Practical Principles for the Practically Perfect

OCD

Anxiety manifests itself in many forms. Phobias, social anxiety, panic disorder, and even obsessive compulsive disorder (OCD) are commonly categorized under the umbrella of anxiety. There is, however, another emerging diagnostic disorder with which I have personally become familiar with in recent years: perfectionism. 

Perfectionism plays a major role in a variety of psychological disorders. Despite an abundance of research, there is still no concrete definition of what it is. Perfectionism can be characterized by excessive concern over making mistakes, high personal standards, the perception of high parental/employer expectations, doubting quality of one’s actions, and a preference for order and organization. From afar, it may not seem so harmful, but it can interfere with routines, everyday interactions, and emotional regulation. 

I didn’t recognize the severity of perfectionism that I experienced until my junior year of college. I sat in a lecture focused on the difference between being outcome-oriented and task-oriented. The professor explained that outcome-oriented people feel the need to seek approval from others. They are in constant need of validation and often set extreme goals that are not achievable. Task oriented people were those who live in the present, set realistic goals, and do not rely on the approval of others for their success. As I considered these opposing mindsets, it was apparent that I resembled the first; I panicked at the thought of future failure, set practically impossible goals for myself, and sought success from the approval of others. 

What then, is the relationship between an outcome-oriented mindset and perfectionism? Outcome-oriented individuals spend little time living in the present. Instead, they are focused on future outcomes or past failures. Performance psychologist Craig Manning teaches that anxiety comes from living in the future. When our thoughts are constantly centered on future events where we are expected to perform, our anxiety spikes. It turns out that agonizing over the past doesn’t help much either. As we set our focus on past failures or mistakes, our confidence in our ability to perform in the future decreases, again leading to high anxiety levels pointed toward future performance. 

Although perfectionism isn’t notably linked with the outcome-oriented mindset in psychological literature, the connection that I drew between the two was the spark that ignited my path towards empowerment. While my tendencies toward perfectionist symptoms are deeply rooted in past experiences, there is so much that I, and others who experience perfectionism, can do right now to lower the anxious feelings and constant stress. 

First, we can work on setting realistic expectations. Growing up, I relied on the expectations of others to guide the expectations I held for myself. This is normal as we are learning and growing, but eventually, we should begin to set our own expectations and determinants for success. Setting realistic expectations requires that we consider our strengths and limitations. In recognizing what we can do, we also acknowledge room for error, improvement, and learning. People who experience high volumes of perfectionism often perceive that others have extreme goals and expectations for their behavior. Setting our own expectations draws attention away from others’ expectations for us and towards the expectations we set for ourselves. Although difficult, learning to set realistic expectations allows us to worry less about others and spend more time living in the present. 

Another tool we can use to calm anxious perfectionism is proactive self talk. Proactive self talk is a popular practice in performance psychology. It includes using proactive language, recognizing skills, and being aware of our thought patterns. Many athletes and teams use proactive self talk to improve sports performance, but its effects extend past the arena or stadium. Proactive self talk has actually been proven to lower levels of anxiety when performing under pressure. For perfectionists, proactive self talk becomes a tool that instills confidence in concrete skills and actions that enhance their performance. The fear of inability shifts to a confidence in individual ability. 

These practices are just a couple of methods that can lower the anxieties that accompany perfectionism. Personally, I have been empowered through a balance of professional therapy, diet and exercise, and research-informed practices. Don’t be afraid to reach out to a professional for assistance; they have resources and training that can link you with the help you need! 

Although my struggle with perfectionism hasn’t been easy, I have learned more compassion– both for myself, and for others. I have learned that it is empowering to speak out about my experiences and encourage others to share theirs. Most importantly, I have learned that there is help and there is hope for everyone experiencing mental illness. 

Lydia Judd is a senior at Brigham Young University studying psychology. She lives in Dallas, TX with her husband where she works as an RBT at Blue Sprig Pediatrics.  

Frost, R.O., Marten, P., Lahart, C. et al. Cogn Ther Res (1990) 14: 449. https://doi.org/10.1007/BF01172967

Hatzigeorgiadis, A., Zourbanos, N., Mpoumpaki, S., & Theodorakis, Y. (2009). Mechanisms underlying the self-talk–performance relationship: The effects of motivational self-talk on self-confidence and anxiety. Psychology of Sport and exercise, 10(1), 186-192

Hewitt, P. L., & Flett, G. L. (1996). The multidimensional perfectionism scale. Toronto: Multi-Health Systems Inc.

Manning, C. (2017). The fearless mind: 5 essential steps to higher performance. Springville, UT: CFI.

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 Haunting of Trauma Past

“Trauma is personal. It does not disappear if it is not validated. When it is ignored or invalidated the silent screams continue internally heard only by the one held captive. When someone enters the pain and hears the screams healing can begin.”

― Danielle Bernock

You experienced something traumatic. You lived through it. You thought it was now in your past. Then, suddenly, the memory of your trauma is plaguing you as if it happened yesterday. How can you deal?

Many of the clients I see for trauma experience this. They feel they are making progress, personally or in a relationship, when suddenly they are hit by a figurative train and feel like they are back to square one. In every case, I assure my clients that this apparent “setback” is normal and not any sort of sign that they have done something wrong. There are seven steps I advise my clients to follow when facing resurfacing trauma:

  1. Identify the triggers. Think about what may have brought the trauma back into the limelight for you. Maybe it was running into the parents of a deceased friend. Maybe it was returning to the site of an accident. Maybe it was reading a scene from a book or hearing something on the news that resembles what you went through. That is your trigger. 
  2. Notice your physical and emotional responses. Sometimes triggers are not as obvious as seeing something that derails you on the news. The strangest things can be a trigger, and these will be different for everyone based on the traumatic situation and the individual’s personality. Pay attention to what is going on around you when you feel upset or unsettled. Listen to your body — are your muscles tightening? Are you holding your breath? Are you clenching your jaw? Is your heart beating faster? Maybe you are experiencing changes like a loss of appetite or overeating, or you are having trouble sleeping (including oversleeping). Maybe you feel anxious, are having panic attacks, suffering from mood swings, feeling helpless, depressed, detached or disassociated. Knowing your personal responses can alert you to distress, giving you an opportunity to address the trigger quicker.
  3. Whenever possible, remove the trigger. In some cases, it is easy to turn off the news or avoid a place that brings up unsettling emotions/events.  But in other instances, it is uncontrollable or unavoidable. Focus on what is in your power and do that. Do whatever you need to do to put your mind (and body) at ease.
  4. Validate your emotions. Remind yourself that shame, embarrassment, or sadness over “relapsing” are negative emotions that do not help you in the long run. Instead, try giving room for your emotions. Sit with them. Let them be a part of you. Try not to push them away, as that can cause issues for yourself in the future. Acknowledge your feelings, experience them, and then — when you are ready — move forward with a positive mindset.
  5. Be patient with others. A dear friend of mine had a stillborn baby several years ago. To this day, she is hurt when people ask how many children she has. So if you are facing trauma again and someone says or does something that seems insensitive to you, remember that they may not know your story and mean no harm. And sometimes the people closest to you may say something hurtful. Everyone responds differently to trauma; consider teaching others what are helpful and unhelpful responses or actions for you so they can help you heal. 
  6. Practice self-care. This step always comes up! b is invaluable to healing. Take care of yourself. Find an outlet. Be creative. Take up a hobby or practice a dusty one. Journal. Exercise. Travel. Dig in to what makes you tick and you will find that that self-exploration and self-love does a world of good in helping youband find happiness. 

And step seven, whenever possible, seek professional help. Your trauma does not have to define you or your relationships. Trauma is complex, and affects us mentally, emotionally and physically in ways that often do not make sense. Seeking professional help, can aide you in understanding your trauma faster and lessen its impact. You deserve to get the help you need. I am trained and experienced in helping people face and work through trauma, using EMDR, inner child work and other modalities. I am here for you. 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:

How Can I Help?: Supporting Those Facing Infertility

At a neighborhood function not too long ago, Rachael complimented Abigail on her cute children. Abigail quickly responded with, “It’s about time that you jump on the bandwagon and have some cute kids yourself!” What might have seemed like a harmless comment to Abigail cut Rachael right to the core. What Abigail did not know was that Rachael and her husband had been trying to get pregnant for years and were struggling with infertility.

It is estimated that 15 million Americans (one in six couples) have infertility issues. If it is not you going through it, it is your sibling, your friend, your coworker, or your neighbor.  Like many physical health conditions that have mental health implications, infertility often goes unnoticed by well-intentioned friends, family, and co-workers. If you are trusted to be let in on the tender topic of someone’s infertility, there are certain things you can do to help those struggling with this difficult trial.

  1. Learn more about infertility. Understand the causes, the language, the options, the process. This will not only help you understand the infertility journey, but it will mean so much to the people struggling that you took the time to understand their situation.
  2. Take comfort in knowing that it is not necessary for you to give advice. In fact, it is not your place to give advice. It is unlikely that you will suggest a route that has not already been thought of and some options might not be realistic, as you may not be aware of your friend’s personal, medical, or financial situation or history, nor their personal beliefs or values. Though it is natural to want to jump in and help problem-solve, infertility is an extremely personal issue; the decisions that need to be made and obstacles that need to be managed are deeply personal.
  3. Avoid trigger phrases. Though you mean well, there are certain responses that are rarely comforting and tend to minimize the very real fears and challenges your loved one is trying to share with you. A few of these include: “Where there’s a will there’s a way”; “Don’t worry; your time will come”; “It will happen when the timing is right”; “Just relax, it’ll happen when you’re less stressed”; “What’s meant to be will be”; “At least you can get pregnant.”
  4. LISTEN. While you may want to offer solutions or words of comfort, oftentimes, the best thing that those struggling with infertility need is a listening ear. They need someone to talk to and someone to be there for them. Instead of chiming in with possible solutions to their dilemma, let them guide the conversation and then be supportive of their plans, whatever they may be. Just listening will mean so much to the person trusting you with this deeply personal issue!
  5. Help where you can. Instead of working overtime to “fix” situations that are beyond anyone’s control, focus on making smaller decisions and stressors more manageable. Attend appointments. Watch kids (if there are older children involved). Be an exercise buddy (sometimes, those undergoing treatment need to lose weight in order for treatment to be more effective). Help around the house. Supply meals. Pick up groceries. Suggest a fun activity, like a comedic movie or a paint class or a number of other non-baby related things. These daily hassles tend to feel even bigger in the face of major life challenges like infertility.

Lastly, my advice would be to recognize and validate the uniqueness of their situation. Although many face infertility, no two struggles are alike. What one person finds most difficult can be very different from another’s perspective. For some, it may be the physical discomfort that comes from medications, daily injections, or invasive ultrasounds and procedures. For others, the financial commitment can generate significant stress and even become a barrier to treatment. Many mourn the loss of a “natural” conception. This is why one of the most helpful approaches is to remain open to a loved one’s experience. Sit with them in the lows, celebrate the highs, and just be present when things feel stagnant. Hear them out. Hear their story. Be there for them…whatever that might look like!

You may feel completely overwhelmed and unsure what to do or how to help. You may worry about saying the wrong thing or not saying enough. That is okay. Your loved one trusts you enough to confide in you and surely does not expect you to know exactly what to say or do. Remember that imperfect support is always better than nothing at all. Learn about infertility, avoid trigger phrases, listen, and help where you can. As you do these things, you will be able to support your loved one through the colossal trial that is infertility, and can bring a sense of peace, hope, and happiness back into their lives. If you are struggling with infertility, and believe the support of a therapist would be helpfuI, contact me. Let me be here for you!

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

Resources:

When Your Consent is Taken Away

“Our lives begin to end the day we become silent about things that matter.” ~Martin Luther King Jr.

Almost a year and a half ago, Alyssa Milano posted on Twitter: “If you’ve been sexually harassed or assaulted write ‘me too’ as a reply to this tweet.” 24 hours later, there were more than 500,000 responses. 12 months later, the hashtag was estimated to have been tweeted over 18 million times. The #MeToo movement has caught people’s attention worldwide, yet sexual assault continues to be a difficult topic. Although uncomfortable to discuss, it is prevalent and life-altering, and worthy of our attention and dialogue. I write this post in line with April’s Sexual Assault Awareness Month campaign to raise public awareness about sexual violence and to educate communities on how to prevent it.

In my initial research for this blog post, I found some staggering statistics I would like to include:

  • Approximately eight out of 10 sexual assaults are committed by someone known to the victim
  • More than half of female victims of rape reported being raped by an intimate partner and 40.8% by an acquaintance.
  • A forcible rape occurs every 6.2 minutes within the United States.
  • Nearly 1 in 5 women (18.3%) and 1 in 71 men (1.4%) have been raped at some time in their lives
  • Most female victims of completed rape (79.6%) experienced their first rape before the age of 25, and 42.2% before the age of 18.
  • More than 1 in 4 male victims of completed rape (27.8%) experienced their first rape when they were 10 years of age or younger.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

Let’s discuss the basics of sexual assault. The term “sexual assault” refers to sexual contact or behavior that occurs without explicit consent of the victim. Some examples of sexual assault include attempted rape; fondling or unwanted sexual touching; forcing a victim to perform sexual acts; penetration of the victim’s body; sexual intercourse against a person’s will; forcible sodomy (anal or oral sex against a person’s will); forcible object penetration; marital rape; sexual contact with minors, whether consensual or not; incest; or any unwanted or coerced sexual contact.

Sexual assault can happen to anyone of any age, gender, race, and socioeconomic background. It can happen at any time or place. Assailants may be strangers, acquaintances, friends, or family members, and they may use violence, threats, coercion, manipulation, or other forms of pressure or deception to commit sexual assault.

Not all sexual assault is rape, but rape is one of the more well-known forms of sexual assault,. For its Uniform Crime Reports, the FBI defines rape as “penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.” This can be done in one of three ways; the first is called a “blitz” sexual assault, which is when a perpetrator quickly and brutally assaults the victim with no prior contact, often at night in public.  The second is called “contact sexual assault”, and is when a perpetrator tries to gain their victim’s trust by flirting, luring the victim to their car, or otherwise trying to coerce the victim into a situation where the sexual assault will occur. The third type of rape is a home invasion sexual assault–when a stranger breaks into the victim’s home to commit the assault.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

The distinguishing line between sexual assault and consensual sexual activity is just that: CONSENT. Consent is a voluntary, sober, enthusiastic, informed, mutual, honest and verbal agreement. It is an active agreement that cannot be coerced. Consent is a process which must be asked for every step of the way. Consent is never implied and cannot be assumed, even in a relationship; simply dating a person does not give the right to sexual interactions. Legally, an intoxicated person cannot give consent!

Survivors of sexual assault often blame themselves for somehow behaving in a way that encouraged the perpetrator. When your consent is forcefully taken away, it is not your fault. I cannot possibly stress this enough: The victim is never to blame for the actions of the perpetrator! In my experience as a clinician, guilt is a feeling that each victim experiences during his/her healing process. Because of this, it is essential that victims get the appropriate and necessary treatment from a licensed, experienced therapist. I have treated numerous clients who have experienced sexual assault, and am equipped to help you or your loved one along this difficult yet beautiful path to healing. It is possible, and I am here for you. Please contact me today or click here to schedule a session.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

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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Abuse: When Love Hurts

“If you walked away from a toxic, negative, abusive, one-sided, dead-end low vibrational relationship or friendship—you won.”  ~Lalah Delia

Healthy relationships involve respect, trust, and consideration for each other. Relationships where abuse is present, on the other hand, involve mistreatment, disrespect, intense jealousy, controlling behavior, and/or physical violence. I tend to focus more on building healthy relationships in my blog posts, but after attending a recent training, I realized I cannot ignore a topic that so many readers can relate to. While Hollywood is depicting the vast majority of relationships as happy and fulfilling, more than 12 million American women and men experience some type of abuse in their relationship over the course of a year. Relationships where abuse is present, unfortunately, are NOT uncommon. I hope this post is not only informative for my readers that may find themselves in a relationship where any kind of abuse is present, but also motivational for them to speak up.

What types of relationship abuse are there?

Abuse is the misusing or regularly/repeatedly treating someone with cruelty or violence. While that definition is straightforward enough, there are many types of abuse that need to be discussed when defining abuse.

There is physical abuse (any form of violence, such as hitting, punching, pulling hair, and kicking).

There is emotional or psychological abuse (threatening the physical health of the victim or the victim’s loved ones, purposely controlling the victim’s freedom, and/or acting to undermine or isolate the victim, intimidation, gaslighting, putdowns, controlling behavior, and betrayal).

There is sexual abuse (being forced into any sort of sexual activity).

There is verbal abuse (yelling, put-downs, name-calling, making threats, constantly correcting or interrupting a person, and even employing the silent treatment).

There is spiritual abuse (also known as religious abuse; a form of controlling a person under the guise of religion or the misuse of religion for selfish or secular ends).

Basically, abuse is about domination and submission; it is about giving and withholding in the extreme. In a relationship where abuse is present, a form (or multiple forms!) of abuse is (are) employed by one partner to maintain power and control over the other partner in an intimate relationship. The feelings of love, loyalty, and devotion in the relationship make it difficult to recognize reality, break the cycle, and get help.

Who can be in an relationship with abuse?

Anyone can be a victim to a relationship where abuse is present. No matter the race, age, sexual orientation, religion or gender, anyone can be a victim (or perpetrator!). It can happen to people who are married, living together or who are dating. It affects people of all socioeconomic backgrounds and education levels.

What causes abuse in relationships?

In relationships where abuse is present, often the offender has low self-worth, or has a history of abuse in their family-of-origin and thus feels powerless. Because of this, they use behaviors, such as threats, violence, and mind games to gain a sense of power and control over their partner. The following infographic from the National Domestic Violence Hotline outlines and gives specific examples of abuse in relationships. Regardless of where you start reading on the wheel, everything comes back to the center, the true motive for any kind of abuse: power and control.

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What are the signs of relationships with abuse?

As previously mentioned, relationships with abuse are not limited to physical violence. Here are some warning signs to be aware of for any type of relationship where abuse is present:

  1. Trying to control where you go/who you see/what you say.
  2. Demanding to know where you are every minute.
  3. Accusing you of being unfaithful or of flirting.
  4. Isolating you from family and friends, often by behaving rudely to them.
  5. Constantly comparing you unfavourably to others.
  6. Deliberately breaking things you value.
  7. Threatening to use violence against you, your family, friends or pets.
  8. Harming you physically.
  9. Forcing you into unwanted sexual encounters.
  10. Punishing you by withholding affection.
  11. Insulting, demeaning, criticizing, or shaming you with put-downs.
  12. Controlling every penny spent.
  13. Preventing you from making your own decisions.
  14. Refusing to trust you and acting jealous or possessive.
  15. Telling you that you are a bad parent; threatening to harm or take away your children.
  16. Intimidating you with guns, knives or other weapons.
  17. Pressuring you to use drugs or alcohol.
  18. Making everything your fault (gaslighting)
  19. Controlling your appearance: your clothes, how much/little makeup you wear, etc.
  20. Using sarcasm and unpleasant tone of voice.
  21. Saying things like “I love you but…” or, “If you don’t _____, I will_____.”

It is common for someone who is being abused to believe that the abuse he/she is experiencing is his/her own fault and that the abuse is somehow deserved. This is a form of abuse itself and could not be farther from the truth! If you walk away with nothing else from this article, I hope that you know that you are never to blame for the abuse!

Being a victim of any type of abuse in a relationship is traumatizing. It can cause anxiety, lowered levels of self-esteem, diminished self-worth, distrust or difficulty connecting with others, and–in severe cases–post-traumatic stress disorder (PTSD). Getting out of and moving on from a relationship where abuse is present will require a steady support system of family, friends, and often a support group. In many cases, the victim needs drugs an advocate–someone to give them a voice in order to break free from the toxic relationship.  That is where I come in; I am an experienced, licensed therapist who has seen multiple couples and individuals work through relationships with abuse. I can help. If you are concerned that you may be a victim of a relationship where abuse is present, please do not hesitate to contact me with questions or to schedule a session. My door is always open and I am here to help.

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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I Don’t Have Trauma…or Do I?

I Don’t Have Trauma...or Do I - Cluff Counseling - North TX Couples TherapistMost people associate trauma with terribly difficult and disturbing events like war or a natural disaster. Because of this, you may think you have never experienced something traumatic. However, any distressing event that falls beyond your normal scope of human experience can be considered traumatic! Odds are high that you HAVE experienced trauma. How have you dealt with it?

I was recently talking with a friend who told me she had never been through anything traumatic in her life. Although I knew she was referring to the fact that she had not experienced a death of a loved one, abuse, an accident, or something of like nature, I silently disagreed with her. While those experiences are incredibly traumatic for any individual who faces them, trauma is not limited to life-changing events like those. Trauma can happen every day in the normal course of your day without you realizing what you are up against. In this post, I will focus on the two different types of trauma and how we are all affected by trauma’s expansive reach.

Let’s start by defining trauma. What is it really? At its Greek core, trauma means to wound or to pierce. A search for this word will yield a definition much like this: “A disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury; an emotional upset, an agent, force or mechanism that causes high distress.” Basically, trauma is intense emotional distress resulting from stressful life experiences. Oftentimes when describing trauma, it is divided into two major categories: Big “T” and little “t” traumas.

Big “T” trauma

Big “T” trauma, or complex traumas, are events that involve physical harm and/or a threat to life or physical safety. Big “T” trauma is trauma in its most severe form, and can often result in Post-Traumatic Stress Disorder (PTSD). Examples of big “T” trauma include being in a combat/war zone, a natural disaster, a terrorist attack, immigration, rape, sexual assault, abuse, death, sickness, moving, financial stress, a car/plane accident, etc. These are extraordinary and significant events that leave us feeling powerless, helpless, and as if we have little or no control in our environment. This element of helplessness is a key difference between of big ‘T’ traumas and little ‘t’ traumas–feelings of helplessness being much greater in big ‘T’ traumas. These events can forever alter a person’s life, and may influence our ability to make/maintain relationships, and function later in life. One big ‘T’ trauma can be enough to cause severe distress and interfere with our daily functioning–which is intensified the longer treatment is avoided.

Little “t” trauma

Little “t” traumas are life events that are more common experiences that, although upsetting to an individual, are less severe or dramatic than big “T” traumas. A few examples of little “t” traumas include being teased in elementary school, always being picked last for a team, divorce, death of a beloved pet, losing a job, or losing friends by moving from school to school during childhood.  It is not necessarily the event that determines whether something is traumatic to someone, but the individual’s experience of the event. If an individual experiences an event as life-altering or upsetting in such a way that it changes the way they think about themselves or others,  it is likely a little “t” trauma.

The term little “t” trauma does not imply, however, that the emotional impact of such an event is insignificant compared to big “T” traumas. The emotional wounds can be as lasting and severe as big “T” trauma wounds!

Trauma’s reach

Everyone has endured some sort of trauma in their lifetime. Both big “T” and little “t” traumas have a strong influence on our view of the world and shape how we cope in life. For example, the little “t” traumas of being teased by peers and being picked last for the team can leave us feeling inadequate or insecure amongst our peers. Big “T” traumas may leave us orphaned, severely dissociated, or less physically capable than we may have previously been. The four core signs of trauma include the following:

      • Hyperarousal: These symptoms can be difficult to manage and can vary from person to person. In general, hyperarousal includes having a difficult time falling or staying asleep, feeling irritable or having outbursts of anger, having difficulty concentrating, hypervigilance (constantly being on guard), and being jumpy or easily startled
      • Dissociation of body and mind: This includes feeling disconnected from oneself, problems handling intense emotions, sudden/unexpected shifts in mood, depression or anxiety problems, derealization (feeling as though the world is distorted or not real), memory problems, concentration problems, and significant memory lapses.
      • Constriction of body and perceptions: Which may include the skewed notion that the individual was responsible for causing the trauma.
      • Feelings of helplessness: The inability to act or think for oneself, or to act effectively.

When symptoms of trauma continue for more than three months, it is considered PTSD or Posttraumatic Stress Disorder. Fortunately, all symptoms are not permanent if addressed properly–which means that healing for both little “t” traumas as well as big “T” traumas are completely treatable. Receiving treatment can truly reshape the way we view both the world and ourselves!

Trauma is treatable

Treatment for trauma consists of specialized counseling techniques and practices that will help you cope and deal with trauma and its effects on your life. I use EMDR (Eye Movement Desensitization and Reprocessing) , as well as Pia Mellody’s inner child framework to treat trauma. Because trauma contributes to negative thinking, negative behaviors, and difficult emotions, counseling for trauma can help you change your thinking and behaviors, which will, in turn, impact your mood. Counseling with me is a safe place where you can explore some very difficult issues that are hindering you from the life you want to live or the person you wish to be. If you think you may struggle with trauma, please reach out to me! Untreated trauma can lead to serious life consequences, the longer it is left untreated.

As always, the take away that I want you to remember (and cling to) is that treatment is available. Healing is possible! No matter where you have been, I can help you get relief from your trauma symptoms. Remember that everyone responds to traumatic situations differently; you may be experiencing only a few of the aforementioned symptoms, or you may be experiencing many. The severity, frequency, and duration of symptoms vary depending on the individual and his/her specific trauma event. What may affect one person may not affect another person in the same way. Counseling can help you explore your trauma and find the healing you may still need. Please feel free to contact me with any questions you may have.  I look forward to working with you!

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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When Addiction Raises Your Child

When Addiction Raises Your Child - Cluff Counseling - Lewisville TherapistAccording to The US Department of Health and Human Services, more than 8.3 million children currently live in a household where at least one parent is addicted to alcohol or drugs. Do those children notice their parents’ addiction? How does it affect them?

Addiction comes in all sizes and severities. There are addictions to substances like alcohol, tobacco, prescription drugs and illegal drugs (heroin, cocaine, methamphetamine, PCP/angel dust, hallucinogens, etc); there are impulse control disorders like kleptomania, pyromania, and gambling; and then there are behavioral addictions to food, sex, pornography, video games, smartphones, working, exercising, spirituality, cutting, shopping, etc. Because addictive behaviors are often done in isolation, the impacts of the behaviors, to loved ones, are often thought to be minimal.

Due to the many faces of addiction, its impacts can vary greatly. For example, a mother may physically leave her home to frequent bars, clubs, hotels, casinos; as a result, her children may suffer from neglect or abuse by her or others. Other addictions can take place at home and do not require a physical absence–like the father who abuses substances or gets involved in pornography/sex addiction from home. In such cases, his children may inadvertently experience psychological or emotional absence that can cause relational issues later in life. Depending on the age(s) of the child(ren), they may miss out on/not learn important things like how to brush their teeth or take care of their personal hygiene, table manners, stress management, problem solving, communication, how to make/keep friends, conflict resolution, etc. One woman, a new mom, recently told me she is not familiar with any nursery songs to sing to her daughter because she was never sung to herself.

This same woman shared with me the consequences she experienced of having a mother who was addicted to prescription pain medications. She said, “It was terrifying. Every day I dreaded coming home from school because I was afraid my mom would be passed out or dead on the bathroom floor. I was young–maybe third or fourth grade?–but I knew something was seriously wrong. I felt powerless. In order to feel like I had some semblance of control over my life, I formed OCD behaviors; I started pulling out all my eyelashes and even patches of hair off the top of my head. I even resorted to bullying a nice girl in my neighborhood! Eventually, the girl’s mother told my mom and I was put in therapy.” My heart goes out to this woman, as well as the other adult children of addicts whose stories I hear.

The real-life example above illustrates how children–even when they do not fully understand their parent’s addiction–feel its effects, and behaviorally act out their confusion and pain. They may wind up bullying, self-harming, or practicing OCD behaviors (obsessive-compulsive disorders) like cutting, eating disorders, etc. Many of these children go on to distrust authority figures, have commitment issues, and may wind up facing addiction themselves. Although these behaviors are often maladaptive, they are simply the way the child copes and tries to take care of him/herself. It is important that teachers, mentors and other adult family members recognize these as such, instead of punishing the child, and help them learn adaptive ways of coping (watch for a future blog post on specific ways you can help!).

If you are battling addiction, please remember–there is help! Just recently, I posted about the possibility of relying on a support animal through addiction and/or trauma. Not long before that I went into detail on support groups and group therapy which is accessible nationwide. And last summer, I posted about the benefits of therapy in general. The truth is, help is out there. In fact, it is readily available if you make (and follow through with) your decision to get help. So please, I urge you to contact me or schedule a session–not just for your own sake, but also for your family’s.

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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