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Posts Tagged ‘counseling’

At Affordable Relationship Counseling, licensed marriage and family therapist, Dr. Barbara Cunningham, specializes in issues of grief and loss. Death, divorce, breakups, pet loss, homicide, suicide, career transitions, moves and many other changes all may herald in a period that the client may experience grief and loss. Dr. Cunningham emphasizes that all people belong to an emotional system. Emotional systems are made up of individuals, all of whom are interdependent upon one another to a greater or lesser degree. Thus, exits from the family system may create a kind of “emotional shock wave effect,” wherein relationships shift among members upon the death of an important family member.

As Dr. Cunningham experiences just such a change…the serious illness of her own mother…she is observant of the emotional process swirling about her and within her. She often advises clients not to make major decisions or changes for a year following the death of an important family member or after a divorce. This is a cautious way to insure that the brain calms down enough to make a rational decision. Homo sapiens are a social species. When we lose a profound attachment, it is an automatic impulse to grieve and even to look for a replacement love object to comfort us in our loss. The idea of doing so is normal…letting the passage of time occur to insure the decision is made with reflection is good insurance. To learn more about Dr. Cunningham’s model of practice, 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 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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At Affordable Relationship Counseling, Dr.Barbara Cunningham,licensed marriage and family therapist, provides couples and individuals with insight based psychotherapy to create more satisfied, connected lives. One aspect of that journey is described below. Evening hours and affordable rates are available. The office is open from Tuesday through Fridays, beginning at noon or one and going as late as nine p.m.

To me, poetry is the word transformed at the edge of experience. It works on a creative level to transport people to the borders of their interpretive struggles. Providing clients with a poem to read that is relevant to their presenting problems and/or asking them to write a poem about these problems are interventions that can be harnessed to help cope with and/or give new meaning to misery and suffering. Nothing is as important as touching pain at a level beyond intellect. Thus, in addition to clinicians’ creation of written lists of symptoms and presenting problems, perhaps poetry, with its compression and speed and intensity, is an especially useful exercise for the therapist. Seeing intense family and couple interactions can stuff the therapist with countertransference that needs to be worked out with more than an intellectually based consultation. Reading and writing poetry can create a healing place not only for the elderly client who may be working on his/her life review, but also for the therapist. Paying attention to the way the poem looks on the page and being aware of rhyme and line endings can actually slow us down and make us listen with different ears. Poetry has the power to make us see the heart of the matter.

If a therapist is not one to enjoy creative writing, at the least, poetry should be on his/her professional reading lists. The synthesis of feeling captured in brevity is another lens through which to view all experience and, especially, ultimate concerns. The sounds and sense of words in a poem seem to touch our brains in a way that speaks to our spirits. Poetry has healing power. It speaks to emotions. It is experiential.

The use of metaphor has been recognized by mental health leaders such as Jung, Milton Erickson, Jay Haley, and Edward Friedman as a way to access the unconscious needs, wishes, thoughts, and fears of the human being. It follows that there probably is an important connection between suffering, recovery, and the writing and reading of poetry. It is a different way to talk to each other. There is something about condensed language and structure that seems useful in times of trauma, including the crisis of aging and dying. Maybe by reading or writing a poem, a client can gain some sense of control. It can tease out the nuances of symptoms, habits, feelings, and beliefs that can help guide the way forward. It may be part of the road leading into the unconscious. We can turn to poetry to repair some damage. In the aftermath of 9/11, I remember seeing an eruption of poetry. It seemed to be a common means of exchange during those traumatic months following the attacks. Discursive language did not seem able to touch the horror the way that poems could. Poetry is a powerful way to capture the subjective and spiritual core of experience. It can take us to places that our intellect cannot access. It can help us to process unresolved issues.

To learn more about my model of practice, visit my web site at http://www.cunninghamtherapy.com or call 619 9906203 for additional information.

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In my practice in San Diego, I specialize in relationship counseling, couples counseling, and marriage counseling. I do counseling with straight, gay, lesbian and transgendered couples in my practice.

Presently, I see a couple with two grown children. They have remained stuck for years in the repetitiveness of a distancer-pursuer cycle. The more he puts up walls, goes into his “cave.” or just gets too busy to make time for them, the more she pursues him by asking to “talk,” and even getting critical and blaming, just to get some reaction-any reaction- out of him. Both partners appear for treatment with a resigned look on their faces and seem to be frustrated and hopeless about their relationship. This cycle has gone on for years, and no matter how many times the woman complains about their lack of connection or no matter how many times the man pleads with his wife to stop nagging and just let him be, the battle continues. Sometimes the battle takes place underground-for example, in his resentment, he knows that it will make his wife angry whenever he is late. So he’s habitually late. His wife knows that it will make him mad if she buys too many new shoes at Nordstrom, so she splurges on multiple pairs of Jimmy Choo’s. Other times, the batttle takes place above ground, and they just go over and over what is stopping them from moving forward until one of them tires of the blaming behavior and withdraws. And so it goes.

When this couple finally appears in my office, early in the assessment phase of treatment, I assign them each two books : The 8 Concepts of Bowen Theory and Extraordinary Relationships, both by Roberta Gilbert, M.D. I explain a bit about my model of practice. I emphasize that when two people are anxious, it is common to blame the other for all the problems. Our brains are hardwired to do this. The work is to use that tiny part of our brain that has evolved above other forms of life and, on a good day, allows us to think about our thinking. Reading the books is an example of using that cognitive capacity to calm down the emotional while at the same time learning a new kind of causality about relationship functioning. Blaming behaviors reflect a linear causality. My model looks at problems from the perspective of a circular causality. This means no one is blame! Instead, problems are co-created, or tri-created and,in some cases, may be rooted in each partner’s multigenerational story as well as unfinished personal business from past relationships that ended poorly.

In order to find out context (with the idea that nothing ever happens in a vacuum anyway), in the second and third sessions, I take a family diagram of three or four generations. I look for patterns of strength as well as  problematic patterns that may repeat over generations. I look at levels of functioning and variation in each generations’s sibling group. I look at patterns of closeness and distance. Some partners come from families who are emotionally expressive and, in the extreme, “into each other’s business.” Oftentimes, the other partner comes from a family that is the polar opposite: family members are distant and isolated from one another, emotionally, and, at times, this can be reflected in family members being flung all over the globe or just not communicative despite living in the same town. I look for levels of functioning academically and professionally. I look for how well members can “hold” intimacy over the long haul through each members’ number of marriages. I look for patterns of loyalty and infidelity. I like to think of this effort as being akin to climbing to the top of the bleachers to see the football game rather than sitting on the fifty yardline. Past is, indeed, prologue.

The assumptions I hold are myriad. Four key assumptions involve the following: 1.) We are all more alike than we are different; 2.) we are interconnected; 3.) the human being has a need for both connection and separateness; and 4.) functioning is reciprocal (for example, the more one overfunctions in relation to another, it may, in part, determine the level of underfunctioning in another).

An example of interconnectivity can be seen in emotional shock wave effects after the death of an important family member. It is common to watch dramatic changes among the relationships of those who were closest to the deceased family member. We all can think of someone, for example, who has been married for many years and one partner dies. Within a year, the other partner passes. It may reflect how profoundly connected the partners may have been, so that even their mortality is affected by the distance of death.

In my view, change is about going outside your comfort zone. It is in a frustrated partner’s comfort zone to blame and criticize the other person to justify why he/she is right. Paradoxically, this blaming effort merely serves to solidy the other partner’s opposing position. There is gridlock. The therapy effort is to work toward being able to visualize your own part in a problematic relationship dynamic. This involves getting some separateness from all the togetherness in order to see how you are impacting the dynamic yourself.

Learning and then applying family systems principles to one’s own life is an ongoing challenge and lifelong process. My model of therapy sets people on the road to making this shift in their thinking. To be able to transform ones thinking from individual (blame) to systemic (cocreated) is a continuing effort. Keeping one’s eye on oneself instead of on other can change a couple’s dynamic in a dramatic way.

Dr. Cunningham has her doctorate with a specialty in marriage and family therapy. She is licensed in the state of California as a marriage and family therapist. Dr. Cunningham has published an academic book chapter on her family systems treatment and has been an adjunct professor at a COAMFT accredited graduate school of marriage and family therapy. She has long life experience and has enjoyed seeing thousands of couples in her career. For more information about Dr. Cunningham’s model of practice, visit her website at http://www.cunninghamtherapy.com or call 619 990-6203 for a complimentary telephone consultation.

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After years of seeing distressed couples as a licensed marriage and family therapist in my office in San Diego, I have learned that love can be messy. Relationship counseling offers couples a counseling opportunity to take on the work of deepening their love in the face of current challenges they are facing.

Judith Viorst got it right when she said, “One advantage of marriage, it seems to me, is that when you fall out of love with him, or he falls out of love with you, it keeps you together until you maybe fall in love again.” Couples who come into marriage  expecting it to be easy are deluding themselves. The good news is that it is in the triumphs over challenges that love can deepen.

It is a “given” that infatuation has a limited shelf life. There is something a bit delusional that drives the euphoria of infatuation. A physical attraction combined with one’s wish to find a companion with whom he/she has a lot in common drives the “urge to merge.” Over time, as warts begin to appear, all the hopes and dreams one pins on a person in one’s wish for a “perfect union” may become shattered. The people who once reflected one another in such a flattering way may begin to find fault or seem less exited. Now, instead of euphoria, one or both become reactive, as they stand by watching another dream crumble. Once again, Judith Viorst shows remarkable insight when she says, “Many of us are done with adolescence before we are done with adolescent love.”Many people seek counseling trying to re-establish that blind euporia that comes from infatuation.

The deeper, more mature love that poets have written about for centuries is borne of hard work and effort. In the case of love, effort means having the capacity to see your part when there are problems and being a proactive rather than a reactive partner. Realistic expectations and the ability to see one’s part in a difficult relational challenge remain part of what defines the successful couple. To learn more about Dr. Cunningham’s model of marriage and family therapy practice, visit her website at http://www.cuuninghamtherapy.comor call 619 9906203 for a complimentary consultation.

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Dr. Cunningham often hears couples come to marriage counseling and relationship counseling with issues related to anger. Each partner often begins couples counseling with a wish for the therapist to “fix” the other.  Counseling aims to help each partner increase their capacity to visualize their own part in the dance. This increased self-responsility to at once be true to expressing your feelings to your intimate other and, still, to decrease blaming him/her is an overarching goal of most psychotherapy within my model, no matter what the presenting problems.

In his book entitled TO A DANCING GOD: NOTES OF A SPIRITUAL TRAVELER, Sam Keen has a dialogue with anger (pp. 114-119).  Anger says, “If you doubt that I am the companion of love, remember the ecstasy of the reconciliation that comes after fighting. After a good expression of clean anger, lovers have established the integrity of their separateness, and they may come together without fearing that either will be eradicated by the act of love. If you can’t fight, you can’t love.”

Interestingly, this quote from Keen has been backed up by specific research in the field. John Gottman’s research disspelled a prevalent myth about marriage. He found that fighting is not predictive of divorce. If couples are engaged with one another and learn principles of “fair” fighting, learning more effective ways to resolve conflict can, in fact, lead the way to deepening relational growth. Notably, important work by John Gottman identified lethal forms of communication between partners that were predictive of divorce and he called them the four “Horsemen of the Apocalypse” (stonewalling, criticism, contempt, and defensiveness). He found that these communication patterns in relationships were dangerous to holding relationships on a course of stability and longevity.

Thus, Keen’s quote is backed up by Gottman’s empirical findings.  Anger that is not expressed or held back may be classified as a kind of stonewalling. So-called happy couples may be ignoring or hiding the anger that exists within and between them. Marital partners who are more able to express anger in a timely, reflective, and respectful manner, especially with a Gottman technique that he referrs to as “soft startups,”  may be more adept at repair attempts and thus are more likely to stay together in a more fulfilling way.

Anger has to be a respected member of the partnership. If not, the couple may not be genuine with themselves or with each other. Furthermore, anger unrecognized or in disguise may be more dangerous than when it is out in the open and dischargeable. Hidden anger can lead to sudden disruptions, including failure in the marriage, a damaged sex life, domestic violence, and anxious child-rearing that may even lead to child abuse. When unconscious and unexpressed anger festers, it grows and becomes regressively more primitive.

If one considers the tasks of loving from the perspective of  Bowen Family Systems Theory, lovers must also be able to establish the integrity of their separateness if they are to remain connected as effective marital partners. If partners are fused too tightly, they will not be able to come together without fearing eradication by the other. Bowen would wholeheartedly agree with Keen that lovers who can cleanly express their anger are likely to be more engaged lovers. Lovers must have a bottom line and be differentiated enough to not “cave in” or accommodate to another just because they fear losing the relationship if they do not give in. Those who can make a move for “self” are also able to freely choose to make a move for “other” instead of just going along, with resentment following closely behind. They are able to be at choice about when they wish to be separate and when they wish to be connected while, at the same, they have a greater capacity to respect a differing need for closeness and/or distance at various times in their partner.

Makeup sex often occurs without a clear resolution to existing problems. It occurs because the couple just gets tired of fighting and feeling all the  negative energy and want to restore the illusion that they are really doing ok without necessarily doing the work to get there. In my view, an accurate description of problems brought to therapy always addresses the reciprocity between a couple and one’s ability to identify or visualize one’s own part in a dynamic. The “automatic” impulse is to focus on what is wrong with other instead of working to see what one’s own part may be and then moving toward changing it. Part of the work in “fair” fighting, from my perspective, then,  is the capacity to “step up” and see what you can do to shift the unhelpful dynamic that led to the fight. Makeup sex can feel goodin the moment, but may be a mere escape from taking responsibility on your end to make things better in the longterm. Makeup sex that does not include each partner’s effort to change can feel euphoric, but without the promise of future increased connectedness. Some people have compared the feeling to getting high on cocaine.

The more you love, the more susceptible you are to being hurt. When a person is hurt, the natural response is anger in some form or other. While anger is a painful emotion, it also brings wakefulness, alertness, and, if it does not burn out of control, can even lead to clearer thinking and action about one’s own functioning in relation to important others. Anger is an emotion creeping into many of our expressions. Problems are tackled, obstacles are attacked, roadblocks are smashed, fears are conquered, and skills are mastered. I believe that it is not enough to be angry about some things.  If you can be aware of your anger, express it with an eye to including in your expression what you have done to trigger such anger-provoking behavior in another, and fight fairly, then you will discover that you can love better and not be in a state of chronic festering resentment Anger needs to be expressed and recognized as an integral part of life and living. At one time or another, it  is part of being transparent to a significant other. Being emotionally “naked” with another is difficult;  the process of this effort describes the challenges in the journey toward increasing transparency. As David Schnarch noted in his book entitled PASSIONATE MARRIAGE, this capacity to increase transparency can lead to what he refers to as ” wall socket sex.”  Certainly, the expression of anger in a nonblaming manner with an eye to what one has done to trigger the other to behave in ways that inspire anger is a helpful, systemic approach to conflict resolution. To learn more about Dr. Cunningham’s model of practice, visit her website at http://www.Cunninghamtherapy.com or call 619 9906203 for a complimentary phone consultation.

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At times, the pain of separation seems more than we can bear; but love and understanding can help us pass through the darkness toward the light. And in truth, grief is a great teacher, when it sends us back to serve and bless the living. . . . Thus, even when they are gone, the departed are with us, moving us to live as, in their higher moments, they themselves wished to live. We remember them now; they live in our hearts; they are an abiding blessing. ~Jewish mourners’ Kaddish (Central Conference of Rabbis, 1992)

Dr. Barbara Cunningham offers insightful counseling to survivors of homicide, specializing in helping sibling survivors move through their grief and their loss (read about her model of practice at http://www.Cunninghamtherapy.com).

According to the U. S. Department of Commerce (1991), almost 2 million children from birth through 18 years of age become bereaved siblings each year. Although homicide is the least frequent form of violent dying, it may have the most profound and lasting impact on surviving family members (Rynearson, 2001). Since the mid-1980s, the rate of murder committed by youth has doubled, increasing by 102% (State Legislative Responses to Violent Juvenile Crime, 1996-1997). Homicide survivors are defined as significant others who are left behind to mourn victims of homicide. While society recognizes that the violent loss of a child is one of the most devastating experiences a parent can confront, there is little societal recognition of the impact of such a loss upon surviving siblings (Fanos, 1996). Despite the large number of adolescents and young adults who are faced with this catastrophic personal and family crisis, there is a lack of theoretical constructs and systemic treatments from which to generate a theory of sibling bereavement (Walsh & McGoldrick, 2004).

The loss of a brother or sister has a lasting effect on the overall development of the surviving sibling and the family system, and it is extraordinary that so little attention has been directed at understanding the impact of loss in young adulthood upon both individual and family life cycles (Carter & McGoldrick, 1999). The role and function sibling relationships play in identity formation is becoming recognized as a powerful force in personality development (Provence & Solnit, 1983).

Complicated grief is often part of the clinical picture with sibling survivors of homicide (Rando, 1993). In this blog, complicated grief is defined as involving an intensity of symptoms that affect people over an extended length of time or as barriers to daily living caused by grief (Weiss, 2000). Green, Lindy, Grace, and Gleser (1989) found that the experience of surviving the homicide of a loved one frequently led to complicated grief reactions. Rynearson (1984) pointed out that “the manner of dying rather than the event of death determines the meaning of death, which in turn influences the form and cause of bereavement” (p. 1452).

Allen (1991) noted that surviving the homicide of a family member was detrimental to the survivors’ psychological well being because homicide is “stigmatizing, unnatural, especially burdensome, and unexpected” (p. 18). Parkes and Weiss (1983) empirically supported their belief that the mental health effects of homicide on survivors were more pronounced than those experienced by individuals who lose a loved one because of an anticipated death. Furthermore, Allen (1991) noted that “the closer the survivor and the victim were, the more difficult the bereavement” (p. 20). Raphael’s (1983) summary seems the most appropriate to conceptualize the severity of the grief experienced by relatives of a homicide victim: “First degree family members are the ones who are the most impacted by the death, and the greater a family member is involved with the deceased, the more deeply the loss is felt” (p. 67). Kubler-Ross’s (1969) stage model of grieving has not been useful in helping these forgotten grievers to feel validated in their need to remain spiritually and emotionally connected to their deceased loved ones and to surviving family members (Walsh & McGoldrick, 2004). Instead, a model of treatment that has a deeper perspective and that examines multigenerational and emotionally interdependent functioning is needed (Bowen, 1976; Walsh & McGoldrick, 2004).

In addition to therapy focused upon issues of grief and loss, especially in the context of violent crimes, Dr. Cunningham also specializes in couples counseling, marriage counseling, and individual counseling/psychotherapy. To learn more information about Dr. Cunningham and her systemic model of practice, visit her website at http://www.cunninghamtherapy.com/ or call her at 619 9906203 for a complimentary telephone consultation.

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  In my private practice in San Diego, I work to provide quality services for marriage counseIing, relationship counseling, and individual psychotherapy. Oftentimes, I listen to young girls and women of all ages obsess about their weight, their appearance and their disappearing youth. I try to provide a safe holding environment as they work to relieve themselves of the overwhelming social pressures to be the prettiest, the skinniest, and the sexiest version of themselves they can create. I coach them to practice self care and take pride in themselves. However, I also coach them to make their life purpose revolve around what they can accomplish rather than merely upon a superficial and dangerous emphasis upon appearance and youth.

After talking at lunch with a close friend and colleague about the troubles of Demi Moore, I had a moment to reflect upon society’s demands to value appearance over substance. Magazines, movies, tv shows, and internet blogs seem to scream that “youth” trumps wisdom-that what we wear matters more than what we think. Some young women and many older women buy into this message so passionately that they kill themselves trying to meet these youthful, botoxed, skinny standards.

This week,  ABC News reported on Demi Moore’s downward spiral as reflecting her obsession with losing weight and battling against the clock as she approaches the big 5-0.  After public humiliation in the face of her estranged younger husband, Ashton Kutcher, betraying her with gorgeous, younger women, she seemingly dropped off her own psychological cliff. Demi appeared so emaciated in this week’s photos that she could have been mistaken for a cancer patient. Sad. Really sad. As she moves into a new decade, her refusal to eat seemed to say symbolically that she just could not swallow it. That she simply wants to disappear. 

Moore’s reported erratic behavior and alleged drug abuse sends a loud message to her daughters that adulthood is not fun and that aging gracefully must be for fools. She makes it appear that it is devastating to cross from youth to middle age. This woman’s daughters are learning deep lessons by watching their mother. Partying with their mother. Suffering as they watch their mother suffer. Wondering if growing older is really as devastating as Mom would have them believe. Moore reportedly gave an interview to Harper’s Bazaar and said, “What scares me is that I am ultimately going to find out at the end of my life that I am not really loveable, that I’m not worthy of being loved…that there is something fundamentally wrong with me.”

When daughters watch their mothers obsess about weight, worry about their changing appearances, be more ambitious about choosing their wardrobes than they are about the enduring consequences of their life choices and try to “hang” with and/or marry much younger men in an effort to cling to their own youth, they are receiving a devastating message. As mothers, we must realize that we are always modeling something–but what? In fact, the deepest lessons our daughters learn is by watching what we do, not what we say. So what are the lessons that we teach our daughters by our own actions?

Little girls learn at an early age if Mom is more concerned with style over substance. Sadly, Rumor, Scout and Talullah may have learned that their mother believes that her greatest value is in her appearance–that her validity as a human being is wrapped up in what she weighs, how she looks, and whether she is still “hot.” In a mad effort to deny her own mortality, she hangs with young people and seemingly tries to deny she is turning fifty with erratic behavior and recreational drugs. If Demi’s daughters are fortunate, they will look at life and their own intrinsic value differently than their mother. They will try to make meaning out of their life in a way that honors experience and wisdom over youth and appearance. Instead of survival of the prettiest, they will see their survival as being rooted in resilience-in the lessons they can discover that are present, but must be uncovered, in each of their life challenges.  Hopefully, Ms. Moore will benefit from professional help so that she can turn her life around. As a woman and as a mother who is facing myriad challenges, she now has an opportunity to teach her children more about the meaning of life by giving new meaning to her own. She has the opportunity to show that there is no shame in stumbling if one picks themselves up from the fall. She can model the joy of recovery from all of the Sturm and Drang so publically displayed. She has the opportunity to review and perhaps modify her values that have privileged vanity over inner substance gained from a life well lived. She has the opportunity to bounce forward, not just back-because of, not in spite of, her recent adversities.

To learn more about Dr. Cunningham‘s strength-based practice, visit her website at http://www.Cunninghamtherapy.com or call her at 619 9906203 for a complimentary telephone consultation.

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In my San Diego marriage counseling and couples counseling practice, I have learned that our “automatic” response in the face of anxiety is to make the problem all about what our partner is doing wrong. Such a blaming attitude rarely moves a relationship forward. As a family systems specialist and relationship counselor, I encourage couples to focus on their own part in an unhelpful dynamic. In order to help them do so, I ask them to become a researcher on their own multigenerational context. Questions asked may, in part, answer “Who am I in the context of my relationship functioning and how did I get this way? What shaped me to be who I am as a husband, wife, or significant other?” This cognitive or “researcher” attitude inherently calms people down and decreases the anxious focus on symptoms or presenting issues. As each person calms down while doing research on their own family of origin, the couple can move into the next phase of directly engaging with problems that are present in the here and know.  The research on one’s own family engages the cognitive brain and cools down the emotional brain–emotionality usually dominates thoughtfulness and any effort to shift the balance can be helpful in moving forward in a more positive way in the couples’ challenges.

In an article entitled “Family Systems with Alcoholism, A Case Study,” Ann McKnight (1998) underlines the notion that information is power. She suggests several questions one might ask important members of one’s family of origin, some of which are listed below:

Can the family shift from viewing [an impairment or symptom] as an individual problem to viewing the [impairment or symptom] as a family problem?

Can the family come to view the [impairment or symptom] as a disguised opporunity to allow members to understand their relationship system rather than as a disease to be cured in an individual?

How do people in the family hold on to their personal boundaries?

How do family members manage to stay connected?

Are there many examples of emotional cutoffs between family members?

How do people play out underfunctioning and overfunctioning reciprocal positions in the family?

What is the maturity level of each person? Of the family? (Define emotional maturity as a combination of impulse control and whether a person can function in a hostile relationship environment whether at work or at school)

Look at the functioning of people in both work and in relationships. How many times were parents, aunts and uncles married? What did people do for a living?

How do certain family-of-origin patterns repeat themselves in subsequent generations, including in your nuclear family today?

How did people in the family-of-origin bind anxiety?

Can you identify any multigenerational patterns of strength in your multigenerational legacy?

Many other questions can be generated in order to become a scholar on oneself. In relationship counseling contexts, it is always helpful to learn more about one’s origins before focusing on what one’s part is in an unhelpful relationship dynamic. To learn more about Dr. Cunningham’s model of practice, visit her website at http://www.cunninghamtherapy.com/ or call 619 9906203 for a complimentary telephone consultation.

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Relationship counseling
can be an avenue of personal growth in the service of improving the connection with your partner. In my model of couples counseling, partners become increasingly aware that being in an intimate relationship over the long haul calls upon both partners to self-regulate their  reactivity to one another at various times. It also requires that partners or spouses preserve their connection with the important other without sacrificing themselves: it necessitates that each partner has the capacity to hold onto their core values, principles, and non-negotiable bottom lines. This may mean that one may, at times, have to say difficult things despite risking disapproval. Similarly, if one hears difficult material from one’s partner, there is an opportunity to reinforce growth behavior in other by affirming the openness instead of clobbering one’s mate for being transparent just because what they had to say made us feel uncomfortable. Thus, it is in the context of relationship functioning that one can transcend self and move onto a path of personal growth. In his 1996  article entitled “Affect and the redefinition of intimacy” (In: Knowing, Feeling, Affect, Script and Psychotherapy, ed. D. Nathanson, New York: Norton, pp. 55-104), V. Kelly makes some important observations about relationships. What follows below is a direct quote of this material (and reflects my thinking on part of  what the the work should entail in relationship counseling):

“All close relationships require proximity that causes us to step on each other’s toes. If, for whatever reason, one does not say ‘ouch’ and communicate the distress experienced as a result of the other’s actions, a complex dilemma is created. The need to disguise the distress causes the inmost self to be hidden from the other. The distress, if unrelieved, eventually triggers anger and resentment that must also be hidden. This causes further withdrawal and hiding of the inmost self. The other, perhaps not even aware of the offense, experiences feeling of rejection triggered by the withdrawal, without information adequate to allow reestablishment of the intimate bond. Now hurt, this other may also resort to withdrawal, thus setting in motion a recursive loop of rejection and hurt” [pp. 87-88].

Understanding that the withholding of important emotions can be just as damaging to a relationship as perpetual nagging about intense emotions is only part of what one has to “get” in therapy. It is the co-determined nature of this dance that is also important. How often are our responses simply reactivity in response to our partner and how often are our responses truly reflective? This ability to know the difference between reactivity and reflectivity is part of  the art of living in relationships in a fulfilling way. On one hand, to be able to identify within ourselves when we are being reactive and when we are being reflective takes skill and sometimes patience (sometimes we just have to “buy time” and calm down before taking any action or saying something about a sensitive subject). Knowing how to stay connected to one’s partner while still preserving some separateness takes effort, emotional ambition, and continued practice. It is important to appreciate that the expression of one’s emotions is primarily relational. At Affordable Relationship Counseling, work is focused upon helping each partner identify and then modify their part in the relational dance to increase mutual satisfaction. Such an effort often results in personal growth as a result of learning new principles to address challenges one may have in remaining in a relationship.

To learn more about Dr. Cunningham’s model of marriage counseling, couples counseling and individual counseling, visit her website at http://www.Cunninghamtherapy.com or call her at 619 9906203 for a complimentary telephone consultation .

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