Vulnerability for the Wrong Reasons?

Vulnerability is powerful! Championed by heart-centered leaders like Brene Brown, Simon Sinek, and Michelle Obama, we’ve taken notice of how it can pave the way for authentic leadership and deeper connection. Vulnerability has its place in allowing people to feel seen. Learning to lean in to the discomfort to grow, It can serve as a catalyst for change. 

I myself have experienced the positive power of vulnerability as a leader. Yet what if there are times we embrace vulnerability for the wrong reasons? To manipulate others? Forced intimacy to get our needs met? Learned helplessness to be seen and cared for because we find we are unable to help ourselves? Showing up in the form of:

People Pleasing.

Co-dependency.

Manipulation.

It’s not uncommon to support vulnerability as a meaningful tool after trauma. For some, it starts with addressing the absence of vulnerability in a person wanting to feel strong, independent, and in control. For folks with mental health diagnoses of Complex Post-Traumatic Stress Disorder (C-PTSD) and Borderline Personality Disorder, vulnerability within relationships can feel even more complicated.  C-PTSD, for example, recognizes the impact of repeat relational trauma that challenges a person’s sense of safety and security. The unpredictable environment of not knowing if their needs will be met, when they will be met, or how often. Attachment trauma. Rupture with no repair. If vulnerability has the capability of bringing people closer together, can it manifest as a learned behavior with significant consequences? 

As a therapist, I find myself worried that vulnerability can be contrived in response to trauma, pressure, and pleasing of others. Concern that individuals who have had their boundaries violated will embrace vulnerability as a tool but not recognize the risks. What are the consequences of strategic vulnerability for agenda-driven reasons? Perhaps the person receiving the fabricated expression of vulnerability finds it draining or false. Individuals engaged in forced vulnerability to get their needs met may find themselves in burnout, resentment, or fatigue. By embracing inauthentic vulnerability, are we unknowingly elevating our risks of being physically or emotionally hurt again?

With these challenges in mind, I continue to engage clients in an energy wheel exercise in order to explore their relational boundary work each week. Presented as slices of pie, I ask them to map out their energy dedicated to various tasks each week, both personal and professional. Emphasizing relational energy, I encourage clients to remain curious by asking, “what’s my energy pie look like today?”

In the example above, the client indicates spending a lot of energy in Week 1 pleasing her father by spending time with him, meeting his needs, and putting out emotional fires. By actively practicing boundary work over the next several weeks, the client indicates a more balanced energy towards her primary goal of finding a job. By processing the shift in energy, the client recognizes an increase in self-confidence and improved well-being in not feeling as drained by the interactions with her father. This discovery not only reinforces her motivation to continue her important boundary work with family members, it also helps her explore her relationship with vulnerability.

As we can expect, boundaries and vulnerability go hand in hand. From a trauma lens, boundaries and vulnerability are equally challenged by the maladaptive coping skills we develop to survive a threatening experience. Therefore it is important to explore a client’s relationship with vulnerability, identifying how they feel about it, when they embrace it, and how it can serve as an opportunity to bring them closer to connection in healthy relationships while protecting them against unhealthy patterns.

Avoidance and Attendance: Advocating for yourself

It’s that time of year. The time where you might feel the urge to disengage from therapy in response to the season, holidays, or stress.  The time when you may need an appointment the most in order to support you through trauma, family conflict, isolation, and loneliness. For some, the crises seem to intensify during the holidays. Perhaps you are experiencing depression symptoms due to the winter weather or maybe you are battling loneliness in spending the holidays away from your loved ones. Perhaps you are attempting to navigate the unwanted memories of trauma during your family’s holiday dinner or are experiencing high anxiety because of money stress and holiday shopping. You on your journey to sobriety and anticipate having to navigate holiday parties around family and friends where temptation may lead to relapse. Combine these stressful situations with your ability to cope and you may feel you can engage in therapy fully to receive support, or in some cases, desire to disengage in response to the overwhelming feeling of all that is weighing you down. It can feel like a balancing act to engage your supports when feeling stressed, but rest assured, it can be an empowering experience to engage in through the holiday season in support of your personal and relationship goals.

Avoiding Appointments

The more easily measured type of avoidance when overwhelmed is a change in attendance in your scheduled sessions. Perhaps you find yourself canceling sessions when in the past, you’ve been consistent in attending each week. Or maybe you find yourself cancelling last minute due to feeling like you need to use that time or money for another task? How do you explore your needs when you haven’t been able to justify spending the time or money on your own mental health? Depending on how your therapist structures sessions, you may want to consider advocating for yourself in exploring the following:

• Completing a phone call with your therapist to communicate what is going on in your world and attempt to re-engage in sessions to support managing your stress.

• Engaging in a phone session instead of a face-to-face to explore and address present stressors if you are unable to attend in person.

• Identifying a different appointment time that encourages attendance such as an early morning before work or later evening if appropriate and depending on if your therapist has openings at those times.

• Identifying biweekly or monthly sessions for the holiday season to account for financial constraints and time management.

• Reviewing your attendance contract with your therapist to explore opportunities and restrictions, such as possibly placing scheduled appointments on hold and resuming at a later time if appropriate.

Emotionally checking out

The hope is that with ongoing rapport, the conversations with your therapist above can support you with healthy communication and accountability when experiencing increased distress. Your relationship with your therapist, or rapport, becomes even more important when you find yourself engaged by your therapist around a lack of emotional participation in session. Perhaps you begin to notice that you struggle to arrive on time to your scheduled appointments, jumping into sessions with details unrelated to yourself or changing subjects rapidly throughout the scheduled time. Or maybe you remain surface-level in your processing, not dropping down into emotions and deeper meaning in session because you are avoiding the stress or have worries that it will become unbearable when talking about it. With healthy communication, you can name what’s going on for you and process the outcomes with your therapist. Here are some examples of how you might start the conversation:

• In response to running late: “I’m struggling to get here on time and it feels rushed lately, like we have to fit it all in. Can I talk to you more about what that’s like for me?”

• In response to staying surface-level: “I have to admit, it’s easier to talk about the lighter things than the deeper, more stressful stuff. I think I’m worried that if we talk about it, it will just make me feel worse.”

• To encourage connection: “I feel very disconnected from my body, like my head is fuzzy and floating and I just want to be numb rather than this stressed all the time. Can you help me feel more like myself?”

• To encourage feedback: “I’m needing something different in our sessions to help me. Can I talk to you more about that?”

• To name fears: “I’m afraid that if we talk about these things, I won’t be able to function or get things done afterwards,” or “I’m reluctant to talk about this now because we won’t have our next appointment until after the holiday.”

Any of these statements can lead to a supportive conversation with your therapist to further identify and explore your needs. These sessions can prove to be some of the most impactful and fruitful in not only holding space for emotion and processing of stress, but also supporting vulnerability and self-advocacy in exploring how you can engage all of your supports in ways that feel beneficial to you.

Hear me

Vulnerability is hard. Yet for many of us, the power of being seen, heard, and understood makes engaging in vulnerability worthwhile. Your therapist, engaging you from a place of compassion and empathy, can better understand your needs when you speak of them. Your therapist can offer a neutral curiosity with ongoing optimism conveys the message that, together, you can find relief. Whether it be concrete tools for coping or holding space for your emotions, your therapist can create a safety net to address any fear, guilt, or shame you may be harboring in these moments of distress. Engaging in holiday travel, consider your therapy sessions a roadmap to relief! With direction and insight, you can address avoidance and attendance from an authentic, supportive place to best serve you during the hustle and bustle of the holiday season.

“You are as amazing as you let yourself be. Let me repeat that, you are as amazing as you let yourself be.” Elizabeth Alraune

Exploring Equine: Therapeutic Focus and Interventions

I have lived around horses since I was pretty young and have always been drawn to these magnificent animals. Their size alone fascinates me and the temperament of each horse is as unique as you and I. The relationships between our clients and horse therapist is something that we are not able to provide. Horses seem to have an extra sense when something is wrong or when a person needs a hug, a shoulder to cry on or just someone to walk with. These horses know when a person is struggling with traumatic incidents, self defeating behaviors, self control and low self esteem. 

We have all started to hear more about Equine Assisted Psychotherapy groups and other sessions that involve animals in our practices. The terms are somewhat new to the world and started getting more attention in the 1990’s- many years after we knew the impact on mental wellness that is provided in equine work. Horses are non-judgmental and will easily meet the client where they are at. The types of therapy that we provide at Peace Within Counseling and many other equine treatment facilities is extensive. 

• Ground work- grooming, leading, obstacles. These activities lead to a greater sense of relationship by being able to touch the horse, telling secrets to the horse and allowing the horse to get to know the human as well as getting to know what the horse likes or dislikes.  Matching the breath of a horse is very grounding. Connections are important, and at times, easy to gain with a trusting horse and companion. However, when putting a traumatized companion with a horse who also has faced trauma it can be a bit of a human challenge.  The person may have numerous hesitancies and extreme anxieties when facing this 1000 pound figure in front of them. However, most times the horse can sense the hesitancy and be able to pull in where no other human can emotionally touch. The horse can bring a comfort that the person may not accept from others. For instance, a young child who recently lost a parent was working with one of our horses. This child was shutting down and afraid to connect or accept others. The horse recognized this and pulled this child in for a huge hug. This boy broke down at this moment and was able to allow the touch and continued to work through his struggles and grief.
   
• Ground driving horses- a new phenomenon to me as of last month. We had a group of about 30 people join us in a group with 2 Percheron horses- each about 2000 pounds! The group had a chance to bond by brushing, petting, talking and even being able to sit on these gentle giants. Everyone faced a huge hurdle by walking behind these beauties while leading them around the round pen! These humans were able to control 4000 pounds of animals with a slight tug on their reins. We were able to fight the fear of the intimidation of an 18 foot horse that towered over everyone. This was a great time to understand the power that we posses and the control we can have if we allow ourselves to focus. 
   
• The horse can be another tool to add to ones toolbox. This is where people find total relaxation by being near to the horse. Energy work can be done at this point. We are able to lead the horses around the arena with our energy- no leads, no halter, no whips. Pure energy and pure exhilaration! We can gain a sense of accomplishment, leadership and regain lost self control when we are able to be at one with the animal. We teach the human companion to vision what they want the horse to do and the horse will follow. And when the horse does not listen to our desires, we have a great teaching moment with our humans as to how sometimes life doesn’t go as planned. We all struggle at one time or another and we incorporate these mindsets into our clients. Many times, people can relate to this and compare to a time in their life where things went wrong and maybe even notice the strengths that were gained from this. Then we try again with the horse- maybe some relaxation has happened through this acknowledgment and our horse will listen, maybe not.  
   
• Riding is another way to use horses in therapy. This is another fantastic opportunity for the human to feel the power and strength under their body. It can be a cathartic experience to be able to lead this horse around the arena with a small nudge or a slight pull of the reins. The movements that ensue are very relaxing and beneficial to those traumatized clients. I’ve known many people who trailride and end up being so relaxed that they have fallen asleep on their companion- not a goal we pursue in therapy, however.

This is just the beginning of understanding Equine Assisted Psychotherapy. Many people become certified in Equine Work through many programs. At PWC we have Equine programs where we ( the therapists) work closely with a horse handler or certified coach- someone to watch and  make sure the horses and humans are safe and to teach the do’s and do not’s of working with horses. Those certified in Equine Work as coaches are going to be able to share activities and sense things within the horses that most of us may not understand. Coaches can teach the roles of the horses in the herd and how we can relate this to our family, social and work dynamics. As a therapist, we are able to help relate to the dynamics that happens before our eyes to what the human is needing at the moment. We are able to focus more on leadership or focus more on boundaries with the obstacles that the coach can help lay out. We can fill in the clinical gaps that the coach may not be able to understand. By having a relationship with our clients, we can give them what they need through the relationships with the horses. It is a fabulous, amazing and miraculous bond to watch form in just moments.

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If you would like to learn more about our programs, please feel free to reach out to me at (303) 888-9042. We are offering Individual, Family, Couples and Group sessions this Summer and Fall. We offer kids and teen groups and soon will be adding groups for adults, cancer survivors and those struggling with PTSD and other traumas. We will also be hosting a brunch and team building morning in July for all therapists- watch for info soon.

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Guest post written by Nakoma Garcia, MS, LPC

Nakoma Garcia, MS, LPC graduated from Indiana Wesleyan University with a bachelor's degree in Social Work in 1997. She later went back to grad school for Professional Counseling at Grand Canyon University. She is a licensed professional counselor in the state of Colorado. She is trained in EMDR and also offers Equine Assisted Psychotherapy in her practice. She has worked with hundreds of individuals and families who have dealt with life changes and helped them find peace and strength. Nakoma is passionate about working with people who feel change is hard and helping them understand that it does not have to be.

Staying Present: Finding Focus in Session

In my years in practice, I find building a rapport with the client and being able to stay present during intense moments are of utmost importance. In order to make progress, a foundation must be built where the client feels safe and supported. Below you will find useful techniques in building a rapport and staying present with your client during sessions.

Building Rapport

• Ask the client what specific goals they have for therapy.
• Make sure the client knows that you are there for them, so if perhaps they deviate from the goals they were working on and/or want to talk about something else during a session, allow them to so.
• Do not impose your views or beliefs on your client.
• Be nurturing, empathetic and non-judgmental.
• Ask how we will know they are making progress or have met a specific goal.
• Each session, ask what the client may need to explore how the session is productive for them.
• Encourage the client to voice his/her opinion in the session. If the client does not agree or like something you as the therapist says, make sure you create an atmosphere where they know they can bring that up without negative consequences.
• Stay present with the client during intense moments, and during all moments.

Staying Present

Helpful techniques in doing so include but are not limited to:

• Ask the client what it was like for them to say that (whatever it is they shared that was painful) out loud.
• Thank the client for trusting you with the information.
• Validate the client’s feeling during those moments. “that sounds so painful, sad, terrifying.”
• Be comfortable with silence.
• Allow the client to process through at their speed.
• Tell the client you are there for them, with them, that there is no judgment.
• Before the session ends, ask the client if there is anything they need to help them transition back into their day.
• Make sure you (the therapist) know what you need to care for yourself.
• Yoga, meditation, and exercise may help.
• In order to stay present, we need to be one hundred percent focused on the client; make sure you seek out your own therapist if needed.

I find these tools useful in my practice and hope you will too.

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Guest post written by Trisha Swintom, LPC, LMFT

Trisha Swinton, LPC, LMFT is a Licensed Professional Counselor and a Licensed Marriage and Family Therapist. Trisha is currently in private practice and has been practicing for about 14 years. She currently works with adults providing individual and couples therapy. Her educational background includes a Bachelor’s degree in Elementary Education, a Master’s degree in Special Education and a Master’s degree in Community Counseling with an emphasis on marriage and family therapy.

http://www.trishaswintoncounseling.com

Avoidance and Attendance: How to Address Each in Therapy

It’s that time of year. The time where certain clients disengage from therapy in response to the season, holidays, or stress, and the time when others need appointments the most in order to support them through trauma, family conflict, isolation, and loneliness. When working for an agency, the crises seemed to intensify during the holidays. First it was the client diagnosed with Bipolar Disorder experiencing depression symptoms due to the winter weather. Then the client with trauma from sexual assault having to see their perpetrator at the family holiday dinner. Or the single client with no access to family experiencing increased suicidal ideation in response to spending the holidays alone. Or the client with high anxiety becoming stressed about money and gifts for their family, losing sleep and snapping at their kids. And finally, the client sober from alcohol for three months having to navigate holiday parties around family and friends where temptation may lead to relapse. Combine these factors with a client’s distress tolerance and they could engage in therapy fully to receive support, or in some cases, disengage in response to their symptoms. As helping professionals, how do we balance the variety of client needs with consistency, empathy, and grace?

Lack of physical attendance

The more easily measured is a change in physical attendance in your scheduled sessions. Perhaps the client starts to cancel sessions when they’ve been consistent in attending each week in the past. How do you explore their needs when you haven’t been able to see them in the office for several weeks now? Depending on how they are engaging you to cancel the appointments, you may offer a couple of ideas in response to their distress:

• Completing a phone call to gauge what is going on in their world and attempting to re-engage them in sessions to support symptom management.
• Offering a phone session rather than a face-to-face to explore and address present stressors if they are unable to attend.
• Identifying a different appointment time that allows physical attendance such as an early morning or later evening if appropriate.
• Redirecting text messages of distress by offering an appointment to discuss and support them.
• Reviewing their attendance contract with them to determine how they’d like to proceed, including possibly placing scheduled appointments on hold and resuming at a later time if appropriate.

Lack of emotional attendance

The hope is that with ongoing rapport, the conversations above can demonstrate healthy communication, accountability, and boundaries with a client experiencing increased distress. Rapport becomes even more important when engaging a client around a lack of emotional attendance or participation in session. Perhaps you begin to notice that the client arrives late every week, jumping into sessions with surface-level details or changing subjects rapidly throughout the scheduled time. Or maybe they remain at head-level in their processing, not dropping down into emotions and deeper meaning in session with you. With healthy rapport, you as their support can gently name the behaviors you are seeing in the room to encourage a healthy conversation about their avoidance. Here are some examples of how you might approach them in a compassionate way:

• In response to their running late: “I’m noticing how rushed it feels lately coming into our sessions and feeling like we have to fit it all in. Can you tell me more about what that’s like for you?”
• In response to staying in their head: “I’m noticing you are very much in your head today when it comes to describing how you feel, can I ask you to pause a moment and share with me what’s happening in your body right now?”
• To encourage reflection: “I feel like you are very far away in this session even though we are sitting across from one another, what does it feel like for you?”
• To encourage feedback: “I’m hearing that you have a lot on your plate right now. What can I do to help you best in this moment?”

Any of these gentle inquiries can lead to a tenderness and connection to emotion as well as an access point for clients to identify and explore their needs. These sessions can prove to be some of the most impactful and fruitful in not only holding space for emotion and modeling what it looks like to communicate needs, but also supporting vulnerability and self-advocacy in the client as to how they can engage their supports.

I hear you

As a therapeutic support, engaging clients from a place of compassion and empathy can be powerful to their experience. Balancing a neutral curiosity with ongoing optimism that, together we can find relief, can be empowering for the client. By starting with gentle reflection and gaining better understanding of their emotional response to stressors in their life, we can then encourage exploration and practice of positive coping. Whether it be concrete tools for coping or holding space for their emotions, we are creating a safety net to address any fear, guilt, or shame they may be harboring around their functioning in these moments of distress. Like any roadmap, with direction and insight, we can address avoidance and attendance from an authentic, supportive place to best help our clients in navigating their world.

“If we can share our story with someone who responds with empathy and understanding, shame can’t survive.” Brene Brown in Daring Greatly: How the Courage to be Vulnerable Transforms the Way We Live, Love, Parent, and Lead.