured so much pain, especially since they often feel isolated or alienated. One topic I encounter very frequently is that of compulsive sexual behavior, or what is more commonly coined as “sex addiction”. There is a great deal of misinformation regarding this type of behavior, but the American Association of Sexuality Educators, Counselors, and Therapists takes a firm position when it comes to the topic of “sex addiction”: AASECT “1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be informed by accurate human sexuality knowledge”. This statement, in essence, means that treating compulsive sexual behaviors as an addiction is more likely to do harm to clients. After all, who is to say what is too much sex or what constitutes healthy sexual behavior? There is no universal baseline upon which all individuals should base their sexual behavior. To be clear, this does not mean that sexual behavior cannot become a focal problem in a person’s life. Like any compulsive behavior (shopping, stealing, video games, etc.) sexual urges and pornography consumption can cause significant distress and are worthy of treatment. If a client is reporting significant problems in their relationships, work, or their ability to complete necessary life tasks, I am likely to label the problem as compulsive sexual behavior and treat it as such. Most compulsive behaviors create a sense of satisfaction with diminishing returns, thus leading to escalation. However, these behaviors rarely resolve the real problem. My outlook is that every behavior or pattern intends to meet a need or create positive outcomes. Sexual behavior is no different. There are a lot of reasons clients report turning to sex as a comfort behavior: among them are suppressive education, relational differences in desire, high stress, or deviant (i.e., atypical) desires. After normalizing that there is no “normal” way to be a sexual being, my mission becomes to identify the relevant problem or need causing the behavior. Consider this simple, empathetic metaphor for compulsive behavior: “You’re in a desert, starving. You find an oasis filled with pineapples. Any sane person would eat the pineapple, even if they are allergic to it” You see, compulsive behaviors are used in absence of an alternative. A person taught to feel shame related to their sexual urges may fear being honest about them. When suppressing these urges proves ineffective, they may use pornography as an outlet. Given the relief they may feel to finally have an outlet, they pursue it more and more, until it becomes a problem. Instead of treating the outlet, my job is to help the client find adaptive solutions for their distress Among many options, these may include: Taking ownership of sexual desires Education about healthy sexuality Self-soothing techniques from distress I find that this approach produces the most effective results, especially when it comes to improving communication about sexual needs and desires. Clients often report a reduction in shame when thinking about their sexual selves. If you, your partner, or a loved one are struggling with sexual compulsivity a sex therapist, especially one certified by AASECT, may be the healthiest and fastest way to find relief! 7/9/2024 0 Comments I'm Rubber, You're GlueA Guide to Setting and Honoring Boundaries Because clients don’t exist in a vacuum, therapists often explore how they are impacted by others. This creates space for a conversation about boundaries. While this can be a beautiful and impactful conversation, it often requires a lot of intense and difficult soul-searching. While hopes and goals for relationships can be very flexible and may change over time, interpersonal boundaries are reflective of needs, values, and expectations from every relationship.
When informed that these terms are not interchangeable, clients often indicate that they don’t know how to set and hold good boundaries. When I hear this sentiment, a saying comes to mind; Good fences make good neighbors. In a culture where we are taught to be kind, empathetic, and patient, it can be very difficult to say no. But saying no when you need to makes it easier to build trusting relationships. The “fence” is the boundary and the “neighbor” is the relationship. Fences are built with the intention of maintaining safety and self-respect while still honoring your desire to build a relationship with your neighbors. If you aren’t sure how to build a good fence, consider using the tips below as a starting point. Good boundaries share the following five characteristics: Non-negotiable If you say no to someone to stay true to your values, they may try to convince you to give a different answer. Unfortunately, if you “fold”, it can leave someone with the impression that you are more flexible than you’d like. Good boundaries can be flexible, like rubber. Breaking through rubber requires effort, but it is not rigid. Special circumstances (settings, people, etc.) may require you to be more rigid or flexible. That said, it is up to your discretion to determine how you want to enforce your boundary. Whatever expectation you set, the other person should stick to, like glue. Clear and specific A boundary has expectations that are clearly outlined. Blurry boundaries leave cracks and are more vulnerable to violations. To set expectations, you may need to reflect on your values and explore where you are most at-risk of being diverted. Consider the following: How does it protect you? To whom does it apply? When should you establish it? When should you evaluate and adjust it? Reasonable consequence Knowing what will happen if a boundary is violated is empowering. You have essentially created a script to follow when someone pushes your boundary; If ____ happens then ____ will happen. Consider what is within your power to do if someone breaks a boundary. Consequences are not punishments, but rather steps toward maintaining safety. Here are a few examples::
About your behavior Notice how all of the consequences above include the word “I”. The best way to honor your boundaries is to ensure that you are in control of what happens. It might feel easy to tell someone that they can’t or have to do something, but it is impossible to control how they behave. Enforced every time When considering boundary enforcement, another saying comes to mind: “The people who are resistant to your boundaries are those who benefitted from you having none. “ Creating a boundary may seem easy, but enforcing it can be incredibly difficult, especially when setting new boundaries in an existing relationship. We often avoid boundaries for fear of hurting feelings, coming across as rude/mean, or losing the relationship entirely. That said, boundaries exist for a reason, and the people who deserve to be a part of your life should honor them. Here are some gentle reminders that may help with enforcement:
Below are a few examples of strong boundaries; of course, this is not a comprehensive list of ideas, as all boundaries are situational and subjective. But these may spark some good ideas for boundaries you’d like to set and explore!
As noted above, setting and maintaining boundaries is hard work. If you need assistance in building up the strength and confidence to do so, working with a therapist may be the most helpful pathway to follow! 7/9/2024 0 Comments Therapeutic Swear WordsRemoving some words from our vocabulary is extremely easy. If a word becomes taboo, for example, it only takes a few dirty looks from strangers before the word begins to fade from use. There are some words, however, that seem harmless on the surface but can do a lot of damage if left unchecked. I’ve decided to call these Therapeutic Swear Words. Here are just a few of the words I have added to my own list of TSWs, and potential alternatives.
Should - This is a word which comes with an inherent judgment. Saying “I should be able to work through this problem” implies if you cannot, you are somehow failing. Some people have already noticed the problem with overusing this word. I have heard the saying “Should is a dirty word!”, or in more playful terms, “Stop shoulding all over me!” So, how do we work towards eliminating this word? Here are a few things I have tried. “I could solve this problem, if I had more time.” “I need new tools to help me solve this problem.” “I want to solve this problem.” All of these options allow space for a person to feel disappointed the problem is not yet solved, while also creating a job for improving the pattern (i.e., finding new tools). Maybe - Realistically, there are many times when this word is valuable. When it is used as an unnecessary qualifier, that is when it becomes a TSW. For example, “Maybe I’m just not ready yet.” Often, we use maybe to lessen the impact of a statement on another person. However, the cost of protecting another person can be sacrificing a need of your own. In this case, I suggest eliminating the word if it is not imperative to the statement. If you truly are not sure how you feel about a specific issue, this is a perfect word to use. Otherwise, stick to your guns and say what you feel! Sorry - Culturally, we hear a lot about this word. When someone apologizes too much, they often get some sort of reprimand from those who care about them. But what is it we are trying to communicate when we say sorry? More often than not, we are trying to say thank you to a person for making space for our needs. For example, if I had to send food back at a restaurant, I may say “I’m so sorry” to the server. What I really mean is “Thank you for not making me eat this bad tasting food.” While there are times in life where an apology is warranted and necessary, overusing the word sorry can lead to feelings of guilt and distress. As I said, this list is nowhere near comprehensive. My suggestion to you, reader, would be to think of the words you use everyday that could be sending the wrong message. Pay attention to when and why you say them, and look for alternative words or phrases which send a more positive message! When we encounter problems in our lives, we all have instincts for how to manage and resolve them. These instincts come from social learning and observation of behavior models in our lives (i.e., parents, teachers, coaches, etc). While we can get helpful tips and tricks for conflict resolution, we are often impacted by a sense of urgency. This can render these tips ineffective. For example, I was once taught to make a pros and cons list whenever I encounter a problem to help me decide how to proceed. This is a wonderful tip, but only comes in handy when I fully understand the problem at hand.
When I sit down with my clients and discuss conflict resolution, I have one motto: Slow is fast! If we can take things slowly and fully unravel the problem, we can resolve, not just the current issue, but the overall pattern. Doing so will create meaningful, lasting change, rather than temporary relief. During the hundreds of session hours being devoted to conflict resolution, I began to notice a pattern; conflict tended to become exacerbated when one client was ready to implement a resolution and the other appeared to have just realized there was even an issue. There is a model called the Transtheoretical Model, which indicates that there are 5 stages of readiness for change when an individual encounters a problem. If a person is not ready for change, it is more likely that any strategies implemented will likely revert back to the original behavior, rather than lasting. Click here for more information on the Transtheoretical Model. While that framework is incredibly useful for deciding when a person may be ready for change, it doesn’t speak to what steps need to be taken for a person to get to that point of readiness. So, I used my experience with conflict resolution to develop a new framework for clients that could help them get ready to make changes. I call it the Four Stages to Every Problem. Below, I have listed and defined each stage. 1. Realization - During this stage, a person will be coming to the conclusion that they are experiencing a problem. They may notice that something isn’t aligning right in their world or recognize a need for change, but do not have a direction for how or what to change. 2. Integration - During this stage, a person will begin to explore how the problem is impacting their internal world as well as their surroundings. They will ask themselves questions about the magnitude of the problem, who is impacted, and what needs the problem is creating. 3. Solution - The solution phase is for brainstorming different ideas and actions that may create some relief. During this stage, clients will explore several different pathways they could follow to resolve the issue, or make it at least slightly better. They will also consider whether they have or need to get all of the necessary components to implement their solutions. 4. Implementation - During this stage, a person will put one or several of their brainstormed solutions into action. They will give it some time (I recommend at least two weeks) to see how the solution(s) impact their routine, their wellbeing, and their overall sense of relief. If things are going well, the person can decide to maintain the new solution(s) and continue evaluating in the future. If relief is only slight, the person can adjust frequency or intensity of their solution(s) and reevaluate the relief they are experiencing. If minimal or no relief has been created, the person will step back into stage 3 and adapt their solutions using the new information from the first trial. This model can be completed individually or with a partner. No matter who is involved, it is important to give yourself permission to step back into a previous stage if you feel more information is needed. I believe that when we try to move through the problem too quickly, it can cause us to miss valuable information, which makes it more likely that the problem will repeat itself. Download the PDF file below for some helpful questions to help you navigate each stage! One last note: for more difficult problems or conflicts, things can become pretty tense between partners, especially when there is a disagreement with how to resolve the issue. If you or your partner notice this tension, it can be helpful and expedient to engage with a therapist, who can serve as a neutral party and help you find a mutually beneficial solution. In the last several years, we have become a culture that is divided and afraid of “the other side”. When we hear something offensive we tend to jump to anger which furthers an already huge gap. This is especially true because our culture has not set us up with a way to give feedback that isn’t divisive. This generally results in feedback being met with defensiveness or shame. After several ruptures in like this in communication, resentment can build up for both partners. As a result, feedback is often avoided which can create resentment. The longer resentment builds up, the more likely we are to explode on partners, friends, or family who continue to do offensive things, especially when they are unaware of the problem.
There is an alternative method of getting feedback called “Restorative feedback” which is feedback that relies on empathy, connection, and future hope. The goal is to create repair for the person who feels hurt by a situation, while not shaming the offending person for their behavior. Restorative justice isn’t our natural inclination, so adjusting to this behavior may be challenging. When teaching my clients to make these adjustments, I walk them through a few simple steps! Setting the stage 1. Gain permission to give feedback Making sure someone is in a good mental/emotional state to hear feedback is the first ingredient in the recipe for success. If they say it is not a good time for them, it is important to schedule a conversation soon, so it doesn’t slip either of your minds. 2. Find an appropriate setting If you’re in front of others or in an uncomfortable space, hearing feedback can be extra challenging. Most ideally, you can create a space where you both feel physically comfortable, can face one another, and there are as few others/distractions as possible. Expressing Empathy 1. Recognizing their intention Generally, people have innocent intentions, even when they do offensive or hurtful things (i.e., creating laughter/connection, checking a bias/learning something new, or giving a compliment). Unless you have compelling evidence to the contrary, assuming positive intent and letting the offending person know that is what you’re doing can be an effective way to keep you both on the same team.. 2. Recognizing aversion to feedback and expressing your intentions As I mentioned above, it’s pretty safe to assume a person receiving feedback will have a primarily negative reaction (i.e., defensiveness, anger, shame, etc.). As such, it can be so helpful to remind them that is not the reaction you are seeking. Expressing hurt feelings 1. How it hurt you If someone says or does something that specifically wounded you (i.e., making fun of a disability you have) it is important to let them know, using feeling words (if you find it challenging to express feeling words, you can access a great resource at https://feelingswheel.com/ ). 2. How it may hurt others Some errors in behavior may hurt other people (i.e. a comment rooted in racial bias). Whether you belong to that subset of humans or not, it may be helpful to express the potential feelings that may occur if that audience were present. Expressing opportunities for repair 1. Behavioral adjustments Giving the person examples of how you’d like them to behave or speak in the future is indicative of your desire to continue interacting with them, which may keep you on the same team. This could also help them to understand what rules are present in your relationships, especially when their behavior was triggering. 2. Learning opportunities Often, marginalized populations feel obligated to educate offending people. While that would take a lot more time or effort than some are willing/able to put in, it may be helpful to point that person to some helpful resources (i.e., people, books/podcasts, lectures, etc.) so they can do the learning themselves Here’s an example of how this might look: “Hey, can we step into the other room really quick and talk? I know you like to make jokes and it’s usually awesome to hear them! I know feedback can be hard to hear, but please know that I’m telling you this so we can avoid future issues. Here goes: When you made that joke about __________, it made me feel sad/hurt. I would really appreciate it if you would stop making jokes about __________, especially around me. If you want to know more about why that kind of thing is problematic, there’s this really cool ________ that you could check out. Let me know if you have any questions!” It is my hope that after reading this, you might be willing to try restorative communication with as many people as you can. Together, we can combat the divisiveness in our culture and bring people back together! |
About the author:Leighanna Nordstrom, BS, MA, MFT-C Archives
October 2024
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