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Therapeutic Separation for Couples

By Margy Davis-Mintun, LCSW, ACSW

When a marriage/live in relationship feels broken and the zest of the early years seems lost, before jumping to the solution of divorce, why not consider a less drastic yet jarring experience, a therapeutic separation. This type of separation is designed between clients and therapist to increase the possibility of reinvigorating and rediscovering the essence that has been covered by stress, work, children and life’s distractions.

Good candidates for a therapeutic separation are couples who can remember that in the past they experienced pleasure, joy and companionship with each other, and through the years distance has prevailed and loneliness has become the more frequent companion.

What a therapeutic separation is designed to accomplish is to create enough distance, physically, by living apart to really allow the opportunity to feel the absence of the partner. During this time of living apart the thrust is to repair the marriage, rather than move toward divorce. We know that 70% of second marriages end in divorce, a higher number than first marriages. We also know that many relationships can repair provided a concerted and focused effort is directed toward that end so long as both want the relationship to continue. Furthermore, we know that past feelings of connection can be rediscovered provided the purpose/opportunity is designed for such.

In a therapeutic separation, the couple agrees to the terms of the separation, with the guidance and counsel of the therapist. Both are engaged in ongoing therapy and there may be occasion for individual work as well. In these separations, dating becomes the means of contact with each other, and contact is reduced to a minimal level so that each can gain a glimpse of what it would be like to live without the partner and experience the most positive aspect of being together. There are mutual rules established around the terms of the separation, these include and are not limited to such choices as monogamy, dating others, privacy, finance, how to deal with work, family and friends, and if relevant the care of children. The time frame is 3-6 months, anything longer tends to increase the possibility of moving too far apart to come back together, and anything shorter tends to be too quick to actually fully benefit from the time apart..

This separation discourages problem solving (regarding the couple) outside the therapeutic relationship in order to prevent further harm and repeated failure of repair.
The goal is to rediscover the positive aspects of the relationship, to build safety within the context of the couple and to provide space for the individual as well as the couple. In the therapy process, problem solving differences, communication and negotiation skills are enhanced, so that the couple can practice newly learned skills. Assumptions are reevaluated and beliefs are examined. When there are breakdowns in the relationship outside the therapy session, those are discussed and reviewed in the protective environment of the psychotherapy session. The goal is to recreate the positive underlying theme in the couple so that assumptions, if made allow for the benefit of the doubt rather than falling to negative interpretations.

With the support of therapy, and the commitment of couples to find ways to stay together in a more meaningful and rewarding relationship, therapeutic separations have been successful in preventing divorce and in creating stronger, more loving, and healthier partnerships. The key in deciding to try this as an alternative to divorce, is that both partners in the relationship want to remain together, are willing to work toward this end and commit to the process of creating a more satisfying and stronger connection with each other rather than “jumping” into divorce.

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Holiday Myth and What to Expect

Garth Mintun , LCSW, CSW-G

Do you wonder why when we have the full range of emotions for approximately 11 months of the year, we expect to be happy 100% during the Holiday season the last month of the year? These expectations tend to be carried forward from generation to generation and are transmited in our culture, the myth that we should be able to be completely happy and in the absence of happiness, we may judge ourselves harshly.

In our psychotherapy practice, people come in for consultations during the holiday season often because of past histories of painful experiences during this period of the year and sometimes because they wonder why they are “not happy and what’s wrong with me”. Their notion is that others are happy, and something must be “wrong with me” and can “you fix it”. I address the “myth of 100 % happiness” and work from the awareness of the following facts about holidays:
1. Families gather more than any other time in the year. Families are composed of individuals of whom some are doing well/poorly, feel well and/or feel badly. We hold feelings/opinions toward everybody in our family at different times, i.e., anger, sadness, guilt, joy, and often mixed feelings about individuals.
2. We grieve our tragedies, deaths and losses. We mourn for those of us who cannot come “home” for the holidays”. With grief there arises intense sadness.
3. As the year comes to a close we tend to review the past year, the events that caused both pain and joy, as we look forward to the New Year. This process may generate strong emotions.

We would not expect ourselves to have only one emotion during the first 11 months of the year. I wonder if we can allow ourselves instead to have our many feelings during the holiday season and allow space to feel all those feelings as human beings? Perhaps we could celebrate our human-ness with all of our mixed emotions. Perhaps we could gently attend to our own process with compassion and love, honoring the fullness of our being. In giving ourselves grace we can honor our experience. As we move forward with more openness to our own process, we often find increased tolerance for others as well.

When with family, we often experience sadness, anger and need to take a deep breath and “be in the moment”. We don’t need to verbalize all of our emotions; we can be selective about the emotions we share with family and close friends. Perhaps we can expand our ability to connect with ourselves in a more caring manner.

What if we can expect and allow the wide range of human experience this holiday season and not “should “ourself away. Let the feelings at the present time and let the “Season” be part of the experience and less of expectations. Perhaps I can give myself space to have the whole range of feelings this holiday season and expect this instead of a Merry Little Christmas…….Maybe we can have a Human little Christmas and a Wide range of feelings in the New Year.

Have a Wide range of feelings this Holiday Season!!!

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Coping With Anxiety

By Margy Davis-Mintun LCSW

“Generalized Anxiety is characterized by at least six months of persistent and excessive anxiety and worry” according to the DSM IV manual of mental disorders.

Anxiety is most often manifested when focusing on the past or the future. It’s impossible to feel anxious and present simultaneously. Anxiety is usually experienced through remembering the past and projecting into the future. Since it’s impossible to live in either the past or the future, anxiety takes over.

Often negative experiences of the past are relived in one’s mind, and in this process, the individual actually experiences the emotions as though the experience is occurring in the present. In an effort to avoid the repetition of negative past experiences, one may begin to imagine the situation and project that incident into the future, attempting to prepare for a new and different response. The problem is that the projection is only that, and, despite the best planning, the situation does not usually play out in the manner imagined, our responses tend to be spontaneous, regardless of the amount of planning. This process is often experienced as worry.

A cycle begins in our thought process where we are attempting to avoid negative experiences in the future. Unfortunately in doing so we re experience the suffering and pain of the past with little advantage to future changes. The suffering and pain is actually repeated in our planning process, and we relive that which we are trying to avoid.

The illusion we engage in is the belief that we can actually prepare and prevent pain in the future by creating scenarios in our mind and altering the events that are yet to come.
While anticipating the future and preparing/planning has an important role in life, we can become anxious by the continuous repetitive thoughts that recreate over and over the past events causing more suffering than relief. These thoughts can take on an obsessive quality and re occur as worries.

It’s not uncommon that we criticize our past actions, and curse ourselves for our behaviors/words, and try to make corrections in our mind by thinking about what we could have or should have done differently.

There are a couple of simple alternatives that help alleviate the worry/anxiety. The simplest is to become focused on the present, since it is only possible to live in the moment. This can be done by either paying attention to breathing, or paying attention to our senses. We can only breathe and experience our senses in the present, e.g. hearing, touching, smelling, and seeing. These two options allow us to come out of the past and future and focus on what is actually possible, that which is now.
An easy way to attend to breathing is to pay attention to the breath, noticing inhaling and exhaling our breath. For some it helps to count and slow down breathing so that we are taking oxygen in a rhythmic pattern of slow and deep (belly) breathing. This process of noticing our breath brings us back to NOW and allows disruption from worry. Another option is to take in our senses and look and actually see what surrounds us, pay attention to the sounds in our environment, and notice our body sensations such as the contact between our body and the surface we touch, or feet on the ground, or our hands. Also notice the scent in the surroundings. Since we can only have our senses in the moment, this also brings us out of worry and into the present.

Activity can also alleviate worry, taking a brisk walk or exercising is helpful. A healthy diet and eating meals rather than snacking as a means of coping with worry is also helpful… Generally, activities in which we are mindful of the moment will help distract from worry and keep us focused on that which we have control.

Though these suggestions sound elementary and simple they actually require our presence to our self, becoming alert to drifting back into old patterns of worry. Sensations in our body can signal that anxiety is taking over. This is commonly felt by racing heartbeat, increased sweating, and tension in the chest or body. By becoming aware of these tell tell signs in our body, we can catch our anxiety at the initial stage and begin to move away from worry before full blown anxiety takes place.

If you are inclined toward meditation, art or music, sometimes those are also ways to gain some relief from anxiety. Remember to focus on the present. Easy as this sound it takes practice and mindfulness, and over time, old patterns of worry begin to diminish. You will find that much is possible in the present and nearly nothing is possible when the mind is stuck in reviewing past actions and trying to create remedies in the future, only worry and anxiety persist, causing one to become lost in the illusion that we can control the future.

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Mentoring Youth Programs

Mentoring/Making a Difference( talk given by Garth Mintun, LCSW, CSW-G at the Sheridan Indiana Kiwanis Club on 10-13-06)By Garth Mintun, LCSW, CSW-GI. What is mentoring: Wikopedia definition: Youth mentoring is the process of matching caring, concerned…

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YOU are in charge of your Health-Advocating for Your Wellness

Sometimes we forget that we (the consumer of health care services) are in charge of our wellness. This is indicative of the system because often when we receive medical service whether it is psychiatric or for physical ailments it appears that the “experts” have all the power. That is not true, they are our consultants and we need to navigate our own health care by advocating for our wellness. This is true (we are in charge) whether we are in psychotherapy, counseling, or at our physicians office for a check up. The health care regulations make the consumer in charge of our own health. All of us need to take responsibility for advocating for our wellness by doing the following:

1. Recognize that you are in charge of your health.

2. Act in charge of your wellness

3. You are in charge of your health care plan and the health care rules protect you
a. The rules in health care are made to protect the consumer
b. The problem is that health care providers don’t always follow the rules and forget that you run your own health care plan
c. Consumers win most appeals with insurance if you challenge them with their own rules

4. Take charge of your health care plan when in a hospital
a. Stay in the hospital for as long as necessary and until you have a safe discharge plan!
b. Make sure that representatives of all the physicians and hospital have a meeting called a care plan , so you understand what your choices are
c. Don’t leave the hospital until your care plan meeting takes place and all your questions are answered
d. Make sure that you have a safe discharge plan to home or wherever you are going.

5. Take charge of your health care plan when you are with your physician
a. Formulate your questions before you see your Doctor.
1. Ask your Doctor what the numbers say or the % of this outcome.
a. Don’t ask if you are going to get better, ask what the %‘s
2. Don’t ask your Physician to play God; he/she is your consultant!
3. Don’t ask your Physician about wellness, he/she doesnÂ’t know—

6. When you are really sick, don’t be a hero, get an advocate
a. Figure out who that should be before you get real sick
b. If you are having surgery, make sure you have a responsible person on site to sign for you at the surgical center and make decisions if you remain unconscious and something goes wrong.
c. Stop procrastinating and start paying into Long term care insurance before you really get sick and it is too late. It is one of the few insurance programs you will use when you are alive.

7. Most illness is life style related; change your life style to enhance wellness

8. Pay attention to what your parents are going through now and make an effort not to repeat it their mistakes when you get to be a senior.
a. Medicaid planning is for everybody whose estate is worth less then 2 million
b. Be wary of your parents “gifting” when they are sick, see your Medicaid planning attorney even if your parents never plan to be on Medicaid. It makes sense.
c. If your parents want a qualitative life style, make sure that they put enough money into “custodial care” or have a generous long term care insurance program for life.

9. Working with health care insurance
a. Study the small print of the booklet well
b. When you call your health care insurance representative make sure you do the following:
1. Get their name and number to respond to later
2. Most of the representatives do not give accurate information, make sure that they log what you ask into the computer and then log how they answer the question. If they won’t log on the computer and print it out for you, then talk to their supervisor
3. Ask for their supervisor (ask nicely)
4. Ask for how to appeal their interpretation (you will probably win if you are persistent!
5. Ask them to fax or call when they logged the response on the computer.

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