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It’s common knowledge that physical exercise has the potential to improve our mental & emotional health. Finding a form of exercise that you enjoy can be a great way to reduce stress, increase blood circulation & thus oxygen to the brain, connect with friends and/or even engage in moving mindfulness meditation. Despite the many benefits of exercise, it’s easy to develop a fairly sedentary lifestyle, especially if your commute to work has you sitting in traffic for hours. At the end of a long work day, heading to the gym might not be your idea of a good time, so if you’re considering incorporating exercise into your routine, it’s important to find a form that you genuinely enjoy! Awareness of your unique physical, mental and emotional needs can help you make an appropriate choice. If your job leaves you feeling isolated and you’re craving connection, a long solo run may not be your best option. A group hike or fitness class may however be just what you need to improve your cardiovascular health as well as your sense of social connectedness. If becoming more physically active is this straight forward for you, that’s great! Incorporating more exercise into your life can improve your energy levels, confidence and self-esteem… but what if your needs are more complicated or if getting in touch with your body through exercise feels uncomfortable, scary or even downright terrifying?

If this sounds familiar, you’re not alone. It’s not uncommon, especially among survivors of trauma. Psychological trauma occurs when an individual’s perceived coping resources are completely overwhelmed by the stress/threat they perceive during a deeply disturbing or distressing event. This means that psychological trauma is defined by one’s unique experience and physical, mental & emotional response rather than the event itself. You may have survived such an event and developed great insight into its impact on your life, yet still feel stuck experiencing its negative effects (i.e. anxiety, depression, dissociation, emotion dysregulation, social isolation, etc.). This is because trauma affects parts of the brain that are distinct from cognition; parts of the brain that are involved in the body’s automatic responses, such as the amygdala. Often called the alarm bell system of the brain, the amygdala is responsible for detecting and responding to threats. Trauma can make the amygdala hypersensitive or completely insensitive. As you might suspect, either of these outcomes can present significant challenges. In his book, The Body Keeps the Score: Brain, Mind & Body in the Healing of Trauma, Dr. Bessel Van der Kolk, M.D. explains that “Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.”

If these words describe your experience, any physical activity that increases awareness of your body may be triggering. If you feel triggered every time you try to work out, it’s understandable that you might find yourself avoiding exercise. Nevertheless, in the words of Dr. Van der Kolk, “Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. […] In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.” Should you decide you’d like to work toward this first step, it’s important to do so in an environment and manner in which you feel as safe as possible. Working with a mental health professional to explore what this means for you and develop a plan based on your needs and preferences might be helpful. Maybe you feel safest in your living room with a guided fitness or meditation video. Maybe you feel safest in a yoga class taught by a trauma informed instructor… or you might just happen to feel most comfortable in the middle of a group dance class. I personally find dance to be the most healing and liberating form of meditative exercise…but I didn’t always. I started dancing as an adult and initially felt a great deal of anxiety around the vulnerability that comes with learning new steps and body movements in a public group setting. Partner dance was about as far out of my comfort zone as I’d ever gone and I recall experiencing several particularly embarrassing fight, flight or freeze responses. Now, three years later, it’s difficult to adequately express my gratitude for the journey of personal healing and growth that dance ignited and continues to facilitate. If dance interests you as a form of exercise or therapy, stay tuned for my next post! I’ll be discussing the therapeutic nature of creative, expressive movement and the power of vulnerability & connection.

By Samantha Latty, MBA, MS, APC

This group therapy is for clients that may be struggling with any of the following:

• Poor self-esteem
• Excessive Worry
• Impulsivity
• Unbearable Emotional Pain
• Overwhelming Feelings
• Self-destructive Behaviors
• Self-injurious Behaviors
• Chaotic/ Stormy Relationships
• Poor Boundaries
• Drug or Alcohol Abuse
• All or Nothing Thinking
• Confusion About Self

Dialectical Behavioral Therapy (DBT) is a structured therapeutic treatment based from Zen Mindfulness practice placing emphasis on the balance between acceptance and change. Outcomes of this class will provide DBT clients with tools to recognize and increase awareness of thoughts, feelings, and body sensations while strengthening attention to the present moment in order to respond with healthy strategies to maintain control, cultivate living life from a place of “wise mind,” gain interpersonal skills to improve relationships, and begin building a life worth living.

Our Dialectical Behavioral Therapy (DBT): Skills Training Group will provide a validating and safe environment for clients to learn coping skills to manage stress they encounter in life. Dialectical Behavioral Therapy teaches skills that help reduce the intensity and frequency of overwhelming emotions, while also offering guidance for navigating these distressing emotional moments. DBT skills include:

Mindfulness—Mindfulness is a core concept within DBT that promotes full awareness of your present moment (i.e. thoughts, feelings and physical sensations) without judgment and without trying to change it. Mindfulness strives to focus the mind, direct attention and achieve a better understanding of feelings.

Emotional Regulation—Emotional Regulation concentrates on taking control of emotions. Difficulty controlling extreme emotions can lead to impulsive or ineffective behaviors. The goals of Emotion Regulation are to better understand the emotions you experience, reduce emotional vulnerability and decrease emotional suffering.

Distress Tolerance—Pain is a part of life and being unable to deal with pain may lead to impulsive or destructive behavior. The goal of Distress Tolerance is to help people better cope with painful or distressing moments in more effective ways that won’t make the situation worse.

Interpersonal Effectiveness—The focus of Interpersonal Effectiveness is building and maintaining positive relationships. This module introduces tools to express beliefs and needs, set limits and negotiate solutions to problems without threatening relationships with others. Interpersonal Effectiveness skills can help in taking care of relationships, balancing your needs with the demands and needs of others, balancing things you want to do with things you ought to do and building/developing mastery of self and self-respect.

The group will be led by Elyssa Reid Ed.S., LPC, CRC, NCC and Scott Leenan M.S., LPC, CRC. Once enrolled in the program, clients who do not have a DBT therapist may be assigned a clinician to meet with once per week. The fee for the group is $125 per week. Space is limited to 10 participants so please register as soon as possible to ensure your space. For more information, you may contact us at Intown Counseling and Wellness at 404-478-9890 or e-mail us at [email protected]

You would think that this would be an easy question to answer, but for most of us it’s quite confusing. In America, we tend to believe that 1 drink per day for women and 2 drinks per day for men is acceptable, but what if you’re a woman who has 2 glasses of wine every day – does that make you an addict? And not only do we have to worry about the amount of alcohol or drugs that we consume, people can also develop addictions to behaviors, like gambling, exercise, sex, work and spending. So when does too much of a good thing tip the scale and become an addiction?

Here are 10 important questions that you need to ask yourself:

1. Do you feel unable to control the behavior you are engaging in?
2. Are you unable to consistently abstain?
3. Is the behavior counter-productive to you, meaning, instead of it helping you adapt to situations or overcome problems, it tends to undermine your abilities?
4. Is the behavior persistent despite it causing you significant problems medically, at home, at school or at work and/or difficulty in interpersonal relationships?
5. Do you have an increasing “hunger” for alcohol, drugs or rewarding experiences?
6. Do you hide your behavior from your friends or loved ones?
7. Since engaging in the behavior, have you experienced an increase in anxiety, depression, agitation, and mood fluctuations, or have you noticed an increased sensitivity to stressors or difficulty in identifying your feelings?
8. Do you need larger and more regular amounts of whatever you are engaging in to receive the same effect?
9. Do you spend an excessive amount of time engaging in the behavior or recovering from its effects?
10. Do you feel preoccupied with the behavior or substance use?

If you answered ‘yes’ to ANY of these questions or if you feel that your behavior is leaning in that direction, you may want to consider talking to a professional to determine the best course of action for you.  The sooner you can get the appropriate help you need the better.

By: Melissa G. Macdonald, LCSW

Summer is nearly over and it will be time for the kids to go back to school soon! You may be overjoyed at the thought of your children returning to school, but you may also dread the inevitable meltdowns that occur when the kids have to adjust to going to bed and waking earlier and completing their homework each night. The kids have gotten used to staying up later, sleeping in, and having more freedom to choose their activities over the summer so getting them back into a routine can be difficult, so here are some tips:

1 .) During the initial transition, give your kids a break and extend some compassion and understanding. Think of how hard it is for you to return to work after a short vacation. Summer is essentially a 2-month vacation for your kids!

2 .) Even though summer break is over, continue to plan fun activities with your kids. Schedule fun outings on the weekends and/or plan a fun activity to do on a weeknight.

3 .) Incorporate some academic games, science projects, or story writing activities each week to prepare your child’s mind for the long school days. These activities can be fun and entertaining while also developing their interest for learning.

4 .) Children need more sleep than adults and are more adversely affected by insufficient sleep. If you haven’t been keeping your kids on a bedtime routine that is similar to their school year bedtime, start now! Gradually move their bedtime up 10-15 minutes every night and start waking them up 10-15 minutes earlier until you’ve reached appropriate times.

5 .) Start eating breakfast every morning. Hungry children have a hard time focusing and retaining information at school. Healthy breakfast foods that are rich in whole grains, fiber, and protein while low in added sugar are your best bet.

6 .) If you have a difficult time getting your children dressed and ready to hit the door, making a list with their morning tasks may help! If they complete each task, give them a check mark or sticker next to that task. If they complete 75% of the tasks for the day, they get a small reward (i.e. quarter/dollar, TV/electronic time). If they complete their tasks 3 out of 5 school days, reward them with a larger incentive on the weekend (i.e. trip to the movies, dollar store, small toy). It’s very important that parents stay consistent while using this type of behavior chart. If the child does not complete the tasks, they should not be rewarded and more importantly, if the child does complete the tasks, they should get rewarded to encourage appropriate behavior in the future.

7 .) A new school year is often filled with a lot of anxiety inducing as kids navigate new classes, teachers and classmates and possibly new schools. It’s very important to help your children cope with their anxieties. Usually a simple conversation is helpful and dinnertime is great time to check in with the kids. Many parents also find that therapy is a great tool to help during times of adjustment. It provides kids a place to explore their feelings, while getting additional support outside their families.

By: Afton Murphy, MA, APC

While individual therapy is by far the majority of what we do at Intown Counseling and Wellness, we also get a lot of requests for relationship counseling, couples counseling, family therapy, marriage counseling and pre-marital counseling. When people initially call our office seeking therapy, they’re often unsure which of our services will serve them best. After getting some details about their concerns we consider treatment options while considering the individual and their family system.

Without ignoring the importance of looking at an individual’s internal dynamics, our practice takes a broader view that individual behavior can also be understood to occur within the framework of the family. A family member coming to us with symptoms is viewed merely as a representative of a family experiencing instability. The identified patient is thought to be expressing what other family member are thinking and feeling, but unable to acknowledge or that their behavior is diverting attention from other family problems.

The family structure today is very diverse and has evolved a great deal. Pulling from the popular television show Modern Family, our practice relies on traditional therapies when working with Atlanta’s modern families. Some of the families that we work with include married or soon-to-be married couples, cohabitating gay, lesbian and heterosexual couples, single-parent-led households (divorced or never married), families led by grandparents, and foster families to name a few.

Each family is unique in its rules, member roles, power hierarchy, communication styles and its way of problem-solving. Within our family system, individuals are tied to one another by powerful emotional attachments that usually endure over the lifetime of the family. The power of the family is deemed so strong that despite the possible separation of its members by vast distances and sometimes even death, the family’s influence remains.

Family therapy isn’t solely focused on one particular individual, even if only just one family member is engaged in treatment. We frequently get calls about couples counseling when one partner is not receptive to the idea. If you want to improve your relationship, work on yourself—even without your partner, therapy can be a powerful experience. As you begin to make changes, your partner’s behavior may also change. Even if your partner never goes to therapy, going alone can help you deal with the stress of relationship problems. Regardless of your situation, finding help requires speaking to a licensed professional counselor who will sit down with you to find out what will work best. No treatment fits everyone and understanding one’s unique situation is needed to determine how to move forward

By Scott J. Leenan, MS, LPC, CRC

Addiction is often defined as an illness not just of the individual, but of the entire family.  Any change in the behavior of one family member affects not only each of the other family members, but the family system as a whole.  When a family member has a problem with addiction, the family responds in a variety of ways, many of which are deemed unhealthy.

Family therapy, even in only a few sessions can be an invaluable tool in reducing the family’s feelings of guilt or confusion related to addiction.  Family therapy can also be helpful in preparing a family for changes that are needed to enhance and maintain the addicted person’s recovery following treatment.  Understanding some aspects of addiction and the roles a family adopts are a key to recovery for the addict and the family because insight and understanding can help us move forward and inform action.

A family often adopts rules of behaviors and roles so that the family can adjust to having a family member with active addiction.  The rules and roles serve as survival techniques and are in response to and a way of dealing with the addiction in the family.  They are an attempt to bring order and stability to an often chaotic and stressful family structure.  Even though a family member might be in treatment and/ or early recovery, the rules will continue to operate within the family and be passed from one generation to the next, so a basic understanding is key.

There are four general rules that typically operate in a family struggling with addiction.

• The Rule of Rigidity
• The Rule of Silence
• The Rule of Denial
• The Rule of Isolation

The Rule of Rigidity—A family struggling with addiction is highly inflexible.  It doesn’t adapt to change very easily and is fights to keep its family members in line.  Its rigid behavior is an attempt to deal with the addiction within the family.  An individual struggling with addiction is unpredictable and the family learns to anticipate the increasing variability of its addicted member.  In order to maintain some stability, more and more rigid rules of behavior are imposed on the non-addicted family members.

The Rule of Silence—Families affected with addiction are bound by the rule of silence.  They cannot talk about what is happening within their family.  The rule of silence doesn’t just pertain to talking to people outside the family, but also restricts family members from talking to one another.  It not only prohibits talking about the behaviors and actions of the family, but also discourages discussion about feelings.  The family has a vested interest in keeping its members quiet about what is going on inside the family.  If there were open and free communication, individual members would be forced to change.  The rule of silence is often so strong that children who grow up in this type of family system have difficulty expressing themselves for the rest of their lives.  The rule of silence operates at the expense of one’s emotional well-being and one’s ability to function honestly and openly in the world.

The Rule of Denial—The denial within a family struggling with addiction begins with the denial that there is any problem with addiction itself.  As the behavior of family members becomes more and more dysfunctional, the denial becomes stronger and stronger.  If the family system can effectively deny what is happening, it does not have to change.  The people in this system are told to deny what they see, hear, and feel as if it’s not true.  Not only are they told to ignore the behavior of the addicted member, but they are also supposed to pretend that nothing is wrong—to pretend that things are “normal.”  It becomes increasingly difficult for members to differentiate between what is real and what is pretend.  Over time members becomes less confident in their ability to trust themselves and others.  In addition to denial of behavior, this concept also applies to denial of feelings, which are hard enough for most people to understand, but denial of one’s feeling creates additional confusion.

The Rule of Isolation—A family with rampant addiction is a closed system.  It resists the movement of his members and resists adding outsiders as members.  The members cling to each other emotionally, but rarely if ever become intimate.  The family tries remaining self-sufficient, believing that no one outside the system could understand and that no one outside the system should be trusted.  The system cannot afford to have outsiders know what’s going on inside the system.  As the family’s behaviors become more extreme, the family becomes more and more isolated.

To become a health person and a member of a healthy family system it is helpful to understand these rules because by identifying them, one has the ability to break the cycle.  If the cycle is broken there is an opportunity to become healthy and lead a happy life.  This process is neither easy, nor quick, but it is possible and there are many people who are breaking through the chains of rigidity, silence, denial and isolation.  For more information about family therapy work at Intown Counseling & Wellness, please call our office at (404) 478-9890.

by Scott J. Leenan, MS, LPC, CRC

During my time as an addiction therapist, many of my high-functioning, professional clients have remarked at the difficulty they feel in relating to other alcohol and drug addicts at 12-step meetings. Their reasons for this vary, but usually revolves around a common theme: Their addiction has not resulted in the same “rock bottom” as the other addicts who attend the meetings. While they admittedly have been drinking or using drugs excessively, they may not have lost their job, all of their money, been in rehab, been to jail multiple times, or been unable to maintain their family life and friendships. Because of this, there is a tendency to minimize or deny that they have an addiction problem until an eye-opening event makes it impossible for them to ignore their problem anymore. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) reported in a 2007 study that 19.5% of all alcoholics (nearly four million people) are of the “functional” subtype.

Being a high-functioning addict is equally as dangerous as being a lower functioning addict, and possibly more so. First, the warning signs tend to be overlooked due to the idyllic appearance of the high-functioning addict’s life. Second, treatment is frequently delayed. As there typically are underlying causes for dependence issues, some high-functioning addicts have the means to take extraordinary measures to keep their psychological discomfort away, such as going on a shopping spree or buying themselves a new car when they feel depressed. And finally, when these individuals fall, they fall hard because they have so much to lose. All of these reasons make it imperative for these high-functioning addicts to seek out timely and appropriate therapeutic help to support them in their recovery process.

While peer‐led self‐help groups, such as Alcoholics Anonymous (AA), can help keep the individual who abuses substances abstinent, group therapy really should be a staple of their recovery process. Group therapy provides opportunities for high-functioning addicts to understand and explore the emotional and interpersonal conflicts that contribute to their abuse amongst other relatable peers and a licensed therapist. The Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) reported in 2005 that “people who abuse substances often are more likely to remain abstinent and committed to recovery when treatment is provided in groups because of rewarding and therapeutic forces such as affiliation, confrontation, support, gratification, and identification. The capacity of group therapy to bond patients to treatment is an important asset because the greater the amount, quality, and duration of treatment, the better the client’s prognosis.” To find out more about our group therapy options, check out the Group Therapy Service page on our website, intowncounseling.com.

Written By Melissa Macdonald