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 Breast cancer is the second most common type of cancer in women. About 1 in 8 women born today in the United States will get breast cancer at some point in their lives.

Although these are daunting statistics, the good news is that the majority of women can survive breast cancer if it’s discovered and treated early.

Women who hear the words “You have breast cancer”are catapulted into a new reality immediately upon receiving their diagnosis. It can help to talk to a professional about your feelings, thoughts and fears. Please do not hesitate to call me if this is what has happened to you or to a loved one. I have walked that road and have the wisdom, training, and life experience to offer compassion, empathy, and direction. You can reach me at 619 9906203.Look around my website to learn more about me and get some free tips just for stopping by at http://www.cunninghamtherapy.com
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I am an MFT at the doctoral level. In my work at Affordable Relationship Counseling, I encourage clients to work on their current relational challenges by researching their multigenerational family stories. Over the holidays, I picked up a novel entitled BREAD GIVERS by Anzia Yezierska. I opened it without any more interest than that it was set in 1920’s Lower East Side New York and that, like the earlier experience of my maternal grandparents, it described the Jewish journey of immigrating to the U.S. from Russia during that historical period. Little did I know that within these pages, it would seem as if my mother was communicating with me from heaven about what it was really like for her as a young, Jewish girl and as a teenager. Fiction and nonfiction merged in my brain and my eyes were awash as I imagined how important the sense of belonging and material safety must have been to children of immigrants.

To differentiate a self as protagonist Sara Smolinsky did eluded my mom. Mom was a redheaded beauty. Appearances were of prime importance as providing carte blanche to becoming a successful homemaker with the means to be comfortable. My mother was the third of four. She had one sister, twelve years her senior, a brother who was nine years older and a brother three years younger.

Life was tough in NY for Jewish immigrants like the Smolinskys. Like my grandfather, Sara’s father was pious (he was an Orthodox rabbi) and also very poor. Like Sara’s mother, my maternal Bubbe did not want her daughters to waste time or money to educate themselves. She worried about them having a good life. A secure life, unlike her own hand-to-mouth struggle from day to day. She hoped that her girls’ future would be secured by a good marriage to a successful, Jewish man. This chronic anxiety about her daughters’ mating outcomes had a multigenerationally transmitted quality and, as theoretically predicted, my mother had transmitted it to me in spades. Such anxiety is rarely useful when one is of the age to settle down and be of calm enough mind to intelligently choose a mate.

After I read the last page of this novel, my understanding about so many mysteries about the marital failures in my own family had deepened. It was as if this piece of historical fiction offered me the insight I might have gained if I had gone back to visit my Mom in a Time Machine. Thank you, Anzia Yezierska!

For more information about Dr. Cunningham‘s model of practice, call 619 9906203 0r visit www.cunninghamtherapy.com

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San Diego Relationship and Marriage Counseling

Model of Therapy and Theory of Change: Underlying Philosophy and Theoretical Assumptions

My guiding principle as a clinician is Bowen family systems theory (BFST).  I believe that family dysfunction is rooted in the extended family system.  Unresolved conflicts from past generations and from childhood continue to be acted out in relationships in the nuclear family.  It is assumed that external systems often determine intrapsychic feeling states, and that it is important to understand both the “. . .historical process in the family and the larger social context in order to transform family relationships in the present” (McGoldrick & Carter, 2001, p. 282). Furthermore, it is assumed that “. . . if one person changes her or his emotional functioning in the family, the system will eventually change.  In this framework, family relationships are forever, and it never makes sense to write off a family member once and for all” (McGoldrick…

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Affordable Marriage Counseling San Diego

Dr. Barbara Cunningham, licensed marriage and family therapist, urges couples to seek marriage counseling sooner rather than later. Here are three reasons why:

1.: Research suggests that couples do better when they do not “stonewall” or turn away from one another when upset about an issue. Counseling provides a safe “holding” environment to discuss and process the “tough” stuff in a way to move your relationship forward instead of getting stuck in the mire.

2. Marriage is worthy of your best effort. It is not “automatic” to succeed at marriage. If it were, there would not be such a high divorce rate. Get professional help to give your partnership the best odds of success.

3. Marriage involves going from independence to interdependence. This may require a bit of coaching during the first year.

Barbara is happy to answer any questions you may have by phone to see if it makes sense to book an initial appointment. Call her at 619 9906203 or visit her website at http://www.cunninghamtherapy.com for more information

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At Affordable Relationship Counseling in San Diego, CA , licensed marriage and family therapist, Dr. Barbara Cunningham, often sees clients who present with issues of loneliness around the holidays. It seems that people feel a heightened sense of loss around Thanksgiving and Christmas. Television, movies, magazines, and advertisments seem to emphasize pictures of happy families that are a stark contrast to what people wish they had in their own lives. Often times burned bridges and broken dreams come into bold relief at this time of the year and make it most difficult for people to get through the days of gift giving, Christmas carols, and holiday mirth. Allowing people a safe holding environment to process feelings of vulnerability may be a beginning point.  It takes courage to begin the therapy process. Talk therapy is a proven way to begin. Research has shown that isolation is not good for one’s overall health. If one is not connected, or feels isolated, one is at risk for myriad health problems. Human beings are a social species.  Adaptation to loss can, over time, bring increased integrity and deeper meaning to life. To learn more about Dr. Cunningham’s strength based model of practice, call 619 9906203 or visit her website at http://www.Cunninghamtherapy.com to get more information.

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Sex addiction is on the rise in India“Families with multiple generations of addiction often tell ‘war stories’ about the previous generation. Frequently, stories are told as jokes because they are so improbable. If grandpa was so drunk he missed the garage and drove into the living room, the family laughs as a defense against the tragedy and chaos of the event. For a child listening , such pandemonium can be concerning, but the child’s reality is everyone is laughing. The incongruity may make it hard for the child to ask questions. After all, if the situation is scary to you, but funny to everyone else, then there must be something wrong with your perceptions.”

-Dr. Patrick Carnes, Recovery Zone, Vol 1. (Pg 137)

Since San Diego’s Mayor Bob Filner has been a heated subject of controversy, the topic of sex addiction has dominated the air waves in our town. I have often depicted sex addiction as a disease of intimacy. Like all forms of addiction, I consider it an escape from uncomfortable emotions associated with close relationships with significant others. Addictive patterns that trigger compulsive behaviors often result in surges of neurochemical highs, whether from behaviors such as sex, drugs, alcohol, gambling, eating, etc., and such behavioral habits can rarely be addressed in short term behavioral therapy. It took a long time for people to be wired by their formative experiences and it will take a long time to rewire their brains to react differently.

Make no mistake, I am a great believer in the transformative power of psychotherapy. I just do not believe in tips, tricks, tools and techniques…psychotherapy should not be “showtime.” It is process. I ask my clients to trust in the process. I ask them to be patient with the process. Developing insight takes time. Hard work. Asking the right questions should generate more questions. Sex addiction, like other addictions, is an ineffective coping mechanism used to self soothe and to escape from the discomfort of intimacy.  Those who would have sex without considering longterm, potential consequences to their behavior have an opportunity to look for ways to heal the wound within, so they can, over time and with a lot of hard work,  increase their capacity for intimacy. To learn more about Dr. Barbara Cunningham, MFT, visit her website at http://www.Cunninghamtherapy.com or call 619 9906203 for a complimentary telephone consultation.

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At Affordable Relationship Counseling, , Dr. Barbara Cunningham offers couples counseling to couples expecting their first child. She encourages new parents to seek counseling as insurance, knowing that such transitions can add stress and create challenges going forward into new roles and responsibilities. With evening hours to accommodate working couples and affordable rates, Dr. Cunningham can work with couples to get them onto a path assuring success. As wonderful and miraculous as a new baby is to both parents, all change brings with it accompanying adjustment and resultant stress. To learn more about her expert marriage counseling services, visit her website at http://www.cunninghamtherapy.com or call 619 9906203 for a complimentary telephone consultation.

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At Affordable Couples Counseling in San Diego, California, licensed marriage and family therapist Dr. Barbara Cunningham offers couples the opportunity to strengthen the foundation upon which their relationship rests. Research suggests that couples wait an average of six years before seeking help when their relationship is in trouble. The stigma attached to seeking professional help is still ever present in our society. Yet it is far cheaper and the course of therapy may be significantly shorter if couples begin sooner rather than later when their relationship becomes “stuck” in unhelpful patterns.

Premarital therapy offers couples opportunities to discuss hot button issues in a safe, holding environment with a neutral third party. Professionals can facilitate discussion and encourage the respect for difference typified in the healthiest of marriages.

Interestingly, one of the least happy times in marriage may be after the birth of the first child. Often times, the father may feel pushed to the “outside” with the demands of a newborn. Working on the marriage during the pregnancy and preparing for the birth may be a wise investment. A division of labor generated in advance, for example, is one idea that may be helpful.

Distancer/pursuer cycles can create chronic problems that increase the intensity of dissatisfaction on both sides. Such problems are better addressed early on.

To learn more about Dr. Cunningham’s marriage counseling and couples counseling services, visit her website at http://wwww.Cunninghamtherapy.com or call her at 619 9906203 for a complimentary phone consultation

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At Affordable Relationship Counseling, Dr. Barbara Cunningham is guided, in large part, by the principles of Dr. Murray Bowen. Dr. Bowen offered a broad perspective on viewing clinical problems. He required an assessment of contextual factors within and between generations as far as one could research facts of family functioning. Such an assessment allowed one to view individual and family functioning as one might view a football game at the top of the bleachers instead of on the fifty yard line. What follows are favorite quotes on the subject from this seminal thinker in the field of marriage and family therapy as well as from E. O. Wilson., who influenced Dr. Bowen’s thinking.

“Family systems theory is based on the assumptions that the human is a product of evolution and that human behavior is significantly regulated by the same natural processes that regulate the behavior of all other living things.”

‘”Symbiotic relationships are a fact of nature and have an important evolutionary function.[Even]…the mother-patient symbiosis observed in schizophrenia was based on a deep (in the evolutionary sense) biological process as well as on a more obvious psychological process.”

“If animals are forced into abnormal proximitiy, they will seek distance through other means, such as hiding or averting direct gaze (E. O. Wilson, 1975)

“Differentiation [is a concept that] defines people according to the degree of fusion between emotional or intellectual functioning. This characteristic is so universal it can be used as a way of categorizing all people on a single continuum. At the lower extreme are those whose emotions and intellect are so fused that their lives are dominated by the automatic emotional system. These are the people who are less flexible, less adaptable, and more emotionally dependent on those about them. They are easily stressed into dysfunction, and it is difficult for them to recover from dysfunction. They inherit a high percentage of all human problems. At the other extreme are those who are more differentiated…[they] are more flexible, more adaptable, and more independent of the emotionality about them. They cope better with life stresses, their life courses are more orderly and successful, and they are remarkably free of human problems.”

“The concept of differentiation has to do with self and not with others. Differentiation deals iwth working on one’s own self, with controlling self, with becoming a more responsible person, and permitting others to be themselves.”

“All things being equal, the basic level of differentiation is finally established about the time the young adult establishes self separately from his family of origin.”

“Levels of differentiation are transmitted from generation to generation.”

Dr. Barbara Cunningham offers evening hours to accommodate working people who seek couples counseling and she also offers affordable rates. Her San Diego counseling office is located in the heart of Mission Valley and is open Mondays through Thursday’s. Call her for a complimentary telephone consultation at 619 9906203 or visit her website at http://www.cunninghamtherapy.com to obtain more information.

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At Affordable Relationship Counseling in San Diego, California, licensed marriage and family therapist, Dr. Barbara Cunningham, often suggests books to her clients that might lead them toward making deeper meaning of their own life experiences. TUESDAYS WITH MORRIE, by Mitch Albom, which covers existential themes, is reviewed below.,

“If you’ve found meaning in your life, you don’t want to go back. You want to go forward.” -Morrie Schwartz

The symbiotic nature of the mentoring relationship through time and space is beautifully depicted in TUESDAYS WITH MORRIE by Mitch Albom. Indeed, the term “mentor” is eponymous with a character in the Odyssey, who advises Telemachus, and pushes him forward in his search for his father. It is especially instructive for the student of marriage and family therapy studies to read TUESDAYS WITH MORRIE as if he were assessing both men from the psychosocial, contextual, and lifespan perspectives. From each of these vantage points, the careful reader will not only internalize Morrie’s lessons, but also become aware of changes in both men as a result of their interaction over time and space. Thus, observing both intrapersonal and interpersonal movement as well as changes one or both men make in their larger environments is cogent to the student of systems. In an effective manner, this remarkable bestseller serves as a kind of adjunct text for individual and family life cycle development students, for it will demonstrate to the budding clinician the notion that everything is connected and must, therefore, be interpreted in a contextual manner, and that when change occurs within one person, change will also become apparent in all whom he/she touches. In a Virgina Satir-like manner, the reader will be taken on a peak experience, the emotional learning experience, the real stuff of learning…the kind of teaching mold from which Morrie Schwartz emerged: the Confluent Educational Movement of the Sixties.

Clearly, Morrie, the former Brandeis, sociology professor of 37-year-old Mitch Albom, is not an ordinary man. He is an extraordinary man whom we meet as he faces his own slow but steady death from Lou Gehrig’s Disease; he is inspirational, because he exemplifies the apex of emotional maturity. It is with a sense of concomitant awe and recognition of developmental stages completed in a timely fashion that we watch him transition into this final life stage, exhibiting a joie de vivre to the end.

On the other hand, Mitch, consistent with his pattern of disconnectedness and negative feelings over his previous life cycle stages, has lost touch with his beloved professor since he graduated in ’79, despite his intention to always keep in touch. It is not surprising that he did not follow through, for in letting important relationships like the one he enjoyed with Schwartz go, we realize that he is merely following a familiar pattern of letting go all that is important to the heart. So, as might be expected, he has also lost touch with his old friend, his wife, and, ultimately, with the essence of his own personhood. In the fast-track culture in which he lives, a culture which is more egocentric and self-serving than those of other times, Mitch shows how his emotional maturity has been retarded by the interplay between family of origin issues and the materialistic values of his generation. His drive to succeed in the business world at the expense of his sense of connectedness to others suggests both a fear of intimacy and an abiding external locus of control (defining his worth in terms of society’s definition of success).

The question of individual differences in native-born resiliency should also be compared and contrasted. Morrie, who had a childhood colored by the loss of his mother, and impoverished further by a cold, distant father, apparently overcame even these attachment challenges, as can be inferred by his admirable responses to his final developmental tasks–end stage intimacy outcomes are positive and, this, in large part, results in an integrity of the life review. It is clear that Morrie displays an emotional maturity impressive to any lay person or to any clinician. Probably not lagging seriously in prior developmental milestones despite non-normative changes in earlier life, the clinician might have to consider biological, individual variants. This humanistic professor, product of the idealistic Sixties, well represents Steve Wolin’s Challenge Model of Resiliency (1991). No Damage Model was Schwartz, but rather a stellar example of initiative, humor, creativity, healthy relationship attachments, independence, insight, and morality.

Albom, a successful sportswriter and unsuccessful spouse, is lurched back in time when he mindlessly but serendipitously sees an ailing Morrie beamed into his living room from his television, which is tuned into Ted Koppel’s Nightline. He is transfixed as he hears how Morrie intends to ‘teach’ his last course to a nationally televised audience: a course on how to live even while dying. The dialectic of teaching others how to live while in the midst of facing death and even enjoying one’s last days when physical handicaps demand a return to the dependency of childhood is difficult at best (especially if one can smile despite needing someone else to ‘wipe my own ass”).

Morrie’s palpable enthusiasm to Mitch’s return to his life is illustrative of Morrie’s ability to enhance and enrich his own growth and development through connection. His manner of finding the positive in perceiving transitional challenges, thus reframing what might have once seemed overwhelming, buoys his journey, for it is all about the ability to live in the moment and in so doing, achieving a kind of freedom which subsequently empowers him to creatively move through and onward to the next milestone task in his life cycle.

Indeed, Morrie delights in the prospect of teaching Mitch one final class: in it, he sees his opportunity to generate wisdom while completing an important task during the last life cycle stage, a life review. Through Mitch, Morrie will also re-connect with a piece of his past, tasks which are generative and are consistent with what is important to do during the eighth life stage.

Thus, in what will prove to be a mutually beneficial partnership, the young man and the old man agree to meet every Tuesday for fourteen weeks. Through deeply affecting dialogue, Morrie offers consummate love, liberally spiced with humor, aphorism, examples, reminiscences, and philosophy. Schwartz personifies successful completion of the developmental tsks of Eriksen’s seventh and eighth age life stages.

Conversely, through Mitch, the training clinician sees what it looks like to not age well…what it looks like when a man has experienced significant failure in negotiating the earlier developmental tasks of adulthood. Morrie offers a picture of intimacy instead of isolation, of generativity instead of stagnation and of ego integrity instead of despair. On the other hand, in listening to Morrie, Mitch, who feels an intensified awareness of his years of isolation and angst of emptiness, is in increasing pain and paralyzed to move forward. He can now admit his drive toward materialistic acquisition has been tragically misplaced over many years. As the sole audience for Morrie when he completed his life review, Mitch became empowered to reframe his own notion of what it meant to live and be a success.

The astute, psychologically-minded reader could handily identify points at which Albom hit developmental lags, just as Albom identified them himself as he listened to Morrie’s review of his own rich life course. Albom effectively illustrates how individuals are agents of change in one another, and then how profoundly individuals affects one another from differing generations, historical contexts, cultures and life experiences intersecting.

As a result of what had synchronistically become a highly successful theraputic alliance, Mitch begins to question his values and reorder his priorities. Most impressive to the training clinician is the fact that Morrie has moved him forward in his individual development, evidenced by his initiative in reconnecting with his brother, suffering from the same disease, from whom he had been estranged for many years. Morrie is able to go ever so ‘…gently into that good night’ (rather than railing against death, as Dylan Thomas exhorted his father to do)after completing his life review, taking joy from his own initiative in getting on Nightline, teaching a former student their mutually, most memorable class, his involvement in a book project, and organizing his own living tribute memorial.

From a holistic perspective, we see in these two men an example of the systemic concept that the whole is greater than the sum of its parts. Teacher and student are profoundly changed by and through one another. Teacher is empowered toward a more joyous letting go of mortality intersecting with his memories of his past history.

Though not free of stressors, he sees it as a life well-lived, exemplified and capped by his ability to be of benefit by connecting with a younger individual.

Conversely, instead of feeling the joys of intimacy through ties to mate, work, and larger society, Mitch suffered an emptiness borne of his compulsive need to define his success in material terms, not serving his healthy development. Mitch is a man whose psychosocial development got ‘stuck’ somewhere in time. Morrie models generativity when most people would allow the physical stagnation to spread to emotional anguish and/or stagnation, thus cutting off their life force energy in spite of the fact that they are still blessed with life.

The importance of connectedness between generations, within families, extended families, communities, career netweorks, agape friends, and between hearts and heads is repeatedly driven home throughout this spiritual book. With each metaphorical example, the reader is charged and changed. Circular causality is on bold parade as Morrie’s empending death marches toward finality before millions, and it is Mitch who, at the same time as his demise, seems to be reborn. Rippling further outward, Morrie’s exemplary way of dying is portrayed to a nation of television viewers, also affected, by witnessing Morrie’s inspirational approach up close and personal. Most saliently, Morrie offers himself to Mitch as an opportunity to develop intimacy with another human being, perhaps the crowning human achievement and one that has eluded the younger man until his professor’s death. Thus, old and young men goad one another toward increasing their respective levels of emotional connection in facing death by and through

one another. By comparing and contrasting where each of these men are when we meet them in terms of their lifespan stage and how each of them subsequently handles the respective tasks that their chronological age suggests, the student can see how feedback loops compliment the completion of milestones within a specific context.

It is difficult to say who got more out of the Tuesday meetings: Mitch or Morrie. Is there an irony to the fact that when people are dying, the living seem more able to hear what they have to say? Should an individual’s ability to reverse developmental emotional retardation as a result of their vertical communication with another be questioned? Did Mitch, in fact, change enough to donate a portion of the proceeds from his bestseller to Lou Gehrig’s Disease research” The circular causality of human interaction and the dialectic that it is possible to find joyous tranformation on the other side of painful transition, even unto death, is part and parcel of the beauty in this little book.

At the close of TUESDAYS WITH MORRIE, Morrie tells the story of a wise, little wave reminding another frightened little wave that he is ‘not part of a wave, [but]part of an ocean.’ Morrie Schwartz and Mitch Albom are testament to Katherine Kubler-Ross’ assertion that ‘…one of the most productive avenues of growth is found through the study and experience of death…individuals who have been fortunate enough to share in the death of someone who understood its meaning seem better able to live and grow because of the experience. Indeed it is patently clear that human beings do have the capacity to utilize an interpersonal relationship positively and move themselves forward, especially if the context is right. Morrie’s life–and death–reflect a man whose ego identity thrived as a result of the composite power and cumulative wisdom of most of his life choices. As Eriksen asserts, ‘Those who can accept [death]accept the whole [more than the sum total] of their own lives and those who get to such a point of maturity find that death loses its sting.

Morrie tells Mitch that “We have a sense that we should be like the mythical cowboy…able to take on and conquer anything and live in the world without the need for other people.” Poignantly, at the end of the book, Mitch resumes a relationship with his ailing brother, Steve, thus exhibiting hope and promise that intimacy will no longer elude him, even after Morrie is gone. And at the beginning of the book, Mitch describes Morrie as “…a small man who takes small steps, as if a strong wind could, at any time, whisk him up into the clouds.” It is a certainty that Mitch Albom would echo the idea that big heroes can reside in small places.

Dr. Cunningham is a relationship counseling expert. She practices couples counseling, marriage counseling and treats relationships issues of all types in San Diego, CA. She offers evening hours and a complimentary telephone consultation. You may reach her at 619 9906203 or visit her website at http://www.Cunninghamtherapy.com

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