Bulimia Nervosa at a Glance

“For me, the bulimia was about stuffing my emotions. So I stopped suppressing my feelings.” ~Cheryl James

My friend’s dad is a dentist; within the first minute of looking into someone’s mouth, he can tell if the person struggles with bulimia nervosa. This is because bulimia–the binging and purging of food–wreaks havoc on a person’s teeth. The acid from the stomach visibly destroys the enamel of the teeth and causes noticeable discoloration. But this particular side-effect of bulimia is only the tip of the iceberg among much more serious consequences that come from this eating disorder and mental illness. Continue reading to learn what it is, what causes it, as well as the symptoms, consequences, and recovery options for bulimia nervosa. 

Even though Derek Zoolander downplays the significance of bulimia nervosa, it is a very serious, potentially life-threatening eating disorder. People with bulimia secretly binge and then purge to get rid of extra calories in an unhealthy and unnatural way. Binging includes discretely eating a large amount of food, within a small amount of time, accompanied by a lack of control during this episode. Purging methods vary from regularly self-induced vomiting, misusing laxatives, weight-loss supplements, diuretics or even enemas after bingeing. Other ways include denying calories to prevent weight gain through fasting, strict dieting or excessive exercise.  The severity of bulimia is determined by the number of times a week that a person purges, usually at least once a week for at least three months. 

The exact cause of bulimia is unknown. Many factors could play a role in the development of eating disorders, including genetics, biology, emotional health, societal expectations and other issues.  Women are more likely to struggle with bulimia than men, but the latter are still susceptible. Bulimia typically begins in the late teens or early adulthood.

Bulimia shares several symptoms with other mental illnesses: Negative self-esteem, problems with relationships and social functioning, difficulty concentrating, poor sleep patterns, withdrawal from friends, etc. Symptoms specific to bulimia nervosa include extreme preoccupation with self-image, body shape and weight; fear of gaining weight; feeling uncomfortable eating around others; trying to “fill up” by ingesting unsubstantial food (ie. condiments), drinking excessive amounts of water or non-caloric beverages, or trying to chew food for an unnecessarily long amount of time; hoarding food in strange places; disappearing after eating (often to purge in a private place); frequently using mints, mouthwash and gum to cover unnaturally bad breath; and maintaining a rigid exercise regimen to “burn off” calories ingested. 

Bulimia nervosa affects far more than how an individual perceives him- or herself or what he/she eats. This eating disorder truly harms a person’s body in the following ways:

  • Unusual swelling of the cheeks or jaw area  
  • Calluses on the back of the hands and knuckles from self-induced vomiting 
  • Bloating from fluid retention  
  • Stomach cramps and other gastrointestinal issues (constipation, acid reflux, etc.) 
  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate) 
  • Dizziness 
  • Fainting/syncope 
  • Feeling cold all the time 
  • Dental problems like enamel erosion, cavities, and tooth sensitivity 
  • Dry skin 
  • Dry and brittle nails 
  • Swelling around salivary glands 
  • Thinning of hair on head, dry and brittle hair (lanugo) 
  • Muscle weakness 
  • Yellow skin (in context of eating large amounts of carrots) 
  • Cold, mottled hands and feet or swelling of feet 
  • Menstrual irregularities
  • Poor wound healing 
  • Impaired immune functioning
  • Dehydration (leading to kidney failure)
  • Heart problems, such as an irregular heartbeat or heart failure
  • Severe tooth decay and gum disease
  • Absent or irregular periods in females
  • Digestive problems
  • Anxiety, depression, personality disorders or bipolar disorder
  • Fertility issues (in women)

Many people with bulimia nervosa also struggle with co-occurring conditions, such as self-injury (cutting and other forms of self-harm without suicidal intention), substance abuse, impulsivity (risky sexual behaviors, shoplifting, etc.), and even diabulimia (intentional misuse of insulin for type 1 diabetes). 

While bulimia nervosa is a very serious mental illness, the good news is that it is not a life sentence. There are many options available for treatment, including medication, support groups and group therapy, and individual therapy. By identifying your triggers, I can help you manage stress and avoid the cycle of binging and purging. Getting support and help often gives you extra strength to fight your eating disorder.  Because bulimia is related to self-image–and not just about food–bulimia can be hard to overcome on your own. Effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications. 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.

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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!)

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When You Feel Frustrated By Others, Remember This Wisdom From Brene Brown

“Imperfections are not inadequacies; they are reminders that we’re all in this together.” ~ Brené Brown

My friend and I were recently driving on the freeway when a silver Jetta swerved around us, cut us off, and then sped away. As an overly cautious driver, my friend was frustrated and even angered by that person’s recklessness. After a moment, she said, “Maybe he’s running late for a job interview. Or maybe…he’s rushing to the hospital because his wife is in labor!” And just like that, her anger and frustration melted away as we came up with a million ways why this gentleman was, indeed, justified for driving so carelessly. 

Brené Brown is a research professor at the University of Houston who has spent more than a decade studying vulnerability, courage, authenticity and shame. In her book, Rising Strong, she walks readers through her research and presents the refreshing idea that people are simply doing the best they can. The above is just one example of assuming others are doing their best.  It means defaulting to the belief that someone’s intentions are honest, and not assume malice when there is uncertainty or doubt surrounding the circumstances. It means regarding someone as innocent until proven otherwise; retaining a favorable, or neutral, opinion of someone or something until the full information about the subject is available. In short, assuming everyone is doing the best they can is a benevolent way of looking at an often cynical world. 

It is not always easy to believe that everyone is doing their best, but the fact is that you and I rarely have the full picture. I was recently frustrated with a relative that never called me back, but when we finally spoke I learned that she had recently lost her job and was simultaneously going through an unexpected divorce. Similarly, I have a friend who bailed last minute on a BBQ a few weeks ago and I later found out his wife had been freshly diagnosed with stage 4 ovarian cancer. They were in the hospital undergoing an invasive surgery when he texted me.  In both of these scenarios, knowing a few more details completely changed my outlook! You and I rarely have the full picture. We do not know what is really going on in other people’s lives. We need to just trust that everyone is doing the best they can! And even if they are not doing their best…I would much rather extend the benefit of the doubt and be disappointed every once in awhile than live with a cynical outlook of others!

What does this have to do with self-care? Everything! Last year I wrote about self-talk, and I shared the power of self-talk–for better or for worse. You and I constantly have dialogue going in our minds, and the way we perceive others and the world deeply affects our reality, how we see others, and even ourselves. Here is why assuming others are doing their best is a great form of self-care:

  1. Assuming others are doing their best helps us see the good in them (and ourselves). You see what you are looking for. If you expect someone to be flakey, aloof, selfish, etc, you will find ample evidence of those traits. However, if you choose to trust they are doing their best, you will avoid self-fulfilling prophecies by seeing the good in others. When you extend the benefit of the doubt like my friend did, as we were driving, your heart will be softened. Instead of seeing the negative, we will see the good in others as well as their strengths. This will completely change your outlook and will help you be more understanding, empathetic and kind…even to ourselves.
  2. Assuming others are doing their best teaches you how to forgive yourself and others. If you work long enough at giving the benefit of the doubt to others, you will soon find that it is easier to extend it to yourself. If you make a mistake at work or burn the dinner in the oven, you will talk gentler to yourself because you know you are simply doing your best! Instead of getting offended at someone’s unkind words, you can forgive their thoughtlessness and move on, instead of being stuck in painful feelings. 

Everyone is doing their best. Everyone is living their lives the best they know how. And when you believe that, you see the good in others, in the world, and in yourself. There is so much good in the world! So next time you are tempted to think something negative about someone, practice giving the benefit of the doubt. Assume he or she is trying his/her best and you will be surprised how positively (and immediately!) it will affect your life. As always, should you have questions or be interested in scheduling a session, please do not hesitate to contact me today.
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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Sticks and Stones Do Hurt…and So Can Words

Feeling insulted and damaged. Never measuring up. Walking on eggshells. These are just a few of many indicators of an emotionally abusive relationship. Emotional abuse is the consistent pattern of abusive words and bullying behaviors that wear down a person’s self-esteem and undermine their mental health. I want to help you recognize this often seemingly invisible, yet very real type of abuse.

The definition of abuse is regularly or repeatedly treating a person with cruelty or violence. In discussing abuse, physical abuse (like shoving, cornering, breaking and throwing things) is likely the first thing that comes to mind. Emotional abuse is often devoid of physical violence; it is speech and/or behavior that’s controlling, punishing, or manipulative. This can include withholding love, communication, support, or money as indirect methods of exerting control and maintaining power. Emotional abuse might also look like someone controlling where you go, to whom you talk, or what you think. Spying, stalking, and invading your personal space or belongings is also abusive because it disregards personal boundaries.

You may be experiencing emotional abuse if someone wants to know what you are doing all the time or requires you to be in constant contact; demands passwords to your phone, email, and social media (digital abuse); acts jealous; frequently accuses you of cheating; prevents or discourages you from seeing friends or family; tries to stop you from going to work or school; gets angry in a way that frightens you; controls your finances or how you spend your money; stops you from seeing a doctor; humiliates you in front of others; calls you insulting names; threatens to hurt you, people or pets you care about; threatens to call the authorities to report you for wrongdoing; threatens to harm himself or herself when upset with you; says things like, “If I can’t have you, then no one can”; decides things for you that you should decide (like what to wear or eat); etc.

The most common form of emotional abuse is verbal, though it often goes unrecognized because it can be subtle. A client recently told me that she remembered a session from years ago when I stopped her now ex-husband from telling her to shut-up as she tried to speak. She did not even hear him say that, but she remembered feeling her body tense up. Research has shown that there is so much more to verbal abuse than people realize; in fact, some people are verbally abused on a regular basis without even recognizing it! Some forms of emotional/verbal use will undermine your self-esteem or make you feel inadequate as a way to establish hierarchy. 

Emotional and verbal abuse may be manifested outright or more insidiously in any of the following manners:

  • Using threats
  • Judging
  • Yelling
  • Patronizing
  • Criticizing
  • Lying
  • Blaming
  • Publicly embarrassing you
  • Ordering
  • Raging (showing violent, uncontrollable anger)
  • Belittling your accomplishments
  • Insulting your appearance
  • Digital spying
  • Tracking your whereabouts
  • Lecturing
  • Denying something you know is true (gaslighting)
  • Trivializing
  • Demanding respect (but not giving it)
  • Keeping you from socializing (isolating you)
  • Interrupting
  • Treating you like a child
  • Name-calling, even using derogatory pet- or nicknames
  • Disguising something hurtful or controlling by saying it in a loving, quiet voice, indirectly, or even concealed as a joke

Whether disguised as play or jokes, sarcasm or teasing that is hurtful is emotional and verbal abuse. There are innumerable signs of emotional abuse–unique to each couple and individual. If you fear you may be being emotionally or verbally abused, please seek help today. 

An emotionally abusive relationship can change you forever. You may feel powerless, controlled, worthless; you may question your memory, live in fear, change how you act to avoid upsetting your partner. Staying in an emotionally or verbally abusive relationship can have long-lasting effects on your physical and mental health, including leading to chronic pain, depression, or anxiety. This is no way to live. Help is available and you DESERVE it. If you suspect your partner, family member or friend may be emotionally abusing you, contact a counselor, an advocate or a pastor for assistance. You can also call the National Domestic Violence Hotline 1−800−799−SAFE(7233) or visit their website (thehotline.org) and chat online with someone right away. I will be posting a follow-up blog discussing what to do if you are in an emotionally abusive relationships in the future. Please, do not suffer through emotional abuse. You and your happiness matter. My door is wide open; allow me to help you! Contact me today!

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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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.

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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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#optoutside

“I believe that there is a subtle magnetism in Nature, which, if we unconsciously yield to it, will direct us aright.” ~ Walden by Henry David Thoreau

Summer is nigh upon us! Stores nationwide have their swimsuits and outdoor pools at the forefront of their aisles. Most places in the United States are warming up and there is a buzz in the air that comes from the excitement summer brings. I want to share some ideas to help you make the most of the great outdoors this summer!

But first, let’s go over the power of being outside. Not too long ago, I wrote a blog post called, “Outdoor Therapy: Nature’s Cure.” In it, I shared that studies are repeatedly showing that being outside has positive psychological and physiological benefits. Ecotherapy (also known as green therapy, nature therapy, and earth-centered therapy) is contact with nature and is a powerful new kind of therapy. This type of therapy with nature has been found to be just as effective against depression as traditional psychotherapy or medication! And the amazing thing about ecotherapy is that it is free. Not only that, but it is completely accessible to anyone at anytime!

I know what you are thinking. I have a job and/or kids and a life with so much to do that makes it impossible to be outside all the time! I hear you. I know that it is not easy to make time to do something elective. Regardless, we need to put down our paperwork, pause our housework, and turn off our computer and get outside. Yes, we have many obligations and responsibilities that demand our attention, and making time for self-care seems like one more thing to squeeze into our overbooked schedules (to learn more about self-care, read this post). I have personally found it therapeutic to walk a trail near my home multiple times a week. I am refreshed and rejuvenated when I get outside, breathe in the air, smell the fresh honeysuckle, observe the dogs and their owners, and feel my body moving (especially helpful since I spend the majority of my day sitting for hours at a time). I can assure you that you will be better off because of the time you spend outside!

The following 55 ideas will jumpstart your summer and up the time you spend outdoors (and none of them require a great amount of time nor a large amount of money):

  1. Walk your dog (or get a dog!)
  2. Count your steps. Iphones, outdoor apps, fitbits, and so many other technological advancements make it incredibly easy to use an activity tracker.
  3. Listen or watch for birds
  4. Look for shooting stars
  5. Camping (or glamping if that is more your style!)
  6. Hike or run a local trail
  7. Chase waterfalls, soak in some hot springs, or visit a local swimming hole, river, or lake
  8. Go fishing
  9. Plant a garden
  10. Pick fresh flowers outside
  11. Pick up landscape photography
  12. Have a picnic
  13. Go tubing, kayaking, or rafting
  14. Visit local farmers’ market
  15. Fly a kite
  16. Set up a hammock and relax!
  17. Have a bonfire (don’t forget the s’mores!)
  18. Go geocaching or letterboxing
  19. Go hot air ballooning
  20. Walk instead of driving (when possible)
  21. Ride your bike
  22. Take up mountain biking
  23. Rent local scooters
  24. Visit a new park
  25. Go on a run
  26. Walk a mile
  27. Explore a new neighborhood or houses under construction
  28. Dance in the rain
  29. Follow a rainbow
  30. Swing on a swing
  31. Play on a playground
  32. Go swimming (and jump off the diving board)
  33. Go surfing
  34. Watch the sunrise or sunset
  35. Try bouldering or rock climbing
  36. Visit a National Park
  37. Take a walk at lunch
  38. Sit on a sandy beach
  39. Plant a tree
  40. Outdoor BBQ
  41. Summer chairlift ride (preferably during the full moon!)
  42. Stroll around the city
  43. Play catch, basketball, kickball, or any outdoor yard game
  44. Get lawn seats to a concert
  45. Stand on a summit
  46. Go boating or sailing
  47. Listen to the ocean
  48. Organize an outdoor scavenger hunt
  49. Color with sidewalk chalk
  50. Wash your own car
  51. Participate in a park clean-up
  52. Try outdoor yoga (for the sunrise!)
  53. Collect seashells or build a sand castle
  54. Sand volleyball
  55. Set up an outdoor movie with a projector + sheet

Which ones will you do first? Consider making a list of these ideas (plus any others you might have!) and crossing them off as you complete them. Put them on the calendar and make them happen! Allow yourself to enjoy the beautiful warm weather this summer.

If you find yourself feeling frustrated with life, discouraged, or lonely this summer, I encourage you to reach for your tennis shoes before medication. Enjoying a healthy dose of mother nature does incredible good for both your mind and body.  I offer walk and talk therapy for some of my clients; it is amazing what can be accomplished when I spend just 20 minutes outside walking with my clients at the beginning of a session! Please do not hesitate to contact me today to schedule your first personalized session.

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

Resources:

The Magic of Saying No

“Whenever you say yes to something, it means you’re saying no to something else.” ~Susan Biali

We all feel badly when we have to say no to something or someone.  It is so much easier to say yes when people need help–even if it comes at personal expense. Though selfless service is necessary and admirable at times, there are other times where it is more applaudable to say no. Saying yes to everything means you will be spread too thin and will not able to get things done well or at all; it is physically impossible to take on something new without slacking on something else!  This post will focus on the magic of saying no in hopes of giving you the courage to say so when appropriate.

(Disclaimer, I am not specifically referring to saying no in relationships regarding boundaries and physical intimacy–though that topic is incredibly important. I will write about this specific subject in the future. Instead, I am referring to saying no instead of yes when asked to take on additional responsibilities that you simply cannot accommodate.)

Whether you have been asked to help watch a pet or child, pick something up, drop something off, or take on additional responsibilities at work, you have certainly been asked to help. Oftentimes it feels like yes is the only acceptable answer, even if it comes at great personal expense. Saying no means you could potentially hurt, anger or disappoint the person you are saying no to. You may fear appearing selfish, lazy, or uncaring. You want people to love (or at least like) you. So you inconvenience yourself and say yes.

However, saying no is actually a sign of strength because it shows that you know yourself and your limits. It allows you to give of yourself fully, within your limits, and not overextend or exhaust yourself. Having and maintaining personal boundaries can build important relationships by fostering honesty, openness and trust. (I am not suggesting you immediately decline an opportunity to help someone when asked. I believe in the power of service and have written several times about its power.) Saying yes when the answer should have been no only leads to frustration and resentment. Learning to say no can be a magical skill when used appropriately!

Now, let’s discuss the steps involved in the art of saying no:

Step one: Honor your time and priorities.

Time is an extremely precious commodity for everyone. There are only 24 hours in a day, so you must choose to spend your time wisely. Even if you do happen to have some extra time (which for most of us is rare), is this new commitment really the way you want or need to spend that time? Does it honor what is most important to you? Are your priorities in line? If you are asked to take on a new commitment that will cut into your valued family time, it may make saying no easier.

Step two: Take a moment + Raincheck

When someone asks for help, instead of giving an immediate (most likely affirmative) response on the spot, say that you need to check your calendar and will get back to him/her. If you end up needing to say no, maybe volunteer yourself to help in the future when you are more available. This can assure them that you are willing and want to help, but are unable to at the moment!

Step three: Do not apologize.

A common way to start out is “I’m sorry but …” as people think that it sounds more polite. While politeness is important, apologizing just makes it sound weaker. Your time is your time. How you choose to spend your time is your choice. You need to be firm, and unapologetic about safeguarding your precious, finite time!

Step four: SAY NO.

You may cringe at the very thought of saying the abrasive, n-o word to someone. That’s okay! There are many ways around this that will still get your point across. Let’s say your friend asks to borrow your car, and you are less than excited about the idea. Here are seven ways to assertively, yet diplomatically, decline:

I prefer to be the only one driving my car.“

I prefer not to lend out my car.”

It doesn’t work for me to lend out my car.”

It’s important to me that I keep my car for my own use.”

“Unfortunately, I’m not going to be able to lend you my car.”

I’m uncomfortable with letting others drive my car.“

I made a promise to myself that I’m not going to let other people drive my car.”  

Notice that all of these suggestions are “I” statements. This puts ownership on you and therefore makes it more difficult for the listener to dispute. If someone is persistent in wanting you to do what he or she wants, keep repeating “no” using any combination of the statements above. Hold your ground until the person realizes you mean what you say.

Remember, saying no does not mean you are an uncaring, selfish person. It simply means you know and honor your time, priorities, and limits. Saying no protects you, earns the respect of others, and frees you to spend your time doing what is most important to you. It is actually quite magical! Setting skillful boundaries is an act of self-compassion. It is liberating and it is your right.

Next time you are asked to help someone, consider your priorities and how you wish to honor your time, pause before answering, offer a raincheck, do not apologize if you are busy and cannot feasibly rearrange things, and if necessary, say no. Remember that there are only 24 hours in a day. In order to spend it wisely, sometimes it will be necessary to say no! As always, please feel free to contact me with questions, and click here if you would like 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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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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Self-Compassion: A Neglected Form of Self-Care

“You yourself, as much as anybody in the entire universe, deserve your love and affection.” ~Buddha

When we look in the mirror, what do we see? We may notice our frizzy hair, crooked teeth, short eyelashes, thin lips, uneven eyebrows or a plethora of other things. Yet when others look at us, they are more prone to see what we overlook–that we are friendly, optimistic, outgoing, hard working, strong, resilient, creative, kind, sensitive, thoughtful… Why are we so much harder on ourselves than we are on others?!

I recently opened a “Marriage Minute” email from the Gottman Institute and read about self-love. This is something that has been on my mind over the last several weeks, and I thought it would be helpful to dedicate a post to a powerful form of self-care that we often overlook: Self-compassion.

Compassion itself is defined as the sympathetic pity and concern for the sufferings or misfortunes of others. Compassion literally means to “suffer with.” In order to have compassion, we must first notice that someone is suffering, and then we feel moved by their suffering so that our hearts respond to their pain. When we extend compassion, we feel warmth, caring, and the desire to help the suffering person in some way. Having compassion also means we offer understanding and kindness to others when they fail or make mistakes, rather than judging them harshly. Compassion is the realization that suffering, failure, and imperfection is part of the shared human experience.

Even though we all need it, self-compassion is so much easier to show someone else than it is to show ourselves! The time has come to focus on extending this kind of compassion to others as well as ourselves.

Practicing compassion towards ourselves is really no different from having compassion for someone else. Self-compassion is…

  • Acting the same way towards ourselves as we do others when we are having a difficult time, fail, or notice something we do not like about ourselves.
  • Being gentle with ourselves when confronted with painful experiences.
  • Cutting ourselves some slack instead of ignoring pain or judging ourselves harshly.
  • Being kind and understanding when confronted with imperfections.
  • Being warm and understanding toward ourselves when we suffer, fail, or feel inadequate, rather than ignoring our pain or flagellating (punishing) ourselves with self-criticism.
  • Recognizing that being imperfect, failing, and experiencing life difficulties is inevitable.

To be clear, self-compassion is NOT self-pity (being immersed in our own problems), self-indulgence (unrestrained gratification of our desires), or self-esteem (our perceived sense of worth or value).  

Ultimately, self-compassion is an ongoing process of honoring and accepting our humanness, and recognizing that things will not always go our way. It is knowing that we will inevitably encounter frustrations, make mistakes, and fall short of our ideals. This is the human condition–a reality shared by all of us! The more we open our hearts to this fact–instead of constantly fighting against it–the more we will be able to feel compassion for ourselves and all our fellow humans in the experience of life.

Here is my challenge to you: The next time you are tempted to put yourself down, practice self-compassion instead. Recognize that you are doing your best, and that your effort is what counts. Give yourself the benefit of the doubt. Celebrate your progress. Be kind to yourself. I can assure you that implementing more compassion (towards yourself) into your life will have a powerful and positive effect on how you view yourself, others, and the world. Should you find that you need help working through self-deprecation, please do not hesitate to contact me today. I am always accepting new clients!

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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