What to Expect When You Are Expecting…To Start Therapy

Starting Therapy

“Psychotherapy can be one of the greatest and most rewarding adventures, it can bring with it the deepest feelings of personal worth, of purpose and richness in living.” ~ Eda Leshan

In 2018, 56.7% of U.S. adults with a mental illness did not receive treatment. Maybe you are thinking about seeing a therapist…but you have no idea what to expect, or where to start. You may wonder what happens during sessions, how long will you be in therapy, how you will know that you are done in therapy, or a million other questions. These are common and completely valid concerns, and my goal in this post is to cover that basic information so you will know what to expect when you are expecting…to see a therapist.

What to expect before you start. 

Before going to therapy, it is important to identify the areas in your life that need help and healing. Consider whether it is an individual or relational issue. This step is huge because it requires humility and courage to admit that you need help and to be vulnerable. The next step is finding the right therapist for you. Brainstorm what qualities (such as experience or personal characteristics) are important to you in a therapist; not everyone is looking for the same thing when starting therapy. For example, researchers Susan Hardin and Barbara Yanico asked men and women what they looked for in a potential therapist and found differences in genders: Men tended to want an efficient counseling process, for the therapist to be directive and self-disclosing; while women have higher expectations for the therapist to be open, accepting, genuine, attractive, and trustworthy. Regardless of gender, these researchers found that prospective clients expect empathy, expertness, and concreteness from an experienced therapist, and a positive outcome. What are you looking for?

What to expect when choosing a therapist.

Once you have found a potential therapist, you may experience trepidation about meeting and disclosing your private struggles to this stranger. To help the matter, I urge you to familiarize yourself with the therapist(s) you are considering. Here are three helpful suggestions:

  1. Look at their google listing and familiarize yourself with their website. For example, on Cluff Counseling’s page, I have a section entitled “About Me” where you will find information about me like my hobbies, interests, educational experience and training. I also have a “Frequently Asked Questions” section that will give you insight to my structure and style as a therapist. 
  2. Do not be afraid to ask for a phone consultation before setting your first appointment.
  3. Ask your questions! Create 3-4 questions you would like to ask each of the potential therapists that you are considering. Common questions I hear are: Do I take insurance? How much is each session? Does it cost more for couple sessions? Do I have experience treating ______? Do I have a sliding fee scale? What is my cancellation policy? Do I do couple therapy if that is needed down the road? How long is each session? What do you need to bring to the first session? 

Remember, you are the client and so it is important that the therapist is a good fit for you. If the first one you talk to, or meet with, does not feel right, reach out to the next one on your list. 

What to expect when you start.

Many people are curious about the frequency of sessions, as well as what typically happens during a session. I schedule one 50-minute session a week–unless a client requests to meet more or less frequently, or needs longer sessions.  In the initial session, I always ask why the person decided to start therapy now, rather than a few weeks ago, or months down the road. The response to this question helps shed some light on the process the process went through to get to my office.  

Next, I begin to gather some history on the problem. If I am seeing a couple, I may ask how they met, what attracted them to each other, the highlights and lowlights of their relationship history. If I am meeting with an individual, I may ask how long the problem has been present, what they have tried, what has given them some relief, and who is in their support system. I spend the first several sessions gathering more information and helping the person feel comfortable with me. 

Lastly, I ask how they would know that therapy can help them. Their response helps me understand what they specifically want to address during our sessions together, and orients me to establish measurable goals for the client. I do not want a client to feel they are committing the rest of their life to therapy; setting goals ascertains that there will be an end to therapy!

What to expect during regular sessions.

Once the initial phase of information gathering is complete, we will get to work on meeting the goals. Often, I will give homework assignments to be completed between sessions that will support the work we are doing in session. We will work on coping skills and tools that can be practiced and applied to any unhealthy patterns in the client’s life. Areas where trauma work is needed are identified and a plan is created to do that work. Goals are continually assessed to  make sure they still fit the needs of the client. I remind my clients that the time spent with me is theirs and I invite their feedback; I do not want my clients to ever feel they have wasted their time in a session. Please do not hesitate to speak up to your therapist if your needs are not getting met!

What to expect when therapy is nearing an end.

One of the ways I know a client is close to graduating therapy is when a client or I suggest less frequent sessions. This speaks volumes about the progress and signifies they are feeling more grounded, are reaching their therapy goals, have established a support system outside of therapy, and are ready to put what they have learned into practice on their own. I find great joy when my clients no longer need my help…my goal is to work myself out of the job! My door is and will forever be open to my clients should they need a tune-up. My final question for clients, during their last session, is how they will know if/when they need to come back to see me. The message I want them to hear is that I believe in them and that coming back to me is always an option. 

If you have been considering getting into therapy, I highly recommend you to do so now.  If you are ready to schedule a session but feel nervous, remember that it is completely normal to feel a little anxious about starting something new! It is the therapist’s job to create a safe, comfortable counseling environment where you can begin to address your individual or relational worries. If you think you may need medication, a therapist can refer you to a psychiatrist, and together the therapist and psychiatrist can address your concerns. 

I love my job. You will find the best version of yourself as you shed the weight of trauma or addiction and work through any relational issues you are facing. I am here for you! Please contact me today to get started!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

References:

I’m Not Crazy! Overcoming the Stigma Around Therapy

“In Hollywood if you don’t have a shrink, people think you’re crazy.” ~ Johnny Carson

Therapist Help

Imagine the following scenario: You go running and roll your ankle. You hear a pop and are in great pain. It turns black and blue and swells quickly. You are concerned it is broken or seriously torn, but you fear going to the doctor for help. What will your neighbors say? Will they gossip about how weak you are for not just “getting through it” or figuring it out on your own? You decide to avoid the doctor, take some Tylenol, hobble around like nothing is wrong, and hope it will just go away on its own.

This example might seem foolish to you…why would you not go to the doctor?! It may seem downright silly to not get help when help is needed!  Likewise, when a person encounters trauma, addiction, abuse, or mental illness, it is of legitimate concern and often necessitates professional help like therapy. In the exact same way a broken or sprained ankle often requires the attention of a doctor, many mental health issues require professional help. And there is nothing wrong with that! 

Recently I had a client look me in the face and say, “I don’t belong here.” She felt she should not be in my office sitting on my couch getting help from a licensed therapist because she was not crazy. She had a fulfilling career, many dear friends, and owned lots of expensive things. She did not believe she fit the image, she had in her head, of someone who needed therapy. In short, she thought therapy was for people that outwardly looked like they did not have their life together and she was not one of them. It hurts my heart to hear the shame she, and other clients have felt for being brave and seeking help. 

When studying roadblocks to receiving therapy, Patrick Corrigan and Andrea Bink (2016) had participants report fear of being stigmatized was the leading factor for avoiding treatment. Participants feared they would be treated differently by their friends and coworkers, that they would encounter rejection or discrimination as a result of seeking out mental health treatment.  Most participants would hide their psychiatric status from coworkers, friends, and even family to avoid being the victim of stigma. Thankfully, in recent years–due in large part to social media attention around the stigma around mental health and therapy–it has become much more socially acceptable to receive mental health care. It is not uncommon to hear about celebrities and prominent figures seeing a therapist; many of them highly recommend it for every- and anyone! I applaud these men and women for using their influence to break the mold and speak up on the many benefits of therapy!

The latest statistics show that the amount of people seeking and receiving mental health support is increasing! In 2018, 47.6 million U.S. adults experienced mental illness…that is 1 in 5 adults! Thankfully, 43.3% of U.S. adults with mental illness received treatment in 2018 and 64.1% of U.S. adults with a serious mental illness received treatment in the same year. 50.6% of U.S. youth aged 6-17 with a mental health disorder received treatment in 2016. Millions of Americans experience mental health challenges each year and millions are receiving help by medical and mental health professionals!

Going to therapy does not mean you are crazy. It means you are smart. Would you sit at home, alone, and let your broken ankle “do its thing” without getting help? No. You would make the proper appointments and follow the advice of the professionals so you could soon be running again. My hope, my plea, my job is to help my clients find lasting healing.  The average delay between onset of mental illness symptoms and treatment is 11 years. Eleven years people will struggle with an emotional “broken ankle” before getting help. Ouch! You do not need to suffer any longer. Make the call–get in to see a therapist today.

I felt sad for the client of mine, and any others who share her sentiments. Just because you receive mental health attention does not mean you are crazy. Just the other day a client, who begrudgingly started therapy at the insistence of their spouse, recently told their new employer that they thought everyone should go to therapy, after they experienced the personal benefits of therapy. While I acknowledge you may believe that going to therapy means you are weak, crazy, limited, hopeless, etc–these stigmatic ideas could not be farther from the truth. I know my clients: THEY ARE BRAVE. They are good people who see their worth. My clients–and those who seek help in other ways–are my heroes and I will always and forever shout that from the rooftops! We need to do away with any and all stigmas that therapy is just for broken, crazy people. It could not be farther from the truth! 

If you have been letting your emotional broken ankle heal on its own because you have felt you do not “belong” in therapy, the time to act is now. Allow a licensed, qualified, experienced therapist, to help you. Emotional health, healing and happiness are possible. Contact me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville,Texas, personally seeing clients in the North Dallas area.

References:

The Link Between Mood Disorders and Addiction

About 20% of Americans with an anxiety or other mood disorder (like depression) also have an alcohol or other substance use disorder.

Do you get anxious when you have to speak in front of an audience, take a test, or talk with a superior? Or maybe when you are facing debt, in an argument with someone you care about or at the precipice of a potentially life-altering decision? Every human being faces experiences that cause anxiety, but some feel it more than others. Research indicates that there is a genetic predisposition to anxiety; some of our nervous systems are more prone to anxiety than others. According to the National Institute of Mental Health, nearly 40 million people in the United States have suffered from some kind of anxiety disorder, including panic attacks and phobias. When you face anxiety, how will you handle it?

(Note: While this blog post focuses primarily on the link between anxiety and addiction, I have witnessed, with my clients, that this information can be generalized to other mood disorders as well.)

Individuals who come from unstable families and lack secure attachment often experience generalized anxiety; they may turn to drugs to calm themselves down. Many teens begin to abuse alcohol in their adolescence; it is their way of managing social anxiety.  A friend of mine abused prescription medications after her brother’s suicide; it was her way of muting her overwhelming feelings of loss. Many addicts relapse; it is their way to escape reality. Several of my clients suffering from post-traumatic stress disorder (PTSD) experience major anxiety; they have a difficult time regulating their nervous system responses and often turn to addictive substances for comfort.  Some people, however, face anxiety head on with exercise, self-care, hobbies, a balanced diet, etc. While everyone experiences some form of anxiety or a mood disorder (like depression) during their lives, only some individuals combat their anxiety with addictive substances.

The question begging to be asked is–does a mood disorder like  anxiety or depression cause addiction? No. So is there a link between anxiety and addiction? That answer is a resounding yes. Can it lead to it? Absolutely.

Anxiety consists of the excessive need for control; ignoring psychological and physical signs of stress; the unending need for approval; perfectionism; and strong reactions within the body and mind. The physical and psychological symptoms of anxiety are similar to withdrawal symptoms from drugs and alcohol. An addict will turn to substances, or other addictive behaviors to calm an anxious state. The avoidance of uncomfortable physical agitation and painful emotions are some of the key components that maintain the connection between addiction and anxiety. Both anxiety and addiction strengthen as the addictive behavior continues. Substance abuse can mask anxious feelings preventing the addict from receiving proper treatment for anxiety.

People who experience anxious moments, but who do not have anxiety disorders, will be able to go about their day when the crisis passes; people with anxiety disorders cannot stop the effects of their anxiety disrupting their everyday life. Professional, social, familial, and academic obligations will be interrupted and damaged by the sense of panic, stress, and foreboding that comes as a part of the condition. Social anxiety disorder frequently “travels in the company” of alcohol or drug abuse, as people with social anxiety disorder might try to make use of alcohol or cocaine to help make them feel more comfortable and less inhibited in social settings.

For individuals struggling with anxiety, substances offer an escape. For others, substances bring a feeling of relative normalcy (self-medication). For some, anxiety is a factor of their personality that also includes aspects like impulsivity that make the anxious person more likely to use substances.  Although not entirely understood, there is a connection between anxiety disorders and substance abuse. About 20% of those with an alcohol or substance use disorder also have an anxiety or mood disorder. In fact, many of my clients with an addiction (mostly sex addiction) are self-medicating their anxiety and depression with their addiction! It is also important to note that addiction can happen without any substances; you can be addicted to an eating disorder, gaming, sex, exercise, etc. The point is that mood disorders can either reinforce or be reinforced by addictive substances.

Treating substance abuse without treating the anxiety that causes it is a fruitless endeavor. 

Treating substance abuse without treating the co-occurring disorder can lead to higher rates of relapse. Due to the similarity of drug and alcohol withdrawal symptoms and anxiety symptoms, both need to be treated at the same time. The treatment for anxiety and addiction is referred to as dual diagnosis and it is important to find an addiction treatment facility, or a therapist, that can address both the addiction and the anxiety.

It is only through therapy that clients can make tangible strides towards restoring a sense of balance and stable mental health to their lives. Simply walking away from treatment after detox is ineffective…and might even prove more harmful. Now is the time to address the symptoms of anxiety and addiction that feed off of each other and keep you in the self-defeating cycle. Allow me to help you break the dependence on the substance or behavior, you have used to manage your anxiety and distress, as well as provide sustainable ways to cope with your mood disorder. Happiness is possible. Healing is possible. Contact me today to get started.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.


References:

Beware the Sting of the Internet: Simple Ways to Protect Your Home from Porn

“There is no dignity when the human dimension is eliminated from the person. In short, the problem with pornography is not that it shows too much of the person, but that it shows far too little.”  ~ Pope John Paul II

Every second…

  • 28,258 users are watching pornography on the internet
  • $3,075.64 is being spent on pornography on the internet and
  • 372 people are typing the word “adult” into a search engine.

Every day…

  • 37 pornographic videos are created in the United States
  • 2.5 billion emails containing porn are sent or received
  • 68 million search queries related to pornography (25% of total searches!) are generated, and 
  • 116,000 queries related to child pornography are received.

In addition to these frightening numbers, 40 million Americans regularly visit porn sites; 35% of all internet downloads are related to pornography; 34% of internet users have experienced unwanted exposure to pornographic content through ads, pop up ads, misdirected links or emails; and 33% of porn viewers are women. There is no doubt, pornography is everywhere. It is accessible just as it is addictive. So how can you protect yourself and your home from pornography? Since the web is accessible on so many devices nowadays, I want to go over some free and relatively easy ways to block pornography in your home.

DNS

The Domain Name System (DNS) is the Internet protocol that converts website names (domain names) to IP addresses. Filters at this level prevent the DNS resolution for the blocked sites, so their content never loads. This is the fastest way to block sites. Every device needs DNS to connect to the Internet, so this type of filtering works everywhere. All you have to do is open the device Settings, look for Network Settings or Wifi Settings and change the DNS servers (also called NameServers) to the IP address provided by your Internet Filter. Click here and refer to step one for specific instructions on how to open the settings, get to the appropriate filters, and block the known IP addresses. This article also has incredibly clear and helpful steps for setting up “clean” server providers on each of your devices. (It is important to note that if you are using your phone’s internet, versus wifi, you can bypass any filtering settings on DNS.)

PARENTAL CONTROL

When you make changes or set up filters on your device(s), you will need to set up parental control options that will disable your children from altering any of your settings or removing the filters you have put in place. This can be done on most TVs and devices like Roku, Amazon Fire Stick, and Chromecast. Each device might have a different name for Parental Control, but it is generally called Parental Control or Restrictions. On IOS (iPhone/iPad), you can do it by going to Settings-> General-> Restrictions and filtering the content you do not want to allow your children to see. On that page, if you scroll down to Allowed Content, I would recommend setting:

  • Movies: PG-13
  • TV Shows: TV-14
  • Books: Restrict explicit content
  • Apps: 12+
  • Siri: Explicit language filtered
  • Websites: Restrict adult content

ROUTER

Too many families miss the significant step of controlling their wireless router. You are responsible for every digital click that occurs on your WiFi network–every babysitter, every relative, every friend. Please make sure you have eliminated the bad stuff before they even decide to connect their device to your home’s network!

BROWSER HISTORY

Once you set up a filter to block pornographic content and enabled parental control, I recommend doing spot checks every day or every couple of days to see what online sites are being visited in your home. Older kids will learn to clear their browser history, but younger kids are not aware of that trick. Some devices (like Mac), even allow parents a way to prevent browser history from being deleted! Be aware of “incognito mode,” which is an internet browser setting that prevents browsing history from being stored. If you want to prevent this and have iOS, delete the app store to prevent more apps from being downloaded and ensure Safari is the only browsing app–Safari does not allow private browsing.

SPONTANEOUS FOLLOW-UP

Every few days, go through your children’s messages and social media apps like Instagram, Facebook, Whatsapp, etc. Look at the photos they are viewing and sharing, as well as with whom they are talking. Scan the photo library on your child’s cell phone as well; although younger kids may not be sexting yet, by the time they hit their tweens they may begin participating in this type of behavior. Be sure to look at your children’s deleted photos and messages because kids these days are smart! 

USE YOUR WORDS

At the end of the day, parents ultimately want their children to make good choices on their own–without filters or blockers or any kind. No parent wants to feel like a bossy, overseeing nag. Having a solid foundation where mutual trust and communication are employed will be the best way to help your kids be open with you. If they know they can come to you with questions, concerns, or mistakes without you getting upset, they will be more likely to be honest and open. So start today. Talk with them. Be real with them. Tell them that you will always be there to help them in any way you can.

Other practical tips include paying for ad blockers that potentially have offensive material, limiting or disabling data on your child’s device, restricting the YouTube app on your/your child’s device, enabling the PIN and call your Cable provider to block porn pay-per-view, and being sure to report offensive material if you do see it in a browser search (this will help improve their filtering). Be sure to keep in mind that whatever filtering tools you choose to go with will need to be installed on every device your child may use to go online: game consoles, cell phones, tablets, Kindles, personal laptops, computers, etc. 

One final tip: Lean on the many available resources to protect your home. Though the internet is full of pervasive material, there is also so much information on how to avoid and protect your family against it. You don’t have to do this alone; feel free to contact me with any questions, or to schedule a session. My door is always open!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

Reconnecting with Reality: 10 Tips to Kick A Phone Addiction

“The price of anything is the amount of life you exchange for it.” ~ Henry David Thoreau

A survey was recently conducted where participants were asked, “If you had to break a bone or break your phone what would you prefer?” The results were astounding: 46% percent of people would prefer to have a broken bone than a broken phone! Before the smartphone era, the average American spent just 18 minutes a day on the phone; today that figure is up to three hours. Three out of 24 hours of our day is being spent staring at a tiny screen…that is 1/8th of our day! Is that how we would prefer to spend our time or would we like to break that cycle and spend our valuable time on something more productive and satisfying?

The urge to pick up our devices is similar to other forms of behavioral addiction. Like gambling or shopping addiction, a small shot of dopamine is released in various regions of the brain through phone usage. That is what keeps us coming back for more, even when we know it is not in our best interest to do so. Instead of improving our lives, technology is actually getting in the way of us living and enjoying our lives. How can we overcome our addiction to distraction so we can focus on the things that actually matter? Here are ten practical suggestions we can implement immediately:

  1. Scheduled screen time. Set a timer for 15 minutes. When it goes off, spend a quick minute checking your phone’s notifications and be done. Push back the alarm to go off every 30, 45, or 60 minutes. You can even ask for help and accountability from your friends and family; tell them you will not be responding to messages as frequently as you used to.
  2. Remove distractions from the home screen. Most of us have Twitter, Instagram, Facebook, etc at the forefront of our screens. If we make those apps less accessible, we will not use them as much. Keep the apps that you want to encourage yourself to use (like those for reading or learning a new language) front and center, and banish anything you want to limit your time with to folders on your second page of apps (or if you have an Android phone, off the screen entirely).
  3. Disable push. An incredibly simple way to cut down on distractions is to turn off “push” notifications for as many apps as you can. Just head to Settings > Notifications to control your preferences. 
  4. Moon mode. On iPhones, there is a little icon of a moon if you swipe up to control brightness and wifi and whatnot. That little moon represents “do not disturb,” and it is kind of magical. It is a glorified silent mode, ideal for nighttime settings or undistracted time at work. Use DND and airplane mode to silence incoming distractions. 
  5. Use a filler. Instead of opening social media to scroll aimlessly, open a different app and be productive. Replace bad habits with good ones like learning a new language through Duolingo, creating flashcards for anything with Anki, self-reflection journaling with Vertellis, or using any number of apps to read or listen to a good book.
  6. Go old school. Many people use their phones as an alarm clock. But because the phone is easily within reach while in bed, many people find themselves scrolling right before bed and first thing in the morning. Cut that bad habit by reinstating your old-school alarm clock.
  7. “Alexa, do what my phone used to do for me.” You can ask these smart devices to play music for you, to check the weather, to read you a text,…the list goes on and on. Use Alexa instead of your screen!
  8. Grayscale. Time Well Spent, a nonprofit focused on changing our relationships to technology, recommends switching your phone to grayscale to make it less appealing. On an iPhone, find “Display Accommodations” and then turn on “Color Filters.” On a Samsung device, find “Vision” and then scroll down to “Grayscale.”
  9. Put it away. Unless there is an important phone call we are waiting for, we really do not need our phones within arms reach at all times. My dad leaves his phone on top of the refrigerator unless he needs it. Think about it–a smoker trying to kick the habit will still reach for a cigarette if it is sitting right in front of him. Ditto for phones; remove the temptation by stashing yours in your bag while at work or in a drawer when you want to have a real conversation at home.
  10. Don’t stop! Keep trying. Stay accountable. iPhones come with a built-in tracking system so we can see just how much time we have spent on any given app each day. There are also apps like Freedom, Moment, and Space that can help us see where we are spending our time and help us set limits. 

No doubt, Steve Jobs’ inventions, in the field of technology, have changed the world. But what most people do not know is he would not even let his children use an iPad. He told The New York Times, “We limit how much technology our kids use in the home.” Steve knew the power and addictive nature of these devices. So let’s be like Steve and limit our use of technology and break the cycle of addiction. The ten suggestions above can get us well on our way to getting off the phone and back to real life connection. If you are reading this on your phone, text or email someone you are thinking about. Let them know you care. Set a time to see them.  And then put the phone away.

(As always, if you find you have questions or would like to schedule a session, please do not hesitate to contact me today!)

Resources:


Clear and Present Danger: Teens and Vaping

“We see clear signs that youth use of electronic cigarettes has reached an epidemic proportion, and we must adjust certain aspects of our comprehensive strategy to stem this clear and present danger.” ~ FDA, September, 2018

There’s a new cool kid on the block according to statistics published by Child Mind Institute. Smoking cigarettes has taken a backseat to the accessible and underestimated–yet still highly addictive–e-cigarette. E-cigarettes are now the most frequently used tobacco product among adolescents; some 2.1 million middle and high school students used e-cigarettes in 2017! This is far surpassing traditional combustible cigarettes. What is the e-cigarette? How does it work? Is it harmful? Because so many individuals are using these devices, it is important to be educated on this new behavior, especially popular amongst teens and young adults.

What is vaping?

Vaping devices include e-cigarettes, vape pens and advanced personal vaporizers (also known as ‘MODS’). When the device is used, the battery heats up the heating component, which turns the contents of the e-liquid into an aerosol that is inhaled into the lungs and then exhaled. Vaping is the act of inhaling and exhaling the aerosol, commonly referred to as vapor, which is produced by an e-cigarette. The difference between traditional tobacco cigarettes and e-cigarettes is that e-cigs do not contain nor produce tobacco smoke, but rather an aerosol. The vapor created by e-cigarettes consists of many fine particles which contain varying amounts of toxic chemicals that have been linked to cancer, as well as respiratory and heart disease.

E-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. E-cigarettes have many names, including e-cigs, JUUL (JUUL Labs, Inc. is the name of the leading electronic-cigarette company), ENDS (electronic nicotine delivery systems), e-hookah, and so much more. JUUL, the newest and most popular vape device, is sleek and tiny (reminiscent of a flash drive), and can be charged in a USB port. It comes in several enticing flavors like crème brûlée, mango and fruit medley. Every JUUL product contains a dose of nicotine, with one pod or flavor cartridge containing about the same amount of nicotine as a whole pack of cigarettes. The JUUL’s subtle design makes it easy to hide, which certainly explains why it has become so popular among middle and high school students. It now accounts for about 72 percent of the market share of vaping products in the United States and more than half of the e-cigarette market. E-cigarette company, JUUL Labs, Inc. recently exceeded a $10 billion valuation faster than any company…including Facebook! 

Is vaping bad for you?

Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. Though it is speculated that e-cigarettes expose the user to fewer toxic chemicals than traditional cigarettes, nicotine is the primary agent in both and it is highly addictive. Nicotine causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.  Additionally, many e-cigarette users get even more nicotine than they would from a tobacco product because you can buy extra-strength cartridges (a higher concentration of nicotine) or you can increase the e-cigarette voltage to get a greater hit of the substance.

Although e-cigarettes have been marketed as an aid to help you quit smoking, they have not been approved by the Food and Drug Administration (FDA) as a smoking cessation device. In fact, a recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to smoke both traditional and e-cigarettes!

Why does vaping appeal to teens?

There are several reasons why e-cigarettes are grabbing the attention of the young people: First, many teens believe that vaping is less harmful than smoking (the packaging does little to convey the risks; it says 5% nicotine, which sounds like nothing, so teens think 95% is water weight or vapor). Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, vape cartridges are often formulated with flavorings such as apple pie and watermelon that appeal and seem less harmful to younger users.

What are the effects of vaping?

Vaping drugs affects how someone thinks, acts, and feels. Some may argue that vaping does not include nicotine, but most do. Even those without nicotine still have chemicals in them that irritate and damage the lungs and other internal organs. Vaping also slows brain development and affects memory, concentration, learning, self-control, attention, and mood. It serves as a gateway drug and increases the risk of other types of addiction later in life. Because this drug was only introduced to the public in 2007, there is limited research on the long-term effects.

If you are vaping, or participating in other addictive behaviors, and want to quit, there is hope! You CAN do it–you can kick this addictive habit and behavior. Start by deciding why you want to quit; own your reason and stick by it. Then, pick a day to quit. Get rid of your vaping supplies.  Avoid your triggers. Tap into available resources like apps, family members, friends, support groups, a therapist, and healthy hobbies. Get the help you need and deserve. I am your cheerleader; please do not hesitate to contact me today to schedule a session! 

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

Supporting A Loved One Through Alcohol Addiction

Each Al-Anon Family Group has but one purpose: to help families of alcoholics. We do this by practicing the Twelve Steps of AA ourselves, by encouraging and understanding our alcoholic relatives, and by welcoming and giving comfort to families of alcoholics.

It can be so difficult to know your place if you have a friend or family member struggling with an alcohol addiction. You may not know what to say or how to help; you may feel like their addiction is straining your relationship; you may resent their choices. While it is true that you cannot force a person to get help for alcoholism, there are various ways you can support them and encourage them to seek treatment.

You have likely heard of Alcoholics Anonymous (or AA). In April, I wrote a post that detailed the basics of Alcoholics Anonymous. I tried to cover everything from what it is, to how it started, its main tenets, if it works, and how it applies to those who do not believe in God. I detailed the strength that comes from utilizing this specialized support group of complete strangers who understand the path of the alcoholic’s addiction.  This is a program of recovery for specifically for alcoholics; Al-Anon, however, is different. It is a program of recovery for people who are affected by someone else’s drinking, whether that be a friend or family. It is one of many resources available to support those indirectly affected by alcoholism. This post is dedicated to how you can support a loved one through alcohol addiction.

There is no one exact formula that will tell you how to support someone facing an addiction to alcohol. Every person is different and, therefore, each person’s recovery process will be unique. Some people may rely heavily on their support system and want to involve you in each step during treatment; others may be more reserved and may only come to you when they need a listening ear or want to talk. The best thing you can do for a loved one who is recovering is to motivate and support them every step of the way. Here are several specific ideas for how you can get involved and offer support:

  • Learn about his/her condition. Understanding that, over time, alcohol rewires a person’s brain and causes it to function differently, sheds light on why he/she cannot simply choose to stop drinking alcohol.
  • Know the warning signs. Some signs are recognizable while others are subtle. Several telltale signs of a potential drinking problem are irrational behavior, lack of interest in hobbies and ignoring responsibilities. (This step is particularly important for those who have not yet recognized the need for help to overcome an alcohol addiction.)
  • Offer to help research alcohol rehab programs and types of therapy. Deciding on where to go for treatment is one of the most important factors in a person’s recovery journey.
  • Attend support group meetings or counseling sessions with your loved one. This will give you insight to their journey as well as guide you in how to handle different situations. (AA meetings are generally open, which means you can attend with your loved one. These meetings offer a great deal of support and advice for living with someone who has a drinking problem.)
  • Attend Al-Anon meetings. Just as those facing alcohol addiction will attend AA meetings, you should attend Al-Anon meetings. Here you will find support as you meet others who also love someone with an alcohol addiction, and will be able to personally work through the 12 steps of Al-Anon. Visit this website to find a meeting near you.
  • Help with the post-rehab recovery plan. Be constant as your loved one navigates life as a recovering addict.
  • Be optimistic. Addiction recovery is a steady uphill battle that will come with victories and defeats. When setbacks come, try not to be critical and face the future with hope. When progress occurs, celebrate it and continue pushing forward.

Family and friends should understand that the recovery process can come with many ups and downs–for both parties. When things get difficult, remember that having a steady support system will make a profound difference for your loved one. Your support will surely influence whether or not he/she seeks help for their drinking problem, will buoy him/her through treatment, and will increase the likelihood that he/she will maintain sobriety after treatment. Your role is crucial!

More than 15 million people struggle with an alcohol use disorder in the United States, but less than eight percent of those receive treatment.  Alcoholics Anonymous is a free resource available to all that will offer tools to both the individual facing the addiction, as well as his/her loved ones. Alcoholism affects everyone, including family members and friends of the alcoholic. This can damage relationships and cause you to feel a wide range of emotions like disappointment, anger, doubt and denial. Although your primary goal is likely to get your loved one help, be sure to get the help you might also need. In many instances, speaking with a counselor is helpful and even necessary. If you feel you could use professional help, I invite you to contact me today or schedule a session. Whether you are the one facing the addiction, or the one offering support, I am here to help you every step of the way!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Alcohol Anonymous: Strength in Numbers

Alcoholics Anonymous

“When I stopped living in the problem and began living in the answer, the problem went away.”

~ Alcoholics Anonymous

According to the 2015 National Survey on Drug Use and Health, 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime. While it may not lead to an addiction for some, it does for others. Alcohol has touched all of our lives in one way or another, whether it is personally or through someone we care about. Because April is Alcohol Awareness month, I want to dedicate a post to one of the most helpful, renowned support groups for those working to overcome an addiction to alcohol: Alcoholics Anonymous.

WHAT IS ALCOHOLICS ANONYMOUS (AA)?

Alcoholics Anonymous is an international group of men and women who have had or are working to conquer a drinking problem. AA is open to all races, politically neutral, self-supporting, and is available almost everywhere. There are no age or education requirements, and membership is open to anyone who wants to do something about his or her drinking problem.

HOW DID AA START?

Alcoholics Anonymous was founded by Bill Wilson and Dr. Bob Smith, who were both recovering alcoholics. In 1935, Alcoholics Anonymous began as a community-based fellowship which encouraged sobriety for other recovering alcoholics. These two men developed the 12 steps to aid their attendees, and later introduced the 12 traditions to help further define the group’s purpose and achieve continuity for AA groups across the country (and later around the globe). AA paved the way for other support groups; today Narcotics Anonymous, Gamblers Anonymous, and Overeaters Anonymous are just three of the many groups that have modeled themselves after the AA meeting concept.

WHAT ARE THE MAIN TENETS OF AA?

The original steps are still intact and many former addicts credit the group with helping them through recovery. The 12 steps that govern all AA group meetings are presented in linear fashion, but participants see them as an ongoing circle. The following steps may be revisited until the recovering addict is comfortable in that stage of their recovery process:

  1. Admit powerless over alcohol
  2. Accept that a higher power, in whatever form, will restore your sanity
  3. Make a decision to turn your will and life over to a higher power
  4. Take a moral inventory of yourself
  5. Admit to a higher power, another human, and yourself the nature of your wrongdoings
  6. Accept that a higher power will remove your character defects
  7. Humbly request the higher power remove your shortcomings
  8. List people you hurt during your addiction and be willing to make amends
  9. Make amends to those people unless it would harm them
  10. Continue to take a personal inventory, and when you’re wrong, admit it
  11. Use prayer and meditation to connect with the higher power
  12. Carry the message of AA to other alcoholics and continue to practice the principles of the 12 steps in your daily life

DOES AA WORK?

Because AA is anonymous, some members of the group do not participate in studies since it could breach anonymity. Many want their participation in AA to remain unidentified, in line with the group’s original intention. Additionally, participants might not want to admit to relapse. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.  Alcoholics Anonymous’ Big Book touts about a 50% success rate, stating that another 25% remain sober after some relapses. Though it is difficult to know just how effective it is, it is safe to say that many people have been helped by regularly attending AA. Just how effective depends on the participant.

CAN AA WORK FOR THOSE WHO DON’T BELIEVE IN GOD?

The first time I read through the twelve steps, I was surprised how often God was referred to. While the faith-based program of AA may be effective for some, it does not work for everyone — particularly those who do not subscribe to God as a higher power.  Might I offer a solution: AA founder, Bill Wilson, encountered the term “higher power” in the book, Varieties of Religious Experience, by William James. In this book, James offers many examples from Christian traditions, as well as non-Christian examples. One of the best examples of “higher and friendly power” is borrowed from Henry David Thoreau walking in the midst at Walden Pond feeling a sense of connection to pine needles. He cited other examples of a “higher power” to potentially include moral principles, patriotism, civic engagement, and even a higher or better self. Therefore, the term “higher power” does not have to be a faith-based term and thus varies from participant to participant.

You could go to an AA meeting in Los Angeles, London or Lima and each one would be carried out in a similar fashion. This is because the steps and traditions of Alcoholics Anonymous are the foundation for every meeting. In each meeting, members will get to know one another, discuss progress and relapses, and support each other through sponsor programs. Although it can be difficult going to an AA meeting with complete strangers and admitting to such a personal issue, it is the only place where every participant knows exactly how you feel. They have been where you are and can support you in your journey. That is powerful. To quote AA literature: “The feeling of having shared in a common peril is one element in the powerful cement which binds us.”  This instantaneous bond cultivates a unique feeling of community and understanding that is incredibly helpful to those recovering from alcohol addiction.

The only real way to find out if Alcoholics Anonymous can help you is to give it a try. See for yourself if you think the help and support from others struggling with the same problem can help you stay sober. As Alcoholics Anonymous has no dues or fees, you have nothing to lose in choosing to visit a few meetings. I strongly encourage it. Call now at 877-600-9205 or go online and use a meeting finder to find a meeting in your area. Click here if you are local to the Dallas/Ft. Worth area and could benefit from community resources. In like manner, if you feel you could use professional help, I invite you to contact me today or schedule a session to begin your journey toward recovery. I am here to help you along the uphill road of addiction recovery!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Opioid Epidemic: Just a Prescription Away

Opiods - Cluff Counseling, Marriage & Family TherapyWhen a person takes a prescription drug for a nonmedical reason, it can quickly lead to addiction and the need for drug treatment. In fact, 25 percent of people who misused prescription drugs by age 13 ended up with an addiction at some point in their life.

One of my clients recently recounted some of the horrors of her childhood. When she was younger, her mother began misusing prescription drugs. My client remembered going with her mother to sketchy parking lots for exchanges, and her mother being completely under the influence of these powerful drugs. Every day when my client came home from school, she feared finding her mother passed out or dead on the bathroom floor. The addiction wreaked havoc on this family. It took years for the mother to get her addiction to prescription drugs under control.

The mother, of my client, was initially prescribed the pills to help combat her pain from a surgery. She never intended to terrify and permanently scar her children by what they saw when she was under the influence. But the temporary relief (or high) that the drugs gave her grew to be a necessity she could not live without. This is the case for most addicts of prescription drugs–they never intended to get hooked to the drugs meant to improve their health.

…But prescription drugs are powerful. Many people believe that prescription drugs are safer than illegal street drugs because they are prescribed by a doctor. When, in reality, they are just as dangerous. Prescription drugs are legal and more accessible than harmful drugs. More people report using controlled prescription drugs than cocaine, heroin and methamphetamine combined! Prescription drugs are in second place, behind marijuana, when it comes to illicit drug use. Additionally, prescription drugs often serve as gateway drugs–hooking people to the high and leaving them needing something stronger. Approximately three out of four new heroin users report misusing prescription opioids prior to using heroin!

Let me tell you the facts behind this opioid epidemic: The US makes up only 5 percent of the world’s population, yet consumes approximately 80% of the world’s prescription opioid drugs. 3.3 million Americans report misusing prescription painkillers. In the US alone, an estimated 54 million people over the age of 12 have used prescription drugs for nonmedical reasons in their lifetime. Prescription opioid overdose rates are highest among people ages 25 to 54 years. Here are the most commonly misused prescription drugs:

  • Prednisone or Cortisone. Used to treat rheumatoid arthritis, lupus, asthma, allergies and many other conditions. Side effects: High blood sugar, increased chance of infection, and thinning bones (osteoporosis). Natural alternative: Raw, whole food diet.
  • Methotrexate ­& Other Chemotherapeutic Agents. Used to treat breast, head, neck, lung, blood, bone, lymph node and uterus cancers. Side effects: Fetal death, livery and kidney toxicity, lung disease, intestinal bleeding. Natural alternative: Whole food diet, natural oils, vitamin C, fasting,
  • Coumadin or Warfarin. This drug is an anticoagulant, or a blood thinner, used to prevent the blood clots from forming or migrating. Side effects: Hemorrhaging. Natural alternative: Vitamin C, Vitamin E, OPC 165 (all natural antioxidant blend).
  • Cholesterol-lowering drugs. Used to promote excretion of bile build-up in intestinal tract to lower cholesterol circulation. Side effects: Inflammation of the muscles (myositis). Natural alternative: Whole foods, fish, spinach, avocado, oats, nuts, beans.
  • Prozac and antidepressants. Used to balance serotonin levels in the brain (serotonin is a neurotransmitter that affects mood, agitation, anxiety and sleep). Side effects: Nausea, weight gain, fatigue, insomnia, sexual problems, blurred vision, constipation, anxiety, trouble sleeping, and more. Natural alternative: Regular exercise, therapy and a whole food diet.
  • Ritalin, Cylert, Dexadrine, Adderal. Used to increase, maintain or improve levels of alertness and attention. Side effects: Abdominal pain, loss of appetite, anxiety, depression, dizziness, hypersensitivity, and suicidal thoughts. Natural alternative: Yoga, regular exercise, a musical instrument, whole food diet.
  • Beta Blockers and Calcium Channel Blockers. Used to lower blood pressure. Side effects: Shortness of breath, palpitations, congestive heart failure, increased death rate. Natural alternative: Reduce sodium intake and alcohol consumption, regular exercise, whole food diet.

I agree that natural alternatives are not remedies for severe medical issues like cancer. However, I believe healthy, natural lifestyle choices will enhance one’s overall health and can prevent further maladies in the future. When we are not supplying our bodies with proper nutrition, disease can manifest itself. This is usually when most people will resort to prescription drugs. These drugs only cover up the problem, but are never actually dealing with the root cause. The human body is a remarkable machine naturally built to function optimally on its own, but it can only do so when we provide it with all of the essential nutrients that it needs!

Taking a long-term medication that alters any of the body’s natural functions can be dangerous. But if taken for a short time and used properly, these drugs can be of great help, health, and healing to the consumer. I find it of the utmost importance to state that I firmly believe there is a place for prescription drugs. When used properly, they can alter and/or correct chemical imbalances and lessen pain to greatly improve one’s quality of life. Many (if not most) of my clients couple prescription medication with counseling to make leaps and bounds of progress in their lives. While I personally cannot prescribe medications, I support the proper usage of them, and often encourage clients to seek necessary medication in addition to attending therapy. Please contact me today if you would like to combine the power of properly used prescription drugs with personalized therapy. I am here to help you!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

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Men Are Not the Only Ones Addicted to Porn

Cluff Counseling - Men Are Not the Only Ones Addicted to Porn - Denton TherapistOne study found that 76% of females, between the ages of 18 to 30 years old, watch pornographic material. Although we may most commonly hear about men being addicted to pornography, women can be as well. Because the stereotypical porn addict is a man, women tend to feel shame and isolation when they “go against the norm” and become addicted to pornography. No one is exempt from falling prey to addiction–especially when pornography is so easily accessible!

There are many myths circulating about pornography usage. First is the myth that it is an accepted societal norm that men view pornography.  Second, is the idea that women do not view porn. Think about a movie where you see a girl deleting her browsing history as her boyfriend walks in the door…or a scene when a woman is caught with stacks of porn magazines under her mattress. If you are unable to think of such a scene, it is because men are the ones depicted as being hooked on pornography. Not women.

A recent German sex study showed that women are just as easily at risk of becoming dependent upon porn as men. In fact, one study reports that half of young adult women agree that viewing pornography is acceptable; a 1/3 of these young women reported using porn regularly.

The truth is that pornography is highly addictive. It truly is like a drug. It has a chemical effect on the brain that first leads to compulsion and then addiction. Substances like cigarettes, alcohol, and drugs bring foreign chemicals into the body (whether it is sniffed, injected, drunk from a glass, lit on fire and smoked, etc). Behavioral addictions, like gambling and viewing porn, bring no new chemicals or substances into the body, but achieve the same effect: the brain releasing dopamine, resulting in a temporary high.

Fight the New Drug–a website dedicated to increasing awareness and providing a community for healing from pornography addiction–gives the best example of what pornography is and does to the brain:

“Porn is basically sexual junk food. When a person is looking at porn, their brain is fooled into pumping out dopamine just as if they really were seeing a potential mate. Sure, filling your brain with feel-good chemicals might sound like a great idea at first, but just like with junk food, it’s more dangerous than it seems.”

Pornography appeals to one of our primary human needsthe need to belong and connect. Because of this, both men AND women are at risk. One article cautioned readers that thinking only men are pulled into viewing pornography is ignorance. Yes, porn has been criticized for hooking males with its focus on and objectification of female bodies. But there are, in fact, women viewers of pornography.  Pornography leaves no one exempt–men and women alike. The truth is that pornography is incredibly addictive–to anyone finding him- or herself in its wake.

According to several studies, men prefer watching visual erotica (pictures and movies) and women prefer actually engaging in interactive erotica (chat rooms, social media sites featuring explicit material, and webcams). Whatever its form, pornography not only impacts the brain–making its user need more and more all the more frequently–but it also harms the user’s attitudes and perception about real life sex, intimacy, and relationships. Pornography may negatively influence a woman in the following ways:

  • Unrealistic expectations around sexual behaviors and performance.
  • Reduced intimacy with real-life partners.
  • Personal sense of inadequacy.
  • Lowered self-esteem.

The excessive use of pornography can even affect a woman’s relationships with herself. One woman reported that she felt cheap, dirty, useless, insignificant, and unworthy of love or belonging. When she reached out asking for help as a 15 year-old girl, her adult-confidant did not believe someone as young and innocent as her could have such a problem. No one believed that she had a pornography addiction and needed help. She was a slave to her addiction for five more years, endlessly trying and failing to conquer her addiction on her own. She eventually reached a point of such deep self-loathing that she nearly tried to end her own life.

Most addicts strive day and night to keep their addiction a secret. It becomes an endless quest to feed the addiction while simultaneously living a double life. This is tiresome, unfulfilling, and–in the end–useless. Most of the men and women I work with know their addiction is unhealthy and want help to overcome it. While they once may have thought that viewing a little pornography would be liberating and fun, they soon find themselves a captive to its grasp. They wind up isolated, unhappy, and unsatisfied–it is a downward spiral. The only thing that is truly liberating is breaking free from addiction.

Tell somebody.

Begin breaking free by thinking of someone you trust or admire. Tell him or her what you are struggling with. It will be difficult, but having a trusted person on your side will help you not feel so alone.

Ask for help.

Next, ask a trusted friend to be your accountable buddy. Ask them if you could reach out to them when you are close to acting out, or give them permission to periodically ask how you are doing in regards to pornography. Researching and then making an appointment with a therapist is another way you can ask for help. Sometimes, just having someone else on your team–and not shouldering the burden of addiction alone–makes all the difference.

If you are a woman battling a pornography addiction, you are not alone. This is not a battle that only men face! I am here to tell you that addiction is addiction, and anyone can become addicted to the addictive, prevalent “substance” that is pornography. Anyone! Along with there being an increased awareness of this addiction, there is also help more readily available for all–male or female, child or adult.

Your sex life, virtual or physical, is one of the most intimate aspects of who you are. By opening yourself up to a new level of scrutiny, you will also open yourself up to new levels of freedom, healing, and grace. Addiction recovery is not an easy road. (In fact, I would dare to say that the only easy road is the one where you give up and stop trying.) But you are bigger and better than that! Yes, your addiction may feel stifling, but your will-power to overcome it, coupled with counseling from an experienced therapist, is stronger than even the strongest porn out there. Hope and healing is available today, now. Contact me or click here to schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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