Call 412.853.2000 for a free 10 minute conversation or to schedule an appointment
Becoming Informed
Depression
Depression, especially more severe depression, is a complex disease and research has yet to uncover a sole cause. Depression can be caused by:
- a serious long term illness such as cancer or chronic pain
- life changes such as the death of a family member or moving
- a family history of depression or anxiety
- past physical, sexual, or emotional abuse
- certain medications prescribed for another condition
- long term illness of a loved one
- long standing marital or family conflicts
- chronic drug and alcohol abuse
- financial problems and unemployment
- other medical condition ( e.g., Hypothyroidism, long term insomnia)
Ruminating and reliving the past is often at the core of depression. However, most of the actions we take and the emotions we feel are a result of what we expect will occur in the future, and as a result our life is determined by how we see this future.
To help you determine if you have depression, you can complete the Hamilton Scale for Depression and give us a call to find ways to create a better future for yourself.
Anxiety, Stress, Panic
Stress and anxiety typically go hand in hand. Stress from work or life pressures often leads to anger. Stress is caused by outside or internal pressure, long term frustrations, and by how we interpret or see our world. Anxiety is often a result of stress that lingers long after after that stressor is gone. Stress typically emerges in situations or thoughts that cause frustration, nervousness, anger and anxious feelings. A stressful situation for one person may not be an issue for someone else.
To help you determine if you have anxiety, take the Hamilton Anxiety Rating Scale (HAM-A).
Three highly effective, well established and lasting treatments for anxiety disorders are CBT, DBT and EMDR. Combined, these approaches will focus on exploring the interaction between your environments, thoughts, emotions, behaviors & decisions you make in life. You will also develop skills for managing distress, mindfulness, and emotional self regulation.
10 Marriage & Relationship Busters
No relationship is perfect and problem-free, and in over 40 years of experience, it's clear that all marriages take work, commitment, and effective communication of needs, expectations and desires. Marriage isn't necessarily hard, but it becomes harder when people "go stupid". Essentially, when one or both partners behave out of anger, anxiety, hurt, defensiveness, or maliciousness, problems escalate quickly. Overall, there are common issues in most marriages where conflict is higher.
- One partner is trying to change the other. The more one partner tries to "perfect" the other, the less perfect that person will become as the struggles grow. The truth is that the best you can do is change how you react to your partner. After all, you married them for who they are...right?
- Talking at as opposed to talking with your partner. The act of simply talking does not translate into effective communication. Constant complaints, repeated criticisms, playing victim, trying to create guilt, yelling, telling your partner what to do, etc., are not communication openers. At best, they are communication road blocks and barriers.
- Loss or decrease in emotional and sexual intimacy. A partner who is emotionally absent, disengaged and not caring or concerned can lead to a drop in emotional and sexual intimacy.
- Loss of focus and awareness or being mindful of your partner due to issues with finances, in-laws, a newborn child, work pressures and a mental health condition or addiction can lead to emotional distancing and loss of connection.
- Emotional or physical affair. Even a micro-affair (when one partner behaves in secrecy and deception with someone outside the relationship) can lead to long term strain and damage to a relationship. Most affairs begin harmlessly, but soon escalate.
- Difficulty letting go of, or forgiving past behaviors. Many marital and relationship problems stem from one or both partners refusing (even if subconsciously) to let go of the past. Letting go does not mean ignoring or sweeping issues under the rug, it does mean not carrying these issues into future arguments.
- Finances. Different values and spending habits occur in 10-20% of relationships. One partner wants to save, the other feels compelled to spend. One partner wants to spend the annual bonus on a new car, the other on the kitchen or living room.
- Ignoring the little things that make the relationship special. Not appreciating each other, focusing on work or money or the kids, not attending to the romantic part of the relationship, not listening, and not acknowledging how much you value the other person.
- Spending too much time and emotional energy plugged in to social media and technology in general, at the expense of spending time with your partner.
- Constantly looking for the negative or for what is not working. This is similar to high criticism, but more generalized in that the partner approaches the relationship with a negative attitude, is emotionally dry and vacant, and through this lens sees mostly what is wrong in the relationship.
Anger Management & Rage
Signs of poor anger management are:
- being quick to anger and losing control over the smallest incidents
- yelling and aggression towards others or destruction of property at home and in public
- repeated cycles of anger followed by remorse and apologies
- substance abuse or addiction (anger issues are often wrapped in alcohol or drug use)
Anger can consume you and other relationships. Sometimes it results in "weaponized" silence where you shut out others to punish or hurt them. And sometimes it affects important people in your life or work.
In therapy you will learn skills for managing anger--progressive relaxation, healthier thinking patterns and problem solving strategies, and spotting triggers and thoughts that lead to anger. You will learn assertiveness skills so that you can express yourself effectively and feel more in control of situations.
To determine if you have an anger management problem, you can take this assessment.
How to choose a good therapist
Looking for a good therapist? What I tell others:
1) The key is to know that you are able to bond or connect with your therapist. Everything else is secondary. You're looking for comfort, rapport and ease in conversation.
2) Therapy technique is not as important as the therapeutic relationship between you and the person you're seeing.
3) Once you've established that a connection is there, look for competence. Do they know their material? Are they up to date on the latest research on therapies? Do they know how to manage the issue that brought you in to see them?
4) Find a therapist who really enjoys their work. Nothing is more defeating than seeing someone who trudges along, day by day, emotionally exhausted from seeing people, or someone who is not fully engaged. You're looking for someone who is excited about being in the same space with you and is there to add value to your life.
5) Avoid "Stepford" therapists who mostly sit there quietly, or who always agree with you, or don't challenge you or encourage you to step out and try new ways of thinking, feeling and behaving. Hopefully you're looking for someone who is active, and directive when necessary, but also knows when to sit quietly and be a witness to your struggle and pain.
6) It rarely dawns on most people to actually interview a prospective therapist. A few brief conversations can give you a lot of information about who will be the best fit for you. Call before making that appointment.
7) Once in therapy, don't be afraid to set the tone and direction (to the extent you can). If you can't today, work towards doing so at a later time. A good therapist, one who is looking out for what is best for you, will look to you to lead and provide direction. They will ask excellent question that force you to think and look at things differently, and will challenge you to meet your goals.
Recent Online Publications
Detail your services
Recent articles:
https://psychcentral.com/blog/10-signs-your-marriage-is-in-trouble-again-after-couples-therapy/
https://www.marriage.com/advice/therapy/emotional-abuse-in-marriage-part-1-of-3
/https://www.marriage.com/advice/therapy/why-male-partners-are-emotionally-abusive-part-2-of-3/
https://www.marriage.com/advice/therapy/breaking-the-cycle-of-emotional-abuse-part-3-of-4/
https://www.marriage.com/advice/therapy/ending-the-cycle-of-emotional-abuse-part-4-of-4/
https://www.slideshare.net/DavidOSaenzPhDEdMLLC/guerrilla-tactics-for-the-difficult-client-2015
https://www.slideshare.net/DavidOSaenzPhDEdMLLC/transforming-your-marriage