What To Do About Family…by Gina Schuchman LICSW


One of the most pressing issues for most people, as they strive to build and maintain healthy lives, is trying to figure out what to do about family. It might be just one or two family members who are causing pain, shame, anxiety or anger, or it might be the whole lot of them.

What causes the most problems in families?

  • History of dysfunction. And this history continues to be dysfunctional in the present. Unresolved abuse/trauma/hurts have a tendency to raise their ugly heads on a regular basis until you understand what they are and heal from them and figure out how to handle the after effects.

  • Past/present blows to SELF ESTEEM.
    • If you were not treated as if you had value in the past, it is likely you will not be feeling good about yourself and will continue to feel as if you are put in the “one-down” position by family members or friends or work relationships. They might actually continue to treat you the same way they did when you were a child with lifelong patterns of interaction being hard to change. No matter what you try to do differently they may stay stuck in these unhealthy and dysfunctional patterns and leave you feeling unworthy, unloveable and full of pain, shame and anger.

    • If your family treated you as if you had more value than others and continue to elevate you above others in the family or the outside world, you will likely carry self-doubt, guilt, pain, and shame as you navigate the real world of relationships.

  • Unhealthy and dysfunctional boundaries.
  • Lack of acceptance of who you are or how you might be different than the rest of the family.
    • As we grow up we might decide we have different values or look at the world differently than the people we grew up with. In some families this is celebrated as they enjoy having new ideas brought in to consider and see it as enlightening and challenging. In other families being different is seen as a threat to the status quo or as rejection and they can reject anything new by trying to change you back or try to beat you down to get you to comply with their idea of how to be. If you stick to your guns you may find yourself on the outside looking in, in your own family.

  • Valuing the needs and wants of all family members in unequal ways.
    • In dysfunctional family systems, not everyone is treated with the same measure of respect and love. There can be one person whose needs and wants pre-empt everyone else. Or there’s a pecking order and people are valued and tended to only after everyone on the list is taken care of first.

  • Not being moderate in response to each other and life in general.

    • It is human nature to react in the extreme and this creates immoderate responses in others. In some families it is not acceptable to show any emotions or talk about any conflicts, while in others it is no holds barred, do and say anything you want, as loud as you want, as violent as you want, as hurtful as you want, with emotions being vomited all over everyone.

So, as you try to get healthy, try to build your own life or family as an adult, you might find yourself doubting whether or not you can do it and still be part of your family. Engaging with them can lead to feeling alienated, shameful, angry, hurt, powerless and hopeless. It can be a tough decision to make when you think you have to decide between having your own life in which you get to be yourself or being part of your family.

Many shrink from this ominous task in fear of losing the connection of their family that has been the grounding they have counted on to keep them anchored and worthy. The fear is that they will be alone forever, unloved and lonely with no meaning to their lives. Yet, to continue to try to fit the square peg of your true self in the round hole of your family’s generations of patterns of relating, can leave you feeling worse.

What to do, what to do?

In the process of growing up/getting healthy/recovery/individuation we have many options for how to handle this. If we continue in immaturity, we react in immoderate ways. We keep quiet, grin and bear it. We rage and manipulate to get our way. As functional adults we try to find the moderate path to being an individual adult who has healthy functional relationships (whenever possible) with our family members.

Seeing a therapist can help you identify what the core issues are so you can decide what you want/need to change and what you can let go of. Once you know the issues you have options on what to do about them.

  • Sometimes just by changing our own behavior and responses can change how others treat us. We can be the best person that we want to be and see if others adjust accordingly.

  • We can start to tell people when we don’t like something and ask them to behave differently with us, setting boundaries and holding the line on a daily basis. For example, many people have parents or siblings who have drinking or drug problems and they create drama and discord and abuse their family members in many different ways. Deciding not to talk to them or visit them when they are under the influence can be a big step towards a healthier life for you even though others will not like it.

  • We can invite family members to join us in counseling to try to work with them on how to improve our relationships. For many family members, once they understand how you’ve been feeling, they are happy to work on adjusting their behavior and have no intention of having you feel unloved or unworthy. Some are unwilling to hear it or feel so attacked they shut down. It’s always worth a try to see if fences can be mended.

  • We can limit our contacts with people we don’t feel safe or valued with. You might have a family that gets together every week for a big family party and you leave feeling terrible every time. Maybe start to go less often and see if you can tolerate it any better. You might feel better knowing you only have to see them once a month or twice a year. Some people have felt obligated to speak to a parent daily even though the conversations leave them feeling depleted and full of shame. Deciding that you have the right to choose can improve your life pretty quickly, maybe less often or maybe limit it to 5-15 minutes instead of the 2 hour “chats”.


  • Last resort, for many, is to let go of family members and build a new “family”. Each of us gets to decide for ourselves when enough is enough. If this happens for you, be assured that there are many people who have chosen this path and found wonderful people who like them just the way they are, who have their back and have better connection skills to build a new core group with. It is not “second best” if your first best makes you miserable.


Be kind to yourself and try to figure out what brings you joy. You have the right, and you deserve, to feel joy in your relationships. Relationships, like people, are perfectly imperfect, and so you should not expect constant joy. What you can hope for and expect is to have people in your inner circle who are kind, loving, respectful and generous who are “works in progress” themselves and willing to grow and change to build empathic connection in relationships with you. Trust me, there are many people, like you, in the world looking for a new group to belong to.


The Quick-Start Guide to Healing Trauma and Psychological Wounds by Neil Strauss

A  Framework For Transformation

Over the course of writing The Truth, I came to develop a very specific take on healing trauma, specifically developmental trauma, as I slowly but surely reduced my own.

As an overall framework for psychological healing, think of the childhood pain and shame we store—and the dysfunctional behaviors and thoughts created by them—as cancerous tumors attached to the heart by a short elastic cord.

And when we go through intensive therapeutic processes, such as the chair work I experienced in the book, we’re able for just a moment to pull that ugly tumor out of our chest and get a glimpse of who we really are without it, to see the difference between our authentic self and the reactive self who makes a mess of our life.

However, when the process ends, the elastic snaps back and the trauma fastens once again to our heart, until after a few hours or days or weeks back in daily reality, we can no longer tell the difference between our truth and our wounds.

But if we stretch the elastic enough times, eventually it will wear out. And when we release it, the load it’s carrying will no longer snap back into us, but instead hang outside limply, a passenger in our life but no longer in the cockpit.

Specific Steps To Deep Change

With this framework in mind, the first step is to find a therapeutic process that’s powerful enough to stretch the elastic. Typically, this means setting time aside for a two-to-five day experiential intensive. This will allow you to dive deep into your past and bring up feelings in a way that a one-hour therapy-room session typically can’t.

I find talk therapy, in particular, less effective for deep healing and change, especially since so many of the wounds we carry are emotional, often created before we were capable of talking or having intellectual thoughts.

For some people, a single workshop may be enough to experience a life-changing shift. For others, going to several over the course of a few years may be necessary. And a few people may require more extensive in-patient therapy.

Whatever the case may be, just going to intensives or workshops is not enough. It’s important to maintain any shifts, revelations, or improvements after the first healing experience with the following four things:

*Consistent Support: Decades of dysfunctional behavior can’t be eliminated in a weekend. To keep your head right, it’s important to retain a regular regimen of individual or, even better, group therapy with others who share similar wounds. Even if it’s just a monthly or bi-monthly hour-long phone call.

*Self care: If you take care of your mind, body, and soul through healthy eating, exercise, positive self-talk, appropriate boundaries, sleeping well, and a practice such as yoga or meditation, you will be less vulnerable to your past dysfunctional behaviors and beliefs. A lack of self care typically leads to a lack of self regulation.

*Tools: Through therapy, reading, and research, you can gather tactics and techniques for retaining your new healthy, functional behavior and thoughts. Sometimes, when under too much pressure, stress, or poor self-care, you may begin to backslide into old habits of dysfunctional behavior. And it’s important to use a tool here—for example, using non-violent communication, focusing on slow diaphragm breathing, or having an inner dialogue to soothe your agitated inner child—to keep from going over the psychological cliff.

*Patience: When cleaning a room, it gets more messy before it gets orderly. The same is true of cleaning your mind. Often, as you begin the healing process, you will begin feeling the pain or shame that your dysfunctional behavior was protecting you from. But if you can tolerate those raw feelings and process them in a healthy way this time, then you will no longer need the dysfunctional behavior. It won’t have a purpose because there’s no longer any toxic shame or pain to avoid. At other times, a behavior or belief that you thought you defeated may rear its head again. Don’t get frustrated. Think of self-improvement as climbing a mountain. Sometimes you’ll feel like you’re in the same place you started, but the truth is that you’ve climbed higher and you’re just looking at the same view.



If you’re ready to start exploring your psyche, unpacking your emotions, and healing your wounds (and we’re all wounded in varying degrees), here are a few places and therapies I recommend starting with.

I’ve focused on the centers, counsellors, and therapies I had positive experiences with while writing The Truth. As such, some of the sections focus on relationship healing.

There are of course many other workshops and therapies that have helped others. So if you’d like to add your own recommendations, please do so in the Comments section here: www.neilstrauss.com/neil/trauma-healing/.

Trauma-Healing Workshops
  • The Society Inner Game Intensive: www.thesocietyinternational.com (Conflict of Interest Note: These are workshops that I facilitate, usually with the same therapists who helped me in The Truth.)
Trauma-Healing Therapies
  • Group Therapy
    • I have yet to find a good website for finding a group, and recommend reaching out to local therapists you trust or forming one yourself with a professional faciliatator. If all else fails, here’s a possible online resource to start with: https://groups.psychologytoday.com/rms/
Relationship Intensives for Individuals
Relationship Intensives for Couples
Recommended Reading for Trauma Healing
Recommended Reading for Relationship Healing
Diagnostic Tools

How to Move Beyond Blame and Reclaim Your Wholeness by Vicki Tidwell Palmer, LCSW, CSAT

This article is based on Pia Mellody’s Post Induction Therapy model of treating childhood trauma.

When it comes to dealing with childhood issues, most of us tend to gravitate toward one of the following extremes: “It’s in the past, so what’s the point?” “It’s all my parent’s fault I’m the way I am!”

Imagine going to a medical doctor and telling him that you don’t want to give him a medical history because you don’t see the point. Getting a good history is as important to your mental health as it is to your physical health. At the other extreme, if you blame your parents for everything that’s wrong in your life, you remain a victim of the past. You stay stuck because you aren’t taking responsibility for your life. The truth about the impact of childhood experiences lies somewhere closer to the middle.

Believing that your childhood has no influence over your THE INEVITABILITY OF CHILDHOOD TRAUMA

Humans have the longest childhood of any species on Earth. We live with our primary caregivers anywhere from 15-18 years and sometimes longer. Not only do we live with our caregivers for a very long time, during the time we live with them our brains are still developing and we lack basic cognitive and emotional skills to process what happens to us. Children are like sponges and are highly adaptable. They are also naturally egocentric. If your parents got a divorce when you were growing up you may have wondered if you were responsible. If one of your parents often looked unhappy or angry, you may have thought it was because of something you did. It’s important to remember that children are not “adults in little bodies.” They are completely dependent on their caregivers. That’s why children are so vulnerable to childhood trauma.

Although we’re all born with certain innate characteristics and tendencies, children are “calibrated” by their family of origin. If their family is chaotic or violent, over time they will adjust to that level of chaos or violence. They don’t have a choice. They become desensitized and habituated. That’s why, as adults, we’re attracted to what’s familiar, even if it’s dysfunctional or abusive. We naturally fear what is unfamiliar.


1. Identify What Happened You must identify the type of abuse you experienced as a child. There are 5 kinds of abuse: physical, sexual, intellectual, emotional and spiritual. Abuse can be overt or covert. Beatings or sexual molestation are examples of overt abuse. Abuse can also be covert or hidden. An example of covert abuse is when a 7-year old boy is told as his father leaves for a military tour of duty that he needs to take care of his mother and is now the “little man” of the family. Neglect and abandonment are also forms of abuse. Many times, this simple process of identifying key events will give you insight about your childhood.

2. Tell the Truth After identifying significant childhood events, you need to tell the truth about what happened to you. This is best done in a therapeutic setting, preferably in a group. When you talk about what happened, are witnessed by others, and listen to others’ stories, you continue to gain insight about your experiences and begin making connections between past events and the current circumstances of your life.

3. Integrate the Functional Adult (Inner Parent) The Functional Adult, or inner parent, is an internal part of the self we all possess. It’s the healthy part of us that knows the next right thing to do. The Functional Adult has the five core issues identified by Pia Mellody (esteem, boundaries, reality, dependency and moderation) in balance. In family of origin work, this part of the self is consciously integrated so that it can be easily accessed when needed.

4. Reintegration of Child States There are two primary internal child states that have the most impact on us in our adult life — the Wounded Child and the Adapted Adult Child. When the Wounded Child gets activated in adult life, you will feel one-down, overwhelmed, passive or dissociated. You will feel younger than your chronological age. The Adapted Adult Child is an older internal child state. You may experience this part of the self as being one-up, contemptuous, or defiant. All addictions are acted out from this internal state. This is your “inner teenager.” When working with child states it is helpful to ask yourself, “how old am I feeling?” to help you identify which child state you’re in.

5. Re-Parenting The bad news may be that you didn’t get the parenting you needed, but the good news is that you can learn to re-parent yourself. The Functional Adult in you parents the inner child states through affirming, nurturing and setting limits. The Adapted Adult Child parents through attacking/ criticizing, neglecting and indulging. The Adapted Adult Child is usually the sense of “adult” that most of us have until we do in-depth family of origin work. The key tools for re-parenting are to first notice which child state you are in and then activate the Functional Adult to parent that part of the self.

6. Ongoing Inner Work with Major Caregivers Children absorb everything that happens around them. If one of your caregivers was irresponsible about how they handled their emotions, you absorbed the mis-managed emotions of that caregiver. This is an example of enmeshment. The child who has absorbed a caregiver’s feelings will literally have too much of that emotion and will carry these excess emotions into adulthood.

Shame is the most dominant carried feeling. These carried feelings can wreak havoc on our lives in the form of toxic shame, rage, or intense anxiety. One way to discharge carried feelings is through a process called “feeling reduction.” Feeling reduction work is a therapeutic process where the client metaphorically “gives back” the carried feelings to the caregiver. This is a symbolic experience with the caregiver rather than an actual event. The work can be done whether the caregiver is still alive or not. If you’re struggling to maintain sobriety, staying in abusive relationships or situations, or repeating patterns that are familiar from childhood, it’s probably time to look more closely at your childhood experiences. Family of origin work is a fundamental and necessary part of recovery and healing. If you want deep and lasting transformation – change at the core – going back to your roots is the place to start.

It’s never too late to give yourself the parenting you needed. MORE ABOUT THE RECLAIMING

© Copyright 2013-15 Vicki Tidwell Palmer, LCSW, CSAT All Rights Reserved

Teens: Installing Resiliency for the Journey by Catherine Mollner MA., LPC

I am deeply grateful to Pia Mellody for her excellent work in identifying and describing the healthy attributes of the human person.

The world is getting bigger for teens as they embark on the monumental task of exploring their identity, discovering whom they are and becoming a member of a wider society. They need the help and support of the adults in their lives as they traverse this journey.

Your affirmation, nurturing, and direction provide a firmer foundation as teenagers move away while they stay close. From the teen’s perspective, “If I know you are there, and that you have my back, I can move out into the world and figure out who I am”.
Providing support on the journey is easier when familiar with the terrain of the land known as adolescence. Teens take another run at the developmental stages. Remember when they were toddlers and began to discover they were separate beings? While we sometimes think of it as “the terrible twos”, it really is a wonderful thing as the child realizes, “Hey, you want me to do one thing, and I want to do something else. I’m different than you!” It is the beginning of self-care and independence. True, there’s a road to hoe ahead. Nonetheless … whew! We do not want them to be dependent throughout their lifespan.

What are some of the peaks and valleys that make up the land of adolescence? They are suffering from a severe case of comparisonitis as they assess their skills, achievements and sense of value related to what they see others doing. If they come up short, their sense of self-esteem plummets.

They are pushing for autonomy. They have moved out of the child phase of “what can you do for me?” and are currently in the adolescent phase of “let me do it myself” before getting to the adult stage of “what can I do for you?”
They are plagued by a time warp problem. They cannot link events together to form a comprehensive view of their own history. It is difficult for them to see that because they didn’t study they got a bad grade. Or that because they missed curfew, they cannot use the car next weekend. While it may befuddle us that they are blind to the consequences, this time warp phenomenon is a defense mechanism. If they connected these events, they would experience more guilt, shame and anger than they could manage.

Teens are very egocentric and see themselves as more important than they really are. It helps to remember that it requires an incredible amount of energy, self-focus and ability to change to become an adult. Remember, they are moving from dependency, to independence, with the final destination of interdependence.

Teens believe they are invulnerable, and that nothing bad can happen to them. They take risks thinking they will not get caught. They take drugs thinking they will not become addicted. They think they can stay out late and not get mugged. They pull the fire alarm and are surprised when they get in trouble.

Their friends become vitally important as a source of support and security. Acceptance in a group and a “best friend” contribute significantly to their sense of competency and confidence. At the same time, they are more sensitive and vulnerable to peer humiliation. To protect against disapproval they choose friends who are similar. Think of it more as a coping strategy rather than not being able to think for themselves.

At times teens can be very dependent, and at other times absolutely rebellious. Sometimes cooperative, while other times confused about the rules and testing them to the hilt. They will at times be unreasonable and illogical, while other times surprisingly sensible. Sometimes they seem so mature … and other times amazingly immature.

This inconsistency is normal … chaotic … but normal. In part it has to do with the uneven rate of brain development. During adolescence, the part of the brain that can think logically develops faster than the part of the brain that regulates emotion.

What are some attributes of emotional health and resiliency and what role can adults play to coax their installation in the younger generation?

Let’s begin with the relationship with self. The truth is that everyone on the planet has inherent worth. No one earns this inherent worth, so it cannot be lost. It cannot be made more or less than what it is. Everybody has the same amount of inherent worth. We differ in every other respect; our appearance, strengths, weaknesses, intelligence, likes and dislikes. But in terms of the inherent dignity, value and worth of the human person, we are all alike. No one is worth more or worth less than anyone else. This is the truth. We either remember it, or forget it. But it is the unchanging truth.

For most of us, as we get socialized into our families, communities, and peer groups, we start to forget the truth of our inherent worth and come to believe that our worth is determined by external things. Some people look to their performance as an indication of their worth. Others come to believe their worth is determined by how they look, the clothes they wear or how much money they have. Some people think their worth is dictated by what others think of them. While all of these things can be either pleasant or unpleasant, they are fleeting. They are external and not an indication of the truth of our inherent worth. It helps to remember that inherent worth cannot be raised by strengths or lowered by weaknesses. Those who do not apply the concept of internally based self-esteem to themselves will try to obtain a sense of value through the affirmations of others or by comparing themselves to others. Teens are notorious for this.

When based upon externals rather than being connected to the truth of inherent value, the sense of worth slides up and down. Sometimes teens will look around and find that they got the best grade in the class, or played a phenomenal soccer game, drive the spiffiest car or are the most popular (today). This could be the makings for a great day. However, potential doom is always lurking around the corner. Next week someone else might play a better game. For the teen who wasn’t invited to the “cool party”, did not make it to National History Day, or missed the easy catch in center field, misery is certain as their sense of external value drains away.

Sometimes to cope with the instability of externally based self-esteem teens will imagine that they are better than others so they raise their sense of worth. While there may be some transitory benefits when a teen sits on their grandiose perch of excellence in some outer source of value, it doesn’t feel good to others to be looked down upon. The pain of grandiosity shows up in relationships. Getting up every day and facing the world for teens who believe they are worth less than others is painful. We can help teens appreciate their strengths rather than using them to feel better than others. We can help them have compassion for their weaknesses. When teens remember their worth, they have an easier time seeing the inherent worth of others.

Being in a healthy relationship with self paves the way for healthy relationships with others. This brings us to the second attribute of emotional health and resiliency for teens; boundaries. There are two components of a healthy boundary system. The first is that a boundary offers protection from harmful words, emotions and ideas that could be directed toward the teenager. When their protective boundary is in good working order, teens are able to better keep themselves from being a victim. The second component of a boundary system is containment. With an up and running containment boundary, teens are more likely to be considerate of others and aware of the words, actions and energy they send out into the world. A boundary is different than a wall. A wall does a great job of offering protection, yet there is no way to be connected through a wall. When a teen is walled off, they are not listening to what is important to others and they are not telling others what is important to them. On the other hand, without a boundary at all, there is more than enough connection, but no protection. When a teen is all open and vulnerable, they are very reactive to what others are thinking and feeling, and often feel blamed. They also have a ready-fire-aim approach to interaction. Everything that pops in their mind quickly comes out their mouth without being filtered.

Launching into adulthood requires that teens start to know how they tick, tock and trigger. We humans are multifaceted creatures. Mind, body, emotion and behavior all weave together in the whole of our being (and doing).

When we see, hear, or experience something, the data goes into our brains where we assign it meaning. Think of it as an automatic thought. The manner in which we experience something happens inside our head. This produces an emotion. Along with the thought, emotions are the “go juice” for our behavior, which has consequences. It is important for teens to know and practice the human capacity to think about our thinking. The automatic thought is just the beginning. A different thought (hopefully a more realistic one) can produce a different emotion, fueling more adaptive behavior with better results.

Often teens will have a sense of impending doom, but not know how to stop the dominos from falling. If they can identify the thought fueling the discomfort, they have an opportunity to turn the tide.

The transition from automatic to intentional thinking takes a lot of effort, knowledge and skill. You can help by teaching them to own their own thoughts, emotions and behavior. They’re watching you, and taking in what they see. Model it by not blaming others for your thoughts, emotions and behavior. Secondly, allow them to share their thoughts and emotions. Remember, you don’t have to agree with their perspective to acknowledge that they have it. It helps to have an attitude of curiosity rather than control. When you have this attitude of curiosity, it helps the teen identify their thoughts and feelings. The more they do this, the healthier and more resilient they become. You can also help by not putting teens in situations where they have to stuff their emotions. Emotions don’t tend to change by stuffing. Instead they brew and either erupt in a fury, or leak out sideways. A more resilient approach is to acknowledge the emotion and identify the thought that created it.

All of this helps teens internalize a value system, so they can operate from the inside out rather than the outside in. Young children focus on following the rules to avoid getting in trouble or trying to win approval. During adolescence, we want our teens to internalize the values we have tried to transmit. Sometimes that process is messy as they test out what works for them and experience the consequences of experimenting with different ways of doing things. Hopefully the pain leads to growth and the internalization of healthy values.

We all have a desire to be seen, heard and known. It is affirming to teens when the adults in their lives notice and tune into their emotions. While being on the other side of an angry teen can be uncomfortable. It can help to know that anger is almost always a secondary emotion that covers up fear or pain. The helplessness and vulnerability that come along with fear and pain can be intolerable. So anger comes in on the heels as a more powerful emotion, and teens feel strong rather than weak. Rather than going toe to toe with the anger, be curious and try to connect with the underlying emotion.

Remember the acronym WAIT (why am I talking). Often, teens don’t care what we know until they know that we care. We can show we care by listening. Adults have a better developed ability for delayed gratification. Listen first. Teens will be able to listen to our point of view more easily if they have first shared their perspective and know that it has been heard.

Remembering inherent worth; developing a healthy boundary system; understanding the connection between thought, emotions, behavior and results. It is all part of creating balance, health and resiliency.

You can help the teens in your lives shore up the ability to remember their inherent worth in three ways. First, as you esteem yourself. They are listening when you demean yourself. Secondly, as you esteem your colleagues, spouse and friends. They are watching the ways in which you interact and talk about others. Thirdly, how you esteem them. Your attitude – what is going on between your ears – matters more than you might think. It helps to have an attitude of: “I take joy in your very existence”. Thoughts like this leak out in a way that affirms their being. It conveys to them that you see them, hear them and know them. You can affirm their doing by appreciating their accomplishments. However, remember that their doing neither adds to nor diminishes their inherent worth. Nonetheless, it needs to be noticed and encouraged. You also can help by correcting them so they can improve their doing. Teens need to correct their doing for growth and capability. Provide corrections in a supportive manner. Making mistakes is part of the growth process. This is where it really pays off to have made a distinction between their being and doing. It helps to make praise as specific as criticism.

It is also important to be aware of how serious depressive illness can be for teenagers. Depression is an illness, not a weakness. More than just feeling down in the dumps, it is pervasive, intense and attacks the mind and body at the same time. It differs from stress and sadness in that it is associated with an imbalance of chemicals in the brain that control mood, sleep and appetite.

When people think of depression, what often comes to mind is sadness, tears and a sense of being constantly burdened. However, two often overlooked signs of depression; especially in teenagers; are irritability and agitation. Because low energy and impaired concentration get in the way of completing tasks and follow through on projects, depression can interfere with work, school, friends/family life and responsibilities. Changes in energy, sleep pattern and appetite can be a warning sign. Concentration, decision making and organizational skills deteriorate. Memory suffers; even someone with a good memory has trouble recalling information, particularly if it was recently learned. Quite a liability for a high school student. Not only is thought process altered by depression, but thought content is changed as well. Suddenly, the world is seen through gloomy glasses. They feel like a loser, in an unfair world, dreading a miserable future.

Each of these changes … physical, emotional and social … chips away at a teenager’s sense of well being.

Be aware of the signs of suicide. While some signs of suicidality are obvious (like a person saying they want to die), other signs may be more subtle. Giving away valued possessions, preparing a will, or making amends. Knowing someone who has committed suicide increases the likelihood as does a family history of severe depression or suicide. Usually it is not so much that the depressed person wants to die. They just want the pain to end, and they have trouble seeing other paths out of the misery.

If a teenager talks about suicide, take it seriously. Most who commit suicide are not in treatment at the time of their death. Often with treatment, suicidal thoughts will disappear.

While miserable, the good news is that depression is very treatable. The causes of depression are varied and include biochemistry, environmental, behavioral, emotional and social components. So, the approach to recovery needs to be multi-faceted as well.

One way therapy tries to break the cycle of distress is at the point of thought. Another place to try and break the cycle is through behavior.

When teens try to control things they can’t, they tend to become angry or anxious when they realize things aren’t happening in the way they want. Perhaps trying to get their parents to put in a swimming pool, buy a cabin, and a fancy sports car … like everybody else. They may also take responsibility for things outside their control. Perhaps needing for everybody to like them all the time. This adds to their distress.

Relaxation strategies help decrease anxiety and get out of the limbic system brain function of fight/flight/freeze, so frontal lobe thinking can happen.

Another therapeutic component is to ensure basic emotional needs are being met. These needs include having a source of nurturing and affirmation; a place to belong and have a sense of connection and being a part of something; a sense of making a meaningful contribution; a way to have success experiences and a sense of competency.

We can also take a look at the way the teen is relating to others … family, school, friends … intervention here can play a role in breaking the cycle.

Some parts of therapy are extremely pragmatic and focus on problem solving – helping the teen think; “Here’s where I am, here’s my goal, is what I am doing heading me in the right direction? If not, what can I do to get pointed in the right direction and unstuck?”

As you aim to be present to, support, care for and offer guidance to the teens in your life, remember that you are human, imperfect and fallible. The human condition is messy. We could stray off the path, and may make bad calls. To keep moving ahead, it helps to debrief after a mistake so we learn from it and don’t fall into despair.

What was I thinking when I did this? What did I expect to happen? What exactly went wrong? How did my mistake affect people around me? What can I do now to repair this mistake? If I’m ever in this situation again, what will I do differently? What have I learned? This is an important attitude for us to have about ourselves, as well as an important attitude to have toward our teens. Again, teens will pick this up by watching how we treat ourselves, our peers, our spouses, and them. Being able to accept ourselves as imperfect … albeit well meaning … humans … is one of the most lofty and productive goals to be sought during these brief, guiding, enforcing, and care giving years. The teenagers in your life don’t need you to be perfect … because, as human beings, they themselves will never be perfect either.

You help them when you model for them how to make the most of their strengths, come to grips with their limitations, and manage their humanness to become the best they can be.

by Catherine Mollner

Family of Origin Workshops or Bottom Up Trauma Work by Jan Bergstrom, LMHC

Every year on a regular basis I conduct family of origin workshops called “Healing Our Core Issues”. They investigate the origins of adult dysfunctional behaviors. These workshops are based on the empowering work of Pia Mellody.

During this dynamic educational and experiential process, participants learn to identify and address those early childhood issues, which have fueled various addictions, depression, eating disorders and painful relationships. The program is not about blaming caregivers; it is about getting in touch with the feelings that follow any less-than-nurturing event that occurred in the past, and resolving the consequential grief and anguish. The “Healing Our Core Issues” Workshop in separated into four phases:

Informational Phase – during this phase, participants will learn about the two forms of trauma: Abandonment and neglect, which is a parent being too far away or enmeshment, a parent being too close. Participants discover what kind and to what degree of trauma they got, and how it shows up today. Participants will begin to understand the relationship between the child and the adult as perceived by the child.

Debriefing Phase – This phase consists of delving into the past and recollecting less-than-nurturing and/or abusive childhood experiences and identifying associated thinking and feelings.

Experiential Phase – In this phase, participants will re-experience childhood in a safe and nurturing environment. They will release painful emotions and begin to reclaim their rights and personal power through Inner Child and Feelings Reduction work.

Ongoing Recovery and Empowerment Strategies – Lastly participants will receive a set of strategies, tools, and resources to make permanent these empowering principles in their daily lives.

This workshop ultimately assists the client in being able to live more fully from their functional adult self. Most clients are aware that without some therapy or intensive work, they struggle and slide into “trauma reactions” in their interactions. Through the education and three experiential processes during the workshop, they work toward the goal of”having their own back” and being empowered.

In reviewing their childhood, then accepting and speaking the truth of what occurred they make an adult to child connection, by meeting the needs of the younger parts that are wounded during childhood. This essentially is a process of re-parenting them. Finally they work to protect and stand up for their childhood parts and step fully into functional adult by learning to care for self, advocate for self, shedding emotions and beliefs that no longer work.

The Importance of Couples Boundary Work by Jan Bergstrom, LMHC

When a couple initially comes to see me for a 2-hour intake session, I have already asked them each to fill out my intake form. I study their intake sheets and am prepared with many questions. I ask each partner how they see their relationship and to give me specific examples of the presenting problem. I spend about 40 minutes with each one on how they see the relationship with the other partner present. I then formulate their “dance” or the pattern in which they communicate. Some couples experience this pattern as a vicious cycle that keeps them stuck in relationship, which results in building walls, distance, loneliness and frustration. In my work with couples, they get a clearer understanding of the old learned behaviors from their family of origin and how these patterns keep them stuck. Then, I teach ways to find new behaviors that create more satisfaction and intimacy in their relationship. Ultimately through this practice, couples make choices to move from habitual behaviors (relational patterns from past) to new learned and healthy functional behaviors. The relationship grows to become more about mutual sharing and intimacy and away from a vicious alienating cycle.

There are times when this “top down” approach to couples work is not enough. The couple keeps sliding back to the old patterns of behaving. I may then recommend that some “bottom up” work needs to happen. As I mentioned on the treatment page for individuals, this is more experiential and investigates the beginnings of family of origin trauma. I usually recommend that each individual of the couple do an “intensive” workshop to help create awareness and growth through an experiential process of treatment. This workshop is “Healing Our Core Issues”. I conduct separate workshops for men and for women in my private practice on a regular basis. Please see my page on workshops for further information. If these historical patterns or woundings are not addressed, they keep persistently erupting in a couple’s communication.

Using these, methodologies with couples create positive changes within 4-6 months. Couples start experiencing more connection in the relationship through the practice of using healthy boundaries and learning new skills. These therapies are unique and extraordinarily effective. After a couple of months, much of the couples work revolves around using their speaking and listening boundaries. This method of communication takes practice so that there is only one speaker and one listener at any one time. Through effective use of internal boundaries, the communication gets clearer, effective and authentic which creates truth and intimacy in their relationship.

I do offer Couples Boundary workshops in my private practice. Couples learn effective ground rules to achieve and sustain true intimacy, attain self-esteem and emotional stability, understand their strengths and limitations and acquire concrete tools for building healthy relationships.

Your ability to be relational lies in your ability stay relational in the face of someone else’s disconnection. — Pia Mellody

Working Pia Mellody’s Model of Co-dependence with Individuals by Jan Bergstrom, LMHC

When an individual comes to see me, I work with them to map out and understand their family of origin experience. The purpose of reviewing what happened is NOT to stay in the past, however to understand how those patterns or woundings show up in their present life and relationships. I use Pia Mellody’s model of working with co-dependence that looks at these states of immaturity in one of the five areas: Self Esteem (how were they valued), Boundaries (how were they protected physically and emotionally), Reality (how they were validated in their sense of self), Self Care and Interdependence (how they had their needs met or not), and Moderation (how limits were set and enforced in the family). Everyone has damage in one if not all of these areas growing up.

After debriefing the client on how they adapted in their family of origin, the educating process begins. Teaching the Five Core Self Skills of loving the self, protecting the self (through use of internal boundaries), creating and knowing the self, taking care of the self interdependently, and containing and moderating the self, creates a foundational base that supports healing, growth and renewal.

In addition, another essential part of this process is to begin to understand how “parts of selves” were created to survive their family system. These parts of selves are wounded and adapted and these states show up in their adult lives currently. So the process of therapy begins by cultivating a more functional self to intervene with these states or re-parent them. Strengthening and growing a functional adult self is essential for successful relationships

Eventually through this process of therapy, clients realize that being healthy and relational is nothing you have, it is what you “do”. Living life fully and intimately comes from a commitment to this daily practice. This kind of mindful awareness and action results in more satisfaction, joy in one’s life, and encourages each individual to incorporate a “practice”.

Sometimes it is necessary for bottom up work, when cognitive understanding of one’s family of origin trauma is not sufficient to create change and healing. I recommend that client’s do an “intensive” workshop to help create awareness and growth through an experiential process of treatment. This workshop is “Healing Our Core Issues”. I conduct this workshop in my private practice on a regular basis.

The Purpose of Family of Origin Trauma Work

Many of my clients coming for treatment ask about the purpose of doing Family of Origin Trauma work. So a good colleague of mine out of New Jersey, Cindy Browning LICSW, came up with this succinct and creative description of why do this kind of work.

The purpose of attending the workshop is to live from the functional adult. Remember that younger states, wounded-ness and trauma reactions (which all essentially mean the same thing) are the extremes in which we find ourselves when we are not in our functional adult self. These wounded or immature states come from growing up in a less than nurturing family system. During the workshop we map out these younger emotional states and begin to recognize and functionally intervene or re-parent them.

So, what does it take to live from your functional adult?

  • Work the Core Issues. Initially do this by focusing on the first two Core Issues and therefore by going to the Inherent Worth and the Boundary gym. That means through a daily practice of embracing your inherent worth (I’m enough and I matter”) and practice using boundaries.
  • Recognize when you are in a trauma reaction (younger immature state).
  • Re-parent yourself when you are in a trauma reaction. Remember, functional adult self re-parents by affirming, nurturing and setting limits.
  • Be accountable when you find you have had a boundary failure.
  • Continue to allow yourself to live in your body, identify emotions and practice releasing your emotions responsibly (acknowledge them, feel them and breath as you release them). Nurture yourself by allowing the emotions to surface and be released.
  • Keep loving yourself by having your back, allow vulnerability or protect yourself as appropriate, create and know your reality by using boundaries, be interdependent with others around what you need and want, take care of yourself and seek moderation in all things.

What this all means is you will take things less personally, live as though you matter the same amount as your loved ones (this prevents us from going one up and being offensive as much as it prepares us to take good care of ourselves), be accountable and less resentful. You will speak your truth in your relationships respectfully. You will set respectful limits on yourself and your old patterns rather than indulge them.

This is how we embrace our power, which comes from doing Family of Origin Trauma work. Once we understand the map of what we got, we can start intervening with a functional adult self and living more relationally in the present.

More on Self Esteem, Loving the Self and Affirming our Worth

It is through our daily practice to affirm our worth, have compassion and unconditional warm regard for the self despite our imperfections as humans that creates healing. It is not defining ourselves by thinking we are better than others because of our gifts and that we are not less than others because of our short comings. It is living in the “same as position” with others. This is a spiritual practice of living in acceptance rather than judgment.

The first way to deal with self esteem is to throw out the idea that our worth comes from performance, a career that we have, or attributes that we have been born with or created and acquired in our lifetime. In our culture we buy into to concepts that give more worth to individuals that have acquired these things which can be deadly especially if someone loses their job, home etc. If we hold our worth by accomplishments and attributes only then we become socially worthless.

So the task is to realize that worth exists, but that it is equally distributed and immutable. Everyone at birth has one unit of human worth, absolutely equal to everyone else’s unit of worth. No matter what happens in your life, no matter what you do or is done to you, your human worth can’t be diminished or increased. Nobody is worth more or less than anybody else.

One way to look at our worth or self esteem is through the lens of compassion. It exposes the essence of your humanness. Through the struggle of living we come to realize that we are all in the same boat. That there are times of pain, and yet we carry on, seeking whatever emotional and physical sustenance that is available. It is important that we “carry on” in the face of all the pain, past and to come, we continue to struggle. So when we let this awareness soak in, if we let ourselves really feel the struggle, we may begin to get a glimmer of our real worth. It is the force, the life energy that keeps us trying.

So having compassion for ourselves and our journey is the beginning of acceptance of us despite our flaws and imperfections. It is through carrying on with our best intentions. Despite our mistakes, we are doing a good job – because it is the best job we can do. Our mistakes and the pain that follows teach us. It becomes possible to accept everything we do without judgment because every minute of our life we are engaged in the inescapable struggle of being human.

Ultimately we can forgive and let go our failures and mistakes because we have already paid for them. It is our condition that we do not always know the best way – and even knowing the way, we may not have the resources to follow it. Our worth or self esteem is that we are born into this place. And that we continue to live with compassion and warm regards for ourselves, despite the enormous difficulty of life.

Pia Mellody’s Relationship Maxims

Resentment is like taking poison in the hope that your enemy will die.

Resentment is victim anger. Self-pity is victim pain. Both are normal emotions, and they are not toxic if in fact we have been the object of a boundary violation. Resentment and self –pity are important when we feel someone has wronged us and treated us as if we were worthless. Resentment and self-pity help us go to a proper defense. But when we falsely feel that we are victims, when we feel the need to get even with someone who has not victimized us, we become obnoxious and self-defeating. If, for example, our partner has just made a well spoken remark about the opera and we resent him or her for being “arrogant,” that is just a failure of our own self-esteem. Just because something has gone badly for us – we didn’t get invited to a party or our term paper didn’t get a good grade or bad weather spoiled our vacation – does not mean our boundaries have been violated. To feel resentment and self-pity in the latter cases becomes a self-inflicted poison and makes us our own tormentor.

© Pia Mellody